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New Geographies of Chinese Medicine Author(s): T. J. Hinrichs Source: Osiris, 2nd Series, Vol.
13, Beyond Joseph Needham: Science, Technology, and Medicine in East and Southeast Asia (1998), pp. 287-325 Published by: The University of Chicago Press on behalf of The History of Science Society Stable URL: http://www.jstor.org/stable/301886 . Accessed: 30/09/2013 05:36
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New Geographies of ChineseMedicine

By TJHinrichs*
mapsquite 1 HINESE GAZETTEERS OF THE IMPERIAL PERIOD contain unlike those inmodem atlases. Modematlases display mapsofdistinct types: and demographic, forexample. political, topographic, economic, Maps of China, feature thenational borders. In many regardless oftype, a linearound or dynastic divisions aredemarcated, andother internal thelocations ofrivers maps, provinces densities differenindicated to scale,population orelevation abovesea levelclearly tiated codesoverlain on theoutline ofChina. bycolororpattern also include a setofmaps,or tu(depictions, illustraImperial period gazetteers after the table ofcontents. There is a general tions), usually mapoftheadministrative unit in question, as wellas depictions oflocal administrative local schools, offices, andimportant mountain Likelandscape andriver these systems. paintings, mapsare notdrawn from a single fixed tend not todepict boundaries around perspective. They or between administrative units suchas provinces or prefectures, these indicating instead centers. administrative The focusis on humanconstructionsby their schools. Distances anddirections arenotignored, temples, villages, butthey arenot in organizing thearrangement primary ofthemaps, described in accompausually text. Scale mapsusinggrids nying wereknown, butthesenever becamea dominant standard. Like gazetteer illustrations oflocal terrain, "newgeographies" ofscholarship on Chinese medicine shift attention thecleardemarcation ofouter awayfrom boundariesandinner divisions-for around Chinese medicine example, andbetween the sacredand thesecular. Instead, they organize information around keynexuses of suchas experiences ofillness activity andhealing orprocesses ofchange inmedical praxis. Theytend toemploy multiple disciplinary perspectives andprivilege indigenouscategories. Biomedical projections ofthe"terrain" ofthehuman bodyarestill often drawn on as a sourceof knowledge, butnotthedominant one. The use of measurement andattempts atsociometric havedeclined, analysis though considerations of"scale"andconcern for disciplinary rigor havenotbeenabandoned. Recent is notcareless scholarship ofimportant distinctions. Itis concerned with boundaries, butmorein thewaysin which they areconstructed andfixed than in constructing andfixing them.
*HEAL, Harvard University, CoolidgeHall, 1737 Cambridge Street, Cambridge, Massachusetts 02138. I wouldlike to thank BridieJ.Andrews, PeterK. Bol, Chen Hsi-yuan, Arthur Kleinman, Joan G. E. R. Lloyd, Kleinman, John Moffett, Jeanne Shea,andan anonymous referee for their thoughtful comments on drafts ofthisessay. (? 1999byThe History ofScienceSociety. All rights reserved. 0369-7827/98/1301-0012$02.00 Osiris,1998,13:287-325 287
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medical history is between the One ofthethickest lineson ourmapsofChinese traditional orpremodern ofourmapsofChinese andthemodem. Thisis also true medicine, as practiced inpremodern medical historiography. Thehistory ofChinese tomodem history ofmedicine, ChinaandJapan, hasbeencharacterized, incontrast and biographical studies; as as consisting largely of bibliographical, philological, bytheinterests ofclinilacking thestatus ofan independent field; andas motivated Thesegenres andlinks totheclinic cal practice rather than theconcerns ofhistory.1 remain prominent andvital did notdisappear with thetwentieth century, andthey in scholarship today. on Chinese medicine around theworld medicine, including those of Although notall "traditional" historians ofChinese whocontinue to work in these earlier centuries andthoseofthetwentieth century are practitioner-scholars, theclearseparation of scholarship scholarly traditions, medical history, first taken from practice is a historical keytothemodelofmodem theWest. Whilethere are stillmedically trained historians of Western medifrom becamedivorced from in thecourseof the medical practice cine,medical history readthetexts ofearlier nineteenth century. Prior tothat time, Western practitioners ownpractice, of Chinesemedicine masters forinsight intotheir as practitioners historians trained affilicontinue to do today.Practitioner-scholars andmedically in Europe, medicine stillplaya vitalrolein thefield atedwith schoolsofChinese Asia,andNorth America.3 indevelhavebeenamong themost vigorous Someofthese practitioner-scholars I willexamine to understanding Chinese medicine that opingthenewapproaches havecontributed tothesharpening here.4 Historically, however, practitioner interests arenowsmudging anderasing. Forpurscholars ofthevery boundaries that newer the continuownidentity orpromotion, haveemphasized posesoftheir practitioners own of their or of their tradition. Forpurposes ityof Chinese medicine particular Thesevicoherence andunity. earlier texts haveapproached seeking practice, they tendencies havebeenreinforced sionsof essential by parallel growing continuity constructions inChinese nationalist andChina, shared ofWest outoftheopposition ofOther. constructions ofSelfandorientalist inthis ofChinese medicine field Themodem ofthe emerged early century, history oroutright ban. ofrestriction wasunder threat Chinese medicine when bylicensing andnational medicine was defined, outofemerging Chinese professional interests,
I Chen Bangxian, rev.ed. of Chinesemedicine), in Zhongguo vixue shi (The history "Preface," shiren" Liang Song de "Shangyi 1936),p. 9; Chen Yuanpeng, Shangwu yinshuguan, (Shanghai: of medicine" and "scholar aficionados de liubian("Gentlemen yu "ruyi"-jianlunqi zai Jin-Yuan in theJin andYuan) ofchanges a discussion Song:With and Southern in theNorthern physicians" of (A history igakushisoshi Chi-goku daxue,1997),p. 1; andIshida Hidemi, (Taibei:GuoliTaiwan 1992),p. 311. shuppankai, daigaku Tokyo medical (Tokyo: thought) Chinese shi, yixue Zhongguo inChinasee ChenBangxian, 2 On the from ofscholarship practice separation Explaining see CharlesRosenberg, insights forpractical texts use of earlier p. 9. For theWestern Univ.Press,1992), Cambridge History (Cambridge: ofMedicine inthe and Other Studies Epidemics
p. 1.
I Forexample, zashi(Journal yishi inChina, Zhonghua history medical ofChinese themain journal ChineseMedicinein of Traditional is associated withtheAcademy of ChineseMedical History) with similar academies areaffiliated ofChinesemedicine all mainland scholars andnearly Beijing, Internaor universities. institutes at research departments history or anthropology thanwith rather along include practitioner-scholars of Chinesemedicine commonly on thehistory tionalsymposia historians andanthropologists. with professional I Thosediscussed Scheid. andVolker Lo, Zhao Hongjun, Vivienne hereinclude
NEW GEOGRAPHIES OF CHINESE MEDICINE
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incontradistinction toandaccording tocontemporary models ofWestern medicine.5 The practice of thehistory of Chinesemedicine of selfwas partof thisproject inreference definition. ChenBangxian, tothepurposes ofboth the MedicalHistory Research andintellectual Society institutional his(1914) andhis groundbreaking tory of Chinesemedicine theneed,in a civilized fora (1919), identified country, modern ofmedicine likethat inthe history pursued West. Western models ofhistory, scientific and civilization his approach, progress, informed and Western-modeled hisagenda. medical informed WhileChenwaswriting a domestic policies for audience,theEnglish-language Medicine of K. Chimin History ofChinese Wongand Wu Lien-teh, bothof whomweretrained in Western was conceived in medicine, Wong's shock atdiscovering howlittle information-or evenmisinformation-was toWestern available audiences.6 These earlyhistorians wereconcerned with theinternational view of Chinaas backward and accepted theWestern standards to which Chinawas seen according to lag. Theymadeit their in Chinese goal to demonstrate medicine from progress religious andsuperstitious origins torational andscientific foundations.7 Suchproorpositivist gressivist havepersisted inthehistory approaches ofChinese medicine both within andoutside China. project. Needham countered theview that theorigins of scienceand technology wereuniquely European by documenting Chinese preeminence in earlier periods, Chinesepriority in various discoveries, and Chinesecontributions to a world science.He lookedforward to a continuing evolution that wouldculminate in an ecumenical science. Basic questions for Needham andthosewhofollow his approach havebeen,Whatwerethecultural bases of China'searlysuccesses, and how did Chinagetderailed from thetracks ofprogress?8 ForChinese medicine, as forscience,"ethnic" culture beproductive might atsomestages but is ultimately tobe transcended.
One may immediately say [of Chinese medicine]thatits attachment to its own culture is so strong thatit has not yetentirely come out of it.All the sciences of ancienttimes 5See Bridie "The Making Andrews, ofModern Chinese 1895-1937"(Ph.D. diss.,Univ. Medicine, Cambridge, 1996), esp. Ch. 5; Zhao Hongjun, "Chineseversus Western Medicine:A History of TheirRelations in theTwentieth Century," Chinese Science,1991,no. 10,pp. 21-37; Zhao,Jindai Zhongxiyi lunzheng shi (History ofmodern controversies in ChineseandWestern medicine) (Anfei: Anhuikeji chubanshe, 1989); and RalphCroizier, Traditional Medicinein ModernChina (Cambridge, Mass.: Harvard Univ.Press,1964). 6 K. Chimin WongandWu Lien-teh, History ofChinese Medicine: Beinga Chronicle ofMedical Happenings in China from Ancient Times to thePresent Period(Tientsin: Tientsin Press,1932).See theaccount in Chen Yuanpeng, LiangSongde "Shangyi shiren" yu "ruyi" (cit.n. 1), p. 2. 7 Not all historians of Chinesemedicine in thisperiodwereinterested in savingit from theencroachment ofWestern medicine. The "scientific foundations" explored byWongandWuhadrather moreto do with theintroduction ofWestern practices (three quarters ofthebook)than didthoseof Chen,whofound muchofworth in imperial China.See Chen Bangxian, Zhongguo yixue shi,citn. 1,pp. 1-3; andWongandWu,History ofChinese Medicine, pp. i-ii. 8 See Joseph Needhamet al., Scienceand Civilisation in China (Cambridge: Cambridge Univ. Press,1954-); andNeedham, with WangLing,Lu Gwei-Djen, andHo Ping-yii, Clerks and Craftsmenin Chinaand theWest: Lectures andAddresses on theHistory ofScienceand Technology (Cambridge:Cambridge Univ.Press,1970). For a critique of thistypeof questionsee NathanSivin, "WhytheScientific Revolution Did NotTakePlace in China-Or Didn'tIt?" Chin.Sci., 1982,no. 5, pp. 45-66.
This perspectiveinforms JosephNeedham's Science and Civilisationin China
290
TJHINRICHS European, whether ethnic characteristics, distinct very andtheMiddleAges hadtheir these has subsumed sciencewhich and it is onlymodem Indianor Chinese, Arabic, and But whileall thephysical culture. mathematised intoa universal entities ethnic into in ChinaandEuropehavelongago fused sciences biological someofthesimpler ofthetwocivilisations.9 systems with themedical hasnotyet happened one,this
Needham and Lu Gwei-Djen, withwhom he collaboratedon Chinese medical and evaluatedChinese medicinein relationto modem models of scientific history, its rationality, advancement, of its theoretical medicalknowledge-that is, in terms ascertained by laboratory generally of its particular "discoveries," and the efficacy analysis. Otherswho have taken modem science as theirstandardfor evaluation have treatedChinese medicine as a "quasi-science"; theydescribedreluctanceto or as explicable only by rechoose Westernover Chinese medicine as irrational as similarly applifactors. Theydo notsee thesefactors courseto social and cultural overChinese medicine.10 cable to thechoice of Western Growing popularacceptanceof Chinese medicinein theWesthas drawnscholars to its study, encouragedmore positiveviews of Chinese medicine,and motivated forms overother of biomedicaltriumph to narratives of alternatives thedevelopment of Maoism in theWestgrewwiththepopularity in acupuncture of healing.Interest Americainthelate 1960s,growing inEuropeandNorth movements incounterculture andtheopeningofthePeople's Republicof biomedicine, of"establishment" criticism ofacupuncture, especiallyin analgesia,were applications Chinainthe1970s.Certain in thePeople's Republicof China at thetime,and itwas appealingly beingpromoted
and Craftsmen, in Clerks Culture," andChinese "Medicine andLu Gwei-Djen, 9JosephNeedham in keepservice a publichealth note:"How todevelop example, pp. 263-293,onp. 263. As another sphere cultural andIndian theChinese forstates within themodemage is . . . complicated ingwith Paul Uncultures." which are stillpartoftheir haveancient healingsystems they by thefactthat in AsianMedical in Taiwan," and Ecologyof Medical Practice "The Social Organization schuld, Press,1976),pp. 300Univ.California Leslie (Berkeley: ed. Charles Study, A Comparative Systems: added). 316,on p. 300 (emphasis by works to modemmodelssee thefollowing in relation of Chinesemedicine '? For evaluations MedicalHistory, in China," Medicine ofForensic "A History Needham: andJoseph Lu Gwei-Djen andMoxa (1980; rpt., ofAcupuncture A History andRationale Lancets: 1988,32:357-400;Celestial in MedievalChina," and ChineseCulture"; "Proto-Endocrinology Taipei:Caves,1986); "Medicine ibid., inAncient China," Medicine andPreventive pp. 294-315; "Hygiene and Craftsmen, in Clerks in Medicine," ibid.,pp. 379Examinations of Qualifying pp. 340-378; and "ChinaandtheOrigin andRitual Pharmacological Sivin,"Man as Medicine: C. CooperandNathan 395; andalso William Science: in Chinese theHumanBody," from UsingDrugsDerived Therapy AspectsofTraditional Nakayama and Sivin(MIT East Asian Science ed. Shigeru Tradition, ofan Ancient Explorations Chiof work treating Mass.: MIT Press,1973),pp. 203-272. For examples Series,2) (Cambridge, Medicinein ModernChina(cit. n. 5); Traditional see Croizier, as a quasi-science nese medicine in ModemChina" inAsianMedicalSysofMedicalRevivalism "The Ideology RalphC. Croizier, of and Methods Traditional Etiology "Chinese Topley, ed. Leslie,pp. 311-355;andMarjorie tems, in earlier is also apparent of explanation Cure in Hong Kong,"ibid.,pp. 243-265. This pattern nonmedical for Preference ofvalidknowledge. paradigms with different in China,although periods "respect by a prevailing by people in areas of thesouth-was explained healing-forexample, or lack of access to morality, questionable ignorance, and beliefin demons," forspirit-mediums de dili nanfang suojiangudaizhongguo jian wenxian See Xiao Fan,"Han-Song medicines. proper diseasesin ancient andendemic environment (The physical ji qi yingxiang" yudifangbing huanjing Song ofHan through documents as viewedfrom activities on human impact Chinaandtheir south and ofHistory oftheInstitute jikan (Bulletin Lishiyuyan yanjiusuo yanjiuyuan Zhongyang times), of "The MedicalTransforming l; andTJHinrichs, AcademiaSinica), 1993,63(1):67-17 Philology, forthUniv., Harvard inSongChina(960-1279A.D.) (Ph.D. diss., Customs andSouthern Governance coming).
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toWestern exotic audiences. Thispopular interest motivated numerous publications; thepoorquality ofthebulkofthese several inspired scholarly correctives.11 MuchWestern was driven to sort scholarship outtheconceptual simply foundations ofwhat alien.In the1970sand 1980sseveral appears scholars tooktheir cue from Lu andNeedham, paying respect to thetheoretical of Chinese sophistication medicine andattempting tograpple with iton itsownterms. As many noted, various innovations or discoveries weremeaningless in isolation whentreated from the broader system-which these scholars understood as a coherent While unity. providinga useful basisfor approaching Chinese ofthese medicine, many works were ahistorical andacontextual, constructing Chinese medicine as a single bounded rational system, on essential focusing conceptual contrasts between Chineseand Western medicine, andneglecting internal tensions, contradictions, andnonrational aspects.12 In themeantime, anthropologists studying healing in Chinese andAsiancultures wereintroducing theperspective of medicine as a culture system, looking at the socialproduction ofknowledge, taking "rationality" itself as socially constructed, focusing on patient increasingly strategies rather than treating as an isomedicine latedconceptual system, andexamining varieties ofpatient choices across thespecof sacredand secular. trum Anthropological perspectives and social approaches beganto appearin historical scholarship, whichgave increasing attention to the plurality ofhealing systems in Chinaandtheir socialcontexts."3 Disciplinary cross-fertilization hasintensified inrecent years. Anincreasing numberof scholars do both historical documentary research andethnographic field reandhistorians search; andanthropologists more andmore draw on andintegrate the workof each other's fields intotheir own.14 Besidesseeking to provide historical
11 Explicitly citing thispoorquality as a motivation for publication wereLu andNeedham, CelestialLancets, p. xix;andNathan Sivin,Traditional Medicine inContemporary China(Science,Medicine,and Technology in East Asia, 2) (AnnArbor:Center forChineseStudies, Univ.Michigan, 1987),p. xx. Thesetexts aimedat popular, andscholarly practitioner, audiences. For an analysis of thenationalistic andmodernizing ofinnovations resonances in Chinesemedicine that wereactively promoted during theGreatLeap Forward and theCultural Revolution see Elisabeth Hsu, "InnovationsinAcumoxa: Acupuncture Analgesia, Scalp andEar Acupuncture in thePeople'sRepublic of Social Scienceand Medicine, China," 1996,42:421-430. 12 E.g., Ted J.Kaptchuk, The WebThatHas No Weaver: Chinese Understanding Medicine (New York:Congdon & Weed,1983);andManfred TheTheoretical Porkert, Foundations MediofChinese cine:Systems ofCorrespondence Mass.: MIT Press,1982). (Cambridge, 13 Forwork byanthropologists see,e.g.,Arthur Kleinman etal., eds.,Culture andHealinginAsian Societies Mass.: Schenkman, (Cambridge, Patients 1978); Kleinman, and Healersin theContext of Culture: AnExploration oftheBorderland between and Psychiatry Anthropology, Medicine, (Comparative Studiesof HealthSystems and MedicalCare,3) (Berkeley: Univ.California Press,1980); andLeslie,ed.,AsianMedicalSystems (cit.n.9). Forhistorical work that is informed byanthropological perspectives see NathanSivin,"Social Relations of Curing in Traditional China:Preliminary Considerations," Nihonishigaku zasshi,1977,23(4):505-532; Sivin,"Ailment and Curein TraditionalChina:An Anthropological Studyof Classicaland PopularMedicine before Modern Times, with Implications forthePresent," unpublished MS; andPaul Unschuld, Medicine in China:A History ofIdeas (Comparative Studies ofHealthSystems andMedicalCare,13) (Berkeley: Univ.California Press,1985). 14 E.g., Kenneth Dean,Elisabeth Hsu,Paul Katz,Lin Fu-shih, andTanaka Isseihaveall published substantial works bothon earlier periods ofhistory, based on extensive documentary research, and on thecontemporary period, basedon extensive fieldwork. Besidesthemany whoareintegrating the of theother perspectives fieldintotheir ownwork, many scholars of thecontemporary periodare integrating extensive original research ofboth types intheir work rather than relying onlyon secondarysources for background. Severalyears ago,Sivinproposed slightly different disciplinary borders forthehistory of science,including medicine. These are technical history as usuallypracticed by scientists, thephilosophy ofscience, andanthropology andsociology. Sivincalledfor scholars inthe
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prowith concerned areincreasingly anthropologists studies, fortheir background interest recent more inturn, inform perspectives, Anthropological cessesofchange. of scienceand medicine. amonghistorians lifeand local knowledge in everyday and local gazetteers, to look at diaries, texts medical aregoingbeyond Historians anthroplaced which the secular, and the sacred between Theolddivision literature. ontheother, andmedicine ofscience history ononesideandthe andreligion pology of medicine from studies and religion healing of "apotropaic" studies separating is being or "remnants," to "influences" other ofthe elements to reduce andtending eroded. rapidly paraofbiomedical theuniversality of science, andthehistory In anthropology rerestrict their no longer Anthropologists challenge. under has been long digms gaze tobiotheir haveturned anthropologists andmedical Others, to exotic search forsome havebeenlooking andculture medicine, ofscience, Historians medicine. and is socially produced scientific knowledge bywhich nowat theprocesses time have studies constructed. Anthropological bodyis socially thebiomedical bywhich and contested, constructed as it is variously of efficacy exposedthecomplexities conbiomedical In challenging andhealers.15 bypatients assessed, notto mention their haveproblematized works these disease,andefficacy, ofthebody, structions posiundermining radically thus change, toexplaining andrelevance utility analytic ofhistory. accounts tivist thedisfrom stems change that assumption ofthebasicpositivist Abandonment power explanatory with greater andtheories technologies efficient of more covery looksbeyond work takeplace.Newer ofhowitdoes in fact opensup thequestion accord that can be classedas "discoveries"-innovations that thosedevelopments It doesnotseek ortechnological development. ofrationality standards current with processes multiple tointerrogate rather, mechanism but, toa single change toreduce ofchange. attention we see increasing andmedical systems, models In placeofreductionist has Thisshift ofknowledge. andreproduction adaptation, to thelocal production, such Statesawayfrom in theUnited in Chinastudies by trends been reinforced thetreatapproach, response" impact-Chinese as the"Western narratives master and tradition between division andtherelated entity, ofChinaas a monolithic ment and inChina hasbeenparalleled inthe West 16 Thegrowth oflocalstudies modernity.
