In addition to the established sections on academic articles, practice reports, and book review in previous issues, this issue introduces two additional subsections called field notes and translations. For field notes we seek essays of self-reflection from scholars and physicians that speak to issues they encounter in their respective fields—from a clinical subfield, such as midwifery (as is featured in this issue’s field notes), to an academic field such as anthropology, history, political science, or sociology. We expect that these field notes will provide new perspectives on the critical study of Asian medicine in diverse milieus in the present. The section on new English translations of primary sources similarly seeks to reveal fresh angles to examine Asian medicine, but from a different lens through previously untranslated materials from the past. These two new sections thus amplify the central theme of this special issue on the diversity of medicine in China and of Chinese medicine in Europe.
The inaugural field notes, for instance, comes from Gudrun Kotte’s doctoral fieldwork as an anthropologist and also her practical experience as a lecturer in TCM midwife training interviewing pregnant Chinese women in Berlin in 2005 and 2007. She published this research as a book, Wissen, Körper, Kompetenz. Das Erleben von Schwangerschaft, Geburt und Wochenbett von chinesischen Frauen in Berlin (Knowledge, Body, Competence. Chinese Women’s Experiences with Pregnancy, Birth, and Childbed), in 2009, which is also reviewed in this issue. She recalls in her account how she had learned from an early 1913 German translation of the Chinese classic on midwifery, Shou Shi Pian 壽世編 (Treatise for Conferring Longevity on the World, 1785), about the Chinese ideals of a ‘good birth’ like ‘a ripe chestnut that falls out of its shell by itself’. However, contrary to the natural birth process modelled in part on the Shou Shi Pian that she and other German midwives sought to provide for their German clients, the Chinese women she interviewed in Berlin preferred the safety of a medicalized birth in the clinic or hospital. She then asked herself ‘What is a Good Birth’? Her response to this question reveals how Chinese-inspired midwifery practices in Berlin have provided both German midwives and pregnant women with a model for a ‘good birth’, which for various complex social, cultural, and historical reasons ethnically Chinese and pregnant women also residing in Berlin do not accept for themselves. This is an interesting case in which ‘Chinese medicine’ in Berlin has been translated into a new cultural context and tailored to non-Chinese consumers looking for alternatives to conventional medical approaches to the birth process. But this Chinese medical alternative for a ‘good birth’ among Germans today no longer suits the medical expectations of pregnant Chinese women living abroad or the diasporic communities in which they live, a process that might be going on in many transnational Asian therapeutic practices.
The selections in the new translations section similarly expand upon the theme of the diversity of Chinese medicine but within China. Pierce Salguero translated a section on ‘Treating Illness’ in the sixth-century meditation manual by the famous Chinese scholar-monk and founder of the Tiantai school of Buddhism, Zhiyi (538–597). As one of the earliest examples of Indo-Sinitic medical syncretism, this important text reveals a medieval Chinese Buddhist perspective on the methods by which a practitioner may carry out both diagnosis and healing through meditation practices.
Nathan Sivin offers translations of still different perspectives on Chinese medicine and health. He first translates an eighteenth-century example of a diagnostic form that the physician Xu Yuhe wrote for his disciples. Neither the only nor earliest example of this genre, it nonetheless represents the conceptual basis upon which the long history of Chinese medical case records developed. In addition to the various factors that went into determining a diagnosis, one also learns a Chinese physician’s strategies for determining a therapeutic response and evaluating its course. Sivin also includes translations of poems that present arguably the “patient’s perspective” on ageing. Translated on the occasion of Sivin’s friend’s eightieth birthday, the poems by the famous Tang poets Han Yu (768–824) and Bai Juyi (772–846) and the Southern Song poet Zhu Dunru (1080 or 1081 to ca. 1175), reveal insights and unexpected humour about losing teeth, going blind, and experiencing old age. These translations thus demonstrate Chinese poetry as a rich source for exploring specific individuals’ perspectives on health, illness, and life’s inevitable transitions.
Now turning to the academic articles and practice reports, Robert Bivins, Anthony Butler and Georgina Eltenton, and Daniel Maxwell present research within the theme of Chinese medicine in Europe while Sean Lei, Katharina Sabernig, and Xun Zhou offer illuminating approaches to uncovering the diversity of medicine within China. Bivins opens the issue by placing the translation of medical images at the centre of her analysis and thus offers a method for studying how medical expertise was transmitted within one culture and from one (China) to another (Europe). She applies this method to the earliest examples of images of Chinese medicine in the texts of four physicians—Andreas Cleyer (1682), Wilhelm Ten Rhijne (1683), Engelbert Kaempfer (1728), and James Morss Churchill (1821)—over the course of a century and a half. She both demonstrates the multiple roles these images of Chinese medicine played in their works and traces acupuncture’s earliest textual paths into the Western imagination.
