The history of water control in China has been discussed in volumes to the point where China has been termed a “hydraulic society.” But there were more personal relationships with water – writing, healing, cooking, making tea. What was water to early modern writers? Was it really an object of connoisseurship, and if so, what were the stakes? Were tea drinkers supposed to be able to tell the difference between last year's rainwater and the melted snow collected from the branches of winter-flowering plum trees five years ago - as Adamantina (Miaoyu) suggests in the Story of the Stone? It seems a joke meant to highlight her eccentricity (guaipi 怪僻) and obsession with purity, but a story in Anomalous Accounts from Liaozhai (Liaozhai zhiyi 聊齋誌異) suggests that the market really may have distinguished between waters – that “the price of that mountain water...was like that of fine liquor and was of such a quality that it was in demand everywhere.” The Classic of Tea preferred mountain water to that of rivers or wells, but Yuan Mei (1716-1797), in his Recipes from the Garden of Contentment (Suiyuan Shidian 隨園食單), made other distinctions. Water as an often-overlooked natural object of investigation provoked the broadly curious and the narrowly obsessive. Zhao Xuemin (1753-1803), for instance, in his Supplement to the Systematic Compendium (Bencao gangmu shiyi 本草綱目拾遺) added twenty-four kinds of water, each with their own properties and uses, to Li Shizhen's (1518-1593) fifty-six varietals, many of which Li claimed, were newly classified. My paper explores the evolving common knowledge of water, itself infinitely changeable, in the late Ming and Qing periods, and the sources of that knowledge.

Vernacular fiction is a rich and underexplored source of knowledge about the religiomedical marketplace in late imperial China. Beyond engaging physicians in moments of crisis, characters take medicinal formulas to treat constitutional weakness, gift each other culinary delicacies as marks of favor, and engage religious specialists to conduct ceremonies of merit-dedication. Violations of health taboos often advance the plot, demonstrating contested notions of the (im)purity of specific foods, people, spaces, and intimate acts. To what extent are such fictionalized health behaviors illustrative of quotidian understandings of health? Can we find in them traces of the ways medical thinking filtered beyond medical genres, influencing everyday ideas about bodies – their needs, norms, and limits? In this paper, I analyze scenes related to food and drug consumption found in two eighteenth-century vernacular novels, Honglou meng and Rulin waishi. Using Xue Baochai and Lin Daiyu’s discussion of bird’s nest as a central case study, I focus on the ways characters interact with food as a drug-like object – discussing it, abstaining from it, gifting it, and medicalizing its consumption. As literary scholars and anthropologists have demonstrated, food is always a signifier. Consumption choices, or lack thereof, magnify the general interpersonal status differences that likely distinguished real versus ideal health behaviors. I cross-reference the remedies and rationales described in these narratives of applied therapeutics against a range of relevant sources written in the same period, including encyclopedias of daily life, reading primers, and medical sources (materia medica, case study collections, and treatises by prominent Jiangnan physicians). By following information about these therapeutic remedies across literary registers and genres, I aim to nuance the many points of intersection – and contestation – prevalent in textual representations of everyday health knowledge.

In 1846, Bào Xiāng’áo鮑相璈 (fl. 1840) compiled the Yanfang xinbian驗方新編 (New collection of proven prescriptions) to address the distress felt by those who did not have access to or could not afford the services of a doctor. A century later, the situation Bào described had changed little for the vast majority of the Chinese population. This paper examines the second of our conference themes, Medical Practice, by tracing the role of the New Collection of Proven Prescriptions in the health-seeking experience of commoners with little access to doctors in the late Qing and Republican periods. It first establishes the widespread use of the Proven Prescriptions in this period as the quintessential mundane formulary. Both the publishing history of the collection and the testimonials of a range of readers underscore its validity as a proxy for commoner health-seeking behavior and as an entry point into medical practice. I then characterize the register of medicine in the text and describe the various modalities of treatment it offered to those who had fallen victim to one particular ailment: the fearful disease, huòluàn 霍亂 (sudden turmoil, ~cholera). I conclude by briefly discussing the dynamism of the Proven Prescriptions in shaping evolving medical practice in the Republican period