Tech"OvertheBorders: See Nathan borders. acrossthese Sivin, towork science ofChinese history Chin.Sci., 1991,no. 10,pp.69-80. andtheSocial Sciences," Philosophy, nicalHistory, TheHarareAllanYoung, biomedicine consider that works anthropologists' among '5 Prominent Univ.Press, N.J.:Princeton Disorder Stress Post-Traumatic (Princeton, Inventing ofIllusions: mony (CamAnAnthropological Perspective and Experience: Rationality, Good,Medicine, 1995); Byron ExamBiomedicine Lock andDeborah Gordon, Press,1994);andMargaret Univ. Cambridge bridge: of thecom1988). For investigations Kluwer, and Healing,13) (Dordrecht: Illness, ined(Culture, ofDifferent Towards Practitioner: Acceptance Hsu,"The Polyglot see Elisabeth ofefficacy plexities inand Vol.3: Communication inAlternative Therapy, inStudies Evaluation," inTreatment Approaches Hog (Odense:OdenseUniv.Press, ed. SorenGosvigOlesonandErling Therapies, Alternative about and Medicine Anthropology at theMargin:Discoursebetween Writing Kleinman, 1996); Arthur Treated L. Gale,"Patients byPhyandJames p. 10;Kleinman 1995), Press, California Univ. (Berkeley: andPsychiainTaiwan," Medicine, Culture, Outcome Study A Comparative andFolkHealers: sicians Context andHealersinthe (cit.n. 13). Patients ofCulture 1982,6(4):405-423;andKleinman, try, Hissee PaulA. Cohen, Discovering in thefield of olderapproaches 16 For an influential critique Univ. Past (New York:Columbia Chinese Recent on the Writing Historical in China:American tory ofconceptualimplications on methodological focusing perspective, recent Press,1984).Fora more
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inmainland Chinaandtheunleashing control of ofpolitical Taiwan. Thedevolution a surge of inTaiwan sincethe1980shavebrought sentiments Taiwanese-nationalist interest andlocalidentity, both and inregional distinctiveness providing inspiration focused studies. funding for locally scholarly andChiofChina, both biomedical From the1950s, under thePeople'sRepublic becameeven Chinesemedicalhistory nese medicaleducation werecentralized. in thefieldwas restricted to thehistory research morecloselytiedto thelatter: andhadanexplicit mandate toserve ofacademies ofChinese medicine departments ofChinese remained a project medical practice. The history medicine whosepoint was wastodemonstrate national andraisecultural this progress standards, although oftheCommunist tiedtothedifferent andshifting agendas regime andtheperspecas opposed tobiographies and tive wasMaoist-Marxist. Contextual historical work, for toward themes suchas themedical achievements text studies, tended, example, ofthe(proto-Maoist rebellion andoftheCommunist peasant revolutionary) Taiping RedArmy Work oftheCivilWarperiod.'7 Worker-Peasant Sanitation The loosening of ideological strictures sincethe1980shas encouraged newapproaches andmore varied themes. There hasbeena turning away from rigid Marxist frameworks, andfrom thenarrow focus on medical theory andphysician hagiography, toward morebroadly conceived social and cultural histories and studies of a wider range ofhealing practices.'8 Practices previously considered "feudal superstition" -and their study-have gained somerespectability. Thepopularity ofqigong, itspolitical acceptance, anditsnationalistic glamor haveencouraged scholarly work onrelated subjects suchas longevity techniques. With greater tolerance toward religiouspractices, which from theYan'an period (1935-1949)andthe1950shadbeen and"exposed" vigorously suppressed as charlatanry, religious healing is nowtreated more seriously. Under reexamination, itappears essential toa historical project that attempts togo beyond the"intellectual" writings ofelites torecapture thedaily lives ofthepeople.19 Thedepoliticization ofsexualexpression, itsburgeoning as a focus
izationsof culture, see Judith B. Farquhar and James L. Hevia, "Culture and Postwar American ofChina," Historiography Positions, 1993,](2):486-525. 17 Lu Zhaoji,"CongZhonghua yishi zazhikanwoguode yishi yanjiu" atChina's (Looking medical history studiesthrough the Journal of ChineseMedical History), Zhonghua yishizazhi, 1987, ]7(l):1-7. 18 E.g.,Ma Boying, wenhua Zhongguo yixue shi(A history ofmedicine inChinese culture) (Shanghai: Shanghai renmin chubanshe, 1994);Li Jingwei, Yan Liang,andZhu Jianping, Zhongguo gudai wenhua yuyixue (China'sancient culture andmedicine) (Wuhan: Hubeikejichubanshe, 1990); and Zhao Hongjun, Jindai Zhongxiyi shi(cit.n. 5). Forreviews lunzheng ofrecent mainland scholarship see Lu Zhaoji,"CongZhonghua yishi zazhikanwoguode yishiyanjiu"; and Li Jingwei and Zhu Jianping, "Jin wunian lai Zhongguo yixueshi yanjiu dejinzhan" inChinese (Progress medical history research in thelastfive years), Zhonghua yishi zazhi,1994,24(3):133-137. 19Qigong practices generally involve thedirection ofqi flow into andinthebodythrough regulated breathing and movement. By cultivating qi, practitioners seek to acquirehealth, well-being, and longerlife. "Qi" (pronounced "chee") has been variously translated as "psycho-physical stuff," "pneuma and "vitalenergy." Withthespreadof qigong,Chinesemedicine, and Chinesemartial theterm arts, has increasingly entered common parlance in Western countries. For arguments for taking shamanic practices and popular beliefsmoreseriously as objectsof historical research see Song Zhaolin,Wuyuminjian xinyang (Spirit-mediums andpopular beliefs) (Zhonghua bentu wenhua congshu[Indigenous culture of China series]) (Beijing:Zhongguo huaqiao chubangongsi, 1990), pp. 1-5; and Song, Wuyu wushu(Shamansand shamanic techniques) (Chengdu: Sichuan minzuchubanshe, 1989),pp. 1-11.Song ranges widely, drawing on archaeological, historical, and ethnographic materials for both Han andnon-Han cultures inChina. Another example ofscholarship
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oftherapeutic intervention, anditsprevalence as a topicin thepopular presshave helped makeitan acceptable object ofscholarly interest.20 There has also beena heightened interest in socialapproaches tomedical history in Taiwan, especially since 1992,whenhistorians at AcademiaSinica formed a Tu Chengin progress on "Disease,Medicine, group to sharework and Culture." This"medical has described them as practitioners ofan "alternative" sheng history. is "alternative" to themedicalhistory as social history" relative doneby history in Chineseor Western such as Chen Bangxianand scholars trained medicine, K. Chimin focuses more on medical Wong, that thought perse andon institutional structures. It is also "alternative" in that it considers topicsmarginal to Taiwan's Thisnewscholarship mainstream historical scholarship.2' has beenespecially proin areassuchas thesocial contexts of diverse thoseof ductive healing practices, women's andinfant care.22 dailylife, health,
(Shaeds., Wufeng yu shenhua Lin He, and Long Haiqing, customs-Wu Duanshu, on shamanic on "Chu 1988)-focuses especially chubanshe, Hunanwenyi (Changsha: manicmoresand myth) anddangerwith shamans ofChuculture associations andhistorical literary taking (Hunan)culture," to as referred Whilestilloften and cultural richness. interest ous demonsas a pointof regional a cachet. developed haveclearly these "superstition," has at ChinaPeople'sUniversity, in sociology professor assistant 20 For example, Pan Suiming, the since1985.Pan translated of sexuality on thesociology andlecturing research beenconducting in in his sociologicalapproach is apparent intoChinese.Theirinfluence two "KinseyReports" ribaochubanofsex in China)(Beijing:Guangming status (The present xianzhuang xing Zhongguo ZhongChina, inancient of"sexualculture" study an extensive she,1995).Liu Dalin has published 1993),and Renmin Chubanshe, China)(Ningxia: in ancient (Sexualculture guo gudaixingwenhua Zhongguo dangdaixingwenhua: study of sex in China,Zhongguo nationwide thefirst conducted on a surChina:Report incontemporary diaochabaogao (Sexual culture lie xingwenhua liangwan 1992).Thishas been Fendian, Shanghai SanlianShudian in China)(Shanghai: veyofsexualculture of Survey on theNation-wide in ModernChina:Report as SexualBehaviour in English published Man Lun Ng and ErwinJ.Haberle(New York: ed. and trans. Men and Women, Thousand Twenty in other are also notable andreproduction of sexuality treatments 1997).Moreexplicit Continuum, wenyixue Zhongguo suchas Ma Boying, andhealing, tomedicine related works on subjects recent ZhongandSong Shugong, xinyang; Wuyuminjian hua shi(cit.n. 18),pp. 618-781;Song Zhaolin, andnourishing of] thebedchamber of [arts essentials jiyao (Collected fangshi yangsheng guogudai 1991). shudian, China)(Beijing:Xinhua lifein ancient In 1997 the on workin progress. reports 21 At thegroup's present scholars meetings, monthly shehui" ("YiliaoyuZhongguo society andChinese on medicine a larger symposium organized group around from scholars inviting A Symposium]), and ChineseSociety: [Medicine xueshuyantaohui butyiliao ("medicalhealing").For theworld."Medicine"hereis notyixue("medicalstudies"), de yiliaoshi-bingjie"Zuoweishehuishi see Tu Cheng-sheng, and itswork on thisgroup reports as socialhisserving xiaozude chengguo" (Medicalhistory yantao shao 'Jibing, yiliaoyu wenhua' discussion and Culture" of the"Disease,Medicine, to theachievements with an introduction tory, de 1995,6(1):113-154; and Tu, "Yiliao, shehuiyu wenhua-lingleiyiliaoshi Xinshixue, group), at medicalhistory), presented on an alternative and culture: Thoughts society, sikao" (Medicine, Academia Sinica, andPhilology, ofHistory Institute xueshu yantaohui, shehui" "YiliaoyuZhongguo 1997. 26 June Taipei, 22 Another in scholarship, especiallythatcomingout of Taiwanand mainland area of interest in thisareain theWest Interest ofdiseaseon history. ofdiseaseandtheimpact China,is thehistory H. McNeill's PlaguesandPeoples ofWilliam thepublication schoolandwith the Annales with grew inChitheroleofepidemics theories concerning presents N.Y.:Anchor, 1976),which City, (Garden Cao Shuji,"Shuyihluxing includes yu Huabei on diseasehistory Recentscholarship nese history. China),Lishi of bubonic plaguein and social changein northern de bianqian" (The spread shehui shidaide yu Song-Yuan 1997,no. 1, pp. 17-32; Cao, "Dili huanjing research), yanjiu(Historical Lishi period), diseasein theSong-Yuan and contagious environment (Geographical chuanranbing" 1995, no. 12, pp. 183-192; Carol Benedict,Bubonic Plague in dili (Historicalgeography), Univ.Press,1996); Chia-Feng Chang, 'AsCalif.:Stanford China(Stanford, Nineteenth-Century in ChineseHistory" (Ph.D. diss., Univ.London,1996) pects of Smallpoxand Its Significance Lin Futo elitemedicalapproaches); to alternatives foritsattention is also notable (Chang'swork
295
arereconfiguring "Cninese mediin disciplinary boundaries Thesebreakdowns include a shift theoretical cine" as a disciplinary object.The changes awayfrom toessentialist toward which lendthemselves structures ofmedicine, interpretations, ofdiverse andexperiences; a focus on the a consideration healing practices further, inillness practices andexperiences involved andhealing hasdisplaced medical pracfrom thecenter Thisreconfiguring titioners andmedical theory ofinquiry. hasbeen influenced, especially inWestern sensibilities scholarship, bypostmodern that privilegecontradictions, ambiguities, resistance, andthemarginal spacesoflifeover sysofculture. tem, coherence, andelite versions Oneareaofpostmodern interest hasbeen the theexpression ofpower bodyas a locusfor andexperience relations andculture. As an objectof inquiry, as Chinesemedicine has overgrown itsboundaries to livedbodilyexperience, so has livedbodilyexperience include gonebeyond the modern Western models ofthebounded individual bodyandthedichotomies ofself mind andother, andbody, andemotion andcognition. Suchdichotomies havebecometheobjectofcritique in many fields in theWestern academic establishment, including philosophy and psychology. In thesocial sciencesand humanities, this critique has beeninformed bychallenges to thedominance ofWestern models. In Asia,increasing numbers of scholars areadding their voicesto thedebate andare todevelop attempting indigenous approaches.23 Thesecritiques may havesensitized Western scholars seeking serious with engagement non-Western cultures, promoting thedevelopment ofalternative models informed byother cultures.24 In thisessayI willdeal with twofeatures ofrecent scholarship: theretreat from essentialist approaches that treat Chinese medicine as static andthedevelopment of approaches that takeaccount ofchange without reducing itto a positivist narrative;
shih, "Dong-Han wanqidejiyiyuzongjiao"(Epidemics andreligion inthelateEastern Han),ZhongyangyanjiuyuanLishiyuyan yanjiusuo jikan (Bulletin of theInstitute of History and Philology, AcademiaSinica), 1995,66(3):695-745; Fan Jiawei, "Dongjinzhi Songdaijiaoqibingzhi tantao" (On beriberi from theEastern Jinto theSong period), Xinshixue, 1995,6(1):155-178; Xiao Fan, lishishangde yizhong "Guanyu renti jishengchongbing-Manshi lietouyoubing" (On a human parasitic disease: Sparganosis mansoni in Chinesehistory), ibid.,1995,6(2):45-66; Xiao, "HanSongjian wenxian" (cit.n. 10); Fan Xingzhun, Zhongguo bingshi xinyi (New ideas on thehistory of diseasein China) (Beijing:Zhongyi gujichubanshe, 1989); Chen Shengkun, Chibizhizhanyu chuanran bing-lun Zhongguo lishishangdejibing(TheRed Cliff Battle andcontagious disease:A discussion ofdiseasein Chinese history) (Taipei:Mingwen shuju,1983);HelenDunstan, "The Late MingEpidemics: A Preliminary Survey," Ch'ing ShihWen T'i, 1975,3(3): 1-59; andDenisTwitchett, "Population and Pestilence in T'ang China," in StudiaMongolica(Munschener Ostasiatische Studien,25) (Wiesbaden: Steiner, 1979),pp. 35-68. 23 Ishida Hidemi critiques theapplicability to Chinesemedicalhistory of modelsthat privilege biomedicine, progressive a static history, viewofChinese theobjectifying medicine, ofthebody, and splitting spirit and flesh in Chagoku igakushisoshi (cit.n. 1), pp. i-iii, 311-313.Tu Cheng-sheng, whilenoting theinfluence of theAnnalesschool,advocates the development of indigenous approaches tosocialhistory in"Shenmo shixinshehui shi"(What is "newsocialhistory"?), Xinshixue, 1992,3(4):95-116.Ambrose Yeo-chiKingattempts to developa modelmoresuitable forstudying Chinesesocietiesin "Kuan-hsi and Network A SociologicalInterpretation," Building: Daedalus,
24 Perhaps becausetheself-reflexive dimension is considered a standard part of ethnographic approaches, theconnection between cross-cultural engagement andscholarly method is madeexplicit in some anthropological accounts. See, e.g., Judith Farquhar, Knowing Practice:The ClinicalEncounter ofChinese Medicine (Studiesin theEthnographic Imagination) (Boulder, Colo.: Westview, 1994),p. 2; Kleinman, Writing at theMargin(cit.n. 15),pp. 17-18;andArthur Kleinman andJoan Kleinman, "How Bodies Remember: Social Memory and BodilyExperience of Criticism, Resistance,and Delegitimation FollowingChina'sCultural New Literary History, Revolution," 1994, 25:707-723,on pp. 712-713,720-721.
1991, 120(2):63-84.
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and as bounded andunitary medicine ofChinese thetreatment from andtheretreat ofapproaches thedevelopment with pluralities andcontradictions. that grapple
FROM ESSENCES TO PROCESSES
hasbeentoexplore medicine on ChinaandChinese goalofscholarship A common orexplicitly an implicitly adopt their nature. Theseanalyses essential anddescribe essenceand Chinese Western between posingan opposition strategy, comparative for thesearch Accompanying medicine. andChinese medicine essenceorWestern that underlie andprinciples structures forthecharacteristic essencesis thesearch to the Besidespointing system. as a coherent unity thoseessencesand givethem is to analyses ofthese inmany theapproach andChina, ofWest dichotomies larger heldto be a categories-a procedure or socialanalytic cultural demarcate discrete distinctly frequently basedon polardyads, areoften Thesecategories signofrigor. elite/popular, sacred/secular, culture/nature, ones such as mind/body, Western Thuswe andstate/society. stagnation/progress, premodern/modern, theory/practice, elite healing, medical versus orritual symbolic illnesses, versus physical getmental converversus modern folk traditional diversity doctors versus healers, "Confucian" mediversus Western progressive Chinese medicine stagnant genceand synthesis, society. a passive oneither ora recalcitrant acting medicine state andhegemonic cine, andcateofutility, andone'sownlanguage havehadpoints Thesecategorizations therigid application foranalysis. Nevertheless, points starting arenecessary gories anomalies. has tended to produce or foreign, whether Chinese of suchcategories, more tendto be apprehended and disorders sensations and physical Thus,mental for salvation spiritual inWestern cultures. Peoplestrive in Chinese than indivisibly from notto dividetheory pracculture tends bodies.Chinese their by cultivating Hisas well.25 inWestern epistemology under attack increasingly tice,a separation in their repertechniques healers haveincluded "symbolic" elitemedical torically, herbal haveincluded forexample-and folkhealers demons, toires-exorcising have these haveacknowledged commonalities, they scholars Where prescriptions.26 as the times andthelatter ofearlier as remnants theformer totreat practices tended thosevarious theprocesses to examine bywhich ofeliteculture, failing influence with thepast,as does notmark a rupture Butmodernity aretransmitted. practices orsubsumes diverse "ethnic" healing practices, biomedicine ofwhich replaces part ofenlightenment matter is nota simple newandold practices between andconflict arenotsimply andinstitutions Policies andignorance. ofdisorder battling theforces actors-irrediverse ofnegotiation areprocesses among There on society. imposed
25Arthur and Pain Neurasthenia, and Disease: Depression, ofDistress Social Origins Kleinman, Chiu,"Mind,Body,and in ModernChina (New Haven,Conn.:Yale Univ.Press,1986); Martha "Emotional Sivin, 1986);Nathan Univ., (Ph.D. diss.,Harvard MedicalTradition" ina Chinese Illness and ReflecChina.Researches inAncient and Religion in Medicine, Philosophy, Counter-therapy," and 1995),pp. 11.1-19; Variorum, CollectedStudiesSeries,CS512) (Hampshire: tions(Variorum p. 2. Practice, Knowing Farquhar, of jinran"(The permeation fazhanzhongde wu wenhua 26 Zheng Jinsheng, "Zaoqi Zhongyao at "Yiliao yuZhongshamanic with presented culture), development Chinesepharmaceutical early Institute ofHistory A Symposium), andChineseSociety: (Medicine yantaohui xueshu guo shehui" Ritualand Popular Dean, Taoist AcademiaSinica,Taipei,26 June1997; Kenneth and Philology, Univ.Press,1993),pp. 90-91, 128; andSong N.J.:Princeton China(Princeton, CultsofSouth-East (cit.n. 19),pp. 250-274. yuwushu Wu Zhaolin,
297
ducible to state,society, or public sphere-in the ongoingshapingof policies and theirimplementation.27 A focus on processes can be an antidoteto the problems of essentialistapproaches.One of thepillarsof such approachesis thetreatment of China and West as monolithic, polar extremes.Nathan Sivin and G. E. R. Lloyd are attempting to develop a comparative approachthatgoes beyondsuch simplistic assumptions by notcomparing orconcepts, things butprocesses, theevolving ofnatural activity philosophyandsciencein Chinaon theone handandin theHellenic andHellenistic world on theother. Like mosthistorians of sciencetoday, we haveno use fortheidea that science is onething anditscontext is another. We arelooking atideas,their use,andthe socialprocess oftheir creation as a single phenomenon. Howphysicians orastronomers earned a living, howthinkers grouped inwhat themselves, ways they publicly disagreed, andwhat political significance they claimed for arejustas revealing cosmology as concepts, forms ofproof, andpatterns ofthought. From this ofviewitdoesnotmakesenseto askwhether point socialchange wasthe causeofscientific orwhether change, philosophy changed Wesee these politics. as part ofa single manifold ofhistory.28 We can see in these worksthat,besides makingcomparisonboth possible and morefruitful, thecentral focuson processesofpractice and experience helpsto overcome standard assumptions thatdo muchviolence to theirobject. ShigehisaKuriyama, ratherthan comparingancientChinese and Greek medicine as abstracted conceptualsystems, examines what can be better describedas ways of observing and constituting thepatient forexample,sightand touch.Judith through, Farquhar, in heranthropological inquiry into"culture-specific (Chinese) waysof knowing"in medicine,foundthe epistemologicalparadigmthattreatstheory in isolationfrom the processesof clinical encounters unwieldy:"Statements in discourse. .. had to be seen as weapons againstillness,resourcesforaction,rather thanas claims about nature or representations of truth."29 Arthur Kleinmanhas movedawayfrom suchfeatures ofhis earlier workas dichotomies betweenthesacred and thesecularand distinct
