OUP UNCORRECTED PROOF – FIRST-PROOF, 04/12/11, SPi chapter 9 chi n e se m edici n e v ivienne l o and m ichael s tanley-baker Those active in living traditions of medicine, either as practitioners or patients, have oten imagined a long empirical tradition stretching back to a golden age in pre-history. Historians and anthropologists have too easily identiied the essential characteristics of the medicine of a speciic place, even when that place, particularly in the case of China, has been geographically and culturally diverse. In contrast, new research is more concerned in teasing out more complex dynamics between continuity and change as traditions constantly reinvent themselves in order to remain relevant, appropriate, and efective. Excavated records recovered from Shang dynasty (traditional dates: 1766–1122 bce) archaeological sites do indeed testify to very early divinatory techniques for identifying the cause and progress of illness, which is attributed to the malevolence of spirit ancestors.1 Yet while modern forms of ‘traditional Chinese medicine’ (TCM) bear the marked vestiges of astro-calendrical divinatory traditions, concerted attempts have been made in the twentieth century to eradicate its most obviously religious aspects. In the half-century since Needham began his project to write a history of science, technology, and medicine in China in its fullest social and intellectual context, the approaches of social and cultural historians have provided new tools to unlock the many dimensions of more popular (that is, pervasive) or religious healing practices. New evidence from texts written on bamboo and silk recently excavated from late Warring States (fourth to second centuries bce) and Han dynasty (202 bce to 220 ce) tombs has also upset the traditional narratives that sourced the origins of medicine in the word of the legendary Yellow Emperor, 5,000 years ago.2 With these irst medical treatises, set down in the late Warring States, we have a direct window onto the circumstances within which classical medical knowledge and practice irst emerged. hese new sources add depth and richness to the 10,000 extant pre-Communist (to 1949) medical works listed in the 1991 National Chinese Medicine Union Catalogue. his chapter does not attempt to describe the ‘evolution’ of a single entity that some imagine Chinese medicine to be. From a discussion of its mythic origins, through the coalescence of many theories about astro-physiology in early China to the medieval 0001275134.INDD 150 4/12/2011 6:32:53 PM OUP UNCORRECTED PROOF – FIRST-PROOF, 04/12/11, SPi chinese medicine  heyday of religious healing pluralism, it charts the changing emphases in what was always a plural healing environment. Indeed the ethnic and cultural boundaries of China itself are contested. Nevertheless there are clearly elements that pervade the scholarly and religious medicine of the Chinese empire. Most vividly, the extension of imperial bureaucracy reached into the body, whether controlling the body’s luids as if they were the imperial waterways, imagining the organs as oicials, or submitting petitions for cure to deity-oicials in the aterlife. he rupture of imperial authority at the hands of foreign aggression, contemporaneous with the large-scale arrival of European and American doctors and scientists, promised to ring the death toll for Chinese healing traditions. Yet they have continued to prove tenacious at reinventing themselves according to the ever-changing social and political priorities of the twentieth and twenty-irst centuries. We conclude with some observations about how the sensory modalities of Chinese medical thought speak powerfully to a modern global audience who frequently feel their own individual experience of health and sickness devalued in the processes of modern standardized medicine. Mythic origins he beginning of imperial China is dated to 221 bce, when the military machine of Qinshi Huangdi 秦始皇帝 (259–210 bce), irst emperor of the state of Qin, put an end to centuries of disunity during the Warring States period of the Zhou dynasty (1045–256 bce), and established the short-lived Qin dynasty (221–206 bce). With brutal eiciency, the Qin regime moulded a collection of small feudal kingdoms into a highly centralized imperial authority, broadly corresponding in geographic terms to what we know as China today. he Han dynasty (202 bce–220 ce), which came to power shortly ater Qinshi Huangdi’s death, embraced the Qin’s realpolitik and forms of governance, but at the same time sought to distance itself from its inluential but hated predecessor by drawing authority from the sage rulers of a golden age at the dawn of Chinese civilization, ater whom the new administration was supposedly modelled. To this end, the myth-makers and history-writers of the Han retold the stories of the lost golden age for their own times. In traditional Chinese accounts, the origins of medicine and the claim to authoritative wisdom of the medical classics are ascribed to the revelations of sages and cultural heroes. he medical aspects of Chinese mythic history attest to the range of healing traditions that existed in early imperial China. he task of civilizing and domesticating a savage world fell to the ive Sage Emperors, each of whom corresponded to one of the ive directions: north, south, east, west, and centre.3 Two of them, the Yellow Emperor (Huangdi 黃帝), and the Red Emperor (Yandi 炎帝), also known as he Divine Farmer (Shennong 神農), are intimately associated with medicine and healing. Other mythic patrons of medicine include the ‘Medicine King’ Bian Que 扁鵲, sometimes represented as a human-headed bird, and the enig- 0001275134.INDD 151 4/12/2011 6:32:53 PM OUP UNCORRECTED PROOF – FIRST-PROOF, 04/12/11, SPi  vivienne lo and michael stanley-baker matic Mr White (Bai Shi 白氏). he names of these legendary igures occur repeatedly in the titles of medical texts, or as their putative authors. Cultural heroes are thus credited with formulating various ideas that are central to Chinese views of the world, the body, and human society. he legend of the Divine Farmer, in whose name the Shennong bencao jing 神農本草經 (Divine Farmer’s materia medica, c.irst century ce) is written, enshrines the empirical spirit of Chinese medicine, and the concomitant belief that knowledge of the virtues of drugs and food had to be obtained through trial and error. he Divine Farmer’s main role was to rescue human beings from a state of savagery, where they fed on the raw lesh of the animals they hunted, drank their blood, and dressed in their skins, and to lead them towards an agrarian utopia. Famously, he tasted all living plants to ascertain their properties and, according to later accounts, struck all the plants with a magical whip to make them yield up their essential lavours and smells. He subsequently classiied the plants and distinguished those that were safe and suitable for consumption and medicinal use. Testifying to the importance of this tradition of empirical testing, his name occurs in the titles of many famous materia medica texts. he best known patron of medicine, the Yellow Emperor, is particularly associated with knowledge of how cosmic patterns were inherent in all things (laws, punishments, and the calendar) and he played a role in divination. hese attributes link him with the specialized medical arts of understanding the body’s relationship with the cycles and phases of Heaven and Earth, and of accurately predicting the progress and outcome of disease. Prognostications regarding sickness and health were framed within numerological sequences irst found in calendrical systems; thus the ‘Daybook’ (rishu 日書) divinatory calculations, which served to determine propitious times and places for