A Preliminary Discussion of Medical Conceptions of Local Bodies, Seasonal Geographies, and Regional Disorders in Late Imperial China

According to the Person, Place, and Season: A Preliminary Discussion of Medical Conceptions of Local Bodies, Seasonal Geographies, and Regional Disorders in Late Imperial China Marta Hanson * This is a rough draft of work in progress. Comments, criticisms, and citations are all welcome. But please do not cite without permission Introduction Since G. William Skinner’s development over the past thirty years of the * University of California, San Diego, Department of History. 2 「疾病的歷史」研討會 macroregional systems model for analyzing change in China, anthropologists, sociologists, and historians have had to mute their claims for all of China and turn their attention instead to local cultures and regional histories (Skinner 1964-5). In Chinese Society in the Eighteenth Century, Susan Naquin and Evelyn Rawski for the first time synthesized much of this new scholarship for the long eighteenth century of the Qing dynasty (Naquin and Rawski 1987). They followed through on Skinner’s proposal to analyze Chinese history in terms of “an internested hierarchy of local and regional histories” and, therefore, to refine our generalizations of national processes in China by specifying macroregional cycles of development and decline (Naquin and Rawski, 138). Their depictions of the nine major regional societies of the Qing emphasized the cultural diversity and regional distinctiveness of the Qing Empire. Considerable scholarship has been done as well on the central significance of native-place associations to secure a sense of self and community in the business networks, urban cultures, and local societies of the Qing (Goodman, 1995; Rowe, 1984). My work developed out of this scholarship but shifted the focus to both Chinese medicine and cultural notions of regionally distinct local bodies (Farquhar 1994). I began with the premise that there was never one authentic system of traditional Chinese medicine (Sivin 1987) but rather many local medical literate traditions (Wu Yiyi 1993). Not only did these traditions change over time, but also there were diverse medical cultures which differed in practice according to gender and class, at any given time (Cullen 1993; Bray 1997; Furth 1999). Regional traditions sometimes also appealed to conceptions of corporeal differences. One of the most important new literate medical traditions of the Qing —the warm-factor disorder tradition (wenbing xuepai) — came into being, for example, not only through social networks of local physicians expressed in the prefaces of the medical compilations themselves, but also by appealing to a regionally resonant cultural notion of southern corporeal distinctiveness (Hanson 1997). Currently I am attempting to expand this initial research regionally, and further Marta Hanson 3 verify its conclusions methodologically, by synthesizing the extant medical sources on regional body types, geographic climates, and therapeutic emphases. Geography, lineage, and native place all influenced therapeutic emphases in Chinese medical practice. Chinese physicians tended to give regional, climatic, and physiological explanations for significant variations in medical practice. I am most concerned with working out, however, what these medical explanations reveal about how the Chinese conceptualized human variation before the twentieth century? The evidence in primary Chinese medical texts shows that physicians explained human variation in terms of differences in the environment (cold or hot, dry or damp, highland or lowland, northern and western or southern and eastern), social distinctions related to the person’s position in society (male or female, wealthy or poor, noble or base, young or old), and bodily attributes (a stronger or weaker body, fleshy or thin constitution, full or depleted vitality, tight or open pores). How, in short, did different medical cultures utilize, reinforce, and even construct notions of local corporeal distinctiveness, geographically distinct climates, and regional character to promote their medical practices over others? Preliminaries This paper has three parts. First, I set up my views concerning how to think about Chinese conceptions of human diversity. Secondly, I introduce basic concepts in Chinese cosmology and natural history that underlie medical conceptions of human difference. Finally, I give two examples from the Chinese medical canon, miasmic epidemic disorders and a culture-bound syndrome called gu poisoning, to illustrate my arguments regarding the intersections Chinese made between conceptions of disease, space, and ethnic difference. As an introduction, I suggest the following hypothesis: Only with the invention of 4 「疾病的歷史」研討會 evolution, came the invention of biological race. And without a temporal conception of evolution, the biological conception of a racial hierarchy could not have been conceived. The concept of evolution not only transformed all aspects of human thought in the western world during the nineteenth century, it made it possible to make “natural” a hierarchy of human difference based on a biological conception of race. Within the concept of evolution, the idea of recapitulation was one of the most influential. Recapitulation justified racial stereotypes and prejudice as rational reflections of a race-based hierarchy based in the evolutionary development of the human species. Ernst Haeckel pithily summarized the idea: “Ontogeny recapitulates phylogeny.” This phrase was used to distill the idea that the life cycle of a human being, that is its ontogeny, repeats in a specific sequence the evolutionary development of the entire human species, or its phylogeny, generally. With this conception of recapitulation it became possible to rank human variation on a scale of human development, one that placed with the rise of the slave trade in Europe and the Americas, a young African man at a lower stage in the evolutionary path of the human species, than say, a white child, particularly a boy. Before the influence of western evolutionary thinking in the late nineteenth century, the Chinese did not have a conception of race as biological or evolutionary. Without a temporal conception of human difference, the idea that ontogeny recapitulates phylogeny makes no sense. By contrast, the Chinese had a conception that the biology of a single organism--plant, animal, or human--repeats or recapitulates the ecology in which it lives. Human variation was thus explained in terms of ecological resonance, not biological determinism. Certainly the Chinese differentiated between the civilized and the uncivilized, just as their European counterparts have done since antiquity. Becoming Chinese, however, was a fundamentally cultural process. Sinification transformed the simian barbarian into a human and, therefore, into a Marta Hanson 5 Chinese. The distinction between Chinese and Other was based on cultural assimilation of those on the periphery into the central Chinese polity and not, as in the western conceptions of race, on a linear model of evolutionary stages of the development of the human species. Broadly speaking my research examines the intersections of disease, space, and Chinese constructions of identity both of themselves and of minority peoples. My work on Chinese medical texts engages the central question of Chinese conceptions of the other, and particularly for the period 1600-1900, whether or not there was a discourse on race in China before the twentieth century. This is in fact the subject of this paper. I see two problems with the academic discussion over the past decade about race in pre-twentieth-century China. First of all, the scholars writing on race in early modern China have often used the western biological conception of race as a catchall category and project it onto Chinese discussions of human difference. This methodological problem is comparable with the common fallacy in medical history to impose biomedical conceptions of disease onto the past and other cultures. Secondly, historians of China have not yet examined systematically Chinese indigenous conceptions of human variation. Chinese used an ancient idea of resonant local qi, to explain variations in flora, fauna, as well as people. To understand the concept of local qi, one must first grasp three related concepts central in Chinese cosmology and medicine: qi, yin-yang, and the five phases. Basic Cosmological Concepts The concept of qi, although untranslatable into English, can be understood as simultaneously the “stuff that makes things happen” or “the stuff in which things happen,” and “what makes things happen in stuff,” depending on context. In Chinese 6 「疾病的歷史」研討會 cosmology, the world began with Undifferentiated Qi (with a capital Q), and first divided into a polarity of complementary classes called yin -yang, both considered to be aspects of Qi. Yin-yang structured dualities such as female/male, night/day, and cold/hot respectively. Although yin and yang are opposite in quality, they were always viewed as a complementary pair which both structured sequences of change within a systematic framework and whose polarity defined the framework itself. All things in the world were considered to be differentiated manifestations of qi (with a lower case q) which despite their multiplicity could be classified as either yin or yang, depending on their dominant aspect. In medicine, this two-part division was further divided into three aspects each to rationalize the pattern of illness in the body from the outer to the inner aspects of the body. All of the myriad symptoms of illness

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