Fall 1998
Thursdays, 1:00-3:45 p.m.
Bill Hall 403
Instructor:
TJ Hinrichs
Email: <tjhinric@fas.harvard.edu>
Phone: [O] 439-2248
Office Hours: Winthrop 311, Thursdays by appointment
An exploration of processes of change in medicine in China. Will focus on key transitions, such as the emergence of classical medicine, of Daoist approaches to healing and longevity, of "Scholar-Physicians," and the revival of Traditional Chinese Medicine in modern China. Will inquire into the emergence of new healing practices in relation to both popular and specialist views of the body and disease, "cultivating vitality" practices, modes of transmission of medical knowledge, and healer-patient relations. Course readings include primary texts in translation as well as secondary materials. For students without a background in Chinese history, readings from a general textbook will be suggested.
Requirements:
Resources:
Judith Farquhar, Knowing Practice: The Clinical Encounter of Chinese Medicine, (Boulder: Westview Press, 1994).
Manfred Porkert, The Theoretical Foundations of Chinese Medicine: Systems of Correspondence. (Cambridge: The MIT Press, 1982).
Lu Gwei-Djen and Joseph Needham, Celestial Lancets: A History and Rationale of Acupuncture and Moxa, (Cambridge: Cambridge University Press, 1980)
Nathan Sivin, Traditional Medicine in Contemporary China (Ann Arbor: Center for Chinese Studies, The University of Michigan, 1987).
Paul Unschuld, Medicine in China: A History of Ideas, (Berkeley: University of California Press, 1985).
Chimed Web Page: <http://www.soas.ac.uk/Needham/Chimed/>
1. Introduction
September 3
Part I: Canonical Medicine
In the next four weeks, we will be comparing the explanations of canonical Chinese medicine of various scholars with each other and with primary texts. Although the "Classics" of Chinese medicine were compiled between the Han and Tang periods, centuries during which medicine continued to change in China, it has been difficult for scholars to unravel many of the conceptual and practical changes that occurred across these centuries. Compounding these difficulties, modern scholars and translators often attempt to present a coherent description of Chinese medicine, and rely on the interpretations of contemporary practioners, leading to anachronistic translations and interpretations. For an introduction to canonical medicine, we will rely primarily on an ahistorical presentation of the basic concepts in Chinese medicine by Ted Kaptchuk, and compare his analyses with those of other scholars and of primary texts in translation.
What are some of the basic concepts of canonical medicine? What is the larger system or world-view within which these are understood? What are some different way of approaching this system (for example, larger cultural orientations, medical theory, medical practice)?
2. The Emergence of Canonical Medicine
September 10
The Inner Canon of the Yellow Emperor (or as Veith translates it, The Yellow Emperor’s Classic of Internal Medicine), largely compiled in the second and first centuries b.c.e., came to be viewed as the highest authority in canonical medicine. Did canonical medicine represent a radical break with previous approaches to healing and views of the body? Where do these authors see the shift, and how do they account for it?
Primary
"The ‘Wu Shih Erh Ping Fang’," selections. [Are magic, superstition, religion, or rationality distinguished in this text?]
The Yellow Emperor’s Classic of Internal Medicine, trans. Ilza Veith, New Edition, (Berkeley: University of California Press, 1949, 1966, 1972), Books 1-2, pp. 97-131. [Some sections are highly repetitive. Skim these; look for main points, patterns of explication.]
Secondary
Donald Harper, "The ‘Wu Shih Erh Ping Fang’: Translation and Prolegomena," Ph.D. diss., University of California, Berkeley, 1982, pp. 2-42.
Lo, Vivienne. "The Influence of Western Han Nurturing Life Literature on the Development of Acumoxa Therapy," delivered at the Lu Gwei-Djen Memorial Workshop, March 9, 1995.
Kuriyama Shigehisa, "The Imagination of Winds and the Development of the Chinese Conception of the Body," in Body, Subject & Power in China, eds Angela Zito, and Tani Barlow, (Chicago: University of Chicago Press, 1994), pp. 23-41.
