The past two decades witnessed the rapid growth of studies on the history of medicine in China. Historians have shown the great diversities of medicine and healing practices in Chinese history as well as their potential to inform aspects of society and everyday life. Now it is widely accepted that there was no single entity known as Chinese medicine but a plethora of knowledge, practice, and healing arts in the premodern period. A discrete and well-defined field of (traditional) Chinese medicine only started to take shape after 1929, when practitioners felt the urgency to defend their profession in face of challenges from both Western medicine and the state.
Recent studies1 also show that many of the defining features of Chinese medicine, including pattern differentiation and therapy determination, experience-based medicine, and holistic thinking, have more recent origins in the modern period. All these development in the field urges scholars to reconsider some fundamental categories, concepts, and practice now taken for granted in the realm of traditional Chinese medicine (TCM).2
This special issue approaches this problem in Chinese medical history through the lens of knowledge formation and transformation. Continuities and discontinuity were constantly mentioned in historical discourses of Chinese medicine.3 Though many would agree that institutions, professional identities, and the social status of medicine experienced several dramatic transitions in history, few would assume a parallel change in medical knowledge. Knowledge in Chinese medicine is typically described as accumulative rather than transformative, evolutionary rather than revolutionary. This special issue attempts to show such an interpretation is inadequate to achieve an overall understanding of Chinese medicine and its history. We intend to demonstrate that knowledge traditions in Chinese medicine were constantly transformed and reconfigured in historical contexts. The term “cultures of knowledge” is deliberately used here to emphasize that we understand knowledge as a social creation constructed in cultural practices rather than a fixed body of words and thoughts.
To achieve this goal, this special issue embraces a long-durée perspective to show that medical transition and transformation is not a distinctively modern phenomenon but intermittently emerged from antiquity to contemporary China. Even though the modern formation of TCM marks a distinctively new system of medicine, it is not the only notable medical transition in Chinese history. From the article in this issue, one can easily identify the Song dynasty as another key transitional period. Two articles authored respectively by Dolly Yang and Asaf Goldschmidt keenly emphasize the role of the state in facilitating the canonization and institutionalization of medical systems during the Sui, Tang, and Song dynasties. Articles focus on periods after Song, however, manifest a decentering trend in knowledge production in which the role of state becomes obscure. The special issue consists of 12 articles, covering a wide range of topics including materia medica, acupuncture, Dao Yin, formula books, disease concept, life nourishment, and medical institutions. Here, I would like to raise a few important categories that organize and synthesize the perspectives and arguments presented in this issue.
Concept. A concept is a typical form of knowledge that distills complex realities into abstract ideas or terms. Once established, a concept tends to be separated from its historical context and further essentialized as a body of timeless knowledge. Several articles in this issue endeavor to recontextualize a few well-known Chinese medical concepts. Dolly Yang examines the concept of Dao Yin and challenges the previous assumption that it was introduced to medical practice from the Daoist tradition. Yu Xinzhong discusses the emergence of a new disease concept Shu Yi (鼠疫 bubonic plague) in the late Qing period. He argues that the new concept was more likely to be derived from vernacular knowledge rather than Western biomedicine. Lai Lili and Judith Farquhar’s article begins with a prominent concept that relates medicine to food. It unravels the rich philosophical implication and practical dimension of flavor in Chinese herbal medicine.
Genre. Gianna Pomata coins the term “epistemic genre” in conceptualizing the function of recipes and cases in medicine. The term denotes the type of genres that are self-consciously used for creating new knowledge. Not all genres examined in this issue are completely new, but historical actors deliberately used them to form new arguments or to guide new practices in their respective periods.4 Through a close reading of materia medica works, Chang Che-chia uncovers heterogeneous intentions in composing commentaries for the Divine Husbandman’s Canon of Materia Medica (神农本草经). Liu Xiaomeng uses practical works on authenticating medicines in late imperial China to reconstruct the sensory technique used in the medicinal markets. Liu Xiyang gathers a wide range of formula books that specifically aimed to disseminate knowledge on epidemic prevention. By investigating medical works for the care of elderlies in modern China, Pi Kuo-li detects the tension between traditional knowledge and new scientific knowledge. Mang Fan’s review article provides an overview of cutting-edge scholarships that integrate history of publishing and history of medicine. It shows that the history of books provides a powerful tool in formulating research about medical knowledge.
