Miandui jibing: Chuantong zhongguo shehui de yiliao guannian yu zuzhi 面對疾病:傳統中國社會 的醫療觀念與組織 [In the Face of Disease: Concepts and Institutions of Medicine in Traditional Chinese Society] by Angela Ki-che Leung (review)

Rarely is a moment more special in a scholar’s career than the publication in one single volume of over a dozen essays composed in a period of more than two decades. There is more reason for celebration when the author, Angela Ki-che Leung, has contributed to the field of history of science and medicine in China in such fundamental ways. The thirteen articles, three of which appear here for the first time in Chinese, were all originally published elsewhere in journals and edited volumes. Taken as a whole, the articles addressed issues related to, but not necessarily overlapping with, the author’s two previous monographs on late imperial philanthropic societies and leprosy in China. For the purpose of this review, I will leave aside summaries of individual chapters and attempt instead to offer a few observations after reading the whole book. If each article crystallizes the author’s thoughts at a particular moment, what additional insight can we gain by looking at them as a coherent body of inquiries?

In her preface, “A Plea for the Study of Chinese Medical History,” Leung reflects on difficulties she encountered when trying to communicate her work with “mainstream” historians in China. Under the influence of post–May Fourth historiography, many still saw traditional medicine as reflecting the backward and superstitious side of the Chinese past and hardly worth the trouble to study. Moreover, historians tended to see texts dealing with medical matters as abstruse and esoteric and thus of little use for students of general history who do not practice medicine. Acknowledging the legitimacy of such problems, Leung nevertheless maintains that with patience and hard work, the history of medicine could potentially “reveal in a clear and natural way, the different stages of a civilization’s development” (5). She raises Western historiography of medicine as an example of success in this endeavor and calls for fellow historians to “find out ... the close relatedness between the development of medical knowledge and that of the whole culture” (6). The essays included in this volume testify to her own contributions toward that goal.

Thirteen essays are grouped under three themes—“Construction and Transmission of Medical Knowledge,” “Developments in Medical Institutions and Resources,” and “Disease Categories.” Each reader is bound to find some stimulating discussions relevant to his or her interests. I will venture to present three general observations. First, the essays speak to Leung’s consistent interest in exploring the emergence and characteristics of “late imperial” Chinese society under the Ming and Qing dynasties. What was unique about this time period in comparison to the previous era? Leung’s study clearly indicates a broad trend of the imperial court’s retreat and growing influence of local institutions in organizing daily life. The topic of medicine enables her to examine this historical process in its many faces. While past history of Chinese science often praised the development of state-sponsored medical institutions in Song and Yuan China (from the tenth to thirteenth centuries), Leung’s work shows that many such institutions gradually faded away from the fifteenth century onward, such as local medical academies (chapter 2), state-owned pharmacies (chapter 7), and state monopoly over textual authority (chapter 1). Instead, we see the ascendance of private philanthropy (chapter 7) and locally managed leprosaria as central forces in the delivery of care to the broader populace (301–6).

Second, Leung uses medicine as a lens through which she tackles the problem of modernity in Chinese history. Her analysis of small pox vaccination (chapters 3 and 4) and leprosy segregation (chapter 12) in the nineteenth and twentieth centuries reveals dynamic interactions between indigenous and foreign frameworks of knowledge and practice. One may anticipate a fuller exploration of these themes in her current work on...