3. Basic Concepts of Canonical Medicine: Body and Cosmology
September 17
What is the "body" of canonical medicine? How does this body relate to Han cosmology? Is it incommensurable with the "body" of ancient Greece?
Primary
The Yellow Emperor’s Classic of Internal Medicine, Books 3-4, pp. 133-174.
Secondary
Ted J. Kaptchuk, The Web That has no Weaver: Understanding Chinese Medicine, (NY: Congdon & Weed, 1983), pp. xix-xxi; 1-76, 343-357. [Skim repetitive sections.]
Shigehisa Kuriyama, "Visual Knowledge in Classical Chinese Medicine," in Knowledge and the Scholarly Medical Traditions,. ed Don Bates, (Cambridge: Cambridge University Press, 1995), pp. 205-234.
Suggested Readings
Ishida Hidemi, "Body and Mind: The Chinese Perspective," in Taoist Meditation and Longevity Techniques, ed. Livia Kohn, et. al. (Ann Arbor: Center for Chinese Studies, The University of Michigan, 1989), pp. 41-72.
John Hay, "The Body Invisible in Chinese Art?" in Body, Subject & Power in China, eds Angela Zito, and Tani Barlow, (Chicago: University of Chicago Press, 1994), pp. 42-77.
Presentations
Compare the descriptions and translations of key concepts (qi, blood, jing, shen, organs, five phases) by Kaptchuk with those of Paul Unschuld, Nathan Sivin, Judith Farquhar, and Joseph Needham and Lu Gwei-Djen.
4. Basic Concepts of Canonical Medicine: Approaching the Illness
September 24
Primary
The Yellow Emperor’s Classic of Internal Medicine, Books 4-9, pp. 147-253.
Nan-Ching: The Classic of Difficult Issues, trans., annot. by Paul U. Unschuld, (Berkeley: University of California Press, 1986), selections.
Secondary
Ted J. Kaptchuk, The Web That has no Weaver: Understanding Chinese Medicine, (NY: Congdon & Weed, 1983), pp. 77-137.
Kuriyama Shigehisa, "Interpreting the History of Bloodletting." Journal of the History of Medicine and Allied Sciences 50 (January 1995): 11-46.
Presentations
Compare the descriptions and translations of key concepts (meridians, acupuncture points, causes of illness/disharmony) by Kaptchuk with those of Sivin, Farquhar, Porkert, Needham and Lu, and Unschuld, as above.
Kuriyama Shigehisa, "Varieties of Haptic Experience: A Comparative Study of Greek and Chinese Pulse Diagnosis," Ph.D. diss., Harvard University, 1986.
5. Canonical Medicine in Practice: Physicians and Patients, Teachers
and Students
October 1
This week we look at the social relations of physicians of canonical medicine.
Primary
Nan-Ching, pp. 539-44.
Tamba Yasuyori, Ishimpô, selections.
Kenneth Dewoskin, Doctors, Diviners, and Magicians of Ancient China: Biographies of Fangshi. 1983, Fei Ch’ang-fang biography, pp. 77-81; Hua T’o biography, pp. 140-153
Secondary
Donald Harper, "The ‘Wu Shih Erh Ping Fang’: Translation and Prolegomena," Ph.D. diss., University of California, Berkeley, 1982, pp. 42-67.
Ted J. Kaptchuk, The Web That has no Weaver: Understanding Chinese Medicine, (NY: Congdon & Weed, 1983), pp. 138-266.
Nathan Sivin, "Text and Experience" in Bates, Knowledge and the Scholarly Medical Tradition.
Presentations
Compare the descriptions and translations of key concepts (1>signs and symptoms, 2>pulse, 3>patterns) by Kaptchuk with those of Sivin, Porkert, Needham and Lu, and Unschuld, as above. Which of these concepts are explicated in the The Yellow Emperor’s Classic of Internal Medicine
Part II. Diverse Perspectives
6. Demons of Disease and Exorcism
October 8
Demonic views of disease predated canonical medicine, and some think some of these shaped certain aspects of canonical medicine. What were demonic views of disease in early China, and how did people go about preventing and healing them? Do you see relationships between these and canonical medicine? How might relationships the relationships to patients of shamans and exorcists differed from those of doctors?