human activities, became part of everyday health and hygiene practices.4 In China, medical practitioners were oten literate, and their knowledge and practice can be reconstructed both from their own writings and from the written records of scholarly and religious traditions allied to medicine. hrough 2000 years of empire, the authority and competence of the Chinese state were constantly embodied in a multitude of texts generated by the organs of government at every level and medical practice was enmeshed in this bureaucratic process. Access to the upper echelons of the civil service was obtained via a succession of competitive examinations essentially testing mastery of the Confucian canons. An analogous hierarchy existed in scholarly medicine: increasingly, social status depended on the possession, knowledge, and authorship of written texts. In the course of the Han period, a vast corpus of medical knowledge came to be ascribed to the Yellow Emperor. Compilations known as jing 經 (translated as ‘classic’ or ‘canon’) set out many of the cardinal principles of Chinese medical theory.5 Today the Move note 5 Yellow Emperor corpus is now known only through three recensions based on a printed here. edition published in the twelth century. he three texts difer in subject matter, but together describe medical theory: the human body as a microcosm, the origins of disease, and some therapies, principally acupuncture and moxibustion (a form of cautery 0001275134.INDD 152 4/12/2011 6:32:53 PM OUP UNCORRECTED PROOF – FIRST-PROOF, 04/12/11, SPi chinese medicine  or heat treatment generally using artemisia vulgaris or mugwort), and a few drug prescriptions.6 Important treatises of the recension known as the ‘Numinous Pivot’ Lingshu 靈樞 are the earliest evidence for qi (the essential stuf of life that fuels and animates everything in the universe) moving round the body in a regular rhythm through channels called mo or mai (脈), a term variously translated as ‘channels’, ‘vessels’, ‘meridians’, or ‘pulse’. In the theory and practice of healing, those channels, concepts of qi, blood, and yin and yang current during the Warring States period were woven together and brought to bear on the human body. he mai were structural elements in a linear coniguration of the inner body, foreshadowing the familiar tracts and channels of acupuncture. According to context, mai could refer to tracts underneath the skin (recognizable by the valleys between the raised ridges of the muscles), blood vessels, or the pathways of pain and other internal bodily sensations experienced as travelling or responding to palpation along a given plane. At certain locations on the surface of the body, the channels emerged in the form of pulses, which could be read for clues to the state of the body’s qi and the condition of the internal organs through which qi passed. Pulse diagnosis became the supreme diagnostic tool for elite medicine throughout the Chinese empire, and it retains primary importance for practitioners of TCM today. As Han physicians and thinkers came to grips with the puzzling behaviour of sickness, they were guided by a vision of a microcosmic body, united in its essence with the cosmos and the state, and inhabited by the same spirits, which lent it their potency. Just as qi connects every phenomenon in nature with the movements of the heavenly bodies and thus with the deities and the spirits of the ancestors, the imperial rulers aspired to extend their sway everywhere under heaven—and even to the body’s innermost depths where organs functioned as ministers of the empire, the heart as the ruler, the liver as the general. In an increasingly centralized state, the emperor played the crucial role of mediator between heaven and earth, which required him to carry out a cycle of complex rituals. Pursuing virtue, venerating one’s ancestors, and performing the rituals correctly were ways of securing the gods’ approval and ensuring order on earth. Disorder, in the form of civil unrest, natural disasters, famine, or disease, was a sign and consequence of the gods’ displeasure.7 he low of qi around the body was like the low of essential traic through the network of roads and waterways that provided for the well being of the Chinese empire. If the low was blocked or disrupted, analogous consequences would ensue, and the same kinds of remedies were called for. By the Former Han period, in the last two centuries bce, this analogy was generally applied to a newly constructed acupuncture body with fourteen channels. For example, in Lingshu: 12 (Jing shui 經水), part of the Yellow Emperor’s Inner Canon, the acupuncture channels are correlated with natural water courses.8 In the literature of this formative era, we ind a variety of theories about the number of channels, their paths, and their physical nature, in relation to ideas about circulation. Oten, these theories relect alternative views of celestial movements and the structure of Heaven and Earth. For instance, there are traces of an archaic number system based on the number eleven, in which the number six belongs to heaven and ive to the earth. 0001275134.INDD 153 4/12/2011 6:32:54 PM OUP UNCORRECTED PROOF – FIRST-PROOF, 04/12/11, SPi  vivienne lo and michael stanley-baker he treatises from the Yellow Emperor canon are mainly in the form of dialogues, which take place between the Yellow Emperor and a cast of learned ministers, including Lord hunder (Leigong 雷公) and most notably the legendary minister Qibo 歧伯, who specialized in acupuncture and esoteric matters. In one dialogue, the Yellow Emperor asks Qibo about perceived contradictions in the ways in which the channels of the body relect patterns in the heavens. In his reply, Qi Bo 歧伯 correlates particular days in the calendar with each channel.9 It is clear that the mai channels carried no ixed and pervasive numerical associations in early Han times, as inconsistencies are apparent in the assignation of time markers to organ systems and even to yin and yang. Dialogue form is frequently utilized in expository writing of the Han era as a device for exploring conlicting viewpoints and reconciling diverse ideas. By depicting the perfect architecture and rhythms of the human body with the same broad brush-strokes as the larger model of the cosmos, medical theorists were able to ind intelligible structure in an inchoate mass of information, without which it would have been impossible to make predictions or to chart anomalies and sickness, but a single system was slow to emerge. he precursors of what is known today as ‘acupuncture’—the practice of adjusting bodily essences by the use of ine needles—emerged in the Han period out of a diverse range of healing arts: qi and yin and yang practices, numerology, divination, petty surgery, blood-letting, and aspects of spirit healing. he material origins of acupuncture are found in ‘medicinal stones’ or bian 砭,10 which by the beginning of the second century bce, were clearly being used with the speciic aim of inluencing the low of qi along the mai channels so as to remove blockages believed to cause illness. An initial focus was ixed especially on locations where the channels crossed and the vicinity of the joints, where pain and discomfort were most frequently felt. Evidence for this therapy reveals an awareness of danger about the radical nature of this intervention. he ‘Jiu zhen’ 九鍼 (‘Nine Needles’) chapter of Lingshu records the Yellow Emperor criticizing the clumsy use of stone needles in qi therapy.11 Needles intended for moving qi were as slender as a ine hair and of very high quality, but most references in this text do indicate petty surgery or blood-letting rather than qi therapy as such. Chinese smiths certainly possessed the technology to produce