Currents of Tradition in Chinese Medicine, 1626-2006 (review)

What is "traditional" about "traditional Chinese medicine" (TCM)? How can one reconcile the diachronic and synchronic heterogeneity of Chinese medical beliefs and practices with the idea that they constitute a coherent system? Few provide more thoughtful answers than the TCM practitioner and anthropologist Volker Scheid. In his earlier Chinese Medicine in Contemporary China: Plurality and Synthesis (Duke University Press, 2002), Scheid showed how shifting alignments in the sociomedical infrastructures of TCM foster medical plurality. Currents of Tradition takes a complementary approach, analyzing how medical traditions maintain their identity even as their form and content are altered across place and time. His focus is the historically important "current of learning" (pai) associated with the southeastern town of Menghe. Eschewing static translations of pai as "sect" or "school," Scheid argues that medical "currents" are ongoing, dynamic processes of knowledge and identity creation, arising from networks of individuals who carry out the "labor of social memory" to impart meaning to past events.

As adroitly dissected by Scheid, the rise, flourishing, and decline of the Menghe current is a multilayered phenomenon. At the most basic level, it is the story of how Menghe became a prominent medical center after the seventeenth century and how its native sons became national leaders in nineteenth- and twentieth-century medicine. The initial growth of Menghe medicine was intertwined with the emergence of physicians from the Fei lineage. Once known for producing scholar officials, the Feis channeled norms of Confucian virtue into medicine, epitomizing the ideal of the "scholar-doctor" for whom medical virtuosity was inseparable from moral cultivation. Endowed with the social capital to construct marriage alliances with other medical and gentry families alike, the Feis dominated Menghe medical circles from the mid-eighteenth to early twentieth centuries.

Central to this narrative are the kinship and patronage relationships that shaped doctors' education, career paths, and reputations. Although therapeutic ability was indispensable, a doctor's success and posterity depended on his ability to exploit the key social networks of the day. In 1920s and 1930s Shanghai, for example, Ding Ganren (1866–1926) rose to eminence thanks to native place connections and the status of his powerful patients, drawn from the elite of a cosmopolitan, modernizing urban center: industrialists and entrepreneurs, Nationalist officials, and underworld leaders. Other Menghe doctors became prominent in medical modernization movements, where they represented the full range of opinions on the pressing issue of how much Western knowledge to adopt. After the Communist victory in 1949, Menghe doctors moved into administrative and teaching positions in the new state medical institutions, joining the effort to promote a "traditional Chinese medicine" that would constitute China's unique contribution to world culture. Through case studies of Menghe physicians, Scheid foregrounds the individual-level negotiations and compromises that shaped nationwide medical transformations.

But the history of the "Menghe current" is also the history of an idea. Evoking the fame of Menghe doctors past and present (including, by implication, himself), Ding Ganren first articulated the concept of a distinctive Menghe "current." As a native of Menghe who did not, however, belong to its powerful medical families, Ding benefited from this rhetorical strategy, which effaced lineage descent in favor of an identity constructed around native place. Beginning in the late 1970s, state-employed physicians with family or discipleship ties to Menghe medicine began to publish works celebrating the history and accomplishments of the "Menghe current." Social and political contingencies, however, influenced who was officially included. The Wu family, successful in late imperial times, lacked the scholarly connections to ensure the survival of their records. The otherwise eminent Qian family was targeted during the Maoist purges of the 1950s and subsequently excluded from all published accounts until the mid-1990s.

Although Menghe doctors often showed a therapeutic preference for low doses of gentle drugs, Scheid concludes that the Menghe current consisted above all of personal networks rather than affiliation with specific medical strategies. This assessment leads him to offer a cautiously...