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Antiquarianism, Language, and Medical Philology

From Early Modern to Modern Sino-Japanese Medical Discourses

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Edited by Benjamin A. Elman

Based on several research seminars, the authors in this volume provide fresh perspectives of the intellectual and cultural history of East Asian medicine, 1550-1800. They use new sources, make new connections, and re-examine old assumptions, thereby interrogating whether and why European medical modernity is an appropriate standard for delineating the modern fate of East Asia’s medical classics. The unique importance of early modern Europe in the history of modern medicine should not be used to gloss over the equally unique and thus different developments in East Asia. Each paper offers an important contribution to understanding the dynamics of East Asian medicine, namely, the relationship between medical texts, medical practice, and practitioner identity. Furthermore, the essays in this volume are especially valuable for directing our attention to the movement of medical texts between different polities and cultures of early modern East Asia, especially China and Japan. Of particular interest are the interactions, similarities, and differences between medical thinkers across East Asia,
Contributors include: Susan Burns, Benjamin A. Elman, Asaf Goldschmidt, Angela KC Leung, Federico Marcon, MAYANAGI Makoto, Fabien Simonis, Daniel Trambaiolo, and Mathias Vigouroux.


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Asaf Goldschmidt

Abstract

In present-day Chinese medicine, medical case records or case histories (yi’an) serve an important role in medical education and everyday clinical practice. These are the foremost literary means that enable a student or a practitioner to comprehend the clinical processes of diagnosis and treatment. Surprisingly, we do not find many collections of medical case histories in China before the second millennium CE. More precisely, the genre of yi’an collections became prominent only during the Ming dynasty, for various reasons. It is important to note that the first time a physician published a collection of his medical case histories was during the Song dynasty. In this essay I will delineate the story of the Ninety Discussions on Cold Damage Disorders (Shanghan jiushi lun 傷寒九十論), a collection of medical case histories written and published by Xu Shuwei 許叔微 (1079–1154). Xu applied this innovative approach in his attempt to transmit his accumulated clinical knowledge concerning Cold Damage disorders within the context of the changing medical environment during the Song dynasty. This essay shows why Xu chose to implement this innovative literary means to document medical knowledge.

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Fabien Simonis

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The Siku quanshu’s claim that Chinese medical learning split into rival schools in the Jin (1115–1234) and Yuan (1260–1368) periods has misled generations of historians. By reappraising conceptions of illness, textual forms, and intellectual groupings—illness, texts, and “schools”—from the fourteenth to the eighteenth century, this article shows instead that the late Yuan was when Chinese medical thinking started to become purposely integrative. Zhu “Danxi” Zhenheng (1282–1358) developed a syncretic approach to medical knowledge based on the then-unusual notion that illness was infinitely mutable and diverse. To cure all patients successfully, he advocated borrowing the best precepts and methods from several masters. This methodology dominated Chinese medical thinking for more than two hundred years and explains why the most influential medical treatises from the fourteenth to the sixteenth century were anthologies of excerpts from past texts. By the seventeenth century, however, Zhu Zhenheng had been reconstrued as a derivative thinker rather than a syncretist. The new notion of “four masters of the Jin and Yuan” (Zhang Congzheng, Liu Wansu, Li Gao, and Zhu) supplanted and obscured the Danxi synthesis, which had included Zhang Ji’s third-century doctrines on shanghan (Cold Injury). The reinterpretation of Danxi as one among many Jin-Yuan masters naturally bolstered the Siku quanshu’s statement about schools. Ironically, even the most virulent critiques of Danxi ended up promoting the same conception of illness and the same syncretic style that he had championed. Danxi’s concepts and methodology are still shaping Chinese medicine today.

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Daniel Trambaiolo

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The Ancient Formulas (kohō 古方) doctors of the eighteenth century made important contributions to the development of medical empiricism in Japan and to the subsequent growth of interest in European medicine among Tokugawa doctors. The significance of their philological studies of early Chinese texts has been less widely appreciated, despite the fact that the Ancient Formulas doctors themselves regarded philology as fundamental to their efforts to restore the medical knowledge and practices of Chinese antiquity. This essay explores the relationship between the philological and the empirical investigations of the Ancient Formulas doctors Yamawaki Tōyō and Yoshimasu Tōdō, tracing these investigations’ origins in the social and intellectual contexts of eighteenth-century urban medical practice and arguing that these apparently contrasting modes of inquiry were complementary aspects of a coherent epistemology that valued explicit arguments and concrete evidence over intuitive reasoning from first principles.