very ine needles at this period, but no actual examples have survived. It is not until the irst century ce that we ind archaeological records of ine needles that can be linked with qi therapy at named acupuncture points. At all events, the use of needles still evoked a lingering disquiet even much later on.12 At the gentle end of the therapeutic spectrum, heat treatment or massage could be carried out at the blockage sites. Heat treatment tended to be regarded as a cheaper and more user-friendly alternative to needling, and the most widespread and most popular form of this was jiu 灸, translated as moxibustion. Moxibustion embraces a range of heat and cauterization techniques using various materials. It is sometimes spoken of as cauterization or cautery in the broad sense of the application of extreme heat, but it was used only occasionally to sear wounds. It has oten been noted that anatomical research and dissection are conspicuous by their absence from the medical scene in early China. Yet from the irst millennium bce 0001275134.INDD 154 4/12/2011 6:32:54 PM OUP UNCORRECTED PROOF – FIRST-PROOF, 04/12/11, SPi chinese medicine  there are moral exempla of tyrants dissecting the bodies of oicials and pregnant women, of the careful weighing and measurement of the viscera of an executed rebel leader (Wang Mang 王莽 r. 9–23), and records of the results of such cadaver dissections in the canonical medical works.13 In the second century, Hua Tuo 華佗 famously performed abdominal surgery with the aid of an anaesthetic called mafeisan 麻沸散, which apparently rendered his patients insensible as though drunk.14 Chinese theorists were not indiferent to the physical body. However, they viewed it irst and foremost as a dynamic system of functions and relationships, governed by the same regularities observable in the external world. he body was not a discrete object to be considered in isolation but a piece of a correlative universe that echoed with sympathetic resonances and signiicant similarities. It was this that made the body susceptible to medical diagnosis and treatment. Interlocked theories of cosmogenesis and statecrat, structured around the polarity of yin 陰 and yang 陽 and the wuxing 五行 ‘Five Agents’, provided the framework for sets of correspondences that, by the third century bce, had started to dominate ritual and technical thinking. For instance, Lüshi chunqiu argues that the emperor’s conduct, diet, vestments, and place of residence must be aligned with a ritual schedule based on astronomically calculated calendrical divisions.15 Around the dawn of empire they also organized classical Chinese medical thought, sometimes known as the Medicine of Systematic Correspondence.16 Yin and yang are not substances or ixed properties, and are most satisfactorily described as relational categories that organize the wanwu ‘myriad things’ in ‘complementary opposition’. Expressed most fundamentally in spatial alternation, such as back/front and inner/outer or in temporal contrasts such as day/ night or the alternation between warm and cold seasons in the yearly cycle, Yin and yang were to become key criteria for classifying physical substances and describing physiological and pathological processes and, thus, all the vicissitudes of health and sickness as well as stages in the development of diseases. he Five Agents schema extended the correlative basis for understanding the body by means of interrelated series of ive: ive seasons (spring, summer, late summer, autumn, and winter), ive sapors, ive viscera, and so on. It ofered an overarching template for relations between the world and the human body, rooted in a ivefold division of the year. he sets of correspondences summarized here model the natural (that is proper and salutary) relationship of the body with its surroundings, and the structure and form of what Joseph Needham called the ‘organismic’ universe.17 he image of the microcosmic body was further strengthened by social and political analogy. his is particularly obvious in the yin and yang correlations of the Yellow Emperor’s Four Canons, that is noble/ lowly and controlling/being controlled. Whereas the treatises compiled into the Yellow Emperor’s inner corpus do not bear witness to their authors, the late Han period saw the publication of a number of medical texts that speak to us in a more individual voice. In particular, the work of the scholarphysician Zhang Zhongjing 張 仲 景 (c.mid-second to third century) had a decisive inluence on the later course of Chinese medical theory. A foreword to the received text, attributed to Zhang Zhongjing himself, relates that he published two monographs on 0001275134.INDD 155 4/12/2011 6:32:54 PM OUP UNCORRECTED PROOF – FIRST-PROOF, 04/12/11, SPi  vivienne lo and michael stanley-baker febrile disease in response to an epidemic that devastated his town. hese two treatises were subsequently combined to form the much-cited Shang Han Lun 傷寒論 (Treatise on Cold Damage), which describes the course of febrile disease and includes a compendious materia medica with medicines for each stage. he ‘cold damage’ of the title is a systematic aetiological theory of febrile disease due to external attack in light of the progress of yin and yang. Eight centuries later, during the Song Dynasty (960–1279), Zhang Zhongjing’s magnum opus gained a fresh lease of life when it was identiied by government oicials desperately searching for sources of ancient wisdom to combat a deadly series of epidemics.18 hey prepared a new edition, which is still published and consulted today, and enjoys particular popularity in Japan. Religion and medicine Society in early China was peopled by religious igures who mediated spirit presences, including gods, nature spirits, and deceased ancestors. he wu 巫—diviners, mediums, shamans, or specialists in ritual, both male and female—were employed as mediums at court to avert demonic inluences, resolve inauspicious events, and perform the work of communicating with the invisible realm. As an integral part of exorcisms and sacriices to the spirits of nature at the correct times in the annual and seasonal cycle and summoning up the spirits of the departed at funeral ceremonies, they issued proclamations to expel illness and its causes, and used eigies and talismans to intervene in the course of disease. Female wu executed ritual songs, dances, and prayers, and participated in healing ceremonies alongside priests and medical practitioners of various kinds.19 he religious arena provided crucial continuity in face of dynastic rupture and political transformation. In medieval times, certain medical ideas were able to thrive and evolve in the context of religious movements.20 At the beginning of the irst century ce, millennial cults sprang up across China, some of them posing a threat to the power of the state, like the Yellow Turbans sect of Zhang Jue or Zhang Jiao (張角, d.184), which led an uprising against the Han ruling house. hough the uprising was crushed, it signiied the beginning of the end for the Han empire, which collapsed in 220 amid local wars, famine, epidemics, and waves of refugees. One of the ways in which the Yellow Turbans won converts for their cause was by ofering to heal the sick, oten by such ancient practices as incantation, and burning talismans and administering the ashes in water. heir main sacred text was the Taiping Jing 太平經 (Canon or Scripture of Heavenly Peace), a text grounded, on the one hand, in the theory of the Unity of Heaven and Humanity (天人合一), wherein individual virtue was thought to invite corresponding response from Heaven. On the other hand, it also contained theoretical descriptions of the body comparable to those found in Huangdi neijing, as well as numerous longevity prescriptions