Donald Harper, "The ‘Wu Shih Erh Ping Fang’: Translation and Prolegomena," Ph.D. diss., University of California, Berkeley, 1982, pp. 67-107; 601 ff (on gu).
Bodde, Derk. Festivals in Classical China: New Year and Other Annual Observances During the Han Dynasty 206 b.c. - a.d. 220, (Princeton: Princeton University Press, 1975), pp. 387-395, 75-138; optional: 302-316.
7. Daoism and Medicine in Medieval China
October 15
Medieval Religious Daoist (Taoist) texts present a very different view of the body, and of disease. Many of the perspectives and techniques developed and elaborated Religious Daoism were incorporated in many people’s everyday health regimens and in medical texts and practices, usually in limited and simplified forms. How do the Daoist views of the body and health compare to those of classical medicine? Of "shamanic" or "fangshi" practices? What types of practice are advocated and developed in these texts? What are the goals of these practices?
Primary
"Body Gods and Inner Vision: The Scripture of the Yellow Court," trans. Paul W. Kroll, in Religions of China in Practice, pp. 149-155.
Tamba Yoshinobu, Ishimpô, Vol. 2, pp. 55-59.
Hong Mai, Records of the Listener, selections.
Secondary
Livia Kohn, "Medicine and Immortality in T’ang China," Journal of the American Oriental Society 108.3 (1988):465-469.
Kristofer Schipper,The Taoist Body, pp. 100-112.
Michel Strickmann, "Magical Medicine: Therapeutic Rituals in East Asian Tradition," unpublished ms., selection.
Li Jianmin, "Contagion and its Consequence: The Problem of Death Pollution in Ancient China," presented at the 21st International Symposium on the Comparative History of Medicine — East and West, Taniguchi Foundation, Mishima, Japan, Sept. 1-7, 1996.
Livia Kohn, "Kôshin: A Taoist Cult in Japan; Part II: Historical Development," Japanese Religions 20.1 (January 1995): 34-55.
8. "Nurturing Life"
October 22
Touched upon earlier, in regard to the emergence of canonical medicine, "nurturing life" or "cultivating vitality" practices have a long history in China, from ancient breathing, gymnastic, and sexual techniques, to modern qigong. This history, however, is not a linear one. What are some of the major historical developments in the history of "nurturing life" practices? How have practioners’ goals and specialists’ recommendations differed over time?
Primary
Tamba Yoshinobu, Ishimpô, Vol. 2, pp. 55-59.
Secondary
Donald J. Harper, "The Sexual Arts of Ancient China as Described in a Manuscript of the Second Century b.c." Harvard Journal of Asiatic Studies 47 (1987): 459-98.
Charlotte Furth, "Rethinking Van Gulik: Sexuality and Reproduction in Traditional Chinese Medicine," in Christina Gilmartin, et. al., Engendering China: Women, Culture, and the State, (Cambridge: Harvard University Press, 1994), pp. 125-146, 408-412 (fn).
Nancy N. Chen, "Urban Spaces and Experiences of Qigong," in Urban Spaces in Contemporary China: The Potential for Autonomy and Community in Post-Mao China, ed., Deborah S. Davis, et. al., (Cambridge: Cambridge University Press, 1995), pp. 347-361.
Suggested Readings
Douglas Wile, Art of the Bedchamber: The Chinese Sexual Yoga Classics Including Women’s Solo Meditation Texts, (Albany: State University of New York Press, 1992).
Taoist Meditation and Longevity Techniques, ed. Livia Kohn, et. al. (Ann Arbor: Center for Chinese Studies, The University of Michigan, 1989),
9. Gender and Healing in Late Imperial China
October 29
For the Ming (1368-1644) and Qing (1644-1911) periods, commercialization, the spread of printing, and the spread of literacy created wider markets for medical texts and other varieties of literature. The textual resources of this period give us rich materials for studying the lives of women and non-elite groups. In this section we look at scholarship on gendered bodies, and women as healers and patients. What were women’s roles as patients, decision-makers, and healers? What were women healers’ status, and when were they called in preference to other types of healers? How did canonical medicine theorize gender difference? How did Ming healers distinguish women’s diseases from men’s diseases? What diseases were specific to women? How were women able to assert control over their bodies?
