Medical Encounters, Practice, and Archives in China
Tel Aviv University-Max Planck Institute for the
History of Science Joint Workshop in Honor of Charlotte Furth and Nathan Sivin
Monday, 19 September
Theme II Medical Practice (Panels 4-5, 11 papers) Theme III Medical Archives (Panel 6, 3 papers)
8:30-9:00 gather for coffee and tea
9:00-11:00 Panel 4 Situating Medical Practices in Time, Space, & Text (4 papers)
Recently recovered medical and related manuscripts, buried in tombs over two thousand years ago or longer, reflect knowledge and practices distinct from and, perhaps, purposely edited out from the transmitted textual tradition. This includes the definition and treatment of particular illnesses. This paper examines this complex question by focusing on the transition of the role of the Heart (xin 心) from 4th c. BCE to 3rd c. CE in bamboo and silk manuscripts. The transition in clinical approach, from diagnosis of outer to inner bodily signs, that occurs over this time is apparent in the medical manuscripts but is also a conflict that is inherent in the word xin from the beginning. This paper looks most carefully at Qin-Han recipe texts, but frames the cures of Heart Pain and other xin ailments and symptoms in terms of the larger magical and philosophical recovered-manuscript literature of this time frame.
Medical encounter and practice in Early China are a barely opened research field, as social sciences in the last decades were more focused on medical theory and the development of medicine as science than on the actual practice of medicine. This paper aims at presenting the information gathered from the Qin dynasty (221-206 BC) medical recipe manuscripts of the Beida 北大 collection, the Liye 里耶 well n°1 and the Zhoujia tai 周家台 tomb n°247 concerning the process of medical encounters and practice during this period. With the Qin medical recipes, one begins to distinguish the pathway of medical consultation of the past, starting with the diagnosis where the senses of both patient and practitioner were paramount, followed by the medical actions. The Qin period practitioner disposed of drug remedies, whose preparation methods are described in the recipes; the healer could also rely on quite peculiar ritual and symbolic medicine, as incantations or exorcisms, or use a combination of all these practices. These sources are therefore the best material to understand the healing mechanisms in Early China, but also the medical theories and ideas circulating at the time. Moreover, they open up another important research field concerning knowledge and knowledge holders. Qin medical practice appeared to use ritual as a technique consisting of several specific phases and types of efficacy. These methods were deeply tied to religious and cosmological knowledge, like the deities or demons to address, calendric sciences and hemerology, which leads us to question the identity of the agents: who were these recipes actually intended to?
People have wished for luck and avoided misfortune ever since, especially for medical practitioners and pregnant women. In the past, delivering a baby was a matter of life and death to women due to the deficiency of medical knowledge and medical practice. Their best option was searching for the best combination of time and space for delivery. A smooth delivery was not only relied on professional assistance from medical physicians or midwives but also required the perfect timing in the right place. Divination provided a prediction about the best combination of time and space with luck for each delivery. Hence, divination for delivery was a practice to seek luck and avoid calamity.
This paper aims to critically examine the medical encounter during the 12th and 13th centuries. The medical encounter between a doctor and a patient is the epicenter of medicine. It is during these brief moments that years of preparation and training culminate in what the physician hopes would be a cure for the patient’s disease. Even the slightest mistake during these encounters can cause deterioration in the patient’s condition or even lead to fatal consequences. In this paper I would like to reconstruct the clinical scene during twelfth- century China based on surviving case records and one or two visual depictions. I will predominantly use one physician’s collection of medical case records (Xu Shuwei’s 許叔微, 1079-1154). Additionally, I will also use medical cases recorded by patients, scholars, and officials originating from other medical and non-medical primary sources. In this paper I will discuss how physicians reached their diagnosis and implemented treatment within this complex social context. I will also suggest that argument and debate became central in determining the pathology of the patient, in part at least, due to the growing access to printed medical literature. Lastly, I will revisit Sivin and Lloyd’s assumption about the Way and the Word being a way to distinguish the basic assumptions in Greek and Chinese science and medicine and to what extent this assumption is relevant in 12th- and 13th-century China.
11:00-11:30 Coffee Break
11:30-13:00 Panel 5 Medical Practice via Placebos, Talismans, and Recipes (3 papers)
The paper concerns the ways in which the modern notions of placebo and placebo effect may aid in elucidating premodern medicine and healing, and in turn suggests that there is something to learn from past medicine in our contemporary handling of these terms. I focus on the role of hope in the theoretical thought of European late medieval medicine as it can be learned from the writings of university teachers of the art. I am interested in how these authors handled and elaborated on Greco-Arabic traditions of discussing hope and identifying how they conceived hope should be incorporated within medical practice.
This paper explores new ways of analyzing recipes in the medical archive of the Unschuld Collection (preserved at Staatsbibliothek Berlin) by digitizing and converting its recipe volumes into a relational database that is amenable to statistical analysis. Encompassing handwritten volumes from the 16th to the mid-20th century, this collection is unique in its representation of popular medical practice in China extending beyond elite knowledge. We extracted 41,393 medical recipes from 227 recipe collections, each yielding the therapeutic indication, lists of ingredients including their amounts in a recipe, advice on their processing, and specifics of their application. Stripped from any theoretical or otherwise explanatory context, this data sheds light on what the everyday prescription practice in rural China looked like: What were the most frequently used drugs? Also, what regional, personal, or simply erroneously written drug names were used and how can they be identified? What illnesses were treated? What cluster of illnesses occur? What were the major drug processing techniques employed? Most importantly, though, a starting point is given to later on apply similar statistical methods to printed recipe collections to determine the degree to which such codified therapeutic approaches coincided with or differed from real, everyday practice.