encompassing meditation, breath and qi techniques, self-cultivation, diet, plant and animal drugs, and the use of charms and talismans. It was later assimilated into the Daoist canon.21 0001275134.INDD 156 4/12/2011 6:32:54 PM OUP UNCORRECTED PROOF – FIRST-PROOF, 04/12/11, SPi chinese medicine  he Way of the Celestial Masters [Tianshi Dao 天師道], which also originated in this period, marked the beginning of Daoism as an organized religion. Religious Daoism found many adherents among the medieval ruling classes. he Celestial Masters held that illness was a punishment for evil deeds and could be cured by confession, submitting petitions in due form to the Celestial Bureaucracy, and atonement through acts of benevolence and public charity such as building roads and donating food to the poor.22 he Shangqing 上清 (Highest Clarity) school of Daoism, which grew out of the same tradition, was in part a reaction to the southward migration of the Celestial Masters, interfering with local religious structures. he Shangqing school rose to prominence in the ith century under the guidance of Tao Hongjing 陶弘景 (456–536). A key igure in the history of alchemy and medicine as well as religious Daoism, he not only compiled the Shangqing corpus, but also wrote treatises on alchemy and published the irst known critical edition of the Shennong pharmaceutical canon. He enjoyed imperial favour and patronage, especially for his work in the ield of alchemy.23 he conjunction of medicine, alchemy, and high oice is a recurrent theme in the lives of prominent medieval authors.24 A distinguished example is the scholar-physician Sun Simiao 孫思邈 (581–682 ce), who held government posts at the beginning of the Tang period. Sun Simiao was noted for his eclectic intellectual and religious views, which are exempliied in two massive and wide-ranging medical works where Buddhist chants and demonic medicine stand on an equal footing with classical scholarly medicine.25 Like Tao Hongjing, Sun Simiao was a seminal igure in the development of alchemy. Classic Chinese alchemy set out to understand and master the workings of the cosmos by studying its physical nature. By scrutinizing a substance in all its stages of transformation from its primordial state, an alchemist could learn to apply powerful analogies with cosmic time cycles—from the dawn of time to its end, wherein lies its beginning. hrough a carefully calibrated process of successive heating and cooling, the alchemists attempted to speed up the sequences of time so as to transmute imperfect base metal into perfected ‘gold’. hese practices were known as waidan 外丹 (external alchemy). he alchemists’ desire to master the physical world led them on a quest for elixirs of longevity and immortality. Highly toxic minerals like cinnabar, mercury, lead, and arsenic were used to preserve the material body in life as well as death. Arsenic, a commonly used ‘mineral drug’, is a nerve poison: when consumed over an extended period, even in small quantities, it results in lapses of consciousness, weakness, cardiac abnormalities, peripheral neuropathy, diarrhoea, and delusions. However, it may also induce hallucinations and ecstatic visions; and it seems that this, together with the gradual character of the pathology, allowed users to embrace the symptoms of poisoning as acceptable side efects. Countless Chinese literati and even some of the emperors of the Tang dynasty are said to have perished from the efects of immortality elixirs over the centuries and this tragic irony brought about the demise of external alchemy.26 As commercial and cultural interchange between China and the outside world intensiied in the irst century ce, Buddhism began to spread into China along the Silk Roads. Early Buddhism was at times misinterpreted (sometimes deliberately) in China as a Daoist sect and much of Buddhist terminology, thought, and symbols was adopted by 0001275134.INDD 157 4/12/2011 6:32:55 PM OUP UNCORRECTED PROOF – FIRST-PROOF, 04/12/11, SPi  vivienne lo and michael stanley-baker Daoist sects.27 Buddhism ofered a radical new view of the aterlife centred on the idea of progressive incarnations of an immortal personal soul, and it proposed meditation and prayer as the main path to salvation and healing. he Buddhist devotion to deities struck a particular chord with indigenous popular religion and the Buddha was readily assimilated into the local pantheon, oten in the role of Medicine King, as were the boddhisatvas of healing, undergoing thorough sinicization in the process. Both Buddhism and Daoism prospered greatly in the Sui (581–618) and Tang (618– 907) period, when China was uniied once more ater centuries of division. he Sui emperors especially were active patrons of Buddhist institutions. At its apogee in the early Tang, Buddhism was the main form of religious observance across the entire social spectrum. Under the auspices of the Tang ruling house (the Li family), debates among exponents of the major religious traditions were staged at Court, creating a lively, competitive intellectual environment conducive to the fusion of religious ideas and the exchange of healing practices.28 With increasing prosperity, Buddhist monasteries became important cultural and social centres, some of them providing cheap hostel accommodation, epidemic relief, or free in-patient care in inirmaries called Beitian fang 悲田坊 (ields of compassion).29 As ever, healing proved to be an efective mode of evangelism. However, the increasing material wealth and inluence of monastic institutions brought them into collision with the state. Literary depictions of monk and nun healers play upon stereotypes of debauchery and immorality, much as in medieval Europe and India. Monks specializing in the treatment of women’s illnesses bore the brunt of these prejudices. In the great suppression of Buddhism under the Tang emperor Wuzong from 842 to 845, thousands of monasteries were closed down or destroyed, their accumulated wealth was seized, and their inirmaries were taken over by the imperial authority.30 But despite this persecution, monastic centres continued to play a vital role in the preservation and scribal transmission of medical literature. Our current knowledge of Chinese medicine in the Middle Ages is derived in great part from manuscripts copied by Buddhist monks living in farlung communities along the Silk Roads.31 The Song period and politics Medicine received strong state support in the Northern Song dynasty (960–1127), owing to the personal involvement and interest of successive emperors, coupled with pressure on the Song government to tackle a series of major epidemics. he Song government sponsored the publication of medical texts, founded the irst Imperial Medical School, and established a formal system of medical education. It launched an empire-wide initiative to collect and record local herbs and remedies, which greatly expanded the repertoire of materia medica. his in turn stimulated the production of new illustrated herbals and prompted a reappraisal of drug classiications. Seeking ways to combat the epidemics, theorists and practitioners revisited ancient medical learning and reintegrated it into 0001275134.INDD 158 4/12/2011 6:32:55 PM OUP UNCORRECTED PROOF – FIRST-PROOF, 04/12/11, SPi chinese medicine  current practice. In this climate, a new elite of scholarly physicians, the ru yi 儒醫 (literally ‘Confucian physicians’), emerged.32 Towards the end of the irst millennium, in the period spanning the close of the Tang dynasty and the beginning of the Song, the empire entered a period of rapid and continuous economic change. With population growth and greater prosperity came a general expansion of the educated classes. As a consequence, competition for posts in