Whereas Bivins examines medical images to show how European physicians received and transformed Chinese medicine from the 1680s to 1821, Lei analyses medical images to show how just over half a century later the late nineteenth-century Chinese physician, Tang Zonghai, did the same with Western medicine. In the process, Tang also radically re-conceptualised and re-visualised the body of Chinese medicine. Lei contributes a tour de force based on his discovery that the concept of “qi-transformation” (qihua 氣化) in the famous dichotomy attributed to Tang, namely that ‘Western medicine is good at anatomy; Chinese medicine is good at qi-transformation’, was, in fact, based on Tang’s understanding of the new steam engine technology from the West. In addition, this new understanding of qi-transformation in the body, which is based on the model of the newly invented steam engine, enabled him to incorporate Western anatomy into Chinese medical doctrines about specifically the bladder, Triple Burner, and kidneys. Instead of further essentialising the differences between Western and Chinese medicine, Lei’s thorough rereading of Tang’s corpus demonstrates instead how deeply hybrid his published medical works and anatomical images were.
Similar to Bivins and Lei, Sabernig also uses visual evidence by examining the Tibetan medicine murals at the Labrang Monastery, which is currently home to the largest number of monks outside of the Tibetan autonomous region. This article also discusses an example of medical knowledge transmitted and transformed through a visual medium sometime during the eighteenth to nineteenth centuries. In this case, the movement of medical images was from the Chakpori Tibetan medical college in Lhasa, just opposite the Potala Palace, to the medical college at the Labrang Monastery in northwest China. The nineteen murals depict the contents of the first two parts of the Four Tantras (Gyüshi) and are influenced by the medical thangka illustrations of the Blue Beryl, the well-known commentary on the Gyüshi. The Labrang monastery medical murals, however, contain significant differences in the portrayal of the ‘tree metaphor’ from the original version. Sabernig’s analysis thus reminds us to consider not just Chinese-European medical exchanges but also medical exchanges between China and its immediate neighbours, especially intra-regional medical transformations within the Tibetan-Chinese sphere.
Xun Zhou’s contribution moves the historical range of this issue’s academic articles forward into modern China and applies an anthropological approach similar to Gudrun Kotte’s practice report. Zhou combines intensive interviews with over a hundred survivors of the devastating famine of the Great Leap Forward (1958–1962)—collected over four years of research in Sichuan, Henan, Anhui, Shandong, Hebei, Yunnan, Guizhou, Guangdong, and Guangxi—with materials from the provincial party archives of Shandong, Hunan, and Sichuan on the famine. Her article contributes to recent scholarship that goes beyond party policies and state initiatives that led to the worst famine of the twentieth century to life on the ground and how people survived it. The ‘kitchen knowledge’ she uncovers ranged from using edible wild plants listed in early modern Chinese medical texts—namely the 1406 Materia Medica for Famine Relief and 1622 Collection of Wild Vegetables—to consuming white clay, decomposing animals, and human flesh to stave off hunger pangs and taking hot steam baths to counter the oedema caused by malnutrition. Combined with recourse to religious ceremonies and local ritual healing practices, these household-level survival strategies allowed those whom Zhou interviewed to survive the forced collectivisation, political indoctrination, and resource-stripping of Mao’s failed Great Leap Forward.
Moving to the practice reports, Professor Anthony Butler and Georgina Eltenton (written while she was still in her final year at the University of St Andrews) give us a cogent report on the current research on using traditional Chinese medicine formulas to treat eczema, still an often intractable and complex condition to treat with modern medicine. They argue that the action of herbs in Chinese formulas can be separated from TCM doctrines and their action understood in biochemical terms. They use the illuminating case of the London-based Chinese herbal doctor, Luo Dinghui, whose TCM herbal formulas for children’s eczema had shown success and were then developed by the UK-based pharmaceutical company, Phytopharm, into a new drug called Zemaphyte. Despite clinically positive results in test trials, however, the drug was never granted a licence and so Phytopharm stopped developing it.
Whereas Butler and Eltenton discuss the positive potential of westernizing and applying evidence-based science to traditional Chinese herbal formulas, despite obvious regulatory barriers, Daniel Maxwell examines the multivalency of Chinese medical terms in western medical practices through the illuminating example of the concept of jing central in Chinese reproductive medicine. Jing ranges in contemporary English-language sources from the more traditional male qi and semen to modern gametes, something ‘genetic like’, and DNA. But it is not the range of one-to-one translations Maxwell traces so much as the multiple metaphoric ways the jing concept is applied in modern Chinese reproductive medicine that makes this article revelatory.
Finally, this issue is rounded off with a substantive book review section that includes four new monographs ranging from the story of the Chinese herbal Artemisia annua for treating malaria in Africa and the role of barefoot doctors bringing Western medicine into rural China to food as medicine in Chinese health practices and Chinese women’s experience of pregnancy and a ‘good birth’ in Berlin. This section also provides reviews of three major edited books based on library holdings with significant Chinese and East Asian medical materials around the world, namely the National Library of Medicine’s Hidden Treasures, Catherine Despeux’s magnum opus on the Chinese medical manuscripts from Dunhuang and Turfan at the British Library, Bibliothèque Nationale, and other libraries and Paul Unschuld’s private collection of Chinese medical and other manuscripts that is now held at Berlin’s Staatsbibliothek. We hope that our readers will find plenty of substance to process in these wide-ranging articles, practice reports, field notes, translations, and book reviews on the theme of diversity of Chinese medicine in China and Chinese medicine in Europe.