27 Benedict, BubonicPlague inNineteenth-Century China(cit.n. 22); Caroline B. Reeves,"The Powerof Mercy:The EarlyHistory of theChineseRed Cross Society, 1904-1927"(Ph.D. diss., Harvard Univ.,1998); Andrews, "Makingof ModemChineseMedicine"(cit.n. 5); and RuthRogaski,"FromProtecting Lifeto Defending theNation: The Emergence ofPublicHealthin Tianjin, 1859-1953"(Ph.D. diss.,Yale Univ.,1996). 28 Nathan Sivin,"Comparing GreekandChinesePhilosophy and Science," in Medicine, Philosophy, and ReligioninAncient China (cit. n. 25), pp. 1.4-5. A slightly different version appearsin Sivin,"Comparing Greekand ChineseScience," in East AsianScience:Tradition and Beyond, ed. Hashimoto KeizW, Catherine Jami, andLowellSkar(Papersfrom theSeventh International Conferenceon theHistory ofScienceinEastAsia,Kyoto, 2 Aug. 1993) (Osaka: KansaiUniv.Press, 1995), pp.23-31,onp. 26. See also G. E. R. Lloyd, Demystifying Mentalities (Cambridge: Cambridge Univ. Press,1990),for a critique oftheessentialist notion ofdistinct mentalities, including as a test case a comparative ofearlyGreekand Chinesestyles study of scientific andphilosophical reasoning (Ch. 4). Lloyddevelopsthiscomparison further inAdversaries andAuthorities: Investigations into Ancient Greek and Chinese Science(Cambridge: Cambridge Univ.Press,1996). 29 Shigehisa Kuriyama, "Varieties ofHapticExperience: A Comparative Study ofGreek andChinese Pulse Diagnosis"(Ph.D. diss.,Harvard Univ.,1986); Kuriyama, 'Interpreting theHistory of Bloodletting," Journal oftheHistory ofMedicine andAlliedSciences,1995,50:11-46; Kuriyama, "VisualKnowledge in ClassicalChinese Medicine," inKnowledge and theScholarly MedicalTraditions, ed. Don Bates(Cambridge: Cambridge Univ.Press,1995),pp.205-234; andFarquhar, KnowingPractice (cit.n. 24), p. 2.
298
TJHINRICHS diandinnate offormal structures itsimpression idea,with very systems-the medical toward ofsuffering, the lived experience meuncomfortable-toward nowmakes visions, from intheworld.... Mov[ing] modeofsocialbeing as a historicized practice medical and first toward subjectivity andsocialstructures, forms symbolic with a preoccupation newwords to find . . . I am struggling of experience, on to theintersubjectivity then socialspace between cross processes that thesamerecalcitrant toevoke andnewimages andthebody.30
suchas those oppositions basedonessential toapproaches challenge Thegreatest is theobservation healing andsymbolic medicine orbetween EastandWest between Studiesof constructed. butare themselves are notnatural that theseoppositions and as a given of medicine theparameters taken havegenerally medicine Chinese is some again,there While, ofthismedicine. as practitioners doctors havedefined particular ofthis The delimiting it also has itslimitations. to thisdefinition, utility who of practitioner-scholars to theproject objecthas beenrelated historiographic Theappeartradition. toa medical relation incontinuous themselves seektoidentify however, is undermined, tradition ina medical progress andlinear anceofcontinuity change ofhistorical processes manifold atthe closely that looksmore byscholarship traditionally challenges scholarship this that Atthesametime practices. inmedical basis a stronger hopeofproviding itoffers anddiscreteness, continuity constructed them. sustain that oftransmission andtheprocesses continuities for identifying on theconstruction hasfocused years inrecent bodyofscholarship A substantial anddoctors domain as a distinct ofmedicine Theconstruction medicine. ofChinese I treat andtransmission. ofpraxis matters is bound upwith socialgroup as a distinct for historiography. relevance of its particular because however, here, itseparately Medicine Constructing the ofreconstructing from theproject is theshift here inquestion Thereorientation theways ofreconstructing tothat ofChinese medicine essence unified fundamental, over andreconstructed constructed has beenvariously medicine Chinese in which unity internal to constructing ofendeavor. Essential field as a distinct thecenturies andhetorthodoxy andquackery, medicine between boundaries outer is clarifying andforeign. indigenous erodoxy, it is notlinear. historical likeother processes Whilethisis an ongoing process, outofand selfboth medical emerges orthodox ofan indigenous Theestablishment from the a departure Sometimes pastis made ofmedical practice. newforms creates with the recent as a rupture pastanda recovitis constructed often although explicit, oreclecticism. synthesis be constructed through Internal may unity ofantiquity. ery locations-arealways thelinesare drawn-andnotjusttheir The waysin which changing. Northern that Song (960-1126)policiesaimedat the elsewhere I haveargued around of boundaries a redrawing entailed customs" of southern "transformation stake at The customs medicine. orthodox constitute not doesanddoes what properly the to led of demonic fear sick for they the contagion; werebased on shunning sickand of homes the of abandonment quarantining sick, of evacuation villages, in noninterest healers;and,critically, forthepassageof shamanic roomsexcept
30Kleinman, (cit.n. 15),p. 6. at theMargin Writing
299
reacted medicines. anddistributing Officials government-distributed byproducing shamanic healers. In thecourseof or re-educating medicaltexts and suppressing for officials narrowed thescopeof andre-editing texts commissioning distribution, inrelation totheories ofcontagion oforthodox their definitions medicine, especially and demonic medicine. Theseactivities did notsuffice to narrow thescope of all in comparable butthey official andactivities did ariseoutof publications fashion, and contribute to contemporary in thetreatment of epidemics developments and ofproper discussions thenature medical concerning practice.' Entering thesediscussions was the elusivefigure of the scholar-physician or "Confucian" Needham andLu noted theappearance oftheterm physician (ruyi). in itto theemergence Songwritings andlinked of"a newraceofmen... whowere verywell educated but lackedperhaps whichsome of the practical experience rougher leechesofthepasthadhad."Laterscholars haveattempted todetermine to whatextent eliteswereengaging in medicalpractice or,alternatively, physicians wereacquiring elitestatus. Chen Yuanpeng has found that norms in the changing didresult inhigher Songperiod for doctors andforscholarly prestige medical pursuits. He finds evidence fora smallnumber of elitepractitioners andidentifies as oftheruyi counterparts idealboth those rare elitedoctors andthemore substantial number ofelitescholars whopursued textual studies ofmedicine in addition tothe usual studies of cultivated gentlemen and officials. The latter sometimes advised friends andfamily as knowledgeable amateurs or published collections ofrecipes for thegreater good,butthey didnotmakemedicine their primary occupation. RobertHymes, in a locallyfocused ofFuzhou, analysis found that themedical career as an option emerged for members oftheeliteduring theYuan(1279-1368);itwas an alternative for those whofailed toestablish a civilservice career, theoption next inpreference behind theConfucian teaching orexamination curriculum.32 Christine in a study of theYishuischoolof northern Bodenschatz, Hebeiin the Jin (1115-1234) andYuanperiods, hasexamined the processes bywhich the rhetoric surrounding ruyicontributed to a reconstitution of medicalpraxisas well as an ofelitestatus expansion toaccommodate those who, their accesstomore traditional careers turned tomedicine. blocked, Shebridges sociohistorical approaches that set aside issuesof thecontent of medicaltheory or practice and standard internalist that socialcontext. approaches Thedistinctiveness ignore andthe processes ofemergenceofthisnewstyle ofpractice havebeenobscured in modem histories written by practitioner-scholars whothemselves are in a continuous lineof descent from anddefine theparameters ofChinese medicine bythis very ruyitradition.33 Bodenschatz sees theseruyias developing new forms of medical practice and distancing themselves from thesocially dubious traditional doctor. Where thelatter reportedly matched recipes typologically with ailments, ruyi doctors insisted ontaito patients' loring recipes individual circumstances. Thesenew medical practices
31Hinrichs, "MedicalTransforming ofGovernance andSouthern Customs" (cit.n. 10).
Needham andLu, "ChinaandtheOrigin ofQualifying Examinations in Medicine" (cit.n. 10), p. 391; Chen Yuanpeng, LiangSongde "Shangyi shiren" yu "ruyi" (cit.n. 1); andRobert P. Hymes, "NotQuiteGentlemen? Doctors in SungandYuan," Chin.Sci.,Jan.1987,no. 8, pp. 9-76. Hymes is writing abouta prefecture inpresent-day Jiangxi Province, nottobe confused with thehomophonous
32 33 Christine Bodenschatz, "Medizinals neokonfuzianische Praxis"(Ph.D. diss.,Munich Inst. History ofMedicine, forthcoming), pp. 9-11.
Fuzhou in Fujian.
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andclientto doctor bythevaluesofa socialclassnowcommon wereinformed Moral in their milieu. that prevailed discourse neo-Confucian andbytheparticular fointoruyi doctors' werecarried andbehavior emotion moderating with concerns concerning clients andadvised into thus inquired doctors causes." cuson"inner Ruyi to conformity ills.Thedoctors' bodily as wellas their livesandbehavior inner their becameissuesrelecontrol andemotional learning, stature, moral socialstandards, authority moral levelandtotheir on suchan intimate accesstopatients vant totheir tobase Ruyi sought behavior. andouter orientation in inner alterations toprescribe orprinciples, patterns innate meaning concept ontheli, a neo-Confucian treatments and his circumstances. 1i of thepatient theseto theparticular matching of drugs, of a harmoniand language to theprinciples according Recipeswereconstituted society.34 constructed ouslyandhierarchically was defined medicine scholarly thewaysin which AngelaLeunghas examined popular tovarious incontrast theSongandMing(1368-1644), specialties, between andColdDamagedisormedicine onprescription andSongemphases practitioners, inthetransmission tonewdevelopments off primarily this splitting ders. She traces formal ofmore andvalorizing theestablishment example, learning-for ofmedical ofneoto that analogous anddisciple, master between relationships andexclusive ofrelationships densenetworks that Chao hasshown Yuan-ling lineages. Confucian Suzhouphysiamong senseofidentity a strong fostered andliterati publishers with ofelite numbers that increasing ciansintheMingandQing(1644-1911).She finds of theboundaries led to renegotiations specialization and increasing practitioners andphysician identity.35 medical orthodoxy around to "north" those pertaining especially differences, cultural andrelated Geography in conthemes havebeenrecurring and "non-Chinese," and"Chinese" and"south" and Self.We can see thisin Other and ethnic cultural, of themedical, structions theHan (206 B.C.-220 A.D.) to theSong periods of viewsfrom Xiao Fan'sstudy or landsas seasonally and of southern to thesouth diseasesas specific of certain toyin with regard risetobodiesunbalanced Thisgives outofkilter. cosmologically Schafandfauna. Edward flora, andnoxious miasmas, cultures, andyang,heterodox of Tangimagesof southern feralso dealtwithsomeof theseissuesin his study howorthodoxy on Northern Songpolicieshas shown landsandpeoples.My work difand cultural to regional, in relation ethnic, couldbe constructed in medicine
ference.36
to local identity in relation of geography concepts MartaHansonalso unpacks ofgu poisoning fears theManchus, of smallpox among anddiseasein herstudies andthe thesouth, tocolonizing diseasesas barriers miasmatic bytheMiao people, Factor basedonWarm tradition medical ofa southern invention nineteenth-century subclass from a seasonally reworked were specific disorders Factor Warm disorders.
Ibid. paper theSungtotheMing," from ofMedicalKnowledge AngelaKi-cheLeung,"Transmission Pointin Chinese A Turning Transition: "The Sung-Yuan-Ming entitled at a symposium presented in Late and Society Chao, "Medicine June1997; andYuan-ling Calif., Lake Arrowhead, History," 1995). Los Angeles, Univ. inSuzhou"(Ph.D. diss., California, ofPhysicians A Study China: Imperial use itstechnical heretoindicate "Cold Injury," translated Cold Damage,also commonly I capitalize disorders. area classoffebrile Cold Damagedisorders medicine. in Chinese Bird:T'ang TheVermillion H. Schaffer, (cit.n. 10);Edward jian wenxian" 36 Xiao Fan,"Han-Song Press,1967),esp. pp. 130-134; and Angeles:Univ.California ImagesoftheSouth(Berkeley/Los Customs" (cit.n. 10). andSouthern ofGovernance "MedicalTransforming Hinrichs,
34 35
301
class of year-round disorders to a distinct of Cold Damagedisorders in prevailing ofrobust schoola construction intheWarm Factor northern finds Jiangnan. Hanson cultural differences areexplicitly southern bodiesversus delicate arones;regional is thebasisfor local ticulated as physiological. Thisbodily difference legitimating theclaimsto universality andtheauthority knowledge of andinnovation vis-A-vis sanctioned ancient texts madebytheorthodox Cold Damagemedicine bythestate. on venerable The construction ofa regionally distinct medicine is founded notions oflocally which were theories ofnorthern specific elaborated andsouthern qi,from inthecontext bodies.Hanson oftheriseofregionalism placesthese developments in thelateQingperiod.37 andassertion oflocal identity In the twentieth the salient divideshifted century, from regional "north" and south" to "China" and"West." the"illusion" PaulUnschuld notes that of"Chinese medicine" as a well-defined, coherent in response was created to unified, system threats toabolish it.Especially inthe1920sand1930s, urban intellectuals, accepting then-fashionable valuesof scientific socioevolutionary attacked progress, Chinese medicine as backward, or fraudulent. to superstitious, Manyof thosewho sought saveChinese medicine these accepted judgments andthus to strengthen attempted itbymodernizing it:professionalizing practice, standardizing education, systematizingknowledge, removing elements heldtobe superstitious, andgrafting onelements ofWestern medicine. In addition toinforming modernizers' transformations, images ofWestern medicine haveprovided contrasts that helptodemarcate Chinese medicinefrom Western toohaveinformed biomedicine, andthese innovations inpraxis. The models developed for science andmodernization arenotsimple translations of Western ideas butlocal visions, adapted and altered in diselectively, contested, verse practices.38 Bridie Andrews haspointed outprocesses bywhich Chinese medical practice was bothdefined and altered through suchattempts at modernization in the1920sand l 930s.Projects to standardize case histories, for example, entailed a reorganization ofnosology bydisease(bing)rather than syndrome (zheng). Competing schools of Chinesemedicine, suchas theCold DamageandWarm Factor schools, tended to distinguish themselves through in discerning differences syndromes. Organizing case histories to diseasethus according allowed for claimsoffundamental unity in Chinese medicine andfor thedevelopment ofan eclectic medicine drawing broadly on multiple traditions.39 Ironically, Volker then, Scheid hasshown how, beginning inthe1950s, the differentiation ofsyndromes (bianzheng) wasmadethedefining andunifying characteristic
3 Marta Hanson,"Robust Northerners andDelicateSoutherners: The Nineteenth-Century Inventionof a Southern MedicalTradition," Positions, 1998,3:515-550; Hanson,"Inventing a Tradition in ChineseMedicine:FromUniversal Canon to Local Medical Knowledge in SouthChina,the Seventeenth to the Nineteenth Century" (Ph.D. diss., Univ. Pennsylvania, 1997); and Hanson, "Merchants of Medicine:HuizhouMercantile Consciousness, Morality, and MedicalPatronage in Seventeenth-Century in EastAsianScience, China," ed. Keizo etal. (cit.n. 28), pp. 207-214. 38 Unschuld, Medicinein China(cit.n. 13), pp. 250-251. For moreon movements to abolishor scientize Chinesemedicine see Andrews, of ModemChinese "Making Medicine"(cit.n. 5); Zhao "Chineseversus Western Hongjun, Medicine"(cit.n. 5); Zhao,Jindai Zhongxiyi lunzheng shi (cit. n. 5); andCroizier, Traditional Medicine inModern China(cit.n. 5). 39 Forexplanations of"syndromes," also translated as "patterns," seeAndrews, "Making ofModern Chinese Medicine"; Farquhar, Knowing Practice (cit.n. 24); andSivin, Traditional Medicine inContemporary China(cit.n. 11).Foran analysis ofefforts tocreate a unified standard Chinese medicine outofdiverse Chinesemedical practices see Andrews, "Making ofModemChinese Medicine."
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two Fornearly in theprocess. medical practice transforming medicine, ofChinese diseasesandememphasizing between had shifted systems millennia nosological the From inthis respect. hadbeenconsistent andfewauthors syndromes, phasizing differentitosystematize syndrome efforts widespread Scheid finds however, 1950s, mediWestern from Chinese todemarcating central hasbecome Thispractice ation. mediWestern syndromes, differentiates medicine "Chinese cine;theformulation was differentiation accepted. Syndrome is nowwidely diseases" cinedifferentiates to andthus methods conflicting allowed ittoencompass ina manner that conceived fit Chinese Italso helped traditions. for diverse ofidentity point establish a common bea basisforunity byestablishing example, intoMaoistdoctrine-for medicine as differentiation syndrome reconstructing and through theory andpractice tween as distinct medicine Chinese tomark By helping process. an Engelian "dialectical" served differentiation syndrome correct, and as politically Western medicine from toabolish whosought against those struggle intheir medicine ofChinese supporters planned health itsplacein a centrally establishing andsuperstitious, itas backward into diseasecategories of Western care system. It also allowedtheincorporation Chi406 diseases(using In 1995,national standards for medical practice. Chinese teachwere settofacilitate andsyndromes categories) biomedical, not nesemedical, internafuture for a model keeping, as wellas toprovide andrecord ing,research, medicine.40 tional standards for Chinese feature as a defining differentiation hasemerged Theprocess bywhich syndrome andpedagogical the one.Despite political hasnot beena linear ofChinese medicine hazards thepolitical anddespite that itfacilitated, praxis ofthenewmedical utility ofthenewstansuchaspects havecontested someprominent physicians ofdissent, disease medical of Chinese as theabandonment differentiation dards of syndrome differentiation from complex processes ofsyndrome andtheabstraction categories atRevolution The Cultural and treatment. (1966-1976)saw various of diagnosis Theseincluded andrevolutionary. more socialist medicine to makeChinese tempts and to makeit feudaland superstitious considered to strip efforts awayelements and make to train morenewdoctors and easierto learnin order moreaccessible on more focused Researchers to themasses. intensely available caremore medical orelimimedicine-for with Western bysimplifying example, Chinese integrating Muchof diseasecategories. infavor ofbiomedical differentiation syndrome nating views tobiomedical thus involved reduction medicine with Western theintegration to determining was devoted much research of thebodyand disease;forexample, andtherapeutics.41 basesofChinese thebiomedical diagnostics onthelivesofsenior ofessays howa genre physicians hasshown Judith Farquhar based ofChinese medicine a vision to assert in the1980shas helped that emerged
40 Volker (Ph.D. diss.,Univ. Medicine" Chinese inContemporary andSynthesis "Plurality Scheid, of syndrome The linking of the 1995 standards. 1997); see Ch. 7 forthediscussion Cambridge, and by theterms' homophony was assisted (bianzheng) and dialectics (bianzheng) differentiation of synon thepractice has written extensively Judith Farquhar kinship. and etymological graphic ofpraxis, andon multion thecentering inparticular inthePeople'sRepublic, differentiation drome deviations than rather to theprocess as beingessential forintervention andpoints ple perspectives Practice;and FarKnowing see Farquhar, follows that to thediscussion In addition a norm. from Case," in of a Published Analysis ChineseMedicinethrough "TimeandText:Approaching quhar, Univ.California Leslie andAllanYoung(Berkeley: ed. Charles PathstoAsianMedicalKnowledge, Press,1992),pp. 62-73. Ch. 7. Medicine," Chinese in Contemporary andSynthesis 41 Scheid, "Plurality
303
andindividual achievement thedominance oflaboratory on clinical practice against Heresyndrome differentiation andclassroom onceagainplaysa analysis teaching. The individual central rolein medical celebrated in this praxis. literature virtuosity is something ofpractice andthrough attained after longyears ongoing engagement in contrast with patients andcanonical to prevailing models of standardized texts, wereprominent teachers chronicled knowledge. Manyofthesenior physicians and writers whowere instrumental insystematizing andinstitutionalizing Chinese medicineinthefirst decadesofthePeople'sRepublic. Thesebiographies assert theunity and continuity of Chinesemedicine thepersons of thosesenior through doctors, whoareseento embody theessenceofChinese medicine anditsconnections with pastandfuture.42 We see here medical their critics that, through time, practitioners, allies,andtheir havereconstructed and recreated thenature of medicalhealing versus medicine, nonmedical healing, what makes a quackora competent for doctor. Theyhavebeen inprojects ofdistinguishing "ourmedicine" engaged from "what other peopledo," ofconstituting medical Their identity. constructions ofmedicine haveincluded historical claims, reevaluations ofthepastandtherelations ofpresent to itpractice whether as a recapturing ofa newly constituted essential as a continuation past, of a longmarch of progress, or as a radicaldeparture. Modemhistorians of Chinese whether taketheposition medicine, ofally, they ordisinterested critic, professional scholar, havebeenand continue to be participants in theconstruction of Chinese medicine anditsrelations to thepast.Theyhaveboth predicated their work on and produced naturalized, bounded versions ofChinese medicine that areuseful inshiftingorpropagating medical identities butthat lackreflexivity. The authors examined here havetaken as theobject oftheir scholarship notthese versions ofChinese medicine buttheprocesses bywhich Chinese medicine (orruyi or Warm Factorschoolmedicine) is produced, medicine, including processes of construction. Thesescholars haveshown medical identity tobe bound up with other domains of identity: regional, occupational, class,national. Theyhaveshown that thestakes in theconstruction of thesemedicines involve thedevelopment of new forms ofpractice, theassertion ofauthority, thesecuring oflivelihood, thedefense or enhancement of status. Theyhaveshown theconstruction ofmedicine to be inin manifold volved processes ofchange inmedical praxis. Transforming and Transmitting MedicalPractice and Knowledge As scholars haveeschewed andreductionist monolithic models ofchange, abandoninga neatly bounded notion ofChinese medicine as an object ofinquiry, they have turned attention tothecomplex processes bywhich medical praxis is produced and transmitted. One oftheways inwhich Chinese medicine hadachieved boundedness under modem gazeswas through thedistilling ofknowledge from practice. Recent approaches toexplaining change havetended totake priority away from this rarefied object,returning knowledge back to practice, or praxis.The practices in questioninclude thefeeling of pulsesand theapplication of needles-medicalpraxis