the imperial bureaucracy—the traditional career destination for the educated elite—grew ever more ierce. A career in medicine came to be seen as an increasingly attractive alternative. From the outset, the Northern (early) Song Dynasty (960–1125) was marked by intense political debate focusing on the role of government and the appropriate extent of state intervention. his reached a crescendo in the late eleventh century, when the reforming statesman Wang Anshi 王安石 (1021–86) introduced a radical package of ‘new policies’ designed to modernize inance, agriculture, and administration. In this interventionist climate, the Bureau for the Editing of Medical Texts was established in 1057 to identify and publish an oicial canon of medical literature. his yielded thirty editions of canonical medical and pharmaceutical treatises and remedy collections and essentially shaped the corpus of early medical literature as we know it today. he rediscovery and promotion of the Treatise on Cold Damage of Zhang Zhongjing (second century) belongs to this period. A combination of factors at work from the twelth to the fourteenth centuries (during the Song and Jin (1127–1235) and Yuan (1279–1368) dynasties) had far-reaching repercussions for the production of knowledge, especially in the area of medicine. Advances in printing technology enabled the oicial canons to be widely disseminated and also meant that medical knowledge could be accessed and transmitted outside closed medical lineages. he scale of the medical bureaucracy and of state involvement in medical training during these two centuries was unparalleled before or since, until the twentieth century at least. Some oicials had medical texts inscribed or displayed in public places as a public information service and as a way of enhancing the government’s image. One oicial took it upon himself to demonstrate the eicacy of medicines by having them forcibly administered to the people of the district.33 he Southern Song (1125–1275) government made real eforts to address public health issues, commissioning elite doctors to dispense drugs as epidemic relief, but uptake in the southern regions was poor. Oicials reported that the populace shunned and isolated the sick, or entrusted them to the care of wu, traditional practitioners specializing in religious healing.34 Some oicials responded by punishing spirit healers, smashing their altars, giving them oicial medical texts to study, and requiring them to renounce their old occupation and become farmers or medical practitioners. Urbanization and the growing market economy favoured the development of knowledge networks, and provided the rising elite of scholarly physicians with unique opportunities to engage in the production of texts and innovative forms of medical activity. Ater the abolition of civil service examinations under the Yuan (Mongol) dynasty (1279–1368), publishing medical texts became a key way for a scholar and gentleman to 0001275134.INDD 159 4/12/2011 6:32:55 PM OUP UNCORRECTED PROOF – FIRST-PROOF, 04/12/11, SPi  vivienne lo and michael stanley-baker exhibit his intellectual and social status while also ‘accumulating virtue’—a meritorious activity with both private and public aspects, and both moral and practical advantages. Intersections From the late Han period onward, and probably far earlier (although the scarcity of evidence makes this more problematical), the history of medicine and healing in China needs to be viewed in a larger geographical context that extends eastward into what is now Korea and, in the Middle Ages, beyond that to Japan, and westward and southward to Mongolia, Tibet, India and all the nations and cultures that lie along the overland routes linking the ancient capitals with Persia and the lands further west. he medieval manuscripts recovered in the library cave at the Dunhuang shrines in today’s Gansu province, north-west China, ofer a rich mine of source material to investigate the connections and tensions between periphery and centre, or rather between multiple peripheries and centres. Recent research into these sources, most of which are held at the British Library and the Bibliothèque nationale de France, shows the remarkable degree of penetration of the oicial medical texts generated in the capital, but it also reveals an enthralling range of local medical material and international inluences that have let little trace in the oicial canons and other transmitted literature.35 Far away from the Chinese borders, at the end of one of the Silk Routes in Mongolian Ilkhanid Persia, scholars and translators from China, Tibet, Kashmir, India, Europe, and Arabia congregated, around the turn of the thirteenth and fourteenth centuries, at the court of the Judeo-Muslim scholar and Vizier Rashid al-Din (1274–1318)—one of the great intellectual melting pots of its time. Himself a court physician, Rashid al-Din sponsored medical translations and produced a monumental collection of medical knowledge edited and collated from a vast range of sources including Chinese sources. his literature is only now being studied in light of its signiicance for cross-cultural transmission.36 In the end, however, one is let questioning how much inluence scholarly translations like these can have had on actual medical practice. A more accessible point of entry into the practical business of transmitting knowledge may be provided by translating and analysing books of remedies and recipes. In translating concrete details and practices, the present-day translator is brought up against some of the same problems of identifying and interpreting substances and techniques that must have challenged earlier translators, merchants, and ordinary end-users. he Yinshan zhengyao 飲膳正要 evokes a vision of Mongolian expansion that is very diferent from the popular clichés of rape and pillage.37 Viewing the Mongolian imperial presence through the sensual, subtle medium of ingredients and spices, and the technology and philosophy of cookery and diet, we see how it functioned as a vehicle for cultural dissemination and assimilation throughout thirteenth- and fourteenth-century Asia. Yinshan zhengyao incorporates and interprets dietary and technical knowledge from Muslim and Arabic areas, oten sinicizing it in 0001275134.INDD 160 4/12/2011 6:32:55 PM OUP UNCORRECTED PROOF – FIRST-PROOF, 04/12/11, SPi chinese medicine  the process. Buell’s ongoing work is an English translation of Huihui yaofang (Muslim pharmaceutical prescriptions), a Chinese text dating to the Mongolian Yuan dynasty that includes many Arabic prescriptions, with Arabic and Persian drug names noted ater the Chinese equivalents. It provides a fascinating window on the network of commercial, religious, and ethnic interchange that formed Chinese medical culture in and ater the period of the Mongol emperors. he reception of new medical technologies from abroad was played out against the background of an empire in crisis, under attack from the imperialist powers of Europe, Japan, and America. As the increasingly fragile Qing dynasty lost its grip on central power, new medical techniques were entering the country, mainly through Christian missions. he irst Treaty of Tianjin (1858), which granted foreigners immunity from Chinese laws and the freedom to travel, enabled foreign missionaries, for the irst time, to acquire property and to live outside the treaty ports. By the 1890s, missionary clinics had been set up in large towns and cities in many parts of the country, and it was commonly acknowledged that free medical care could win converts where preaching failed. Missionary medicine appealed directly to the poor; wealthier people, who had the alternative of paying for expert medical care, were apt to despise missionary