The Female Hand: The Making of Western Medicine for Women in China, 1880s–1920s Shing-ting Lin Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Graduate School of Arts and Sciences COLUMBIA UNIVERSITY 2015 © 2015 Shing-ting Lin All rights reserved ABSTRACT The Female Hand: The Making of Western Medicine for Women in China, 1880s–1920s Shing-ting Lin This dissertation explores the transmission of Western medicine for women in late nineteenth- and early twentieth-century China. It starts from the fundamental presupposition that one cannot reach a proper understanding of the medical knowledge available at the time without investigating the practical experience of doctors, medical students, and their female patients. Focusing on the practice of Western and Chinese missionary practitioners (male and female), including the hospital buildings they erected, the texts they translated, the ways they manipulated their senses in diagnosis and treatment, and the medical appliances they employed for surgery and delivery, I reconstruct these people’s daily-life experiences, while reassessing the broad issues of professionalization and gender, colonial medicine, translation, knowledge making, and interactions between the human body and inanimate materials in a cross-cultural context. This dissertation first highlights daily life’s contributions to the history of professionalization by examining the on-the-ground, material circumstances of women doctors’ work at the Hackett Medical Complex in the southeast treaty-port city of Canton (Guangzhou). The physical conditions of the missionary hospital and its built environment embodied the multi- layered process through which the concrete elements of Western medicine were circulated, applied, and localized in China’s pluralistic medical landscape. Foregrounding Western missionary physicians and their Chinese students as practitioners who were practicing and learning medicine in a specific medical setting, I argue that the professionalization of medicine for women was not defined through a set of abstract theoretical criteria but was rather embedded in concrete daily practice, in observing, diagnosing, and treating patients. Drawing evidence from translated medical treatises and manuals, I demonstrate in the second part of the dissertation (Chapter Two) how craft-based, material-centered medical knowledge from the West was disseminated in China via the vehicle of words. Missionary doctors integrated the topic of manual skills into their medical discourse and, hence, could monopolize the realm of pragmatic knowledge generated exclusively from the hospital setting. Here, I underline the role that text played in mobilizing female healing techniques. By doing so, I show how Western-trained physician-translators derived their authority not only as practitioners of women’s reproductive health but also as interpreters of female bodies. Whereas published words served as a powerful vehicle in spreading speculative ideas, it was not the only channel through which Western medical knowledge was transmitted and acquired. Rather, an account of doctor–patient encounters at the Hackett Medical Complex clarifies the non-discursive modes of knowledge exchange that prioritized the interactions of skills, body, and instruments in translating technical know-how. As I show in this dissertation’s third part (Chapters Three and Four), missionaries created their new norms of medical practice by placing touching and handling at the center of diagnostic practice. Moreover, the apprenticeship approach and potential linguistic barrier between the missionary teachers and their Chinese students meant that a large body of knowledge passed from one to the other more by observation and imitation than by the study of books. Whereas most scholars in this field have characterized the Chinese encounter with Western science as a translation practice relying on texts, I broaden this assessment by exploring a gendered mode of knowing that emphasizes the role of clinical practice and sensory experience. My fundamental aim in this dissertation is to foreground knowledge transmission and the nature of the women doctors’ work at the level of practice, which was based mostly on their experiences and bodily labor. By focusing this history of profession-in-the-making in the multifarious exchanges between China and the West, I demonstrate how the “expertise” in women’s medicine was generated by doing—that is, by the technical dimension of the social practice of medicine. TABLE OF CONTENTS LIST OF FIGURES……………………………………………………………………………….ii ACKNOWLEDGEMENTS………………………………………………………………………iv INTRODUCTION……………………………………………………………………………..….1 CHAPTER 1. Building a Missionary Hospital: Networking and Reassembling Western Medicine in Nineteenth-Century Canton………………………...