42 Judith Farquhar, "Re-writing Traditional Medicine inPost-Maoist China," inKnowledge and the Scholarly MedicalTraditions, ed. Bates(cit.n. 29), pp. 251-276.See also Scheid'sanalysis in "Plurality andSynthesis in Contemporary Chinese Medicine," Ch. 7.
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narrowly considered. The scholarly object, however, is notcontained in theclinic, thesickroom, ortheperspective ofthephysician. Rather, itextends toprocesses of transmission, learning, andcareer development; experiences ofillness; negotiations among healers, patients, relatives, community leaders, andofficials; andtheactivitiesofpublishers, entrepreneurs, andpoliceofficers. As Chinesemedicine had longbeenbounded in cultural space,so had it been bound in time, in theclassicsofantiquity. born The discovery ofFormer Han (206 B.C.-9 A.D.) medical texts and objectsin archaeological excavations in theearly 1970s,alongwithnewperspectives offered by recent scholarship, has alloweda fundamental ofourunderstandings reworking ofearly medicine.43 The preeminent datedto theWarring States periodand attributed to a singleauthor, butit is now datedto thefirst B.C. and seenas a compilation century ofdiverse texts.44 primary Fora longtime, a contrast hadbeendrawn between pre-Han supernatural healing, theprovince of shamans whocombated demonor ancestor-induced and diseases, a rationalized Hanmedicine ofbalances andnatural From howforces. recent finds, we havelearned that Han eliteswere ever, many practices widely accepted among still aimed atdispelling demons from primarily pathogens, prominent among them, thebody.45 New materials havecontributed notonlyto a morevaried outside and
sitesincludeWuwei,Gansu (datedearlyHan, exc. 1972); Mawandui, excavation 43 Significant Hubei(second exc. 1975);Zhangjiashan, Hubei(Qin Period, Hunan(158 B.C., exc. 1973);Shuihudi, B.C., exc. 1993).See Donald Sichuan(secondcentury B.C., exc. 1983-1984);andYongxing, century (Sir Henry MedicalManuscripts TheMawangdui MedicalLiterature: EarlyChinese Harper, trans., as well as a study Asian Series,2) (New York:Paul Kegan, 1998) (thisbook includes Wellcome of a LacExamination A Preliminary Lo, "The Channels: He Zhiguoand Vivienne translations); EarlyChina,1998,no. 21, pp. 81-123;Gao Dalun, Han Period," from theWestern Figurine quered from on theHan periodbambooslip textYinshu HanjianYinshuyanjiu(Research Zhangjiashan qidiaokao" (Investigajingmai Bashu,1995); He Zhiguo,"Xi Han renti (Chengdu: Zhangjiashan) of theWestern Han), Daziran tansuo, figurine on a lacquered bodychannels tionsof thehuman and explanations kaoshi(Investigations guyishu Mawangdui 1995,no. 3, pp. 116-120;Ma Jixing, 1992); Fu jishuchubanshe, Hunankexhue (Changsha: of Mawangdui) medicaltexts of theancient jichu lilunxilie in China) (Zhongyi of medicine yixueshi (The history Weikang, ed., Zhongguo 1990),pp. 42-53; andYamada Keiji, daxuechubanshe, zhongyiyao Shanghai congshu) (Shanghai: forthe materials discovered no kenkyu (Studiesofnewly shiryokagakushi Shinhatsugen Chugoku 1985). kagaku kenkyujo, Jimbun daigaku 2 vols.(Kyoto:Kyoto ofChinesescience), history 44 Some revised but discoveries, thenewarchaeological before hadbeenproposed understandings of theHan context ourunderstanding and improved consensus scholarly haveincreased thosefinds in Sivin,"Huangti nei ching," For moreon theInnerCanon see Nathan of thetext's production. ed. MichaelLoewe (EarlyChinaSpecialMonograph A Bibliographical Guide, Texts: EarlyChinese Univ. ofEastAsianStudies, for theStudy ofEarlyChinaandInstitute Society Series, 2) (Berkeley: tothe finds that relates these archaeological scholarship 1993),pp. 196-215.Forfurther California, Acta oftheHuang-ti Nei-ching," oftheInnerCanonsee Yamada Keiji,"The Formation formation in MedicalTexts "The Interpretation ofClassicalChinese Asiatica,1979,36:67-89;AkahoriAkira, Chito Traditional inApproaches andProblems," Approaches, Achievements, Japan: Contemporary Kluwer, 1989),pp. 19-28; andAkahori, ed. Paul Unschuld (Dordrecht: nese MedicalLiterature, ancient ofChina's koten no minaoshi" niyoru (A reevaluation iyaku Chugoku "Shinshutsudo shiry6 ofChiexcavated (Clinicalapplication Kampono rinsomaterials), classicsbasedon newly medical 1978,25(11-12):1-16. nesemedicine), 45 Such practices, of the"elite"to thepresent. havecontinued in varying amongmembers forms, MedicalLiterature (cit. n. 43); Kudo Moto, see Harper, EarlyChinese trans., On earlymedicine of ni tsuite" no kankei to kishin ni okeru (The relationship 'Nichisho' Shinkan by6inron "Suikochi July1994,no. 88, pp. to demonsin theShuihudi Qin bambooslip "Rishu"),To-hgaku, etiology in of Illnessin EarlyChineseMedicineas Documented "The Conception 33-53; Donald Harper, B.C. Manuscripts," 1990,74:210-235; Third andSecondCentury Discovered Newly SudhoffsArchiv, 1988), Handai de wuzhe(Shamansof theHan period)(Taipei:Daoxiangchubanshe, Lin Fu-shih, Journal oftheThird ofAsi"A ChineseDemonography B.C.," Harvard Century esp. p. 117;Harper,
medical classic, Inner Canon of the YellowEmperor(Huangdi neijing),was long
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nuanced of Qin andHan healing picture butto analyses oftheprocesses practices bywhich thedistinctive oftheclassicaltradition practices emerged. On thebasisofnewarchaeological Lo has argued Vivienne discoveries, convincinglythat, contrary to previous thatthetwo streams assumptions issuedfrom a common life"(or"cultivating pool,"nurturing vitality" [ yangsheng]) practices were in significant distinct from respects Han medical Lo finds contemporary practices. a contrast between pre-Canonmedical which focuson objective texts, signsofillnessandremoving disease,andpre-Canon lifetexts, nurturing which record practicesaimedat cultivating health. do notappearin pre-Canon Acupuncture points medical anddescriptions texts, ofthebodyandofyin, andqi arelimited yang, and crude. In contrast tothespare ofmedical language lifetexts texts, nurturing develop a rich, and sophisticated sensuous, to describe language of subjective experiences vitality. Lo finds direct links between this literature andtheCanon:specific names of acupuncture features points, ofthechannels (mai),andthe"penetration" ofthe body byyin, yang, andqi andtheir use in "landscaping theinternal environment" inways that wouldbecome"a familiar feature oflater Daoistandmedical practice."46 Lo's work complements that ofShigehisa Kuriyama, whohasbrought a different perspective totheshift between archaic medicine andthat oftheCanon.Rather than locating thecontrast as one of magicversus rationality, Kuriyama sees theemergenceofa body-centered inclassical approach medicine. Whilethebodyisjustone ofmany placesa spiteful spirit might strike, anda Hippocratic physician might be more concerned with theeffects ofa patient's localenvironment anddietary intake, Canonmedicine is intensely concerned with thebody. Like Lo, Kuriyama relates thisshift to a particular wayofexperiencing bodyandself-here,as "windlike":
Theimagination ofwindsprang from a concrete experience oforiented spaceandlocal place,a directly felt senseofseasonal drift andhuman Itbespoke moods. an embodied apprehension ofanevershifting self inanever changing universe. Personal breath could harmonize with cosmicbreath, andhabitually thetwomight be reasonably in phase. Butthecharacter ofall winds, inner orouter, wasthat they always retained somechaotic contingency, thepossibility ofsuddenly blowing in newandunexpected directions.47
Kuriyama and Lo, then, whilesharing their predecessors' recognition of Canon medicine as distinct from earlier healing practices, havelocated theshift in bodily practices andexperiences rather than inthe realm ofideasandhaveavoided reducing those practices andexperiences tochanges insocial, economic, orpolitical structure. Other historians of theearly period haveshown howprocesses of transmission haveconnected physicians to and distinguished them from other groups. Li Jianminfinds patterns of transmission of "secret techniques" common to twogroups,
aticStudies, 1985,45:459-498; andHarper, "The 'Wu ShihErhPingFang':Translation andProlegomena" (Ph.D. diss.,Univ.California, Berkeley, 1982).DerkBoddedescribed varieties ofcommon apotropaic practices oftheHan,from thegreat nuoexorcisms to thewearing ofamulets to wardoff disease-causing demons, in Festivals in Classical China:New Yearand Other AnnualObservances theHan Dynasty, during 206 B.C.-A.D. 220 (Princeton, N.J.:Princeton Univ.Press,1975). 46 Vivienne Lo, "The Influence ofWestern Han Nurturing LifeLiterature on theDevelopment of Acumoxa Therapy" (Ph.D. diss.,Univ.London,1998); andHe andLo, "Channels" (cit.n. 43). See also Harper, trans., EarlyChinese MedicalLiterature; andHarper, "'Wu ShihErhPingFang."' 47 Shigehisa Kuriyama,"TheImagination ofWinds andtheDevelopment oftheChinese ConceptionoftheBody," inBody, Subject, and PowerinChina,ed.AngelaZitoandTaniBarlow(Chicago: Univ.ChicagoPress,1994),pp. 37-38.
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(fangshi, knowledge ofoccult frequently aremasters, Adepts andadepts. physicians Sivinlooksat how Nathan whopossesstechniques"). "gentlemen shushi; literally, He as a physician. status an eliteindividual's established of transmission patterns constituted todisciple teacher from transmission oftextual shows howthepractices onegeneration from totransmit that existed fictive lineages into a "ritual induction that by explanations accompanied in writing, revelations to thenextcharismatic written ororal."48 might be either transformations later clarified has greatly on modesoftransmission Scholarship between inmedicine transition a major Scholars havelongnoted ofmedical praxis. ofthe"FourGreat with theappearance punctuated usually theSongandtheMing, to focuson of thistransition havetended andYuan.Accounts Masters" oftheJin attributing in medicine, change they failto explain theory; thecontent of medical of suchas theemergence trends it to larger or reducing progress it to scientific ofitsphysibytheelitestatus was marked The newmedicine neo-Confucianism. prematching anda moveawayfrom factors, focuson climatic cians,a sharpened andremedies. diagnoses tailored individually toward todiseases remedies scription theory beyond andLeunghavelooked scholars suchas Bodenschatz Morerecently, that led tothelocaldynamics change ofsocialandhistorical outlines andthebroad of transin practices andprocesses theseshifts andto changes to and constituted mission.49 socialrelaandchanging century, thescenein thetenth entered which Printing, for accounts. ChenYuanpeng, example, roleinmany ofthese tions havea prominent forscholarly texts available medical in making has lookedat theroleof printing in medical little interest subjects elites before theSongshowed Where ruling study. of networks withdoctors, Chenhas found complex increasingly or in socializing the from andofficials, local gentry, especially between physicians, socialrelations with oftransmission, pubmodes indominant a shift Wu Yiyihasfound period. Jin the masteroutside andpractice up access to medicalknowledge lishers opening of self-taught to theappearance a development contributing relationship, disciple to on claims to be based "schools" increasingly medical He finds many physicians. of transmission than on direct knowledge.50 rather common principles of thelater in studies remain andtheroleofprinting important Social relations Marta of Suzhou Chao's study physicians. as well,as inYuan-ling imperial period Huizhou texts of medical distribution and thepublishing by Hansonhas examined meansof increasing resonant as a morally in theseventeenth century merchants ofhow ofpublishing, oftherolesandprocesses Suchcloseanalysis socialprestige. of feature Hanson's also a is which and for are chosen key markets, andtexts authors school inSuzhou.51 Factor Warm ofthe oftheestablishment inherstudies approach
48 Li techniques ofsecret The transmission (Jinfang: kaolun" gudai'jinfang' "Zhongguo Jianmin, jikan, 1997,68(1):117-166;and yanjiusuo yuanLishi Yuyan yanjiu China),Zhongyang in ancient Scholarly andthe inKnowledge Medicine," inClassicalChinese "TextandExperience Sivin, Nathan ed. Bates(cit.n. 29), p. 194. MedicalTraditions, of 49Bodenschatz, Praxis"(cit.n. 33); andLeung,"Transmission als neokonfuzianische "Medizin theSungto theMing"(cit.n. 35). from MedicalKnowledge (cit.n. 1); andWu Yiyi,'A Medical yu "ruyi" shiren" LiangSongde "Shangyi 50 ChenYuanpeng, theJinto of Liu Wansuand His Disciplesfrom Study A Prosopographical Line of ManyMasters: Chin.Sci., 1994,no. 11,pp. 36-65. theEarlyMing," of (cit. n. 37); Hanson,"Merchants and DelicateSoutherners" 51 Hanson, "RobustNortherners Medicine" in Chinese (cit.n. 37). a Tradition (cit.n. 37); andHanson,"Inventing Medicine"
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work has shown howtheselective assimilation BridieAndrews's of features of intheearly involved twentieth models medical andinstitutional the Western century oftransmission andproduction of knowledge, introduction of newprocesses such in schoolsand medical texts andteaching as themassproduction of standardized andtheir to modesofreasoning hospitals. Suchprocesses oftransmission relation ofmedical in three andpractice are at thecenter ofElisabeth Hsu's study training in Yunnan Hsu compared thetransmission at theend of the 1980s.52 settings of medicalknowledge on thebasis of fieldwork as a student enrolled at theYunnan MedicalCollege, as a participant inthereading Chinese seminars ofa senior doctor inprivate andas anobserver atthe practice, ofa neighborhood healing performances in theformal qigong healer. She found numerous areasof standardization setting of theChineseMedicalCollege,reinforcing theview thatsuchinstitutions have introduced in thepractice greater ofChinese uniformity medicine. Systematization andstandardization which ofknowledge, wereunderstood as keyto a scientific approach, were explicitly valued. "Standardization"-that is,treating pupils equallywas also expected in therelationship between teachers and students. Student and staff timeand space werehighly and impersonal, structured, controlled, although there was great tolerance forsomeidiosyncrasies and respect fortheprivacy of thespace(ofapproximately twosquare aboveeachstudent's meters) bed.Although students were toldnottoapply theinformation intheir textbooks mechanically, Hsu sawmuch routinized intheacupuncture treatment wards ofhospitals. Whileknowlwereconsidered edgeandpractice to eachother, shenoted integral a separation of from in classroom theory practice that techniques divorced thelearning of theory from practical situations andfixed theknowledge inclassical texts instandard modernChinese. She found with continuity earlier practices oftransmission in,for exstudents' ample, rote memorization oftextbook passages. The senior doctor's with relationship hisstudents, characterized as a relationship between mentor and followers, was morepersonal thansuchrelationships at the Chinese MedicalCollege.He required hisstudents tomemorize substantial passages of classicaltexts, nottextbooks. Theywerenottested on thisknowledge or even tounderstand expected the texts. Understanding wasexpected toemerge not through inmodern explication Chinese butas sudden insight inthecourse offuture practice. The senior doctor referred topassages ofclassical texts inorder toclarify particular situations found inmedical Liketherelationship practice. between teacher andstutheknowledge dent, wastaken conveyed tobe profound andpersonal. A disciple oftheqigonghealer, Hsufound, wasdependent ondirect oraltransmiswas secret. sion,which Herethewritten worditself was potent, thepower to heal notfrom themeaning, coming either personal orfixed, ofthetext, butfrom correct withcorrect performance, pronunciation, of theincantation. Hsu showed thatin these three contexts thenature oftheteacher-student (ormentor-follower ormasterdisciple) andtheorientation relationship toward thetext hadprofound implications for thenature oftheknowledge conveyed. Thesestudies havetended tocenter on thesocialrelations ofphysicians ormedical teachers andstudents in thetransmission ofmedical knowledge whilebringing broader setsofsocialrelations tobearon theanalyses as well.Several recent works
52 Andrews, "Making ofModemChinese Medicine" (cit.n. 5); andElisabeth Hsu,"Transmission ofKnowledge, Texts, andTreatment in Chinese Medicine" (Ph.D. diss.,Univ.Cambridge, 1992).
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havebegunwithsucha widerscope,dealing with the"selective assimilation" of Western medical andpublic health approaches intwentieth-century China as a negotiated process. Among the features that separate these from earlier works is abandonment of theassumptions that Western medicine andinstitutions weresuperior and that Western models were accepted becauseoftheir greater prestige or"imperialist" pressures; instead, they paycloser attention totherolesofdiverse actors outside the state. Earlier approaches had pictured thedisplacement of indigenous byWestern models as causedbynative weakness orattributed thebelated adoption ofWestern medicine and institutions to ignorance, corruption, and self-seeking. We are now a picture getting ofthe rejection oradaptation ofparticular Western models inparticularsituations for varied purposes. We areseeing processes ofintegration between Western and Chinesemodels, rather thantheir complete incompatibility and the substitution ofonefor theother. Finally, we areseeing ever-shifting resistance toor use ofthese in varied models bydiverse groups andunexpected fashions.53 We can see thisin CarolBenedict's study ofresponses to bubonic plaguein the nineteenth century. Benedict rejects theviewthat Western-style state-centered publichealth measures were superior andthe reading ofacceptance orrejection ofthese as an issueofrational atthecomplex behavior. She looksclosely considerations of those whoimplemented suchpolicies andatthereasoning ofthose whorejected or them. British administrators to the1894 epidemic accepted responded of bubonic thehomesand bodiesof plaguein HongKong with draconian measures against a reaction of thegerm based notonlyon their Chineseresidents, understandings via theratfleavector) buton viewsof did notinclude transmission theory (which resistance theChinese as dirty andas sources ofcontagion. Chinese to,for example, in thefaceof a to tradition was based noton a stubborn hospitalization clinging butin largepart on medical as British administrators superior system, maintained, intheclinics as 90 percent.54 rates ranas high thefact that fatality Red CrossSociety, an Reeves'sstudy oftheearly oftheChinese Caroline years thedevelopment in 1904,shows of founded indigenous, quasi-private organization WestChinese with that combined andcharitable newforms oforganization activity theChinese Red links to an international ernmodels. Besideshaving organization, medical care.On andprovided Crossestablished quarantine hospitals Western-style Reeves in "traditional" forms ofcharitable italso engaged theother hand, activity. in civiclifebyincreasingly broadsegments a growing demonstrates participation andsubverts thestatic of a one-way flow of of theChinese population conception whether the to theperiphery, whether thestate or theWest, thecenter, ideas from to showhowthelocalandtheglobalinteracted.55 orChina, community orcharity, of"medical while hadforms China Intheimperial period, governance" to some theclearing ofwaterways disaster including relief, (thought by helpprevent were notidentified orconceived these ofmedicines, andthedistribution epidemics),
ofModemChinese see "Making Andrews; favored byBridie is theterm assimilation" 53 "Selective in China,1895ofGerm Assimilation Theory andthe "Tuberculosis See also Andrews, Medicine." MediWestern versus "Chinese J.Hist.Med.AlliedSci., 1997,52:114-157;Zhao Hongjun, 1937," Plague in China'sPast,"in "Framing China (cit. n. 22); and Carol Benedict, Nineteenth-Century
Calif.: Stanet al. (Stanford, Remapping China: Fissures in Historical Terrain,ed. Gail Herschatter cine" (cit. n. 5); Zhao, Jindai Zhongxiyi lunzheng shi (cit. n. 5); Benedict, Bubonic Plague in
ford Univ.Press,1996). 54 Benedict, Plague." "Framing China;andBenedict, Plague inNineteenth-Century Bubonic 55Reeves, (cit.n. 27). ofMercy" "Power