medicine and to be suspicious of its religious and political agenda.38 From the early eighteenth century, European anatomical texts had been available in China in Jesuit translations but, as long as they were not backed up by veriiable methods of treatment, they were regarded as little more than an exotic intellectual curiosity.39 his changed in the middle of the nineteenth century, with the advent of impressive new foreign techniques, mostly surgical and anaesthetic.40 However, spectacular though some of these were (including cataract surgery and the removal of tumours, cysts, and stones), they tended by their nature to align Western surgeons not with learned scholarphysicians, but with humbler medical artisans. Since antiquity, many kinds of petty and skin-deep surgery had been routinely carried out in China, including blood-letting, lancing abscesses, suturing wounds, removing projectiles, repairing hernias, surgical treatments of haemorrhoids, castration, and acupuncture.41 A small number of foreign miracle drugs, notably chloroform and quinine, were added to the repertoire of materia medica. Smallpox prevention provided an arena for the negotiation of indigenous and foreign technologies. Since the end of the irst millennium, symptoms identiiable retrospectively as smallpox are known to have been endemic among young children. hese symptoms were classiied under the rubric of ‘cold damage’, the syndrome pattern used since the Han period to explain feverish diseases and other, frequently infectious, conditions deemed to be caused by external pathogens. However, in the 1500s, medical practitioners in southern China had begun to carry out variolation (introducing infected matter from a patient with smallpox into the body of a healthy child so as to achieve immunity). here were ive types of variolation, with accompanying rituals, intended to remove ‘foetal poisoning’—according to Chinese medical theory, a hereditary disease arising partly from a disorderly lifestyle, and sexual, emotional, or dietary excess, and thus an oblique moral indictment of the suferer’s mother.42 0001275134.INDD 161 4/12/2011 6:32:55 PM OUP UNCORRECTED PROOF – FIRST-PROOF, 04/12/11, SPi  vivienne lo and michael stanley-baker Variolation did indeed prove efective. hus when Jenner’s vaccine was irst introduced into China in 1805 by Dr Alexander Pearson, it was cast as the competitor of variolation, creating tension and conlict particularly in rural areas. While variolation was carried out privately, Jennerian vaccination was ofered free of charge by some Chinese charitable organizations; however, the vaccine was diicult to obtain, preserve, and distribute. Compared with variolation, vaccination had a irmer methodological basis and better safety record, was easier to deliver, and did not carry the risk of spreading smallpox, making it suitable for institutional mass provision. Nonetheless each side claimed that their own technique involved less human sufering and let fewer disiguring pockmarks, and variolation continued to be practised into the twentieth century.43 Within the Qing (Manchu) administration, the cause of technological Westernization was espoused by a hard core of ethnic Chinese oicials who especially favoured the adoption of foreign military technology. hese fundamentally conservative reformers established the Self-Strengthening Movement (1860–95) under the slogan ‘Chinese learning for our foundation, Western learning for practical application’.44 here followed a limited programme of industrialization, which gave rise to the Fuzhou dockyard and Jiangnan arsenal in Shanghai. In a similar spirit, the Tianjin Medical School was founded in 1881 as the irst state institute for training in ‘Western medicine’.45 he urgency of reform was underlined by China’s defeat in the Sino-Japanese war of 1894–5 and the debacle of the Boxer Uprising, which further strengthened the hold of the imperialist powers over the ailing Qing state.46 Opinion in China was polarized: while conservative Qing oicials repudiated any form of institutional modernization, many of their reformist opponents saw wholesale Westernization as the only way forward. Numerous Chinese intellectuals went abroad to pursue studies in medicine or natural science, particularly in Japan, which had instituted a thorough-going top-down programme reform ater the 1868 Meiji Restoration. Medical training abroad is a common theme in the lives of the major Chinese revolutionary writers and reforming politicians of the early twentieth century.47 Reading the body culturally: sense and sensuality China’s most notable contribution to the mapping of the human body may lie not so much in the visual representation of its functionality as in descriptions of the sensory apprehension of the inner body. In his work on the cultural and social history of perception, Shigehisa Kuriyama explores the contrasting perceptual modalities whereby European and Chinese images of the body were constituted, and describes how diferent ways of understanding the body privilege distinct ways of seeing. For example, Chinese complexion diagnosis, a form of faciomancy that identiies bodily imbalances in the aura or colours of the face, is grounded in botanical metaphors deeply embedded in 0001275134.INDD 162 4/12/2011 6:32:55 PM OUP UNCORRECTED PROOF – FIRST-PROOF, 04/12/11, SPi chinese medicine  early Chinese language and culture. Like the lower of a plant, the complexion is a visible outward manifestation of the underlying health and strength of the human organism. Beyond the modern hegemony of the outward eye, Kuriyama inds diferences between knowledge derived from touch (haptic knowledge) in the Chinese and European traditions. He contrasts the knowledge of the pulse derived from ancient Greek tradition with the Chinese palpation of the mai 脈—a term in which ideas about bodily channels merge with the sensory awareness of the rhythmic pulsation of the vessels—illustrating how direct experience of the body is inseparable from culture-bound preconceptions and theoretical constructs.48 he social historian’s desire to encompass human experience in its broadest sense has led a growing body of scholars to a new methodological turn, known as ‘sensory history’, that challenges the presumption that ‘the past is best seen rather than, say heard or smelled’.49 By exploring culturally speciic styles of perception, this approach holds out the possibility of making histories that are situated within the sensibilities of their subjects. It has produced intriguing and richly evocative histories alive with sounds, tastes, and smells. China has a great deal to ofer this methodological turn in terms of both sources and perspectives.50 In documenting the felt, internal experience of being well, it, and strong, and the sensations of pain, pleasure, and passion, the Chinese healing arts also medicalized the world of the senses.51 Out of this culture of attending to the life of the inner body, and the language and theories that it generated, emerged the single most crucial innovation in early Chinese medicine—the concept of qi. he semantic circuits summoned up by qi confound any simple distinction between mind, body, and emotions, uniting them as changing states of the experienced self.52 he persistence of the concept of qi evokes the aesthetics of a time when the boundaries between these ways of experiencing the self and the world were not clear cut.53 Inner body qi cultivation has always had political resonances. Scholars studying contemporary manifestations of self-cultivation often point to the use of the body as a locus of resistance to authority or the state. Undoubtedly, some forms of qi cultivation, and allied religious and medical rituals, have functioned as