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Susan L. Burns

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This essay uses the writings by Nanayama Jundō, a village doctor who practiced in northern Japan in the early nineteenth century, to explore how rural doctors engaged with the canonical texts and medical theories of their time. Through an examination of Nanayama’s work on the Treatise on Cold Damage Disorders, arguably the most important medical text in late eighteenth- and early nineteenth-century Japan, I argue that for Nanayama the Treatise was a powerful catalyst for innovation. He approached it not as a canonical work, in the traditional sense of that word, but rather as an exemplification of a methodology by which to approach diagnosis and treatment. Nanayama was critical both of physicians who overemphasized textual knowledge and of those who adopted a reductive approach to treatment in the name of practicality. By stressing the knowledge gained from clinical practice, he carved out an important role for doctors like himself, who were without ties to established sources of medical authority, such as well-known medical lineages and scholarly credentials.

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Federico Marcon

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This essay describes how in the early Meiji period the traditional discipline of materia medica (honzōgaku) lost its name but transferred two centuries of knowledge, research, data, images, techniques, attitudes, styles, facilities, expertise, schools, social relations, books, and specimens to the practitioners of the new scientific fields of biology and medicine. At the same time, honzōgaku became the name—associated with that of kanpōyaku, now referring to traditional (Chinese) medicine—of a lost tradition, of a forgotten wisdom, of alternative practices, of a repository of Asian identity that became the object of antiquarian research in antagonistic opposition to Western medicine.

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Angela Ki Che Leung

Abstract

This chapter discusses the process of framing kakké 腳氣 (lit. “leg-wind”) as a modern disease in Kanpō medical texts written in Chinese from the late Tokugawa to the early Meiji period. Before kakké was fully translated into the biomedical term “beriberi” and defined as a disease caused by nutrient deficiency linked to a diet of white rice, it had been understood and treated since classical times as a condition caused by a Wind toxin. Etiological and therapeutic discussions concerning kakké had long been based on those about jiaoqi in classical Chinese medical texts since the early medieval period, which focused on the pathogens of Damp and Wind entering by the lower limbs. Jiaoqi was curiously ignored by late imperial medical texts, and modern Chinese often had to rely on Meiji Kanpō texts to interpret this old disease. Modern Kanpō texts distinguished kakké from its old forms and understood it as an urban disease arising in warmer months and affecting essentially prosperous, young, able-bodied men who indulged in excessive food consumption and a hedonistic lifestyle. Doctors applied regimes of purging and replenishing for therapeutics, methods that were taken from traditional Chinese medical classics on jiaoqi. It was described as a distinctly modern Japanese disease in a prosperous period. This framing was radically different from the biomedical understanding of beriberi, which became dominant in Asia only in the 1930s and saw it as a disease of malnutrition caused by diets that relied too heavily on white rice.

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Mayanagi Makoto, Takashi Miura and Mathias Vigouroux

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During his visit to Japan from 1880 to 1884, Yang Shoujing purchased many rare books, some of which were medical classics formerly belonging to Kojima Naokata. Naokata and his sons Naomasa and Shōkei were bakufu medical officials engaged in the work of analyzing old medical documents and held a large collection of rare medical classics. Following the Meiji Restoration, however, the Kojima family lost their official bakufu status. Yang, having arrived in Japan about half a year before the passing of Shōkei, was able to obtain nearly all of the Kojima family’s collection. After returning to China, Yang contributed to the publication of medical books such as Yuxiu Tang yixue congshu (thirteen titles, 1884), Mai jing (1893), and Wuchang yiguan congshu (eight titles, 1904–1912). A book-body of knowledge transmitted through the Kojima family’s collection was reflected in the publication of these works.