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to modem Western notions of"public as something health." In a quitecomparable out of a sphere of "publichealth," RuthRogaskitraces of thecarving study the andpractices associated with theterm, course ofchanging meanings that weisheng, health onTiantorefer toWestern-modeled was adapted public measures, focusing andmid-twentieth centuries. Theconcept jin between themid-nineteenth expanded to sanitation from moreindividual-oriented healthor hygiene practices policies based on the germtheory. the development and institution Rogaskifollows of of negotiation Western-modeled publichealth policiesthrough complex processes andresistance. andadopted elites both as a means Theywereadvocated byChinese ofextending state control andfor thepurpose ofasserting Chinese autonpolitical Western encroachment. Under thePeople'sRepublic ofChina, omyagainst public weretiedclosely health mobilizations tothenation-building project.56 HughShapiro inwhich hasexamined theways discourses ofandbehavior around thecategories ofinsanity andspermatorrhea inthis In 1930s changed early century. thelegal labelof "insanity" Beijing, served thepurposes of policewhohad to remove thestreets andtheinterests ofmedical peoplefrom whowanted professionals to maintain in psychiatric for subjects institutions. Forpatients, study thelabelwas anddeployed as a means ofescapeandresistance. experienced tradiSpermatorrhea, an affliction ofthewell-to-do, wasfrom tionally the1920sincreasingly a complaint of thepoorand socially marginal. It becameincreasingly less associated with the overexertions oflabor, andsexualindulgence study, andmore identified with sexuallytransmitted diseasesanddiscourses ofneurasthenia from adapted theWest. In thecases of bothinsanity and spermatorrhea, Shapiro traces a complex interplay between healerand patient viewsand between Western medicaland local underofthebody. standings Theseunderstandings became implicated in sexual, political, andnationalistic ofthetime.57 preoccupations "West"/"China," Theshift ofattention from essences, continuities, andlinear progress tomultifacetedprocesses ofchange-transmission, transformation, appropriation, negotiation, resistance, reconfiguration, construction-exposes thecomplexities anddiscontinuitiesof change. As change is shown to be nonlinear, so arepractices shown to be Whilethedimensions nonunitary. oftime andspacearenotproperly separated, certain approaches havebeenparticularly suited todealing with thediversity ofChinese medical practices.
FROM UNITIES TO DIVERSITIES
Where has beennoted in medical heterogeneity traditions, it is usually associated with theabsenceofinstitutional basesforstandardization andprofessional identity that is considered characteristic of premodernity. The institutional bases of traditionalChinesemedicine in contemporary mainland China-such as ongoing atto achieve tempts standardization andunification sinceearly inthecentury andthe centralized control ofeducation andregulation ofpractice sincethe1950s-do appeartobe contributing tohomogeneity. Nevertheless, ithasbeenapparent tomany observers in somerespects that these features haveintroduced additional elements
Rogaski, "From Protecting LifetoDefending theNation"(cit.n. 27). HughShapiro, "The Viewfrom a Chinese Asylum: Defining Madnessin 1930sPeking" (Ph.D. diss.,Harvard Univ.,1995); andShapiro, "The PuzzleofSpermatorrhea inRepublican China," Positions, 1998,6(3):551-596.
56 57
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paradigm.58
diversity to ongoing factors contribute other moreover, of changeand diversity; Chinese andWesttointegrate Movements settings. institutional andoutside within to contrary diversity, andpractical theoretical multiplied havefurther ernmedicine mediofChinese reduction couldleadtothe that suchintegration predictions earlier biomedical intoa dominant and drugsincorporated cine to isolatedtechniques
hasbeenan or"modem," "traditional" practices, healing ofChinese Theplurality conscholarship broadareasin recent interest. Three focusofscholarly increasing local sources ofhomogeneity: as wellas identifying heterogeneity ducetorevealing and within to multiplicity andattention health practices, studies ofdiverse studies, between bodiesandselves. Geography appreciation an increasing arepromoting ofrecent decades finds Thearchaeological to someextent of Thisis also true in ancient cultures. Chinese ofregional variation although they Chinese medicine, so muchaboutearly that haverevealed thefinds on later as well.In scholarship elitemedicalculture to a common pointstrongly collected writings, localgazetsuchas individuals' which localsources for periods, considthis trend toward abundant, andarchival sources aremore inscriptions, teers, medical workshows, As MartaHanson's is moremarked. medical diversity ering This baseddifferences. inrelation togeographically have beenconstructed traditions werecreated, distinct practices geographically as welltoprocesses bywhich points had beenfoWhileforsometime or combined.59 scholarship mademoredistinct, have researchers more recently between ChinaandtheWest, cusedon thedivisions localperspectives. inboth more globalandmore beeninterested an increaswe areseeing theworld, around medicine With thespread ofChinese Thishaslong China. outside as practiced medicine ofstudies ofChinese ingnumber medicine havebeenpracticed ofChinese where varieties beenthecase for Japan, theUnited medicine ofChinese example, nowwe havestudies in,for for centuries; are whether to specify it necessary are finding Scholars they StatesandEurope.60
58 On factors andTreatTexts, ofKnowledge, see Hsu,"Transmission tohomogeneity contributing China(cit.n. 11), p. 23. On Medicinein Contemporary (cit.n. 52); and Sivin,Traditional ment" "PluralinChina(cit.n. 13),p. 260; Scheid, Medicine see Unschuld, todiversity contributing factors of ChineseMedicine"(cit. n. 40); and Hsu, "Transmission in Contemporary ityand Synthesis andTreatment." Texts, Knowledge, 59 See Hanson, "Merchants Medicine" (cit.n. 37); andHanson, a Tradition in Chinese "Inventing Praxis" als neokonfuzianische (cit.n. 33). "Medizin (cit.n. 37). See also Bodenschatz, ofMedicine" China:NewDiscoveries ofAncient ed.,Mysteries Rawson, see Jessica finds On thearchaeological morespecifiPress,1996).On thosepertaining Museum (London:British theEarlyDynasties from de lai Zhongguo wunian yanjiu "Jin yixueshi and Zhu Jianping, see Li Jingwei callyto medicine (cit.n. 18). jinzhan" intheContext ofChinese HealingPractices A History Pursuits: "Alternative 60 E.g.,LindaBarnes, Focus on theCityof Boston"(Ph.D. withan Ethnographic and Medicines Religions ofAmerican in Europe," of Acupuncture Hsu, "Outlineof theHistory Univ.,1995); Elisabeth diss.,Harvard (Chinese Kampoyaku ChineseMedicine,1989,29:28-32; AkahoriAkira, of Traditional Journal in UrLock,EastAsianMedicine Daiichihoki,1988); Margaret (Tokyo: medicine) pharmaceutical Univ.California Press,1980); and Yasuo (Berkeley: ofMedicalExperience ban Japan: Varieties ed. Leslie (cit.n. 9), inAsianMedicalSystems, Medicinein Japan," Traditional Otsuka,"Chinese pp. 322-340.
311
at Chinese as practiced in China-and, if so, where looking in Chinamedicine orelsewhere. Forsometime Japanese scholars havebeeninterested inhistoric connections between as between cultures, andin EastAsia as a India,China,Korea,andJapan, unit forthestudy of medical history.6' In China, interest in historical berelations tween Chinese andother cultures has increased sincethe1980s,with an impact on ofmedicine. studies Chinahasalso seena growth instudies ofthemedical practices ofethnic minorities. With increasing interest inlocalcultural identities, both Taiwan andChinahaveseenintensified work in studies oflocal medicine andhealth practices.62 Thesestudies challenge theviewofChina, andthus ofChinese medicine, as bounded andmonolithic. Theyarebeginning tobuilda picture ofregional variation and to clarify theprocesses by which medical practices spread and,in spreading, transform. Whileanthropological has longbeenconcerned work with local cultures, with thevillagerather than with Chinaas a whole, regionally delimited focuses are an increasingly well-established trend inthe practice ofChinese history. Through these, we arebeginning togeta finer picture ofhistoric local variation in Chinese healing cultures. Besideslocallyfocused histories, we are also seeingmore local detail in
61 Earlier of histories examples of East Asian medicine includeOtsuka Keisetsu, Thyiigakushi (History ofmedicine inEastAsia) (Tokyo: Shunyod6 shoten, 1982);Fujikawa YiI,Toyc igakuigaku bunkashi (Cultural ofEastAsianmedicine) history (Kyoto:Shibunkaku shuppan, 1980); andNagahama Yoshio,Toy5 igaku gaisetsu ofEastAsianmedicine) (Outline (Osaka: Sogensha, 1961).Studies of religious influences on Japanese havealso included culture works relevant to thehistory of medicine. Kubo Noritada has written on thekoshin extensively (inChinese, from gengshen) its cult, in thecontext development of Daoist practices in Chinato itshistorical in Japan. transformations One of thefewDaoist cultsto takerootin Japan, it is devoted to expelling thedemonic "corpse worms," three of a multitude of spirits taken to inhabit thebodyfrom birth. These"corpseworms" exert to undermine themselves their host'shealth, to be freed hoping from thebodywith itsearly demise. See Kubo Noritada, Koshin shink5 no kenkya: Nichi-Cha bunka shi(Study shaky5 koshM of koshin beliefs:History of connections between thereligious cultures of Japan and China)(Tokyo: Nihon gakujutsu shink6 kai,1961);Livia Kohn, A Taoist "Koshin: CultinJapan, Pt.1: Contemporary Practices; Pt. 2: Historical Pt. 3: The Scripture-ATranslation Development; of theKoshinky6,' Japanese Religions, 1993,18(2):113-139,1995,20(1):34-55,20(2):123-142.Also noteanalyses of Daoist "nurturing life"practices in Korea and Japan in Sakade Yoshinobu, to yoseishis5 Dokky5 (Taoism andcultivating lifethought) (Tokyo: Perikansha, 1992),pp. 257-266;analyses ofinfluences among ancient medical in Kan6 Yoshimitsu, cultures no tanJf Chtigoku igaku (Thebirth ofChinese medicine) (Toy6sosho,2) (Tokyo: Tokyo daigakushuppankai, 1987); and theEast Asianfocusof theconference volume Toyo igaku nyumon-Nichi-Cha shimpojiumu no kiroku (Introduction toEast Asianmedicine: Proceedings ofJapan-China ed. Nihon Symposium), Toy6igakkai (Tokyo: Yomiuri shimbunsha, 1990). 62 Interest in historical relations between Chinaandother cultures is noted in Li Jingwei andZhu Jianping, "Jin wunian lai Zhongguo yixueshi yanjiu de jinzhan"(cit.n. 18). See, e.g.,Ma Boying, Gao Xi, andHong Zhongli, Zhong-Wai yixue wenhuajiaoliu shi(The history oftheflow ofmedical culture between China and foreign countries) (Shanghai:Wenhuachubanshe, 1993); and Wang Xiaoxian, Sichou zhiluyiyaoxuejiaoliu yanjiu ofthe (Study exchange ofmedical andpharmaceutical learning alongtheSilk Road) (Urumchi: Xinjiang renmin chubanshe, 1994). On themedicalpracticesofethnic minorities see Li andZhu,"Jin wunian lai Zhongguo yixueshi yanjiu de jinzhan." On local medicine andhealth practices see Lu Zhaoji,"CongZhonghua yishi zazhikanwoguode yishi yanjiu" (cit.n. 17),p. 5; andLin Chung-hsi andFu Daiwie,"Lishizhongde Taiwan kexue:guanyu 'Taiwan kexueshi' yanjiu de huigu yujiantao" (Taiwan's science inhistory: Reviewofthehistoriographyof"Taiwan's history ofscience"), Xinshixue, 1995,6(4):165-199.Thisscholarship is tooprolific to citecomprehensively, butmonograph-length examples includeCeng Yong,ed.,Xiangyi yuanliu lun(On thesources ofXiangmedicine) (Changsha: Hunankexue jishuchubanshe, 1991);andYang Jianrui, ed., Qizhouzhongyao zhi (Chronicle of Qizhou's Chinesepharmaceutics) (Shijiazhuang: Hebeikexue jishuchubanshe, 1987).
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studies, forexample, of particular plaguegod cults.Cleardelineation of thegeographic spread of suchcultsandtheir local contexts has beenfound indispensable to their analysis.63 By focusing on localdynamics, oninteractions between particular officials, other bureaucratic personnel, clergy, landowners, merchants, physicians, andperipheral andless empowered groups, we geta more nuanced picture ofthenegotiated processesbywhich newforms ofpractice andknowledge emerge, eliteandlocal cultures interact, andvarious institutions become resources for asserting interests and ofconflict for sources different local groups andindividuals. HealthPractices The anthropological focus on localcommunities andthewider ofpopular array exandpractices with more broad-based movements valperiences has,incombination in general nonelite of history and medical orizing cultures, influenced thefields A on in focus life across a widerange ofWestern history particular. daily apparent is increasingly influential inTaiwan.64 is immehistorical scholarship Great diversity when do to maintain we decenter medicine andlookatwhat diately apparent people in 1995, health andmanage illness. someoftheTaiwanese Reviewing scholarship Tu Cheng-sheng that ofchildbirth, old age,and thehandling argued illness, health, oflifeandtherefore ofa socialhistory that takes sodeath areall essential aspects ofdialectical A shift from broadforces materialism of attention cial lifeseriously. in practice is also evident in recent movements to healing and from revolutionary works tomine haveseenmore Thelastfewyears mainland scholarship.65 attempting
63 See, e.g.,Paul Katz,Demon inLateImpeBoats: TheCultofMarshalWen HordesandBurning A God's Own Tale: F Kleeman, rial China(New York:StateUniv.New YorkPress,1995); Terry theDivineLord ofZitong(SUNY Seriesin Chinese of Wenchang, TheBook of Transformations StateUniv.New YorkPress,1994); andTanaka Issei,Chagoku (Albany: and Culture) Philosophy of local in China:The backgrounds (Villagefestivals gekino kankyo5 chihJ saishikenkya: kyoson 1989). daigaku, jo, Tokyo kenkyd (Tokyo: theaters) Toy6bunka 64 Thisbasic shift in theWestin the1970sand 1980s.See, e.g.,Kleinman, emerged in approach in of Curing (cit. n. 13); Sivin,"Social Relations of Culture and Healers in theContext Patients China"(cit.n. 13); Topley, and Curein Traditional China"(cit.n. 13); Sivin,"Ailment Traditional Topley, ofCureinHongKong"(cit.n. 10); andMarjorie andMethods Etiology Traditional "Chinese ofVariation, Determinants inHongkong: Some Social andCultural Medicine andWestern "Chinese etal. (cit.n. 13), ed. Kleinman andHealinginAsianSocieties, in Culture andChange," Interaction, in China Medicine See also Unschuld, problem. as a central takeplurality Theseworks pp. 111-142. by thesmall has beenexplicitly supported scholarship Taiwanese (cit.n. 13). This focusin recent Xinshixue ("New Hisin 1992,andbythe journal andCulture," founded "Disease,Medicine, group Culture ofPopular tothe"History devoted in 1990.In thespecialissueofXinshixue founded tory"), that to social history a Chineseapproach proposes and Daily Life" (1992, 3[4]), Tu Cheng-sheng andholistimore organically "human (renqun) groups" treating on sociallife.Tu advocates centers andtheir defined) andsociety (narrowly economy, of government, thedivisions goingbeyond cally, andAmerican inthePeople'sRepublic) ofMarxist (influential that arecharacteristic causalrelations wouldgo to unconventional Tu's "newsocialhistory" inTaiwan)models. socialscience(influential butexpand scholarship andwouldbuildon previous andmiscellanies suchas encyclopedias sources that aspectsof dailylife.This is a social history social,and spiritual thematerial, to encompass of at theentirety butlooks instead of history as a separable component society eschewstreating shi"(cit.n. 23). shixinshehui of society. See Tu, "Shenmo theviewpoint from history see Li on themainland de yiliaoshi" (cit.n. 21). Forwork "Zuoweishehuishi 65 Tu Cheng-sheng, de jinzhan"(cit.n. 18); and yanjiu yixueshi wunian lai Zhongguo "Jin and Zhu Jianping, Jingwei (cit.n. 17). yanjiu" vishi zazhikanwoguode yishi Lu Zhaoji,"CongZhonghua
313
formorediverse fiction sources viewsof childbirth, and other and contraceptive, andillnesses, health andhealers andhealing practices, patients practices.66 We can see a shift ofattention from ofcoherence sources to analyses ofplurality evenin workconcerned withtheperspectives and current of orthodox practices Chinese medicine. Volker Scheidtakestheplurality ofChinese andcontradictions with theattendant medicine, theoretical ofdeveloping a nonessentializing, problems nonreductionistic as thefocusofhiswork analytic approach, on Chinese medicine in contemporary China.He finds thevariation intheways doctors of contemporary traditional Chinese medicine andtreat so great diagnose he suggests, "itwould that, be most ifafter unusual, indeed, tensenior consulting for doctors the samecomplaint one wouldnotwalkawaywithtendifferent herbal prescriptions." Insteadof attoextract tempting fundamental unities outofthe chaosofethnographic data, Scheid focuses on theprocesses bywhich medical practice andknowledge emerge. Rather thanfinding Western and Chinesemedicine as do approaches incommensurable, that treat them as discrete and abstracted systems, he finds effective integration in clinical practice.67 in anthropology Studies andreligion havealso longlookedatvarieties ofhealthrelated practices considered to be outside thescopeof medicine; thus, considered theplurality broadly, ofhealth carepractices has longbeenapparent. Morerecent works haveextended theanalysis ofplurality inChinese healing practices andtaken it in new directions. The disciplinary isolation of thesacredfrom thesecular has broken down. ofcarearetreated Varieties less as isolated systems of,for example, Buddhist, Daoist,shamanic, ormedical healing.68 Daoistandreligion studies havespawned numerous works relevant tohealth and healing practices, from investigations ofesoteric vitality cultivation practices toshamanichealers to plaguegod cults.69 Numerous recent works havedealtwith these
66 See, e.g.,Che-chia Chang,"TheTherapeutic Tug-of-War: TheImperial RelaPhysician-Patient intheEra ofEmpress tionship Cixi (1874-1908)"(Ph.D. diss.,Univ.Pennsylvania, Dowager 1998); Daria Berg,"Die Heilkunde Chinasim Spiegeldes RomansXingshi yinyuan zhuanaus dem 17. ChinaMed, 1995,3(6):59-61; Berg,"The Xingshi Jahrhundert," yinyuan of Utopia zhuan:A Study and thePerception of theWorld in Seventeenth-Century ChineseDiscourse"(Ph.D. diss.,Oxford Univ.,1994); Christopher andHealersin Late Imperial Cullen,"Patients China:Evidence from the Jinpingmei," History ofScience,1993,31:99-150;Zhu Hong,"Women, andHospitalization: Illness, ImagesofWomen in Contemporary Chinese in Engendering Fiction," China: Women, Culture, and theState, ed. Christina K. Gilmartin etal. (Cambridge, Mass.: Harvard Univ.Press,1994),pp. 318338; Francesca Bray, Technology and Gender: FabricsofPowerinLate Imperial China(Berkeley: Univ.California Press,1997); Bray, "A Deathly Disorder: Understanding Women's Healthin Late Imperial inKnowledge China," and theScholarly MedicalTraditions, ed. Bates(cit.n. 29), pp. 235251; Charlotte Furth, A Flourishing Yin:Gender in China'sMedicalHistory, 960-1665 (Berkeley: Univ.California Press,1999); Yoshimoto Shoji,"Kimpeibai to doky6 igaku"(The Jinpingmei and Daoist medicine), Tohei shuikyo (Eastern religion), June1992,no. 79, pp. 36-52; and Yoshimoto, ni mieru "Kimpeibai ChUgoku igaku"(Chinesemedicine as seenintheJinpingmei), Nihon ishigaku zasshi,1992,38(1):133-161. 67 Scheid, andSynthesis "'Plurality in Contemporary Chinese Medicine" (cit.n. 40), Ch. 2, pp. 2, 1 (quotation). 68 See, e.g.,Hsu,"Transmission ofKnowledge, Texts, andTreatment" (cit.n. 52). 69 De Groot is still a rich source for historical accounts andfor thelatenineteenth-century practices he observed in Fujian.See J.J.M. De Groot, TheReligious System of China: ItsAncient Forms, Evolution, History and Present Aspect, Manners, Customs, and Social Institutions Connected Therewith, 6 vols. (1892-1910; rpt., Taipei: Southern Materials Center, 1982). Also of note is Henri Maspero, "Methods of 'Nourishing theVitalPrinciple' in theAncient Taoist Religion" (1937), rpt. in Maspero, Taoism and Chinese Religion, trans. Frank A. Kierman (Amherst: Univ.Massachusetts
314
TJ HINRICHS
andanthropologiobservations ethnographic contemporary byintegrating subjects or regions on particular focusing research, historical with detailed cal perspectives local cases to Chinaas a from carenotto generalize cults, and taking particular and practices, in representations multiplicity great whole.Besidesdemonstrating havegivenus a festivals studies of plaguegod cultsandplagueexpulsion recent inChina.70 toepidemics responses inreligious variation picture ofregional richer theold inquiry, areasofanthropological Whilethese havebeenwell-established as thearena tomark them havetended andthesecular between thesacred divisions Historians from medical history.7' domains apart andmagic, healing of apotropaic from medicine "superstiaspectsof Chinese rational or "scientific" distinguished as thelatter of progress and denigrating theformer as evidence tion," valorizing ofthevicwas that ofearly periods ofan unenlightened past.The story "vestiges" overshamanism andsuperstition. andrationalism ofmedicine tory itinsimplistic toDaoism, related onChinese medicine ways Someearlier writings to do with,forexso broadlyas to includeanything the latter often taking Scholorpopular breath cultivation religion.72 techniques, yin/yangthought, ample, to the has longdrawn attention and Daoiststudies outof religious coming arship