expressions of political and personal autonomy. This can be seen in the bodily cultivation practices of hermits and political recusants from pre-imperial times onwards and of the early revolutionary armies, as well as the purportedly passive protests of the Falun gong 法輪工, which have recently aroused such concern in the Chinese authorities.54 Equally, working with inner body qi can be a deeply conservative and conformist practice. ‘Studies of culture need to pay at least as much attention to sites of concentrated cultural practice as to the dispersed sites of resistance.’55 Traditionally, selfcultivation forms part of the culture of artistic expression and refined leisure expected of retired government officials, living out their remaining years in tranquil rural seclusion. Today’s bands of post-menopausal, sword-wielding women practising their taijiquan in Chinese municipal parks are no more likely to endanger the status quo. 0001275134.INDD 163 4/12/2011 6:32:55 PM OUP UNCORRECTED PROOF – FIRST-PROOF, 04/12/11, SPi  vivienne lo and michael stanley-baker Conclusion Most of the researchers cited in this chapter have, in one way or another, challenged the premise that we can valuably look back at historical events from the perspectives of our current concerns. Certainly those histories that seek to understand sources as they were understood in their own time are more likely to provide rich sociocultural contexts and so capture the historical moment. For the ancient worlds this has meant that recent histories are more intent upon the ritual and religious worlds within which classical medical ideas formed and lourished. For China, what earlier historians let out was, for example, the pervasive power of calculating auspicious times and places, the plurality of beliefs attendant on any medical encounter, and accounts of healing in religious organizations. Yet, it is a folly to think that we can entirely extract the concerns that shape us as readers and writers in our own time from our historical narratives. Nor should we. Both authors of this chapter are as much practitioners of modern qi gong, martial arts, and Chinese medicine as we are historians. Our readings of primary text and interpretation of sources consciously lean towards practice-oriented accounts, as textured through our own experience. Such historical enterprise digniies itself with the idea that it is possible to share something of the sensory and perceptive style of the originators of early Chinese healing practices, and that doing so is germane, indeed essential, to deepening our appreciation of their textual legacies. Added to textual iliation and institutional histories, body-centred readings enable one to observe more readily the luid interplay between exercise, diet, pharmacology, cuisine, ritual, and cosmography, in the constitution of Chinese healing practice. With these methodological tools at our disposal, the door also opens into a rich interregional cultural and material history, and a narrative not only concerned with internal ‘Chinese’ genealogical developments but also ready to tackle the transitions, transformations, and transmissions that happen to medical knowledge as it is exchanged between diferent peoples across physical domains as well as down through generations of healers. Notes 1. David N. Keightley, ‘Shamanism, Death, and the Ancestors: Religious Mediation in Neolithic and Shang China (ca. 5000–1000 B.C.)’, Asiatische Studien/Études Asiatiques 52 (1998), 763–828. 2. Donald Harper, Early Chinese Medical Literature: he Mawangdui Medical Manuscripts (London/New York: Kegan Paul, 1998). 3. Anthony Christie, Chinese Mythology (London: Hamlyn, 1968), 84–91. 4. Martin Palmer, T’ung shu, the Ancient Chinese Almanac, 1st edn (Boston: Shambhala, 1986); Roel Stercx, ‘Religious Practices in the Han Dynasty’, in Michael Loewe and Michael Nylan (eds), China’s Early Empires, a Re-appraisal, (Cambridge: Cambridge University 0001275134.INDD 164 4/12/2011 6:32:56 PM OUP UNCORRECTED PROOF – FIRST-PROOF, 04/12/11, SPi chinese medicine 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22.  Press, 2010); Michael Nylan, ‘Yin-yang, Five Phases and Qi’, ibid. 398–414; Vivienne Lo, ‘Huangdi Hama jing (Yellow Emperor’s Toad Canon)’, Asia Major 14 (2001), 61–99. Nathan Sivin, ‘Huang ti nei ching 黃帝內經’, in Michael Loewe (ed.), Early Chinese Texts: A Bibliographical Guide (Berkeley: Society for the Study of Early China, 1993), 196–215. Paul U. Unschuld, Medicine in China: A History of Ideas: Comparative Studies of Health Systems and Medical Care (Berkeley: University of California Press, 1985), 263–95. Suwen 3.8. he Suwen is part of the Inner Canon of the Yellow Emperor. For a study of the Suwen see Paul U. Unschuld, Huang di nei jing su wen: Nature, Knowledge, Imagery in an Ancient Chinese Medical Text (Berkeley/Los Angeles: University of California Press, 2003). Lingshu 12. See Wu Jing-Nuan, Ling shu or he Spiritual Pivot (Honolulu: University of Hawaii Press, 1993), 69. Huangdi neijing taisu 黃帝內 太经素 5; Lingshu 4.15 ‘Wushi ying’ 五十營, in Wu JingNuan. Spiritual Pivot, 83. Vivienne Lo, ‘Spirit of Stone: Technical Considerations in the Treatment of the Jade Body’, Bulletin of the School of Oriental and African Studies 65 (2002), 99–128. Wu Jing-Nuan, Spiritual Pivot, 258–63. Bridie Jane Andrews, ‘he Making of Modern Chinese Medicine, 1895–1937’, doctoral thesis, University of Cambridge, 1996, 20–48. John Knoblock and Jefrey Riegel, he Annals of Lü Buwei (Stanford: Stanford University Press, 2000), 596; Louis Fu, ‘A Forgotten Reformer of Anatomy in China: Wang Ch’ing-Jen’, ANZ Journal of Surgery 78 (2008), 1052–8; Lingshu 12, ‘Channels and Rivers’ 經水. See Wu Jing-Nuan. Spiritual Pivot, 69, or Fu, ‘A Forgotten Reformer of Anatomy’, 1052. Zheng Bocheng, ‘he Miracle-Working Doctor’, Journal of Traditional Chinese Medicine 5 (1985), 311–12. Lingshu 11.77. See Wu Jing-Nuan. Spiritual Pivot, 254–67; Shigehisa Kuriyama, he Expressiveness of the Body and the Divergence of Greek and Chinese Medicine (New York: Zone Books, 1999), 244–5; Sun Xiaochun and Jacob Kistemaker, he Chinese Sky during the Han: Constellating Stars and Society (Leiden/New York: Brill, 1997), 96–7. Unschuld, Medicine in China, 51–92. Joseph Needham and Ling Wang, Science and Civilisation in China, Vol. 2: History of Scientiic hought (Cambridge: Cambridge University Press, 1956), 291–2. Asaf Moshe Goldschmidt, he Evolution of Chinese Medicine: Song Dynasty, 960–1200 (London: Routledge, 2009), 69–102. Lothar von Falkenhausen, ‘Relections on the Political Role of Spirit Mediums in Early China: he Wu Oicials in the Zhouli’, Early China 20 (1995), 279–300; Michael J. Puett, To Become a God : Cosmology, Sacriice, and Self-divinization in Early China (Cambridge, MA: Harvard University Press, 2002); Harper, Early Chinese Medical Literature, 148–83; and Unschuld, Medicine in China, 17–50. Unschuld, Medicine in China, 117–53; Sakade Yoshinobu 坂出祥伸, Taoism, Medicine and Qi in China and Japan (Osaka: Kansai University Press, 2007); Ute Engelhardt, ‘Qi for Life: Longevity in the Tang’, in Livia Kohn and Yoshinobu Sakade (eds), Taoist Meditation and Longevity Techniques (Ann Arbor: Center for Chinese Studies University of Michigan, 1989), 263–96. Barbara Hendrischke, he Scripture on Great Peace: he Taiping jing and the Beginnings of Daoism (Berkeley: University of California Press, 2006). Peter S. Nickerson, ‘he Great Petition for Sepulchral Plaints’, in Stephen R. Bokenkamp (ed.), Early Daoist Scriptures (Berkeley: University of California Press, 1997), 230–60; 0001275134.INDD 165 4/12/2011 6:32:56 PM OUP UNCORRECTED PROOF – FIRST-PROOF, 04/12/11, SPi  23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 0001275134.INDD 166 vivienne lo