This paper examines the material culture of dietary supplementation in Republican China. It uses Shen Bao 申報, one of the most widely read newspapers of the day, as a lens through which to view what sorts of supplementation were available in Shanghai and how they were presented, packaged, and accessed. In the Republican period, many modernizers believed that Chinese bodies needed to be fortified to meet the demands of the global struggle for survival, a conviction that the new discovery of vitamins and vitamin-deficiency disorders only intensified. Simultaneously, individuals suffered from a host of chronic conditions that they associated with the stresses and hectic pace of urban life in an industrializing city: fatigue, weakness, indigestion, insomnia, infertility and more. In response, Chinese drug companies and popular health columnists urged citizens to supplement their diets to strengthen themselves individually and as a nation. The products that promised to revitalize included pills and elixirs with vague but evocative names. Some supplements drew on the appeal of science, boasting that they contained vitamins or phosphoric acid. Often, their promoters favorably compared their efficacy with that of established bupin 補品 such as ginseng or astragalus. What was the relationship between medical expertise and this culture of supplementation? To what degree were the supplements coming out of China’s burgeoning pharmaceutical industry shaped by doctors or classical medical knowledge, and were they ever prescribed, or were they always a form of self-medication? This paper explores such questions.

This paper extends the scholarship of Michael Strickmann, Paul Copp, and others on ritual healing practices that used therapeutic seals (yin印) and ensigillation (shouyin 手印) in healer-patient encounters. I reflect on the significance of the earliest records on “palm mnemonics” (zhangjue 掌訣) that not only specified functions for different locations on healers’ palms (zhang) but connected healers’ bodies with that of their patients in new ways. Furthermore, the second term jue, variously translated as “method,” “secret,” “mnemonic,” “rhymes,” or, “tricks of the trade” has a long history since the 2nd c BCE when it specified not only esoteric practices privately and orally transmitted, as in koujue 口訣 (oral jue) and gejue 歌訣 (sung jue), but also a genre term that designated the narrative collection of such techniques (ref. Constance Cook draft 2021). Possibly the earliest use of “corporeal jue,” called zhangjue, however, appear much later in two seventh-century primary sources: one of the two “Canon of exorcisms” (jinjing 禁經) chapters in the Revised Formulas Worth A Thousand (Qianjin yifang 千金翼方, ca. 650s) by Sun Simiao 孙思邈 (ca. 581-673) and the Dhāranī-spell of Janguli, the Poison Woman (Changjuli dunu tuoluoni zhoujing 常瞿利毒女陀羅尼咒經常, T no. 1265) recorded in 1152 but attributed to a 7th-century Buddhist monk. I ask new questions of these two sources: 1) within which genres did authors first describe such “palm mnemonics”? 2) how did hand seals differ from “palm mnemonics” in early medieval China? 3) what is the significance of using zhang (palm) in zhangjue (palm jue) for the healer-patient encounter in contrast to the more well-known oral mnemonics koujue 口訣 (oral jue) and gejue 歌訣 (sung jue). Answers to these three questions suggest broader issues related to three dimensions that concern my book manuscript “Grasping Heaven and Earth: The Healer’s Body-as-Technology in Chinese Medicine”: 1) within which genres does one find instructions for the “healer’s body”; 2) the mediating role of material things in healing rituals to connect healers’ bodies to those of their patients; and 3) the distinction between what healers needed to know conceptually to cure patients and whether (or not) their own corporeality was necessary to ensure an effective healing process.

This essay deals with the epistemic genres in Waike Zhengzong (The Orthodoxy of External Medicine 1617) written by external physician Chen Shigong (1555 – 1636). It first examines the structure and written forms of the book, then focuses on the analysis how Chen Shigong defined external medicine, and finally concentrates on the medical cases from the book. The book was described by Qing physician Xu Dachun (1693-1771) as “well-structured with chaotic case records”. This essay argues that Chen probably deliberately distanced himself from a general formulation as Xu expected. Instead of using yi’an (medical cases), Chen used the term zhiyan (healing verification or treatment validation) as the title for medical cases. Without following the formulation of yi’an, the epistemic genre zhiyan allowed Chen to transmit his practical knowledge and experience, such as knowledge for surgeries, moxibustion, variation for recipes.

