Innovation in Chinese Medicine (review)

Twentieth-century attempts to legitimate Chinese medicine as a healing system have produced a persistent but fallacious popular stereotype: Chinese medicine as the timeless, unchanging, ancient wisdom of the Orient. The twelve essays in this volume are a welcome addition to the growing body of scholarship that explicitly seeks to counter this stereotype. Incorporating diverse modes of inquiry—ranging from anthropological fieldwork, archeological research, philological and literary analysis, clinical observations, and social and cultural history—the authors richly document the diversity and dynamism of Chinese medical traditions from antiquity to the present.

The first four essays examine how medical practitioners and authors from the fourth century B.C. to the eleventh century drew on ideas from a wide array of healing practices to articulate what would become the fundamental concepts of classical Chinese medicine. In the dominant model that emerged, health and illness were determined by the state of qi (energy-matter) circulating through a network of channels and meridians that integrated the parts of the body into a holistic system. Doctors also developed an ever-more sophisticated "system of correspondences" based on the metaphorical concepts of yin and yang and the five phases, which they used to explain the myriad transformations of qi that underlay the course of disease and the action of drugs. Within these broad parameters, numerous therapeutic and etiological approaches emerged. The second set of essays examines significant developments of the seventh to the nineteenth centuries, including the creation of dietetics as a medical subdiscipline, changes in the official pharmacopoeia and new taxonomies of material medica, and the revision of existing theories of febrile disease. The last group of essays analyzes how doctors from the sixteenth to the twentieth centuries developed new ways of thinking about the nature of medicine itself. The case history became an important textual form for creating medical knowledge. The increasing power of biomedicine after the mid-nineteenth century compelled Chinese physicians to integrate modern science and traditional practices, whether as a tool for political revolution or as a strategy for ensuring the continued survival of classical medicine as a viable healing system.

The central theme of "innovation" proves a useful analytical vehicle for identifying and studying these important phenomena; the editor weaves a compelling historical narrative from these diverse case studies. Although Hsu and her contributors recognize that the concept of innovation has traditionally been coupled with notions of scientific revolution and technological progress, they also use their findings to argue persuasively for a broader understanding of the term. The Chinese innovators described herein did not openly seek to discredit the past, and they routinely invoked the authority of antiquity to legitimate their ideas (5). Yet it is undeniable that they combined existing forms of knowledge in unprecedented ways to create new fields of inquiry, new ways of interpreting the observed world, and new technological processes. Thus, as Hsu rightly affirms, these comparative perspectives from China can "enrich our understanding of 'innovation' and the complex processes it involves" (2).

This volume, however, signals the potential tensions that arise when adapting models from the historiography of the European scientific revolution to the history of other cultures. For example, how does one avoid defining innovation so broadly that the term loses its explanatory power, thereby making it difficult to distinguish between what is truly innovative and what is simply new? To what extent are such distinctions even relevant in societies that do not see change in positivistic terms? Ultimately, this volume highlights the limitations of existing models and makes a case for a more catholic history of science, one in which analytical frameworks can account for the multiple patterns of epistemological and technological change that have existed in human societies.