Primary
The Heart and Essence of Danxi’s Methods of Treatment: A Translation of Zhu Danxi’s Dan Xi Zhi Fa Xin Yao, trans. Yang Shouzhong, pp. v, Table of Contents, 345-393.
Secondary
Charlotte Furth, A Flourishing Yin: Gender in China's Medical History: 960-1665; (forthocoming), ch. 1.
Francesca Bray, "A Deathly Disorder: Understanding Women's Health in Late Imperial China;" in Knowledge and the Scholarly Medical Traditions, ed Don Bates, (Cambridge: Cambridge University Press, 1995), pp. 235-251.
Suggested Readings
Christopher Cullen, "Patients and Healers in Late Imperial China: Evidence from the Jinpingmei." History of Science 31 (1993): 99-150.
Francesca Bray, Technology and Gender: Fabrics of Power in Late Imperial China, (Berkeley: University of California Press, 1997), Part III.
Part III. Developing and Contesting Medical Orthopraxies
10. "Confucian Doctors" of the Jin (1115-1234) and Yuan (1234-1368)
November 5
In the twelfth to fourteenth centuries, with access to bureaucratic careers increasingly restricted, elites trained in "Confucian" scholarship turned increasingly to medical careers. What were the factors that restricted access to more traditional bureaucratic careers for these elites? What made careers in medicine an attractive alternative? How did these elites’ develop a new form of medical praxis? Why might these forms of praxis have been attractive to themselves and their clients? What role did the wider availability of printed texts play?
Angela Leung, "Transmission of Medical Knowledge from the Sung to the Ming."
Suggested Readings
Chao Yuan-ling, "Medicine and Society in Late Imperial China: A Study of Physicians in Suzhou," Ph.D. diss., UCLA, 1995.
Robert Hymes, "Not Quite Gentlemen? Doctors in Sung and Yuan;" Chinese Science , no. 8 (January 1987): 9-76.
11. Medical Governance in Imperial China
November 12
Here, we examine the roles of medical bureaus (from the sixth century), imperially-commissioned medical texts (from the tenth century), government responses to epidemics, and general medical relief such as the distribution of drugs to the poor (especially in the eleventh to fourteenth centuries). Did government medical activities establish medical orthodoxy? Produce and spread medical knowledge? What were some theories of epidemics? How was contagion conceived? Why were quarantines uncommon in Chinese history?
Joseph Needham and Lu Gwei-Djen, "China and the Origin of Qualifying Examinations in Medicine," in Clerks and Craftsmen in China and the West: Lectures and Addresses on the History of Science and Technology, (Cambridge, Cambridge University Press, 1970), pp. 379-395, 434-435 (bibl.).
Hugh Scogin, "Poor Relief in Northern Sung China." Oriens Extremus , no. 25 (1978): 30-46.
TJ Hinrichs, "The Medical Transforming of Southern Customs in Song China (960-1279 c.e.)"
Angela Leung, "Organized Medicine in Ming-Qing China: State and Private Medical Institutions in the Lower Yangzi Region;" Late Imperial China (June 1987) 8.1:134-166.
Carol Benedict, Bubonic Plague in Nineteenth-Century China, pp. 100-130.
Presentations
1) Another side of medical governance:
The Washing Away of Wrongs: Forensic Medicine in Thirteenth Century
China, trans. Brian E. McKnight, (Ann Arbor: Center for Chinese Studies,
The University of Michigan, 1981).
What was "forensic medicine" in China? How were medical theories
brought to bear on determining cause of death? How do the views of the
body and medicine here compare with the orthodoxies described elsewhere?