Current historiography of the Chinese medical body has seen pictures of inner organs from the 11th to the 19th centuries as similar to each other. The Chinese portrayal of visceral organs and structures in the interior of the body did not show a major change until the late 19th century, when modern anatomy began to triumph over the Chinese medical visualization of the body as a result of the ramping up of Western sociopolitical powers in China. Two rationales underpin the current historiography that sees the body pictures in Chinese medical history before the 20th century as constant and reasonable. First, a “culture without culturalism,” which justifies the Chinese medical organs that modern anatomy could not explain as specific to Chinese culture, predicated upon Chinese experiences “on their own terms.” The second rationale runs parallel to the first, basing Chinese pictures of the body upon a universal empiricism, justifying the rationality of Chinese “anatomy” on par with Western science and medicine. These Chinese historical pictures’ difference from and sameness with modern anatomy, are therefore explained away by the incommensurability between Chinese and European cultures and the the universality of empiricism. This paper, however, offers up a different perspective. It argues that, there was a major paradigm shift in presenting the content and structure of inner organs taking place in the late 16th century. This shift came from an autochthonous sphygmological controversy, which therefore needs no “culture without culturalism” to explicate its rationale. Indigenous medical pulse diagnostics suffices to explain the unique Chinese organs without comparing to the European culture. Nor does it need to resort to the empiricism. The paradigm shift, I argue, was due to theoretical controversy bearing upon the commercialization of medicine rather than a new empirical observation of the body.

Recorded stories of the clinical encounter in China stretch back to ancient times. Throughout their history, these narratives have been called by different names, reflecting changes in format, function, and audience. One such transformation occurred during the Ming Dynasty, when 诊记 zhen ji (lit. “examination record”) was replaced with the neologism 医案 yi’an (“medical case,” or “case history”). With the adoption of the CARE (for Case REports) and STRICTA (STandards for Reporting Interventions in Clinical Trials of Acupuncture) guidelines another such shift is happing now, with a concurrent change in name, as the term “case studies” is replaced by “case reports.” In journal guidelines for writing case reports, authors are counseled to avoid drawing conclusions and limit their use of Chinese medicine terminology. Instead, they should include findings from diagnostic tests and imaging. Reports should be written to facilitate retrieval from electronic databases for aggregation and data analysis, and readily understood by clinicians outside of the field. Inclusion into the broader medical world is a significant milestone in the acceptance of Chinese medicine. However, this comes at a cost. Losing a physician-author’s individual narrative style makes cases less memorable. Gone is much of the insight into their thought process, along with references to the Classical texts of the Chinese medicine canon. This has significant effects on the efficacy of cases as a didactic tool. An annotated case from the renowned 20th-century physician Fan Zhonglin (范中林) serves as an illustration of this tradeoff.

This paper examines narratives of healer-patient encounter, especially that with female patients, in Song medical texts and anecdotes. It tackles two questions: how the patient-healer relationship changed along with the development of women’s medicine during the Tang-Song period, and how medical and anecdotal writings informed each other. Two stories from a twelfth-century anecdote collection, Record of the Listener (Yijian zhi), depict two very different pictures. The patients in both stories are female. In one, the patient cannot quite describe her own discomfort, and the physician makes his diagnosis almost purely by taking her pulse; the diagnosis is later proven correct, but the patient’s family refuses to believe it at first. In the other, the patient knows her own condition quite well and has a different opinion from the physician, who turns out to be wrong. The two accounts provide a testing ground for the interplay between anecdotal and medical writings in shaping healing narratives during the Song. In this paper I compare sources on false pregnancy and healer-patient interaction in medical and anecdotal writings to explore Yijian zhi as a source for medical history—not simply as illustrations or supplements to medical texts but as an agent in shaping medical writing and healing culture.

