C. Michele Thompson, Vietnamese Traditional Medicine: A Social History. Singapore: National University of Singapore Press, 2015, pp. xix + 179, ISBN 9789971698355, price: SGD 35.00 (paperback).
Michele Thompson’s Vietnamese Traditional Medicine provides a fascinating transnational history of Vietnamese medicine through its understanding and preventive treatment of smallpox in the first half of the nineteenth century. In this book, Thompson questions the larger scholarly assumption that Vietnamese medical traditions derived most of its theoretical underpinnings and many of its therapeutic practices from Chinese medicine during and after the nine-hundred-year Chinese occupation of northern Vietnam (p. 13). Using smallpox it as a case study, the book seeks to investigate why Chinese and Vietnamese medical practitioners came up with different conclusions on the same disease. Drawing from medical texts written in both Chinese and the Vietnamese Nôm script as well as French colonial records, Thompson walks the readers through the history of smallpox as an epidemic in both Vietnam and China which dated from the time of the first century C.E. Thompson argues that while the Vietnamese borrowed heavily from Chinese medicine, Vietnamese “were active players not only in examining and actively seeking specific European medical techniques but also in choosing some items from the Chinese medical corpus while rejecting others” (p. xix). Although Chinese medical manuscripts provided a wealth of information on the disease and its treatment, it was surprising to see the Vietnamese apathy toward the Chinese method of variolation in their prevention of smallpox. Thompson’s attempt to find an answer to that divergence results in a book that weaves together the often complex and fuzzy layers of medical traditions in Vietnam that encompassed both folk and canonized medical practices, and the influence of foreign ideas.
The book starts out with an introduction on the two methods of preventive treatment for smallpox: variolation and vaccination (Chapter 1). Chinese doctors attributed the cause of smallpox to an internal ‘fetal toxin’ that could be suppressed by the practice of variolation or inoculation often done through the insertion of the dried scabs or lymphs of the smallpox patients into the nasal passage of the person being variolated. Vietnamese medical theorists, however, disliked the variolation practice of using live smallpox virus from human patients as they believed that the roots of smallpox were far more complicated than ‘a congenital fetal poison.’ Vietnamese medical traditions instead take into account external factors that could trigger the contagion such as time, weather, and diet (p. 59). The Vietnamese dissatisfaction with the Chinese method led to their independent quest to find the new treatment for smallpox. The book then follows the journey of a French medical doctor Jean Marie Despiau who was dispatched by the Nguyen royal court to Macao in 1820 to procure and preserve smallpox vaccine which used the less dangerous cowpox virus for the vaccination of the royal children (chapter 2).
The acquisition of the Western smallpox vaccine and its later widespread application in Vietnam despite the Vietnamese preference for non-incision procedure, according to Thompson, proved the Vietnamese ingenuity and their deviation from the Chinese medical traditions. The Vietnamese global mission to acquire new medical technique and the productive collaboration between French medical personnel and Vietnamese doctors in finding new ways to preserve the vaccine for long period of time (p. 43) also demonstrates the vibrant exchanges of medical practices in the pre-modern period, of which Vietnam was an active player.
Some readers might find the book narrower than what its title suggests about a social history of Vietnamese traditional medicine. The book instead uses the case study of smallpox to examine larger issues in Vietnamese medicine including its relationship with China and the West, its linguistic diversity and transmission, its plant-based remedies and therapeutic customs (chapters 3 and 4). Although the smallpox narrative works very well in the first two chapters, it falls short of tying the last two chapters to the main story in a clear and coherent structure. As Thompson moves to discuss more narrowly defined topics such as medicinal plants and botanical pharmacopeia, the audience might be left wondering how they connect to the smallpox narrative. The book’s heavy focus on medical texts also obscures its agenda to offer a social history of medicine. Readers might want to know more about the Vietnamese public reaction to smallpox vaccinations as well as the impact of wider social and political changes in mid-nineteenth century Vietnam on medical practices and transmission.
Despite these minor concerns, Thompson’s monograph successfully demonstrates the Vietnamese ingenuity and autonomy in adopting and transmitting the modern practice of vaccination. The book’s strong linguistic and theoretical foundations make it an important contribution to scholarship on the history Vietnamese medicine as well as the global history of smallpox.