Jibing de lishi 疾病的歷史 [The History of Disease] ed. by Fu-shih Lin 林富士 (review)

Disease, the object of so much of medical practice, not only happens to human beings, it also assumes knowable forms through the discourses we construct around it. The contents of Fu-shih Lin’s History of Disease started out as papers presented at a symposium held by Academia Sinica in 2000. The themes of the symposium were the nature and causes of epidemics, the effects of epidemics on human society and civilization, disease as a cultural or social construction, and the interpretation and cure of diseases. The thirteen papers included in this collection address these subjects.

The collection focuses on the concept and the classification of disease and the evolution and culture of etiology within China’s medical or medical studies system. Some of papers develop their arguments over the course of several dynasties, whereas others explore specific issues in a given era. In the first piece, “Some Suggestions on the Study of the History of Diseases in China,” Fu-shih Lin draws on a broad assortment of studies to propose research approaches, topics, and methods. A history of disease, Lin emphasizes, can be classified as an investigation into the cultural history of medical treatment, historical or geographical pathology, etiology, or social and cultural history.

“Suibing (祟病) and ‘Places’: Traditional Medicine’s Interpretation of Suibing,” by Li Jianmin, explores the correlation between diseases and places in traditional medicine. (Suibing is a term that traditionally referred to the diseases caused by demons and gods; it now refers to psychological maladies.) Li traces how traditional practitioners discussed the causes and pathology of suibing from a medical perspective, naming place as a cause of disease. In other words, Chinese medicine holds that the development of sicknesses correlates with visits to unclean places or places haunted by demons and gods—places of religious worship, open countrysides, tombs, desolate places, and inns.

When medical practitioners encountered syndromes they could not explain organically, such as insomnia, sleep paralysis, sudden death, and pregnancy outside of marriage, they often pointed to social and cultural factors.

In “Between Sleep and Dreams: Perceptions of ‘Dreaming Sex with Demons’ and Female Sexual Frustration in Pre-modern Chinese Medicine,” Hsiu-fen Chen highlights the relationships among disease, medicine, gender, and society. Since the Qin dynasty, physicians have believed that dreams are the result of external demons or evils invading the body, stimulating the zangfu 臟腑 (internal organs), and disturbing the hun 魂 (soul) and po 魄 (spirit). During the Song dynasty, physicians offered verdicts on the sexual frustrations of Buddhist nuns, widows, and unmarried women, maintaining that these women dreamt about sex with demons because they had insufficient yin characteristics or femininity, suggesting that legal marriage was the ideal solution. During the Ming and Qing dynasties, physicians insisted that the “illness” of dreaming about sex with demons was caused by prurient thoughts; they advocated abortions to remove demon fetuses. Chen explains that dreaming about sex with demons was a metaphor for disease and a sort of social diagnosis, as it were. Since the Song dynasty, changes in society and its mores (e.g., the controversies regarding the image of Buddhist nuns, the taboo on widows remarrying, and the chastity of women in general) focused the attention of physicians on female sexual passion and frustrations. Evidently these issues were a symptom of a general social reorientation.

“‘Laughing Disorders’ and the Medical Discourse of Joy in Early Imperial China,” written by Jen-der Lee, summarizes the descriptions and interpretations of laughing disorders found in classical documents, including medical classics and prescriptions preserved from the Sui and Tang dynasties. Different types of laughter (xixiao, shanxiao, and haoxiao) gradually became accepted as symptoms; treatment methods included bloodletting, acupuncture, and herbal remedies. According to medical books, laughter caused the circulation and loss of qi. In other words, it damaged the spirit or essence and reduced one’s energy; therefore, anyone who indulged in excessive laughter would risk his or her health. This conclusion differs significantly from the modern perspective.

Chia-Feng Chang’s “Conceptions...