health to religious their attention turned scholars and French Press,1981),pp. 431-554. Japanese and HealinginAsian et al., eds., Culture in Kleinman in the 1960s.See also thestudies practices of in a Taiwanese Village:A Study "Sacredand SecularMedicine (cit.n. 13),e.g.,Ahern, Societies Physician." ThePlagueGod as Modern "Ong-ia-kong: andGould-Martin, Disorders"; Cosmological ofHealing Traditions Buddhist "Chinese Raoul Birnbaum, include healing of Buddhist Treatments TradiReligious in theWorld's HealthandMedicine inHealingand Restoring: andtheLifeCycle," TheHealing 1989),pp. 33-57; Birnbaum, (New York:Macmillan, E. Sullivan ed. Lawrence tions, in China(cit.n. 13),pp. 132-153; Medicine 1979);Unschuld, Colo.: Shambhala, Buddha(Boulder, (1937), Hobogirin Article"Byo"from and Healing:Demievilles Buddhism and Paul Demieville, 1985). Md.: Univ.PressAmerica, MarkTatz(Lanham, trans. theGods:The CultofFiveEmperors 70 See, e.g.,MichaelSzonyi, ofStandardizing "The Illusion 1997,56(1):113-135;Katz,DemonHordesand ofAsianStudies, Journal China," in Late Imperial de shijie:bei Taiwande liguixinyang yuguixiong Guhun Boats (cit.n. 63); Lin Fu-shih, Burning Taiwan) in Northern spirits Beliefsin malicious heroes: andghostly spirits oforphaned (The world Daoxiang li wenhuazhongxin, daxi,4) (Banqiao,Taiwan:Taibeixian yu shehui (Beixianxiangtu of this functions God's Own Tale (cit.n. 63) (on plague-suppressing 1995); Kleeman, chubanshe, choushen (Nuo: Exorcising zhuyi, Nuo: qugui, cultsee pp. 43, 107-111);Guo Jing, Sichuan-based (HongKong: Sanlian congshu) wenhua thegods) (Shenmi thanking epidemics, expelling demons, xisu zhi yanjiu," Hewen,yu songwang wangchuan, "Donggang 1993); and Li Fengmao, shudian, zongjiao,1993,3:229-265. Dongfang andcontinued it accepted healers, on shamanic work also focused 71 Although earlier Kleinman's realms. andsecular ofthesacred division With Special 72 See the "On theWord'Taoist'as SourceofPerplexity: inNathan Sivin, discussion Philosophy, in Medicine, in Traditional China," of ScienceandReligion to theRelations Reference Sivin arefollowing scholars China(cit.n. 25), pp.VI.303-330.Increasingly inAncient andReligion more Daoism and adopting and philosophical between religious in distinguishing and Strickmann recognize that togroups limitation proposed suchas Strickmann's oftheformer, definitions restricted in of T'ao Hung-ching," "On theAlchemy MichaelStrickmann, patriarch: Zhang Daolingas their ed. HolmesWelchand Anna Seidel (New Haven, Religion, Facets of Taoism:Essays in Chinese Boats(cit. Conn.:Yale Univ.Press,1979),pp. 123-192.See, e.g.,Katz,DemonHordesandBurning "Daoist"to all ofthecategory theloose application n. 63), pp. 37-38.Elena Valussihas challenged inner on "nourishing ofSunSimiao's(581?-682)section In a textual study life"practices. "nurturing yaofang), inGold(Qianjin a Thousand Worth Prescriptions treatise inhismedical (yangxing) nature" orunderstanding, leveloftruth fora higher search the"mystical itlacks,for example, that shefinds and to verywell-known he is "referring she finds evidencethat Rather, or evenforimmortality." of history in theChinese hada longtradition that practices in hisowntime, practices spread widely of people."See Elena Valussi, availableand used by themajority wereprobably healingand that School in Sun Simiao'sQianjinyaofang"(M.A. thesis, Nature' Inner on 'Nourishing "The Chapter Univ.London,1996). andAfrican Studies, ofOriental
315
between and immortality connections cultivation and medilongevity techniques be ignored cine.Itcanhardly that the ridding bodyofdiseaseandmaintaining health toimmortality areintegral andlongevity that several medical classicsappractices, pearin theDaoist Canon,that in more areincluded longevity techniques comprehensive medical andthat all these contain works, shared ofhealth views andvitality. Thedivision between sacred andsecular hasposeda problem inmuch ofthis literature, totreat which tended themedical as natural andthe object Daoistobject as spiritual.73 Moving beyond areasofclearoverlap between thetraditionally distinct fields of Daoismandmedicine to shamanic andplaguegodcults, healing research has been vexedby someof thecentral of Chinese problems history, andrelianthropology, giousstudies: clarifying relations between Daoism, andpopular Buddhism, religion, between eliteandpopular culture, between state andlocal cults, andbetween "Chinese"andlocalcultures. A persistent inthese problem works hasbeenthedemarcationof thesevarious spheres. Recent writers havetackled theseproblems through focused geographically and historically extended studies, rigor and specificity in identifying Daoistandother influences, andattention toa widerange ofsources in determining therolesof different actors involved in theemergence, practice, and ofparticular spread cults. Also notable among scholars working in these areashas been theextensive crossover between anthropology and history in their works, in thesecondary materials on which they inthemethods rely, they employ, andin the forums in which they publish. Putting together theflood ofrecent anthropological, literary, andhistorical scholthat arship has comeoutofmainland Chinasincethe1980s,andbuilding on substantial primary research, Guo Jing has produced a useful overview of nuo (exorcistic) festivals for the expulsionof plague demons.Guo describes not only historical change, butgeographic, ethnic, andsocial(identifying, for example, distinctive palace,village, and military nuo) diversity in nuo practices. He bases his work in parton studies of theatrical aspectsof nuo performances suchas songs, dances, masks, makeup, andcostumes. Suchstudies havebeenfruitful in mapping
73 On studies relating medicine toDaoisminthecontext ofJapanese Daoiststudies see LiviaKohn, "TaoisminJapan: Positions andEvaluations," Cahiers d'Extreme-Asie, 1995,8:389-412,on p. 392. Some recent works that deal with Daoisthealth andmedicine practices include Sakade Yoshinobu, Doky5toyoseishise(cit.n. 61); andYoshimoto Shoji,Dokyel to fur5chlju no igaku(Daoism and themedicine of non-aging and longlife)(Tokyo:Hirakawa shuppan, 1989),a work that has been translated intoChineseand published in Taiwanand thePeople'sRepublicand also intoKorean ("Kimpeibai to doky6 igaku"[cit.n. 66], p. 47 n 1). For a shorter overview see Yoshimoto, "Doky6 toChugoku igaku"(DaoismandChinese inDoky5:Diky5no tenkai medicine), (Daoism:Thedevelopment of Daoism),ed. Fukui Kojunetal. (Tokyo: Hirakawa shuppan, 1983),pp. 257-310.There are essaysby majorscholars in Kohn,ed., Taoist Meditation and Longevity Techniques (Michigan inChinese Monographs Studies, 61) (AnnArbor: Center for Chinese Studies, Univ. Michigan, 1989); andin Sakade Yoshinobu, ed., Chfigoku kodaiyoseishisel no selgelteki kenkyu (Collective studies on theideasofcultivating lifein ancient China)(Tokyo: Hirakawa shuppansha, 1988).See also Catherine Despeux,La moelledu phenixrouge:Santeet longuevie dans la Chinedu XVI sikcle(Paris: Tr6daniel, 1988); Despeux,Prescriptions d'acuponcture valantmile onces d'or (Paris:Tr6daniel, 1987); Ute Engelhardt, Die klassische Tradition der Qi-Ubungen: Eine Darstellung anhanddes Tang-zeitlichen Textes Fuqi jingyi lunvonSima Chengzhen (Munchener Ostasiatische Studien, 44) (Wiesbaden: Steiner, 1987); andJudith Magee Boltz,"TaoistRitesofExorcism" (Ph.D. diss.,Univ. California, Berkeley, 1985). For a discussion of someof theproblems inherent in dealingwith the natural andtranscendent in Daoistpractice anda review ofEngelhardt's Die klassische Tradition der Qi-Ubungen see Kohn,"Medicine andImmortality inT'angChina," Journal ofthe American Oriental Society, 1988,108(3):465-469.
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levels,linksbetween and community groups, ethnic acrossregions, affiliations and songs, andfolk rites, religious for songs performances, usedintheatrical songs ofperformance.74 aspects shamanic and that sawtheemergence in nuo culture a transition has clarified Li Fengmao toepidemics responses ofandnewritual explanations ofnewdemonic development of theinfluence include (420-589). Key developments period in theSix Dynasties behavior anddemonic ofgodly modelin understandings bureaucratic theimperial pundivine administered as a bureaucratically ofepidemics andtheunderstanding newmodels of these in theemergence Daoisminfluential WhileLi finds ishment. culture Daoismandpopular between interaction healso see a complex ofthedivine, andexpelling forwelcoming andrites ofcultsto thesedeities in thedevelopment plaguegods.5 to viewlocal scholars Daoismstudies among tendencies Paul Katzhas observed of influence tosee little socialhistorians toDaoismandamong as subordinate cults of and spread on theemergence In hiswork study. Daoismon thelocal cultsthey to go beKatz attempts Wenin Zhejiang, godMarshal cultsoftheplague-fighting ofDaoist attheinvolvements more closely bylooking perspectives these polar yond standardization processof thana unidirectional Rather and lay believers. priests represenorliterati Daoist,state, bydominant localcultsaresuperscribed whereby of thecoexistence multiple interaction, forextensive evidence Katz finds tations, overtimeand place of involvement of thecult,and thevarying representations thisas a process for seeing He argues of believers. andvarieties lay Daoistpriests traditions, individuals, numerous between exchange a constant of "reverberation," andlocales.76 in the case of another representations multiple Michael Szonyihas explored period. in the late imperial in Fujian Five that of the Emperors plaguegod cult, orthothe been to have by replaced in official sources, thelocalcultappears, Where and local practices did not alter that this finds Szonyi cult, doxFiveManifestations the to cult the in elites representing role of local on the focuses He representations. models to universal for conformity demands between and mediating world outside local gods.77 toefficacious andfaithfulness lifeandnonelite seekstoputdaily that shift broader historiographic tothe Integral andgender. ofwomen has beena boomin studies ofinquiry at thecenter cultures of forchildren, controllers of andcarers rolesof women-as bearers The diverse and intermediaries ownhealth, healers, of their patients, cultivators reproduction, elitemedical in mainstream healersand the sick-had been obscured between
74 Guo Jing, see also Tanaka Issei,Chfigoku he cites, Nuo (cit.n. 70). BesidesGuo andthestudies acrosscoastal research offield years is basedon five study (cit.n. 63). Tanaka's saishikenkyil kyoson historiAsia and on extensive in Southeast Chinesecommunities Chinaand overseas and southern cal research. guiluhe Dongyuan yi Niiqing zaoqi daoshude wenyiguan: 75 Li Fengmao,"Daozang suoshou onNiiqing intheDaoist Canon,focusing (Earlyviewsofplagueas collected weizhu" shenzhoujing wenzhen jikan,Mar. yanjiu yuanZhongguo yanjiu shenzhou guiluandDongyuan jing),Zhongyang guandejiaoliu wenyi daojiaoyuminzhong yusongwen: 1993,no. 3,pp.417-454;andLi, "Xingwen Daoist between of and distinctions plague:Interactions plagueand expelling he fenqi"(Spreading wenhua guojiyantaohui yuZhongguo inMinjian xinyang ofpestilence), understandings andpopular ed. and Chineseculture), beliefs on popular conference of theinternational (Proceedings lunwenji 1995),pp. 373-422. zhongxin, (Taipei:Hanxueyanjiu zhongxin Hanxueyanjiu Boats (cit.n. 63). DemonHordesand Burning 76 Katz, theGods" (cit.n. 70). of Standardizing "Illusion Szonyi,
317
onthelivesofwomen source materials. Besidesitsgeneral focus andchildren, much ofthenewwork hasbeenspecifically informed byfeminist critiques-for example, ofthenaturalized gendered Theseworks haveexploded ofwomen body. stereotypes inChinaas passive, footbound objects ofpatriarchal show oppression. Instead, they that women haveplayed diverse in gendered roles, andstatus participated relations ofpower in complex andappropriated ways, andresisted to serve their power own ends. In a series ofarticles, haslookedatfertility, Lee Jen-der health during pregnancy, childbirthing, andchild-care practices between theHanandthe drawTangperiods, ingon a variety of sources to unearth common practices as wellas medical views. She provides a rich oftherolesoffigures picture suchas wet-nurses, and midwives, birthing theways inwhich assistants, mothers' health wasprotected, andthesources of danger to children during pregnancy, and nursing. birth, Lee has shown a shift in materials on reproduction technologies, from bedchamber techniques tomedical approaches, between thethird andseventh centuries. She sees reproduction emergingas central to medical discourse on thefemale bodyin theseventh century and suggests that this wasa keyfactor intheemergence offuke ("department ofwomen's medicine," as a distinct 'gynecology") specialty.78 Charlotte Furth has lookedat thehistory ofthelearned tradition offuke its from emergence as a medical in theSongthrough specialty theMingperiods. Whilethe bodyofclassicalmedicine hadbeenandrogynous, intheSongffike medicine developed a practice female bodiesas dominated differentiating byBlood function over Qi function. Practitioners andtexts focused onmenstrual regulation for maintaining health anddeveloped prescriptions for women that aimedatBlood function. While menstrual regulation continued to be important in elitemedicine, bytheendofthe Mingchanges in medical approaches to thecirculation tracts andvisceral systems andto sexualrestraint led to a de-emphasis on bodyandtherapy differentiation by gender. Furth looksattheconstruction ofthegendered bodyin relation totensions between the"androgynous bodyof generation" of classicalmedicine andthe"femalegestational body";between a transformational, plastic viewofthebodyanda viewofgeneration in which yinandyanghaveequally important rolesanda strict socialhierarchical differentiation andsegregation basedongender andonthe pollutionassociated with gestation.79
78 Lee Jen-der, "Han-Suizhijian de 'shengzi buju' wenti" (The problem of"birthing butnotraising" betweenthe Han and Sui), Zhongyang yanjiuyuan Lishi yuyanyanjiusuo jikan, 1995, 66(3):747-812;Lee, "Han-Tang zhijian qiuziyifang shitan: jianlun fuke lanshang yuxingbie lunshu" (Medical approaches to seeking children between theHan and Tang),ibid.,1997,68(2):283-367; Lee, "Han-Tang zhijianyishuzhongde shengchan zhi dao" (Childbirth in themedicalwritings of Han to Tang),ibid.,1996,67(3):533-654; and Lee, "Reproductive Medicinein LateAntiquity and EarlyMedievalChina-Gender Discourseand theBirth of Gynecology," ibid.,1997,68(2):283367. 7 I capitalize "Blood" and "Qi" hereto mark them as technical Chinese medical terms. See Furth, Flourishing Yin(cit.n. 66); Charlotte Furth, "Androgynous Males and Deficient Females:Biology and Gender Boundaries in Sixteenthand Seventeenth-Century China," Late Imperial China,1988, 9(2):1-31; Furth, "Blood, Body,and Gender: Medical Imagesof theFemaleCondition in China, Chin.Sci., 1986,no. 7, pp. 43-66; Furth, 1600-1850,;" "Concepts of Pregnancy, Childbirth, and in Qing Dynasty Infancy China," J.Asian Stud.,1987,46(1):7-35; Furth, "Rethinking Van Gulik: Sexuality andReproduction inTraditional Chinese Medicine," inEngendering China,ed. Gilmartin et al. (cit.n. 66), pp. 125-146;and Furth and Ch'en Shu-yueh, "Chinese MedicineandtheAnthropology of Menstruation in Contemporary Taiwan,"Medical Anthropology Quarterly, 1992, 6( I):27-48.
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in thesixhealing to women's pertaining Furth also looksat thesocialrelations such for thesources necessary which for a period centuries, andseventeenth teenth examtoelite medical materials limited Where analyses abundant. analysis aremore on focuses Furth doctor, roleoftheelitemedical andtheauthoritative inedtheory In these healers. maleandfemale with diverse and negotiations practices healing and hierarchy of male and femaleauthority therelations she finds negotiations weremanandbirth gestation, illness, that ways.She shows outin complex played that finds andcare.Furth knowledge offamily-based varieties through agedathome ofmedical oftransmission modes oralandhandwritten didnotdisplace culture print of of thegenre In herstudies and skillsin homeandlineagecontexts. knowledge differed concerns patients' that finds Furth that emerged intheMing, case histories inimporencounter clinical the influenced patients andthat those ofphysicians from tant ways.80 ina collecandmalepatients offemale thetreatment hascompared Joanna Grant WangJi physician AnhuiProvince of thesixteenth-century tionof case histories of women the treatment between differences greater (1463-1539). Grantfinds arenotthan andthose whoseillnesses toreproduction arerelated whosedisorders medical a central "depletion," that ofmen Noting the treatment andwomen. between sherelates inmenthan inwomen, more often was diagnosed ofWang Ji's, concern bymen andphysical "overspending" over moral, financial, toconcern this tendency andsocialflux.81 ofcommercial prosperity in a context inlate that cultures gaveelitewomen hasuncovered reproductive Bray Francesca than hadbeenpreviously their in negotiating fertility control Chinamore imperial tostarolesrelated inmaternal differentiation has also found great Bray suspected. for ofmotherhood, example, ofthesocialandbiological aspects tusanddivisibility ordiffercultures than Rather reducing reproductive wivesandconcubines. among orto sotechnologies) rolesto technology ofmaternal (e.g.,reproductive entiation as intertwined andsocialconstruction protreats technology cialconstructions, Bray
cesses.82
that inZhejiang infuke, specialized lineages atQingperiod Yi-LiWu haslooked MonasBamboo Grove of the Buddhist on thefamous lineage especially focusing in form of medicine a routinized derogated monks practiced BambooGrove tery. howWu to treatment. anindividualized finds, extolled texts that approach eliteruyi "lower as strictly be considered class,"since cannot thesetexts properly that ever, andfunded texts werecommissioned by members of BambooGrove publications the who criticized some even and some explicitly by officials, oftheelite, including monk with healers.83 association of women's impropriety has childcare in thelaterimperial HsiungPing-chen period, In investigating
formedical 80 Furth language-and resonances mucheveryday in thecase histories also finds of daily thelanguage Yin.Yi-Li Wu has found Furth, Flourishing language: in everyday constructs of their theseecho patients' and suggests descriptions in thefuketextsshe studies lifecommon GyneoftheLowerYangziRegionandPopular The Doctors Secrets: Wu,"Transmitted symptoms: ofmedical resonances China"(Ph.D. diss.,Yale Univ.,1998).The popular cologyin Late Imperial Disorder" (cit.n. 66). in Bray, "Deathly areanalyzed language in MingDyandCulture ofGender yi'an:Aspects 81 Joanna Ji'sShishan "Wang Grant, Catherine (Ph.D. diss.,Univ.London,1997). Case Histories" nasty TechofMotherhood: Reproductive (cit.n. 66), Pt.3: "Meanings 82 Bray, and Gender Technology Disorder" (cit.n. 66). "Deathly Uses,"pp. 317-334;andBray, andTheir nologies 83 Wu, "Transmitted Secrets" (cit.n. 80).
319
for theories ofchild sources toshow, anddeveldiverse mined example, physiology howpediatric medicine intoa distinct from theSong opment, developed specialty schoolsof pediatric how different medicine and how practices period, emerged, weredisseminated.84 newborns warm andkeeping pertaining to cordcutting of middle Lookingat experiences age and menopause amongChinesewomen between women of different Jeanne Shea finds variation of different generations, andrural women. women with different levelsofeducation, andurban generations, marked differences between all of thesewomen and Japanese and She also finds women. With common North American Western Margaret Lock, Shea challenges suchas estrogen decline or the"empty about basedon factors assumptions, nest," and middle theuniversality of experiences of menopause Shea finds age. Instead, that formostChinesewomen middle and age is a timeof relatively good health life.She finds satisfaction with differences tothe generational related localpolitical, and economic conditions which women cultural, during go through keyphasesof their is a more lifecycles. Forexample, midlife salient for women whoexpeperiod rienced it after thelate 1970s,whenitbecamea morecommon topicin thepress. She finds morecontingently related to local cultures, experience historical condiandsocialstatus than tobiology orpsychology.85 tions, One ofthethemes recent works on gender running through is thegendered body. Feminist havecontributed critiques significantly toparticularizing anddenaturalizingbodiesas objectsof scholarship. Plurality emerges from thedifferentiation of both andofgazesonbodies:gendered bodily experience body(ies), ritual body(ies), southern body(ies), medical body(ies), disabled body(ies), Daoistbody(ies). These themes runthrough I havediscussed.86 In part, manyof theworks thisplurality is entailed in a shift from essences-the "essential Chinese body"-to contingent ofbodily processes experience; major nodesofcontingency can be found notonly in Chineseness butin diverse vectors ofidentity andexperience. Besidesthemultiofsuchparticularized plicity bodies, recent work introduces other forms ofplurality a focus on themultiplicity through andcontingency ofbodyandself. Bodiesand Selves Scholars indiverse working fields andfrom various perspectives haveanalyzed differences between Chinese andWestern viewsandexperiences ofbodyand self. A is usually contrast madebetween thebounded individuals, naturalized bodies,and mind/body dichotomies ofEuropean traditions andChinese bodiesandselvesthat areconceived andexperienced as processual, as multiple, as integrated in terms of mindand body, and as intimately linked withsocial,environmental, and cosmic
84 Hsiung Ping-chen (XiongBingzhen), Youyou: chuantong Zhongguo de qiangbaozhidao (Infancy: The wayofthediaper intraditional China)(Taipei:Lianjing, 1995).See also Charlotte Furth, "From Birth toBirth: The Growing Bodyin Chinese in Chinese Medicine," Views ofChildhood, ed. AnneBehnke Kinney (Honolulu: Univ.HawaiiPress,1995),pp. 157-191. 85 Jeanne Shea, "Revolutionary Womenat MiddleAge: An Ethnographic of Menopause Survey and Midlife Agingin Beijing"(Ph.D. diss.,Harvard Univ.,1998); and Margaret Lock,Encounters with Aging:Mythologies ofMenopausein Japanand North America(Berkeley: Univ.California Press,1993). 86 See, e.g.,AngelaZito andTaniBarlow, "Introduction," in Body, Subject, and Powerin China, ed. Zito and Barlow(cit.n. 47), pp. 1-19.See also theworks by Francesca Bray, Charlotte Furth, Shigehisa Kuriyama,Marta Hanson, Vivienne Lo, Volker Scheid,andKristofer Schipper that I cite in thisessay.