and michael stanley-baker Terry F. Kleeman, ‘Licentious Cults and Bloody Victuals: Sacriice, Reciprocity, and Violence in Traitional China’, Asia Major, 3rd series, 7 (1994), 185–211. Michel Strickmann, ‘he Alchemy of T’ao Hung-ching’, in Holmes Welch and Anna K. Seidel (eds), Facets of Taoism: Essays in Chinese Religion (New Haven, CT: Yale University Press, 1979), 123–92; Michel Strickmann and Bernard Faure, Chinese Magical Medicine (Stanford: Stanford University Press, 2002). Strickmann, ‘Alchemy’; Strickmann And Faure, Chinese Magical Medicine; Nathan Sivin, Chinese Alchemy: Preliminary Studies (Cambridge, MA: Harvard University Press, 1968). Sivin, Chinese Alchemy; Sabine Wilms, ‘he Female Body in Medieval China : A Translation and Interpretation of the “Women’s Recipes” in Sun Simiao’s Beiji quanjin yaofang’, Doctoral dissertation, University of Arizona; Elena Valussi, ‘he Chapter on “Nourishing Inner Nature” in Sun Simiao’s Qianjin yaofang’, MA thesis, School of Oriental and African Studies, 1996); Fang Ling, ‘La tradition sacrée de la Médecine Chinoise ancienne. Étude sur le Livre des exorcismes de Sun Simiao (581–682)’, doctoral dissertation, Ecole Pratique des Hautes Etudes, 2001, x. Joseph Needham, ‘Elixir Poisoning’, in Clerks and Cratsmen in China and the West: Lectures and Addresses on the History of Science and Technology (London: Cambridge University Press, 1970), 316–39. Erik Zürcher, he Buddhist Conquest of China; he Spread and Adaptation of Buddhism in Early Medieval China (Leiden: Brill, 1959); Stephen R. Bokenkamp, ‘Daoism: An Overview’, in Lindsay Jones (ed.), Encyclopedia of Religion (Detroit: Macmillan Reference USA, 2005), 2176–92. Christine Mollier, Buddhism and Taoism Face to Face: Scripture, Ritual, and Iconographic Exchange in Medieval China (Honolulu: University of Hawai’i Press, 2008). Charles D. Benn, Daily Life in Traditional China: he Tang Dynasty, ‘Daily Life through History’ series (Westport, CT: Greenwood Press, 2002), 227. Stanley Weinstein, Buddhism under the T’ang (Cambridge/New York: Cambridge University Press, 1987); Needham, Clerks and Cratsmen in China and the West, 277–8. Vivienne Lo and Christopher Cullen (eds), Medieval Chinese Medicine, trans. Penelope Barrett (London/New York: RoutledgeCurzon, 2005). Goldschmidt, he Evolution of Chinese Medicine, 103–46; Unschuld, Medicine in China,154–88. T. J. Hinrichs, ‘he Medical Transforming of Governance and Southern Customs in Song Dynasty China (960–1279 C.E.)’, PhD dissertation, Harvard University, 2003, 33–4. Ibid. 31. Lo and Cullen (eds), Medieval Chinese Medicine; Vivienne Lo, ‘Acuponcture et Moxibustion’, in C. Despeux (ed.), Notices on the Dunhuang and Kotanese Medical Manuscripts (L’Institut des Hautes Etudes Chinoises, College de France, 2010). V. Lo and Wang Yidan, ‘Blood or Qi Circulation? On the Nature of Authority in Rashīd al-Dīn’s Tānksūqnāma [he Treasure Book of Ilqān on Chinese Science and Techniques]’, in Anna Akasoy, Charles Burnett, and Ronit Yoeli-Tlalim (eds), Rashid al-Din as an Agent and Mediator of Cultural Exchanges in Ilkhanid Iran (London: Warburg Institute, 2010). Paul D. Buell, Eugene N. Anderson, and Charles Perry, A Soup for the Qan: Chinese Dietary Medicine of the Mongol Era as Seen in Hu Szu-Hui’s Yin-Shan Cheng-Yao (London/New York: Kegan Paul, 2000). Paul Cohen, ‘Christian Missions and heir Impact to 1900’, in Denis Twitchett and John King Fairbank (eds), he Cambridge history of China, Vol.10: Late Ch’ing, 1800–1911, Part 1 4/12/2011 6:32:56 PM OUP UNCORRECTED PROOF – FIRST-PROOF, 04/12/11, SPi chinese medicine 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. 54. 55.  (Cambridge: Cambridge University Press, 1978), 543–90; W. G. Lennox, ‘A Self-Survey by Mission Hospitals in China’, Chinese Medical Journal 46 (1932), 484–534. Daniel Asen, ‘Manchu Anatomy: Anatomical Knowledge and the Jesuits in Seventeenthand Eighteenth-Century China’, Social History of Medicine 22 (2009), 23–44; Marta Hansen, Speaking of Epidemics in Chinese Medicine: Disease and the Geographic Imagination in Late Imperial China (London: Routledge, forthcoming). Andrews, ‘he Making of Modern Chinese Medicine’, 55–9. Adrian Le Tellier, La Chine: essai ethnographique, médical et hygiènique (Paris: Baillère et ils, 1899), 45–52. ‘Inoculation’, in Joseph Needham, with Lu Gwei-Djen, Science and Civilisation in China, Vol. 6: Biology and Biological Technology, Part 6: Medicine, ed. Nathan Sivin (Cambridge: Cambridge University Press, 2000), 114–74. ‘Introduction of Jennerian Vaccination’, in Chi-Min Wang and Lien-teh Wu, History of Chinese Medicine: Being a Chronicle of Medical Happenings in China from Ancient Times to the Present Period (Tientsin: Tientsin Press, 1932), 271–301. Liu Kwang-Ching, ‘Self-strengthening: he Pursuit of Western Technology’, in Twitchett and Fairbank (eds), he Cambridge History of China, Vol. 10, 491–542; and Edward L. Shaughnessy, China: he Land of the heavenly dragon (London: Duncan Baird, 2000), 85–6. Wang and Wu, History of Chinese Medicine, 437–62. Philip A. Kuhn, ‘he Taiping Rebellion’, in Twitchett and Fairbank (eds), he Cambridge History of China, Vol. 10, 264–317. Andrews, ‘he Making Of Modern Chinese Medicine’, 149–76. Kuriyama, Expressiveness of the Body. Mark M. Smith. ‘Making Sense of Social History’, Journal of Social History, 37 (2003), 165–86. Alain Corbin, he Foul and the Fragrant: Odor and the French Social Imagination (Cambridge, MA: Harvard University Press, 1986); Judith Farquhar, Appetites: Food and Sex in Postsocialist China. Body, Commodity, Text (Durham, NC: Duke University Press, 2002). Mawangdui Hanmu boshu, ed. by Organising workgroup, Vol. 4 (Beijing: Wenwu chubanshe, 1985); Shi wen 十問 30–32; Suwen 16; Unschuld, Huang di nei jing su wen; Vivienne Lo, ‘Tracking the Pain’, Sudhofs Archiv 83 (1999), 191–211. Vivienne Lo, ‘Pleasure, Prohibition and Pain: Food and Medicine in China’, in Roel Sterckx (ed.), Of Tripod and Palate: Food, Politics, and Religion in Traditional China (New York/Basingstoke: Palgrave Macmillan, 2005), 163–65; Thomas Ots, ‘The Silenced Body—The Expressive Leib: On the Dialectic of Mind and Life in Chinese Cathartic Healing’, in Thomas J. Csordas (ed.), Embodiment and Experience: The Existential Ground of Culture and Self (New York: Cambridge University Press, 1994), 116–36. Robert Jütte, A History of the Senses: From Antiquity to Cyberspace, trans. James Lynn (Cambridge: Polity Press, 2005), 25–31. Nancy N. Chen, Breathing Spaces: Qigong, Psychiatry, and Healing in China, (New York/ Chichester: Columbia University Press, 2005), 369–74. W. H Sewell, ‘he Concept(s) of Culture’, in Victoria E. Bonnell, Lynn Hunt, and Richard Biernacki (eds), Beyond the Cultural Turn : New Directions in the Study of Society and Culture (Berkeley/London: University of California Press, 1999), 35–61, at 56. 0001275134.INDD 167 4/12/2011 6:32:56 PM OUP UNCORRECTED PROOF – FIRST-PROOF, 04/12/11, SPi  vivienne lo and michael stanley-baker Select Bibliography Harper, Donald, Early Chinese Medical Literature: he Mawangdui Medical Manuscripts (London/New York: Kegan Paul, 1998). Hinrichs, T. J., ‘New Geographies of Chinese Medicine’, Osiris 13 (1998), 287–325. Kuriyama, Shigehisa, he Expressiveness of the Body and the Divergence of Greek and Chinese Medicine (New York: Zone Books, 1999). Lo, Vivienne, and Christopher Cullen (eds), Medieval Chinese Medicine: he Dunhuang Medical Manuscripts (London: Routledge Curzon, 2005). Unschuld, Paul U., Huang Di nei jing su wen: Nature, Knowledge, Imagery in an Ancient Chinese Medical Text, with an Appendix: he Doctrine of the Five Periods and Six Qi in the Huang Di nei jing su wen (Berkeley: University of California Press, 2003). 0001275134.INDD 168 4/12/2011 6:32:56 PM