Material. The “material turn” in the history of medicine redirects the attention of scholars from body concepts and medical theories to the material form of therapeutics, namely technologies and medicines. Three articles in this issue deal with knowledge produced through medicinal materials. La Lili and Judith Farquhar present an ethnography of tasting and using herbal medicines in China’s southern mountains. Liu Xiaomeng investigates the practical technique of authenticating medicines in the market. Both studies emphasize the role of bodily senses in examining and evaluating herbal remedies. Yao Wuyutong’s study, however, explores how the practical knowledge about medicinal ingredients was extracted from folk gatherers and codified in texts produced by the state. Material practices, according to the three articles, are more related to hands-on and down-to-earth expertise rather than highly theoretical abstractions.
Space. New developments in the history of science no longer consider science or any other forms of knowledge as universal claims of truth but as situated practices. Therefore, space stands out to be a significant aspect of knowledge production. Authors of this special issue tackle the spatial questions in Chinese medicine in two ways. Asaf Goldschmidt’s article represents the first approach that investigates the establishment of new social spaces for public health by the central government of the Northern Song dynasty. This state-sponsored model of epidemic relief forms a sheer contrast with the strategies of the Qing dynasty (as described in Liu Xiyang’s research), in which local officials and gentries played a more prominent part in creating social spaces for the spread of formulas and medical knowledge.
Zhang Shujian also emphasizes the tensions between stated-sanctioned knowledge and popular theorizations of acupunctural practice. Another notable aspect of Zhang’s article is the localized production of knowledge in acupunctural schools. It points out the other spatial concern in this issue, the geographical spaces. Yao and Lai & Farquhar’s articles self-consciously situate their studies in specific locations, one in western Sichuan and the other in China’s southern mountains. Liping Bu, however, directs her focus to the United States, probing into the global process in which Chinese medical knowledge is transmitted and transformed.
Nowadays, studies on the history of knowledge have shifted the attention from “knowledge-that” to “knowledge-how.” Articles in this issue also focus more on the practical side of knowledge rather than theories and words. We try to avoid the tendency to essentialize any form of knowledge or culture as innate or unchanged core values of Chinese medicine. Our findings suggest that Chinese medicine should be viewed as a fluid system of knowledge and practice being constantly redefined and transformed throughout history. The authors of the special issue include not only historians but also anthropologists and clinicians. We hope that this interdisciplinary effort can demonstrate the potential to integrate history of Chinese medicine with history of knowledge and bring a new perspective to the study of Chinese medical history.
This article does not contain any studies with human or animal subjects performed by the author.
YU Xinzhong wrote and reviewed the article.
Conflict of interest
1. Lei S. Neither Donkey nor Horse: Medicine in the Struggle over China’s Modernity. Chicago: Chicago University Press; 2014.
2. Farquhar J. Knowing Practice: The Clinical Encounter of Chinese Medicine. San Francisco: Westview Press; 1994; Scheid V. Chinese Medicine in Contemporary China: Plurality and Synthesis
. Durham, NC: Duke University Press; 2002; Andrews B. The Making of Modern Chinese Medicine, 1850-1960
. Vancouver & Toronto: UBC Press; 2014.
3. For a recent initiative for the historical study of Chinese medical knowledge, see Yu XZ. Merging the gap between internal and external approaches: an inquiry into the interdisciplinary studies of Chinese medical knowledge and its histories (融通内外：跨学科视野下的中医知识史研究刍议). Qilu Journal. 2018;5:28–35. Chinese.
4. Pomata G. The recipe and the case: epistemic genres and the dynamics of cognitive practices. In: Greyerz K, Flubacher S, Senn P, eds. Wissenschaftsgeschichte und Geschichte des Wissens im Dialog–Connecting Science and Knowledge. Göttingen: Vander-hoeck & Ruprecht; 2013. p. 131–154. For the use of epistemic genre in Chinese medical history, see Hanson M. Epistemic genres as a conceptual tool in the history of Chinese medicine. Chinese Medicine and Culture. 2022;5(1):1–8.