………………28 CHAPTER 2. Passages between Principle (li), Method (fa), and Technique (ji): Translating Gynecological and Obstetric Texts in China……………………………….……75 CHAPTER 3. A Woman’s Trained Touch: Diagnosis, Physical Privacy, and Clinical Etiquette in Cross-Cultural Medical Exchange……………………………………………...122 CHAPTER 4. The Forceps, the Hands, and the Operating Room: Missionary Medical Training, Female Students, and the Knowledge of Practice………………………………157 EPILOGUE Toward a History of Doing: Writing a History of Practice on Western Medicine for Women in China…………………………………………………………….202 BIBLIOGRAPHY………………………………………………………………………………206 i LIST OF FIGURES Figure 1-1. Countryside adjacent to the [Lafayette] compound...............................................…29 Figure 1-2. Basketball ground in front of maternity ward………..………………….…………..29 Figure 1-3. Hospital buildings…………………………………………………………………..30 Figure 1-4. Hackett lecture hall.……………………………………………………….………..30 Figure 1-5. City adjacent to the compound……………………………………………………..31 Figure 1-6. Boat houses.……………………………………………………….………………..31 Figure 1-7. Free out-patient clinic (1921)……………………………………………………....32 Figure 1-8. Donated furniture (ca 1920s).…………………………………..…………………..32 Figure 1-9. Donated chair (in part) (ca 1920s)..………………………………………………...33 Figure 1-10. The general ward……………………………………………….…………………..34 Figure 1-11. Patients at the Old Mat-shed Dispensary……………………………………………65 Figure 2-1. Female generative organ (Nüyuju)………………………………………………..115 Figure 2-2. Ovum (Yundan)……………………………………………………………….…..115 Figure 2-3. Fallopian tube (Danguan)………………………………………………………...116 Figure 2-4. Forceps (Qianjianqi)……………………………………………………………...116 Figure 2-5. Illustration of how the doctor put his/her hands on the patient’s abdomen……....118 Figure 2-6. Illustration of how to buckle the forceps…………………...……………………..119 Figure 4-1. Cutting the massive tumor………………………………………………………...158 Figure 4-2. Obstetrical Forceps………………………………………………………....……..159 Figure 4-3. Probe……………………………………………………………………….……..159 Figure 4-4. Vaginal speculum…………………………………………………………..……..160 Figure 4-5. Vulsellum………………………………………………………………………....160 Figure 4-6. Chinese doctors and nurses operating…………………………………………….168 ii Figure 4-7. Picture of Dr. Mary H. Fulton and Pudit (i.e., Zhou Chongyi)…………………...177 Figure 4-8. Picture of two students studying for the anatomy quiz…………………………...180 Figure 4-9. Picture of female students in the comparative anatomy class…………………….191 Figure 4-10. Picture of one operating room…………………………………………………….192 Figure 4-11. Sterilizer presented by Mr. Severance…………………………………………....195 Figure E-1. Female cooks in the kitchen of Hackett Medical Complex (ca 1920s)…………..204 iii ACKNOWLDGEMENTS I became interested in the history of Chinese women doctors as a Research Assistant at Academia Sinica, Taiwan. Angela Ki-che Leung, with her enthusiasm and encouragement, opened the door and led me into the unexplored world of these women. My advisors at Columbia University, Eugenia Lean and Dorothy Ko, were exemplary mentors in their patience, inspiration, caring, and immense knowledge. They continually and convincingly conveyed a spirit of adventure in regard to research and scholarship. Without their guidance and unwavering support this dissertation would not have been written. I have been fortunate to have outstanding teachers in other fields who offered insightful comments and suggestions to this project at various stages of its development: Kim Brandt, Ruth Rogaski, Ming-cheng Lo, Kavita Sivaramakrishnan, and He Bian. They carefully read my prospectus and dissertation draft, stimulating me to think about gender, medicine, and professions from cross-regional, inter-era, and interdisciplinary perspectives. I am also grateful to Rebecca Jordan-Young, who broadened my research scope on Feminism and Science Studies and to Pamela Smith, who introduced me to the world of everyday life in pre-modern Europe and insisted that writing a history of past material life is possible. For my archival work in the United States, I am greatly indebted to people who welcomed me with open arms: Martha Smalley at the Yale Divinity School Library; Melissa Grafe at the Harvey Cushing/John Hay Whitney Medical Library at Yale University; Matt Herbison at the Archives and Special Collections at Drexel University College of Medicine; Nancy Taylor, Lisa Jacobson, Kate Fox, Jenny Barr, and many others at the Presbyterian Historical Society (PHS). A special thank you goes to William Leonard, a board director at the iv PHS, who generously shared with me the story about his great aunt, who had done splendid work in China between 1895 and 1924. In Guangzhou (PRC), I had several productive meetings and