Leprosy in China: A History (review)

Angela Ki Che Leung’s book traces the long history of leprosy in China from antiquity (fourth century BC) to the recent past (the 1990s). Reviewing the history of a disease over two thousand years across a vast territory is a daunting challenge, but Leung has succeeded thanks to her effective strategy. Her account impresses the reader with its meticulous and eye-opening detail; I believe this work will oblige both Chinese and Western scholars to reconsider how they think about illness and medicine in China.

Leung uses the case of leprosy to argue for an alternative historiography of Chinese medical discourse. Her introduction contextualizes leprosy in China globally, a contribution to Dipesh Chakrabarty’s crusade to “provincialize Europe” (16). This is an effort to portray “multisited histories of postcolonial medicine” (16), a reference to Warwick Anderson’s ideas about non-Western medical history. Although Leung seems to see these approaches as one, I distinguish them here for the sake of discussion. In the first instance, Leung highlights the distinctiveness of the history of leprosy in China by making occasional comparisons with accounts of the disease in the West from ancient times through the colonial period to the present. She also invokes examples from India and Japan. As for the postcolonial history of medicine approach, Leung not only presents China as a long-neglected monolith in the world history of leprosy but also exhibits remarkable skill in exploring archives; the result is a series of vivid accounts of people and their leprosy stories that cross China’s regional and cultural boundaries. The main body of the book, chapters 1 through 5, gives full play to these two rather ambitious interpretive strategies.

Chapter 1 examines categories of bodily disorders whose symptoms, recorded from antiquity up through the sixteenth century, appear to overlap with today’s Hansen’s disease. Leung carefully differentiates symptoms and possible etiologies within a vaguely defined category of illness that includes dafeng 大風, efeng 惡風, li 癘, lai 癩, mafeng 麻風, and other conditions, tracing their transformations across different periods. The present-day term, mafeng, became popular only after the Ming dynasty. From the mid-seventeenth century the disease gradually became associated with the south. The hot and damp climate of the Lingnan region, which includes Fujian, Jiangxi, Guangdong, and Guangxi provinces, was believed to be conducive to the rampant spread of the disease. Female bodies were blamed for the mafeng/li contagious disorders, which were believed to be transmitted through sexual intercourse. Many medical classics and other kinds of works published in the north present myriad myths, hearsay, and sociocultural stereotypes, all betraying a fear of the unfamiliar south. In a geopolitics of disease, these disorders were mapped and defined much like other diseases associated with the tropical zones.

Chapter 2 continues the discussion of stereotypes, focusing on people afflicted with these dreadful disorders. Leung examines in great detail the legal, religious, and medical aspects of (mis)treating patients and shows how the ill were stigmatized, cursed, and redeemed through Daoist and Buddhist beliefs and practices.

Chapter 3 focuses on the popular practice of segregating the bodies infected with mafeng/li disorders since the sixteenth century. These disorders appear to have been viewed and treated largely in terms of their moral and religious associations. The gendered myth of mafeng/li transmission would remain a recurring theme throughout premodern history. Most interesting here is that Leung tries to shed light on the patients themselves, who were often presented in the medical or historical record as voiceless and faceless objects. Rummaging through mainstream narratives, Leung reveals the agency of the patients who were cast in various roles—as victims, criminals, audacious beggars, or glorified moral paragons. In addition, Leung analyzes how these dangerously contagious bodies were managed through institutional means. Leper houses were nearly all state-funded projects because none of the traditional philanthropists were interested in assisting mafeng/li patients, a phenomenon that prevailed until Western missionaries landed on Chinese soil. The Ming and Qing periods (1368–1911) were critical in...