2) Local identity and contestation of official medicine:
Marta Hanson, "Inventing a Tradition in Chinese Medicine: From Universal
Canon to Local Medical Knowledge in South China, the Seventeenth to the
Nineteenth Century," Ph.D. diss., University of Pennsylvania, 1997.
12. Medical Governance in Modern China
November 19
Western models of public health and sanitary policing were adapted in China in the twentieth century. Which groups advocated these innovations, and why? What factors slowed, sped, or shaped the process of adaptation? What have been some common themes in the history of public health in the twentieth century?
Primary
J. S. Horn, Away with all Pests, pp. 10, 70-80, 94-106.
Secondary
Carol Benedict, Bubonic Plague in Nineteenth-Century China, pp. 131-164.
Ruth Rogaski, "From Protecting Life to Defending the Nation: The Emergence of Public Health in Tianjin, 1859-1953," Abstract, pp. 262-312.
Suggested Readings
Croizier, Traditional Medicine in Modern China. Cambridge: Harvard University Press, 1964).
Ka-che Yip, "Science, Medicine, and Public Health in 20th-Cent. China: Health and Society in China: Public Health Education for the Community, 1912-1937," Social Science of Medicine 16 (1982): 1197-1205.
Ka-che Yip, Health and National Reconstruction in Nationalist China: The Development of Modern Health Services, 1928-1937, Association for Asian Studies Monograph and Occasional Papers Series, 50, (Ann Arbor: Association for Asian Studies, 1995).
November 26 Thanksgiving
13. Discourses of Modernity and the Creation of Traditional Chinese
Medicine
December 3
As western models of medical knowledge and professional practice became increasingly influential among China’s urban elites early in this century, different groups lobbied variously for the abolition, preservation, and modernization of Chinese medicine. What were the stakes for these groups? In what ways has Chinese medicine been transformed in relation to biomedical models? How has "syndrome differentiation" shifted in practice and prestige over the course of the twentieth century? What have been some common themes in the relations between Traditional Chinese Medicine and Western Biomedicine?
Bridie Andrews, "Tailoring Tradition: The Impact of Modern Medicine on Traditional Chinese Medicine, 1887-1937," pp. 149-166.
Bridie J. Andrews, "The Making of Modern Chinese Medicine, 1895-1937," Ph.D. diss., University of Cambridge, 1996, ch. 7.
Bridie J. Andrews, "Tuberculosis and the Assimilation of Germ Theory in China, 1895-1937," Journal for the History of Medicine and Allied Sciences 52, no. 1 (January 1997): 114-157.
Volker Scheid, "Subjectivity, Agency, Synthesis: The Plurality of Chinese Medicine in Contemporary China." Ph.D. diss., University of Cambridge, 1998, ch. 3, 7.
Judith Farquhar, "Re-writing Traditional Medicine in Post-Maoist China," Knowledge and the Scholarly Medical Traditions, ed Don Bates, (Cambridge: Cambridge University Press, 1995), pp. 251-276.
14. Accounting for Plural Healing Practices in Contemporary China
December 10
Until recently, there were predictions that Chinese medicine would be displaced or subsumed by biomedicine or would become standardized, and that "superstitious" forms of healing would disappear. Nevertheless, Chinese medical epistemologies and views of the body have retained their vitality and are increasingly influential around the world, Chinese medical practices are in some respects proliferating rather than converging, and "superstitious" healing is having a revival in mainland China. What are the sources of plurality in Chinese healing practices?
Primary
China Review, Beijing Review, selections.
Secondary
Arthur Kleinman, Patients and Healers in the Context of Culture: An Exploration of the Borderland between Anthropology, Medicine, and Psychiatry, (Berkeley: University of California Press, 1980), 1-17, [60-90], 203-310.
Volker Scheid, "Shaping Chinese Medicine: Two Case Studies," presented at Lu Gwei-Djen Memorial Workshop.
Judith Farquhar, "Multiplicity, Point of View, and Responsibility in Traditional Chinese Healing," in Angela Zito and Tani E. Barlow, eds., Body, Subject & Power in China, (Chicago: University of Chicago Press, 1994), pp. 78-99.