Ritual healing was common in Han and non-Han ethnicities in ancient China; it was used to treat various illnesses, from animal bites to difficult births. The Iu-Mien, a branch of the Yao ethnic group, own many manuscripts written in Chinese concerning ritual healing, including talismans, incantations, and instructions. These manuscripts provide a possibility for a cross-cultural study on religious treatment.
This paper discusses two kinds of Iu-Mien fertility talismans: a set of three facilitate-parturition talismans and a talisman used to pray for offspring. In healing rituals, spells, talismans, and talismanic charts must be incorporated into the ritual process and accompanied by the requisite visualizations (cunxiang 存想). However, in the two aforementioned Iu-Mien talismans, visualizations are not merely mental imaginations produced by ritual specialists, but rather they are further concretized as “scenes” in talismans to enhance healing efficacy. The key to doing so is homeopathic magic; through imitative association, the ritual specialists harness the corresponding power of the imitated object for the spells and talismans, thereby bringing about a mutual correspondence in kind. That is, talismans do not only supplement religious texts but convey a holistic picture associated with the ritual’s purpose.
Although the Iu-Mien ritual healing demonstrates the adoption of healing practices from Song-Yuan religious movements and popular beliefs in southern China, it also contains Iu-Mien innovations. It indicates that the ritual specialists integrate outside rites and talismanic charts into their practices through selection, hybridization, and re-creation to respond to the challenges and impact of external religions.
13:00-14:30 Lunch Break
14:30-16:30 III Panel Theme: Medical Archives
Panel 6 Connecting Medical Archives to History (4 papers)
The literature on medicine and pharmacology in medieval Muslim society is vast and detailed; however, it is mainly based on books from that period and therefore, is covers especially the theoretical aspects. Hence, study and assessment of the practical aspects of Arab medicine and pharmacology in the Mediterranean society, requires examination of authentic documents from that period. At present this can be extracted mainly from documents found in the Cairo Genizah; this unique and authentic source of knowledge supply a valuable historical dimension. My paper aims to provide the basic knowledge about the Cairo Genizah as an historical source (in nutshell – more than 300,000 documents from the 9th – 19th century); its content in general and evidence for practical and theoretical Arab medicine and pharmacology in particular (i.e., more than 150 prescriptions, 70 lists of medicinal substances, dozens of letters with medical advice and 120 fragments of medical notebooks). These been studied systematically supplying us with different and valuable historical knowledge, including information the practical use of hundreds of medicinal substances, relationship between theory and practice and biographical data about more than 600 Jewish medical practitioners. Our knowledge regarding the Jewish physicians and pharmacists also based on Arabic sources. I will present facts and anecdotes about their life, socio-economic. The research provides a better understanding of everyday practical and theoretical Arabic medicine and pharmacology in medieval Muslim countries as well as information on various aspects of the Jewish physicians and pharmacists of that period.
This article reconstructs a biography of al-Shaykh al-Muwaffaq Ibn Jumay ̔ (fl. 1170-1200), one of the most illustrious Jewish physicians of the medieval Islamic world, using both Muslim historiographical and Jewish Geniza sources. The article demonstrates that data mentioned by Muslim authors and details mentioned in the Geniza documents, reciprocally strengthen, confirm and add information about Ibn Jumay ̔’s life, thus creating a colorful biographical mosaic of the famous Jewish physician’s life.
Phlegm (tan 痰) figures as a major cause and symptom of disease in late imperial Chinese medicine. Curiously, however, when we go back to the classics, the very notion of phlegm is entirely absent. The rise of phlegm represents one of the fundamental transformations in the history of Chinese medicine. In this presentation, I argue that a little-known chapter on phlegm in Wang Gui’s 王珪 (1264–1354) On the Art of Nourishing Life (1338), notable for discussing a host of unprecedented practices and concepts in Chinese phlegm theory, was pivotal for this transformation. Noting a strong resemblance with Galenic medical theories, I suggest that Wang’s chapter was the result of an encounter with the Galenic medical tradition during the Yuan period.
My presentation contributes to the conference theme of ‘Medical Encounters’ by discussing the ways in which Wang’s chapter promoted the rise of phlegm in Chinese medical theory, and by elucidating how this rise, in turn, spurred major transformations in the understanding of sickness––in terms of both etiology and therapy. My presentation also contributes to the theme of ‘Medical Archives’ by situating the case of phlegm in the proposed ‘prepositional approach’, and by advancing some methodological reflections. Which approaches might be conducive to tracing such hidden histories of transcultural knowledge exchange in Chinese medicine like the history of Chinese phlegm? Which methods will allow to gauge the hitherto overlooked impact of such exchanges on ‘mainstream’ Chinese medicine?
16:30-17:00 Coffee Break
17:00-18:00 Yi-Li Wu comments and group wrap-up discussion
Yi-Li Wu is an Associate Professor in the Department of Women’s and Gender Studies and the Department of History at the University of Michigan. She earned a Ph.D. in history and an M.A. in international relations from Yale University, and a B.A. in political science from the University of California, Berkeley. Her research on the history of Chinese medicine focuses on the multiple intersections of society, culture, and the body, with special emphasis on the late imperial period (16th to 19th centuries). Her publications include Reproducing Women: Medicine, metaphor, and childbirth in late imperial China and articles on medical illustration, forensic medicine, the treatment of wounds, and Chinese views of Western anatomical science. She is currently completing a manuscript on the history of medicine for wounds and injuries in China.