Medicine for Women in Imperial China (review)

This welcome and essential contribution to the history of obstetrics and gynecology in China is a reprint of a thematic issue of Nan Nü: Men, Women, Gender in China (vol. 7, no. 2, 2005). As Angela Leung observes, historians have been investigating Chinese "medicine for women" (fuke, nüke, chanke) for close to a century now. It is only in the last two decades, however, that a critical mass of socially and culturally informed studies has emerged, and many fundamental issues remain to be investigated. This present volume showcases recent scholarship on the period from the third century BCE to the ninth century CE, and it will certainly generate further interest in this vital but less-understood period in the development of Chinese medicine for women. Later centuries have been well-surveyed, most notably by Charlotte Furth's seminal study, A Flourishing Yin: Gender in China's Medical History, 960-1665 (Berkeley: University of California Press, 1999). We thus know that "the department of women's diseases" became a distinct subfield of classical, scholarly medicine during the Song Dynasty (960-1279), constructed around an explicit model of gender difference shaped by Neo-Confucian cosmology. Here "blood" (xue) became the marker of womanhood, and its health or pathology was the key to understanding women's diseases.

At the heart of this book are three well-selected, complementary research articles that elevate the pre-Song period to its rightful status. Far more than just a precursor to later developments, the rich repertoire of beliefs and practices in these earlier centuries provides an indispensable window onto the cultural rhythms and material resources of the day. Robin Yates traces the origins of separate "prescriptions for women" (furen fang) to the first century, and he documents the primary role continuously assigned to pharmaceutical and ritual practices in the treatment of women. Particularly illuminating is his analysis of how sixth- and seventh-century practices merged popular beliefs and taboos with Daoist self-cultivation techniques and Buddhist theology. Sabine Wilms deftly dissects changing classifications of female pathology to examine how medical writers defined the nature and scope of female bodily difference. She shows that the ambiguous rubric of "illnesses below the girdle" (daixia) that framed medicine for women in the third century was transformed by the early seventh century into a model of female disease centered on noxious vaginal discharges. This, in turn, was later eclipsed by increasing attention to the problem of dysfunctional female blood. Finally, a translated and updated version of Jender Lee's 1996 Chinese-language article on birthing practices from the Han to Tang Dynasties allows this prolific scholar's work on medicine and gender to reach a wider audience. To plumb the social meanings of childbirth, Lee provides engagingly detailed accounts of how people conceptualized, prepared for, and managed delivery, covering topics from birthing positions to the forms of assistance that a husband might give during a difficult labor. These articles are ably partnered by two invaluable resources: Leung's state-of-the-field essay and Charlotte Furth's bibliography of secondary sources. In addition, Marta Hanson's thorough discussion of Joanna Grant's A Chinese Physician: Wang Ji and the "Stone Mountain Medical Case Histories" (London: Routledge Curzon, 2003) provides insight into the methodological challenges that can compromise well-intentioned studies of medicine and gender, while Ricardo King-sang Mak's review of Zhang Zhibin's History of Gynecological and Obstetrical Diseases in Ancient China (Beijing: Zhongyi guzi chubanshe, 2000) assesses the strengths and limitations of traditional approaches to medical history.

Of the many avenues for further research that this volume should inspire, three bear mentioning here. First, while it is customary to speak of Song fuke as constituting a "mature" gynecology (3-4), this tends to imply that earlier practices are of interest primarily as a foundation for later achievements. The findings presented here, however, suggest that we should aim for a less positivistic master narrative. A second question is whether we should continue to...