Hilary A Smith

Forgotten Disease

Illnesses Transformed in Chinese Medicine

• Gebundenes Buch

Produktbeschreibung

Hilary A. Smith is Assistant Professor of History at the University of Denver.

Produktdetails

• Verlag: Stanford University Press
• Seitenzahl: 248
• Erscheinungstermin: 17. Oktober 2017
• Englisch
• Abmessung: 219mm x 143mm x 24mm
• Gewicht: 434g
• ISBN-13: 9781503602090
• ISBN-10: 1503602095
• Artikelnr.: 47770864

Autorenporträt

Hilary A. Smith is Assistant Professor of History at the University of Denver.

Inhaltsangabe

Contents and Abstracts
Introduction
chapter abstract
This chapter summarizes why biomedical translations of old Chinese disease
concepts are problematic. It introduces the Chinese disease name foot qi
(jiao qi) and gives examples from three different periods to show how
differently the name has been used over the course of Chinese history and
why beriberi is an incomplete translation. The chapter then describes three
contributions the book makes to current historical scholarship: it defends
the "framing disease" approach to disease history and extends it to Chinese
concepts; it helps create a more nuanced picture of how modern Chinese and
Western medicine coevolved, supplanting an older idea that they were
diametric opposites that collided in the early twentieth century; and it
questions the notion that Western imperialism improved health in
modernizing East Asia. By introducing past ways of thinking about the body,
the book also encourages a critical, comparative perspective on current
medical knowledge.
1Foot Qi in Early Chinese Medicine
chapter abstract
This chapter introduces foot qi (jiao qi) as it was understood when it
first appeared in books in the fourth century. Foot qi first appeared in a
drug formulary called Emergency Formulas to Keep Up One's Sleeve by Ge
Hong, where it appears as a regionally bounded disease common south of the
Yangzi River, to which migrants from the north were especially vulnerable.
The chapter explores how political circumstances combined with classical
medical beliefs about regional constitutions to make foot qi seem like a
disease that threatened out-of-place bodies. The chapter also argues that
foot qi's early history shows it to have been a commonly used disease name
with a lot of flexibility and ambiguity.
2Competing for Medical Authority over Disease
chapter abstract
This chapter shows how literate doctors in medieval China, both those
employed by the government and those practicing privately, attempted to
claim knowledge about foot qi (jiao qi) that surpassed that of laypeople.
It centers on two seminal texts in Chinese medicine: Chao Yuanfang's
Sources and Symptoms of All Disease and Sun Simiao's Formulas Worth a
Thousand in Gold. Their attempts to redefine foot qi reveal how competitive
the unregulated medical marketplace of Sui and Tang China was; learned
physicians, whom many today erroneously believe to have had the most
authority, faced challenges to their authority from rivals and even from
patients and patients' friends and relatives. The chapter also shows that
medieval foot qi was a chronic disease that could repeatedly afflict a
wealthy and powerful patient over a long period of time, making it a
particularly visible site where competition among healers played out.
3Simplifying and Standardizing Disease
chapter abstract
This chapter shows how the drug formularies produced by an active Chinese
government in the tenth and eleventh centuries standardized and simplified
the definition of foot qi (jiao qi) that learned doctors had created. The
formularies, linked to a new system of public pharmacies, facilitated
self-treatment and removed elements of diagnosis that only a classically
educated physician could perform. Physicians complained that official
formularies dumbed down diagnosis of all disease, especially foot qi. In
the twelfth and thirteenth centuries, private printers abridged the
official formularies, and the spread of woodblock printing technology
enabled knockoffs to be cheaply disseminated and become widely influential.
These formularies produced the only features of classical foot qi that were
later incorporated into the modern concept of beriberi-the idea that the
disease came in wet, dry, and fulminating types-revealing a similar
reductive, standardizing impulse in both Song dynasty and modern
biomedicine.
4The Northerner's Dietary Disorder
chapter abstract
This chapter examines a major change in the understanding of foot qi (jiao
qi) in the twelfth century. Li Gao (Li Dongyuan), one of the most famous
physicians of the Jin-Yuan period known for innovation in Chinese medicine,
added a new "northern" etiology to the old idea that foot qi was caused by
