A Flourishing Yin: Gender in China's Medical History, 960-1665 (review)

Charlotte Furth. A Flourishing Yin: Gender in China's Medical History, 960-1665. Berkeley and Los Angeles: University of California Press, 1999. xiv + 355 pp. Ill. $45.00 (cloth), $17.95 (paperbound); £35.00 (cloth), £12.95 (paperbound).

A Flourishing Yin is a study that enables the reader to appreciate the rich and complex history of Chinese medicine with surprising ease and clarity. As the title shows, the book focuses on the feminine in China's medical history from 960 to 1665, the period encompassing the Song and Ming dynasties. The "female department" or fuke is Furth's subject, corresponding to today's gynecology and obstetrics, with some extension to pediatrics. The study is not a simple focus on women's health and body, but a richly documented account of theory and practice pertaining to gender relations, seen through medicine and medical philosophy.

Furth first draws the reader's attention to the Yellow Emperor's body, which is an idealized, androgynous body that is blessed with a perfect balance of yin (darkness, shadow) and yang (brightness, light). Yin in this view resides therefore in both male and female bodies. For example, flesh is regarded as an element of yin, while bone is yang; similarly, blood is yin, while qi (spirit) is yang. She then discusses how this androgynous ideal copes with the contradiction of the gestational female body. In her fascinating account, we see that in China before the Song dynasty, birth and death were equally regarded as polluting, and hence women had to deliver children outside the home and stay away until sufficient cleansing had been completed; with the emergence of Song fuke, birth became a domestic medical event, taking place inside the home. In the Song fuke, birth was regarded as an area filled with intersecting spheres of human influence (which was seen as part of the natural or this-worldly environment) and spiritual influence by gods (chap. 3). It was the area in which healing ritual had considerable efficacy; hence, the distinction between medicine as science and medicine as ritual was not prominent. Indeed, in the Song fuke, according to Furth, we see that "medicine was fundamentally a domestic activity carried on in the setting of the home, and . . . ritual was integrated into healing strategies" (p. 95).

In the Ming period, a shift occurred: "Both the hostility to ritual medicine and the shift to narrower definitions of disorder 'specific to women alone' were part of a larger late Ming rereading of the relationship of body and cosmos" (p. 184). This shift, Furth cautions us, was not a clear-cut departure from Song medicine, which survived in the Ming in a number of ways. Fundamentally, the body in Ming medicine remained androgynous, and the medical discourse of blood (yin) and qi (yang) continued to be based on a hierarchy that was ultimately reflected in the gender order of male over female. Most important: "Ming medicine may have rejected childbirth rituals and obstetrical pharmaceutics that conveyed essentialized representations of the female body as unclean, but doctors continued to live with conflicting paradigms of a gestational body of female impurity and of an idealized androgynous body of generation" (p. 184).

What seems to have made an effective shift in medicine eventually possible was the emergence of print technology and the circulation of hegemonic medical discourse in the form of books, which in turn reinforced the authority of literate physicians who were predominantly male. With this, family medicine--and especially childbirth procedures, which were transmitted through kinswomen's practice--was gradually marginalized. Also, interestingly, with the emphasis on literacy as well as the rising dominance of the Confucian ethics of female seclusion, hands-on medical technology became more or less obsolete: physicians normally could touch female patients of the society's upper echelons only for a pulse check. Ironically, however, this may be another reason why, though marginalized...