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contexts.87 There is somedanger in thiscontrast ofnewforms of essentialism and orientalism.88 To beginwith, themodelofWestern selvesandbodiesusedfor this is increasingly contrast unrepresentative of post-Freudian, cyberspaced postmodWith these erns. cautions, however, careful attention to bodyand selfin Chinarefor mains critical andfor overcoming distorting assumptions uncovering pluralities andcontingencies atthecoreofexperience. We can see experiences of bodyand selfserving and constructions as fruitful of departure fornew approaches in thestudy of Chinesemedicalpractice points A distinctive ofrecent scholars.89 feature ofShigehisa among a number Kuriyama's in theexperience work hasbeenattention to orientations ofbodyandselfhood and medicalapproaches of healing, distinctive practice including processes by which finds an In thecase ofbody-centered classicalmedicine, aredeveloped. Kuriyama senseof emerging
87 ThomasP. Kasulis,and T. Ames, Roger intheSUNY "self"series: collected See esp. theessays StateUniv.NewYork (Albany: andPractice eds.,Selfas BodyinAsianTheory WimalDissanayake, (1993), andSelfas ImageinAsianTheory andPractice Press,1993),Selfas PersoninAsianTheory Hay, and Powerin China;andin John Subject, eds.,Body, (1995); in ZitoandBarlow, and Practice "Doky6teki 1995). See also Miyakawa Hisayuki, in China (London:Reaktion, ed., Boundaries soulsin theDaoistdoctrine andplural worms (Cadaverous to kompaku" ni okeru shichti shintairon lifeand worldviewsin (Viewsof human teki jinseikan-sekaikan body),in Chagoku of thehuman TheTaoist Schipper, 1994),pp.259-271; Kristofer shoten, I-oh6 Motoharu (Tokyo: ed. NaitO China), Stone Press,1993); andHay,'Arterial Univ.California KarenC. Duval (Berkeley: Art," Body, trans. China see Susan in contemporary and sports Lion Review,1983, 11:70-84. On "bodyculture" (Chicago: People' Republic ofthe MoralOrder inthe forChina:Sports the Body Training Brownell, Univ.ChicagoPress,1995). in recent of Chinesebodiesand selvesputforward of theattributes many 88 We might notethat medion Chinese scholarship ofrecent hereas characteristic I identify attributes work echothevery saliencyand a greater mayhave gainedbotha greater of Chineseselfhood cine. These features I see a paradigms. Western modem against reactions with postmodern intheir homologies attraction alienthereductionisms, forexample, and underplaying, Chineseness riskhereof romanticizing howI wouldsay, ofbodiesand selvesin Chinesecontexts. andobjectifying dichotomizing, ations, navigated andhavesuccessfully hazards ofthese havebeenaware I discuss here thewriters that ever, around them. Vivienne MartaHanson, Furth, Charlotte Farquhar, are Judith discussed thosealready 89Among state to theearly ofbodyin relation Scheid.See also theanalyses andVolker Kleinman, Lo, Arthur B.C.," Harvard Centuries LastThree Cosmos, andBodyinthe inNathan "State, Sivin, andcosmology Space,Time,and Bureaucracy: J.AsiaticStud.,1995,55(11):5-37; and RobinD. S. Yates,"Body, in China,ed. Hay (cit. inBoundaries in EarlyChina," Mechanisms andControl Creation Boundary incontempopractices qigong inpopular andhealing ofbody, self, n. 87),pp.56-80. On experiences in UrbanSpaces in of Qigong," China see NancyN. Chen,"UrbanSpaces and Experiences rary Pressand WilsonCenter Woodrow China,ed. DeborahS. Davis et al. (Cambridge: Contemporary Body-The Expressive Ots,"TheSilenced Univ. Press,1995),pp. 347-361;andThomas Cambridge and ExperiinEmbodiment Healing," Leib: On theDialecticofMindandLifeinChineseCathartic Cambridge ed. ThomasCsordas(Cambridge: and theSelf, Ground ofCulture ence: TheExistential showshowdisscholarship ofbody-focused strand Univ.Press,1994),pp. 116-138.An important and naturalized, e.g., and government policieshaveconstructed coursesof scienceand modernity of theseareas of life.See to theregulation contributing and sexualidentities, differences gender andModernity Dikdtter, Sex,Culture, theBodyforChina(cit.n. 87); andFrank Training Brownell, Period intheEarlyRepublican ofSexualIdentities in China:MedicalScienceand theConstruction of the theconstruction has examined Kohrman (Honolulu:Univ.Hawaii Press,1995). Matthew of discourses thehistory Federation, on theDisabledPersons' disabled"man,focusing "physically andintertheparticular interests thefederation's that informed policies, disabled" on the"physically or avoiding of peoplein embracing in 1988,andvariable responses of itscreation context national men,who have in thefederation amongurban finds Kohrman participation greater thefederation. margintonegotiate whoaremore concerned rural than men, among benefits, accesstomore tangible See Matthew "DamagedBodies: Kohrman, within their communities. and objectification alization forthUniv., in Modern China"(Ph.D. diss.,Harvard ofDisability andthePhenomenology History coming).
OF CHINESEMEDICINE NEWGEOGRAPHIES
321
andfeelings ofthemselves, likethewinds a selfin which thoughts mysteriously arise, in neither reason norvolition, theselfis thesiteofmoodsand oftheearth. Anchored in thisview,are notdistinct are unfathomable. impulses whoseorigins Individuals, thedarkness ofmatter-or immaterial minds castinto set essences-Orphicsouls,say, andunpreagainst material bodies.Rather, individuation mirrors theplurality simply of winds. Different dictability localities havedifferent havepersonal airs,individuals and... individualized orifices on thebody's breaths, surface mediate theconfluence of cosmic, local,andpersonal winds.90 Here we find plurality and unpredictability at thecenter of a classical medicalbody. Reductionto biological or psychologicalmechanisms, like the separation of the sacredfromthe secular,has obscureda focus of illness and healingthatwas at one timecommonand was based on a view of thebody and selfas multiple and permeable. The "corpse worms"and "wormsof consumption," demonicentities thatproduce illness, have been conflated withtuberculosis bacteria,helminthic parasites, and psychologicalprojectionsof the instincts.91 These descriptions distort rather thanelucidatebodilyexperience, losingtheir notonlyin projecting footing contemporary categorieson people who wouldnotrecognizethembutalso in their assumptionsaboutboundedindividuals (hostsinvadedbyparasites)and mindsdividedfrom bodies (projectedinstincts). In medieval through late imperialChina the "corpse worms"were depictedin Daoist and medical textsas threeof a multitude of spirits thatinhabited thebodyfrom birth. Variousspirits guardedand managedthevarious and certain organsystems, disorders (or simplydreams)came aboutwhentheywent roamingoutsidethebody.The corpse wormssoughttheearlydemise of theperson so thattheywould be freeto roam independently. Sometimestheycommunicated and conspiredwithexternal demons,helpingthemoccupy thebody.Upon entering thebody,demonicbeingssometimes tookform as worms, producing disorders such as "consumption" by gnawingat the internal viscera,oftenthe lungs. Sometimes these noxious beings infested therooms and clothingof the sick. Sometimesthey left one personat deathto infest family members orpeople nearby. Such descriptions not only bringus closer to experiencesof illness and healthin medieval to late imperial China but give us a different perspectiveon a range of disordersand
90Kuriyama, "Imagination ofWinds" (cit.n. 47), p. 34. See also Kuriyama, "VisualKnowledge in ClassicalChineseMedicine"(cit.n. 29); Kuriyama, "Varieties of HapticExperience" (cit.n. 29); Kuriyama, "Interpreting theHistory ofBloodletting" (cit.n. 29); Shigehisa Kuriyama, of "Concepts Disease inEastAsia,"in TheCambridge History ofHuman Disease,ed. Kenneth Kiple(Cambridge: Univ.Press,1993),pp. 52-59; and Kuriyama, Cambridge "Between MindandEye: Japanese Anatomyin theEighteenth inPathstoAsianMedicalKnowledge, Century," ed. Charles Leslie andAllan Young(Berkeley: Univ.California Press,1992),pp. 21-43. 91Corpseworms areinnate, ofconsumption whileworms are acquired. are someHowever, they timeslinked in Daoist texts. See Andrews's discussion of earlyattempts to conflate theworms of consumption with thegerms oftuberculosis: Andrews, "Tuberculosis andtheAssimilation ofGerm Theory" (cit. n. 53). Analyses of thecorpseworms as parasites includeSong Daren,"Zhongguo gudairenti chongbing shi"(History ofparasitic jisheng diseasesin ancient China),Yishi zazhi,1948, 2(3-4):44-55; Xiao Shuxuan, "Jiehe bingzai Zhongguo yixueshang zhi shide fazhan" (Tuberculosis inthehistorical ofChinese development medicine), ibid.,1951,3(1):25-33,3(2):29-40, 3(3):1930, 3(4):13-22; Reinhard HoeppliandI Ch'iang, "Selections from Old Chinese MedicalLiterature on VariousSubjectsof Helminthological Interest," ChineseMedical Journal, 1940, 57:380-382; HoeppliandCh'iang, "The Origin of HumanHelminths According to Old ChineseMedicalLiterature," Monumenta Serica, 1938,3(2):579-601; and Hoeppli,Parasitesand ParasiticInfections in EarlyMedicine and Science(Singapore: Univ.MalayaPress,1959).Fora psychological interpretationsee N. H. van Straten, Concepts ofHealth, Disease,and Vitality in Traditional Chinese Society (Wiesbaden: Steiner, 1983),pp. 44-50.
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practices, from "possession" totheemployment ofspirit specialists inavoiding epidemiccontagion. Different healersmight takemarkedly different approaches to these types ofdisorders, someregulating orboosting the qi inorder tostrengthen the body's holdonstraying spirits, somenegotiating with the spirits, andsomecalling on more powerful spirits inorder toexpeltheinfesting demons. Herewe find on three plurality levels:theplurality ofa personhood populated by a multitude of beings, a plurality of healing strategies, and a plurality of waysof looking at thebody. Although descriptions of demonic infestation ofthebodyand ofdiseasewereusually treated separately in medical texts, theviewofthebodyas was notnecessarily "populated" incompatible witha focuson configurations of winds orqi, andwe find these viewscombined eclectically in thewritings ofsome The permeability of selfand theindivisibility is of mind(s)/spirit(s)/body(ies) herevery conceived In somecontexts, it is moredifficult graphically. however, to translate therefusal to demarcate selfrigidly from other in and to fixexperience or thebody. either themind Modemdiscourses ofbiomedicine andpsychology andtosomeextent Western as well-insiston suchfixity. languages Circumventing these limitations has taken theoretical andlinguistic creativity. Arthur andJoan Kleinman havedeveloped a model for medical that anthropology as "theintersubjective of illness, positsexperience, appliedhereto thesuffering forthe medium of social transactions in local moralworlds." Whilegeneralized as well,the field of medicalanthropology and appliedto American case studies is informed of theapproach intersubjective emphasis by decadesof engagement bothindividual-based and withChineseculture. The Kleinmans havefound that as wellas the"sociocentric/egocentric psychoanalytic assumptions, dichotomy" by in from cultures Western cultures aresometimes which non-Western distinguished to Chinese of selfhood, are inappropriate theexperience and conceptualization culture.93 before that Western has also found Judith Farquhar approaches putknowledge multishefinds dominant action andseeka single perspective inadequate. Rather, oftraditional tothemedical tobe central andcontingency plicity bodyandpractice of China.Thismedical in thecontemporary Chinese physicians People'sRepublic to ofChinese characteristic as a defining bodyis constructed medicine, analogous often citedas distinguishing ofsyndrome anddiseasedifferentiation theopposition
92 totheouter andtobe permeable systems multiple viewalso takesthebodytocontain Thelatter bodyofDaoismsee ofthe"populated" ofqi. Fora description arealso configurations spirits world; aimed worms andpractices ofcorpse Body(cit.n. 87),pp. 108-112.Fordiscussions Taoist Schipper, of theThree "MedicalAspectsof theDaoist Doctrine see Miyakawa Hisayuki, them at expelling "Doky6teki ed. Keiz6 etal. (cit.n. 28), pp. 345-350; Miyakawa, in EastAsianScience, Cadavers," of Disease in EastAsia" (cit.n. 90), pp. 56-57; and "Concepts (cit.n. 87); Kuriyama, shintairon" worms, demonic of infesting (cit.n. 61). Fordiscussions no kenkya shink6 Koshin Kubo Noritada, TheProbandItsConsequences: "Contagion see Li Jianmin, practices andrelated disorders, related SympoInternational at theTwenty-first paperpresented inAncient China," lemofDeathPollution 1 Sept. 1996; Li, Mishima, Japan, of Medicine-East andWest, History siumon theComparative possession] jieshi"(Sui [haunting, de yizhong chuantong yixueduisuibing "Suibing yu 'changsuo': Hanxueyanjiu in traditional medicine), forsui disorders and "place": One explanation disorders of Governance "MedicalTransforming 1994,12(1):101-148;Hinrichs, research), (Chinesestudies Rituals Therapeutic "MagicalMedicine: Customs" (cit.n. 10); andMichelStrickmann, andSouthern MS, 1989. unpublished inEastAsianTradition," andKleinman, at the (cit.n. 15),pp. 95-119,onp. 97; andKleinman Margin Writing 93 Kleinman, (cit.n. 24). "How BodiesRemember"
authors.92
323
Western medicine. The Chinese medical from with Chinese the bodyis contrasted a stable ofvieworhierarchical oneas lacking Western anatomical of point ordering The focusis on multiple functional structures (suchas cells,tissues, organs). sysand pathology temsof physiology that are nothierarchically related butinterconirreducible. The boundary between nected and mutually is bodyand environment on lesions inparticular In contrast focus strucpermeable. tothebiomedical bodily inChinese disorders tosingle butpropmedicine arenotconfined tures, subsystems from directions. In contemporary agateacrossthemand can be treated different traditional medical entails oneofnuChinese intervention medicine, then, choosing merous foranalyzing possibleperspectives and treating a disorder. Furthermore, and treatment can evolve together over the courseof a perspective, analysis, treatment.94 Like physicians thisChinesebody, scholars "Chinese approaching approaching medicine" are increasingly and unpredictable: nothierarchiseeingit as multiple nota neatly bounded andnotamenable to single callystructured, of system, points view.Thosechoosing, numerous to focuson bodily among and options, practices ofselfarerevealing that forms ofmultiplicity, experiences contingency, processualand permeability are notmarginal ity, or incidental butcentral to illness, healing, andhealth in Chinese contexts.
CONCLUSION
Theemerging medicine centers mapofChinese theflux oflife-processual, heterogeneouspractices and experiences. It is moreconcerned with boundaries as constructions on thecultural landscape thanas immobile natural features of terrain. By refusing to fixa single authoritative perspective ordefining structure, this work a different mandates sort ofnavigational approach. elitemedicaltheory Centering had theadvantage of allowing scholars to limit thescope of their research to elitemedical texts. Historians couldreconstruct the governmental structures relevant to medical education anddisaster relief through a review ofstandard histories andother published government documents. Historians inmedical interested progress couldmakethis evaluation bymatching earlier medical theories tocurrent biomedicine andbytesting theefficacy ofearlier prescriptions in thelaboratory. Describing ideas as reflections of class structures, political sysor religions, tems, thescholar neednotdemonstrate concretely howone translates intotheother. Fixedperspectives andreductionism satisfy a particular aesthetic of elegance. Scholars concerned with multifold processes ofchange, theproduction ofpraxis in local worlds, livedexperience, diverse healers, anddailylife, on theother hand, cannot thesources easilylimit they examine. Theymust develop newways ofintertheavailable rogating sources, which weregenerally notwritten toconvey informationabout women, children, ortheilliterate. In order to achieve dialogue with their must sources, they maintain a self-reflexive vigilance toward their ownassumptions. If they areto takeindigenous categories andexperience seriously, they must learn from these as wellas from theoretical perspectives developed for non-Chinese historiesorfor ethnographies ofnon-Western Others.
94 Farquhar, "Time and Text"(cit. n. 40); Farquhar, "Re-writing Traditional Medicinein PostMaoistChina"(cit.n. 42); andFarquhar, Knowing Practice (cit.n. 24).
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gaps tobe donejusttofill there is much a goodstart, aremaking Whilescholars beenidenSelvesandOthers Howhavemedical linesofinquiry. existing andextend stillunstudied? places,andlocal worlds times, in themany tified andconstructed How have from competitors? themselves healers distinguished How havediverse cometopatronize andhowdidnonelites When, where, them? distinguished others and learn medicine-and what did theydo? become physicians, physicians, are "southerners" plaint amongelitesthat is a common theSong there Through sorts of andwhat change, How didthis ofandhaveno accesstomedicine. ignorant medical in theprocess? Whenandhowwereorthodox emerged medical practices "southerners" bythese adapted resisted, orselectively viewsofthebodyproduced, influenced practices in waysthat medical Did suchOthers transform or byothers? in China? those elsewhere practices moving, sitting, attention, breathing, focusing Inwhat haveeating, excreting, ways love andmaking birthing, nursing, washing, touching, dressing, looking, speaking, rethantheadeptswho refined, seen,and feltby peopleother been performed, to andcontribute How did thesegainfrom suchpractices? and cultivated corded, In and otherwise? within families How werethey transmitted practices? healing age? status? tolocale?gender? inrelation health wayshavepeopleconceived what and discourses, intopolitical taken beenselectively discourses How havemedical economic, politmediated Howhavebodies andtransformed? medical, into political been negotiated and healing health, How haveillness, ical, and social relations? Howhastheprotection ofcomfamily, gods,anddemons? healers, patients, among from diseasebeennegotiated? munities whether workhavealways beenboundary crossers, ofChinese medicine Scholars scholarship, philological of their or of their medical practices ing in themargins or turning to Chinafrom in science, a background to medical history from turning Tu Nathan As Sivin, ofWestern science. Cheng-sheng, inthehistory a background has been a medicine the of pursuit havenoted, study Chinese andArthur Kleinman ormedical ofscience, ofChinese anthropolwhether history, history atthemargins, so has this in recent areasoflifehas grown years, As interest in themarginal ogy. has tobiomedicine medicine ofChinese as a viablealternative As acceptance field. Where there andpublishers. interest ofstudents, funding agencies, so hasthe grown, arenow in the1950s,they medicine of Chinese historians weretensof mainland texts andthecompiofprimary andprinting Thecollation inthehundreds. counted than houses faster outofmainland materials ofreference publishing pouring lations forless andmore both historical aremaking them scholarship libraries can collect fortwo scholars in mainland Chinahas beenopento foreign Fieldwork midable. are that to organize it possibleforthem objectsof inquiry decadesnow,making Chinese andmore diversity. more opentocontemporary "experience-near" withscholars havealwayshelddialogues Chinesemedicine Scholarsstudying In the last two to countries. and other other in other institutions, departments, international of international organizations, three decades,withtheproliferation and readership, contributors scholarly journalswithinternational conferences, havebeen increasinterconnections and Internet resources, scholarly exchanges, knowlof scholarly cross-fertilization to productive These are contributing ing.95
of scienceas well as thosefocused to thehistory devoted I includeheregroupsand forums 95 or publish conferences that periodic sponsor organizations International on medicine. specifically
325
apparever more perspectives ofscholarly making thelocalness edge.Theyareboth assumes normative which marginality, theidea of thefield's entand undermining bounddisappearing perspectives, Theseshifting centers. andhegemonic structures andopportunities challenges contacts offer flows ofinformation, andwidening aries, medicine." of"Chinese transformations continuing toproduce andcanbe expected
of East Asian Science,Technology, journalsincludetheInternational and SocietyfortheHistory forthe Studyof Traditional Asian Medicine;and Zhongguo Medicine;International Association forthestudy ofthehistory ofChinesescienceandtechnology). kejishixuehui Recent (Association international conferences organized byother institutions include theMedicineandChineseSociety AcademiaSinica,Taipei,Taiwan, 26-28 June1997; andtheLu Gwei-DjenMemorial Symposium, Workshop inChinese on Innovation Medicine, 9-11 March1995,Needham Research Institute, Cambridge, The Groupede Recherche surl'Histoire England. des Scienceset des Techniques en Chine, en Cor6eet au Japon at theCentre National de la Recherche Scientifique, Paris,is planning future workshops on Chinese medicine. Specialized scholarly journals include Nihon ishigaku zasshi(Japan journalof studies in medicalhistory, est. 1941),Zhonghua yishizazhi (Chinajournalof medical history, orig. publ.1947as Yishi zazhi[Journal ofmedical history]), Chinese Science(est.1975),and Yiguwen zhishi (Ancient medicaltextual knowledge, est. 1984).Internet resources include theChineseScienceWebpage(<http://www.albion.edu/fac/hist/chimed/>, est.1997);theChinese Medicine Web page (<http://www.soas.ac.uk/needham/chimed/>, est. 1997),edited by Yi-Li Wu; theNeedhamResearch Institute Webpage (<http://www.soas.ac.uk/needham/>, est.1996),edited byChristopherCullen; the Golden Elixir-Resources on ChineseAlchemy Web page (<http://helios. unive.it/-dsao//pregadio/index.html/>, est. 1996),edited byFabrizioPregadio; theEastAsianScience DiscussionList (<easci@ccat.sas.upenn.edu>, est. 1994),runbyNathan Sivin;andtheChineseMedicine Discussion List(<chimed@ccat.sas.upenn.edu>, est. 1997),runbyTJHinrichs.