environmental poisons entering the body through the skin, which he saw as a
"southern" type of the disease. He thought northerners had tighter pores
than southerners and were less susceptible to environmental poisons but
more vulnerable to ailments caused by eating and drinking too much rich
food and alcohol. Northerners' foot qi was thus a dietary disorder. The
chapter argues that this changed understanding reflects the new prominence
of ideas about northern and southern constitutions in Chinese medicine,
influenced by the long political division of north from south China between
the tenth and fourteenth centuries.
5Getting Rich and Getting Sick
chapter abstract
This chapter argues that writings about foot qi (jiao qi) in fifteenth-
through nineteenth-century China show the effects of rising prosperity on
both health and the medical occupation. Late-imperial sources, including
the new case-records genre, reveal a disease resembling modern gout,
consisting of intermittent foot pain and swelling. Doctors perceived this
as the dietary foot qi first described in the twelfth century but argued
about whether it was exclusive to northerners as their predecessors had
suggested. The significance of northern and southern identity had waned now
that China was politically reunified, but less-elite healers still claimed
knowledge about regional constitutions, diseases, and therapies to assert
special authority. Scholars writing about foot qi generally ignore sources
from this period because the ailment they describe does not match beriberi,
the officially recognized definition of foot qi today, but the chapter
rejects such a present-centered approach.
6Creating Beriberi in Meiji Japan
chapter abstract
This chapter examines the late nineteenth-century Japanese epidemics of the
vitamin deficiency disorder beriberi, which Japanese doctors identified as
epidemics of foot qi (pronounced kakke in Japanese). Previous histories
have presented the association between kakke and the disease beriberi as
the discovery of a truth: that foot qi was really a thiamine deficiency
that had long plagued East Asia. This chapter argues instead that the
nineteenth-century beriberi epidemics were historically new and were caused
by Meiji Japan's modernization on a Western model, including changes to
foodways. Because practitioners of kamp¿ (classical Sino-Japanese medicine)
had lower status and support in Meiji Japan than Western-style doctors, it
was the latter who redefined this old disease concept for the modern age.
The redefinition reflected Western imperialism, not only because it
dismissed indigenous ways of understanding disease but also because
imperialism had made thiamine deficiencies more common to begin with.
7Foot Qi's Multiple Meanings in Modern East Asia
chapter abstract
This chapter examines how a modern biomedical interpretation-that foot qi
was really the vitamin deficiency beriberi-was accepted by the Chinese
elite in the early twentieth century, even though there had never been a
beriberi crisis in China as there had been in Japan. It argues that it was
because of Western medicine's prestige that modernizers in China accepted
Western disease concepts as the "true" definitions of Chinese medicine
disease names. Subordinating traditional disease concepts to Western ones
devalued Chinese medicine by making it seem that only Western medicine
could properly diagnose and treat disease; consequently, foot qi nearly
disappeared from Chinese medicine. Laypeople, however, continued to apply
the name to an ailment more relevant to them than beriberi, namely
athlete's foot. And interest in other nonberiberi meanings of classical
foot qi has recently revived. The chapter thus highlights the persistent
diversity of ideas in East Asian medicine.
Conclusion
chapter abstract
The conclusion summarizes why it is important to approach modern
translations of old Chinese disease names as this book has approached foot
qi: as the products of social, political, economic, and intellectual
factors, rather than as transparent discoveries of biological truth. Such
an approach undermines the false impressions that Chinese medicine is a
monolithic tradition unchanged over several thousand years and that its
ideas and practices have always been antithetical to those of Western
medicine. It also questions the assumption that the diseases Westerners
found in Asia in the late nineteenth and early twentieth centuries were
timeless features of life there, miraculously ameliorated by Western
medicine's innovations. And it allows us to appreciate premodern ideas
about illness that may help us face emergent diseases today. This approach
is especially important now as the terminology of Chinese medicine is being
standardized to facilitate its globalization.