The 1948 Universal Declaration of Human Rights formalized the concept of the person and the fundamental dignity and equality of all human beings. This was the basis for the development of patient rights. The debate how best to conceive patient-doctor relationship continues, and varies according to prevailing cultural and social norms. However, the World Health Organization estimates that there is also growing international consensus that all patients have a fundamental right to privacy, to the confidentiality of their medical information, to consent to or to refuse treatment, and to be informed about relevant risk to them of medical procedures. The patients' right discourse stems from modern and Western principles of the self, that commonly include aspects of autonomy and individualism. But what happened in earlier periods and in non-Western societies? Have issues related to the patient's authority over one's body come up for discussion, and how have they been addressed in the absence of terms and perceptions familiar to us from modern medical ethics? This presentation suggests that Ottomans in the urban centers of the Empire between the Balkans and the Levant, during the 16th and 17th centuries, fostered medical-legal procedures that practically acknowledged the importance of active consent of the patient to the medical care he/she were given. Based on documents from the kadi courts (sijills), we can point to patient-doctor negotiation of treatment conditions. The sijill entries testifying that at least some physicians demanded and received releases from liability from their future patients are especially telling. The documents reveal the negotiations between healers and patients and the awareness of patients for the medical procedure they were about to undergo. A 2018 article in the Lancet claimed that there has never been a better time to be a patient, as this is a patient-centric era of medicine (Natalie Harrison, "Regressing or Progressing: What Next for the Doctor-Patient Relationship," The Lancet: Respiratory Medicine, 6:3 (March 2018), 178-181). Perhaps. But Ottoman sources reveal that in the early modern period, one aspect of the Ottoman medical system was the ability of many patients to choose among multitude of medical options that were available and accessible to them.

In January 1929, the government of Nanjing promulgated its “Provisional regulation on physicians” (医师暂行条例). Western-style physicians (xiyi) in the whole country were encouraged to apply for official licensing from the newly founded ministry of Health. Chinese-style physicians (zhongyi) were de facto excluded from licensing examination. Through continued mobilization and with the support of important personalities of the Guomindang, they eventually obtained the recognition of the State which started to issue licenses in 1936. This licensing process was a key step towards building a legal framework for medical practice in China. It also generated an unprecedented mass of documents providing rather detailed information on virtually every physician officially registered. In the province of Sichuan, that will be the focus of this presentation, I collected about 2300 licensing files. Although the changing organization of the health administration makes it difficult to locate and identify these documents, they provide historians of medicine in China with valuable information on the nascent medical profession. They make it possible to shift our attention from prominent physicians to a larger number of anonymous practitioners, including women. These documents were also a place of negotiation between the medical administration and both Western- and Chinese-style physicians to set the boundaries of professional groups. For medical actors, the licensing process contributed to raise a barrier – although still porous – between xiyi and zhongyi, but also to differentiate physicians (yishi) from other medical professions – midwives, nurses, etc. – and from illegitimate folk healers.

Algerian mothers and babies in French Algeria were exposed to a new world of healthcare through different colonial institutions. The Institut Pasteur (1894), la Goutte de Lait (1905), and Assistance aux Mères et aux Nourrissons (AMN, 1926) were three such institutions, which aimed to treat and cure the Algerians, among them Muslim and Jewish mothers and children, as well as to educate them and to shape their perceptions about health, medicine, and hygiene. High rates of infant and maternal mortality attracted the attention of the colonial authorities and motivated them to create medical institutions to fight this phenomenon. Despite their efforts to be accessible to the locals, these three medical institutions did not dispel feelings of fear and misgiving among the Algerians. The cultural gaps, different languages, and suspicion toward the colonizer – all made it difficult to prefer unfamiliar modern medicine over traditional and local knowledge. This paper will address the stated roles and purposes of each institution and will assess their success in achieving Algerian mothers’ trust and convincing them to turn to modern medicine. In addition, it will focus on the interactions and relationships that were created within their walls between medical practitioners, colonial administrators, and different categories of patients.