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New Geographies of Chinese Medicine Author(s): T. J. Hinrichs Source: Osiris, 2nd Series, Vol.

New Geographies of ChineseMedicine

NEW GEOGRAPHIES OF CHINESE MEDICINE

This perspectiveinforms JosephNeedham's Science and Civilisationin China

NEW GEOGRAPHIES OF CHINESE MEDICINE

NEW GEOGRAPHIES OF CHINESE MEDICINE

NEW GEOGRAPHIES OF CHINESE MEDICINE

NEW GEOGRAPHIES OF CHINESE MEDICINE

NEW GEOGRAPHIES OF CHINESE MEDICINE

NEW GEOGRAPHIES OF CHINESE MEDICINE

NEW GEOGRAPHIES OF CHINESE MEDICINE

medical classic, Inner Canon of the YellowEmperor(Huangdi neijing),was long

NEW GEOGRAPHIES OF CHINESE MEDICINE

NEW GEOGRAPHIES OF CHINESE MEDICINE

NEW GEOGRAPHIES OF CHINESE MEDICINE

NEW GEOGRAPHIES OF CHINESE MEDICINE

NEW GEOGRAPHIES OF CHINESE MEDICINE

NEW GEOGRAPHIES OF CHINESE MEDICINE

NEW GEOGRAPHIES OF CHINESE MEDICINE

NEW GEOGRAPHIES OF CHINESE MEDICINE

NEW GEOGRAPHIES OF CHINESE MEDICINE

NEW GEOGRAPHIES OF CHINESE MEDICINE

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