Needles, Herbs, Gods, and Ghosts: China, Healing, and the West to 1848 (review)

This meticulously researched, broad-ranging book presents an eye-opening account of Western encounters with Chinese healing practices in the thirteenth to mid-nineteenth centuries, making important contributions on several levels. By documenting early Western interest in Chinese healing, Linda Barnes provides much-needed historical context for understanding our present-day fascination with "traditional Chinese medicine." She also examines a period in which one would be hard-pressed to give any objective edge to either Chinese or Western healing repertoires in terms of their overall therapeutic efficacy. She thus provides an invaluable complement to existing scholarship that focuses on cross-cultural medical exchange in the context of Western imperialism and presumed biomedical superiority. Most directly, Barnes presents a compelling study of what one might term "medical orientalism," showing that European (and later American) depictions of Chinese practices were shaped as much by Western self-perceptions and cultural frameworks as by any Chinese realities.

Beginning with papal envoys to the Mongol court, a diverse group of Westerners recorded information on Chinese diagnostic and therapeutic topics ranging from pulse reading to ritual séances, and from botanical drugs to the pursuit of immortality. Some Chinese practices—notably acupuncture, moxabustion, and the use of ginseng and other medicinal plants—were enthusiastically discussed and adopted by Western doctors and medical consumers. But "Western observers routinely misunderstood the practices they witnessed," Barnes observes, "even when reporting them with considerable accuracy" (p. 5). She traces these misinterpretations to three intertwining dynamics: efforts to classify the Chinese according to an imagined hierarchy of peoples defined biblically, geographically, and physically; attempts to explain Chinese religious eclecticism in terms of Judeo-Christian monotheism; and the imperfect mapping of Western anatomical, humoral, and vitalist paradigms onto the Chinese body of qi. The substantive chapters of the book discuss these "racializing," "religionizing," and "medicalizing" dynamics in five successive chronological periods.

Barnes's data are rich in historical irony, suggesting sincere miscomprehension as well as willful distortion on the part of Western commentators. Seventeenth-century Jesuit missionaries, for example, denounced as idolatry the Chinese practice of beseeching deities and transcendent immortals for prescriptions and miracle cures—yet the Jesuits themselves performed exorcisms and prayed for sick Chinese patrons, essentially arrogating for Christianity the sole right to expel demons (pp. 59–68). Overall, Western attitudes were deeply ambivalent, admiring Chinese pulse diagnostics, for example, but deploring Chinese "ignorance" of anatomy. And while eighteenth-century European doctors marveled at the efficacy of moxabustion—the burning of compressed cones of artemesia on the skin at specific acupoints—they effectively stripped away its cultural origins and underlying rationale by defining it simply as a variant form of cautery, a standard European therapy (pp. 181–85).

Notably fluent is Barnes's long, last chapter on the period from 1805 to 1848. The early decades of the nineteenth century witnessed an acupuncture craze in Europe and America, marked by a flurry of publications on and the widespread use of this seemingly miraculous therapy (pp. 304–36). But positive views of China were now rapidly eroded by Western economic, diplomatic, and military conflicts with that country. Simultaneously, the expansion of anatomical and biomedical paradigms increasingly delegitimated the vitalistic and humoral models used to explain Chinese beliefs. For a growing number of Westerners, China and its healing traditions were falling behind in the march of progress.

In sum, Barnes shows that histories of "medicine" must always be grounded in broader histories of healing, for assessments of any given therapy are always constructed in reference to other techniques marked by time, place, and society. Interdisciplinary and informative, Needles, Herbs, Gods, and Ghosts will become a standard reference for anyone interested in the history of medical exchange, the hybridization of healing knowledge, and the intercultural negotiations of illness and cure.