Vietnamese Traditional Medicine: A Social History by C. Michele Thompson (review)

In Vietnamese Traditional Medicine, C. Michele Thompson explores the Vietnamese reception of foreign medical ideas and techniques through the case study of smallpox. The central question is, why did the Vietnamese adopt Chinese variolation after the introduction of Jennerian-style smallpox vaccination? Building on Laderman’s concept of intellectual “dissonance” (pp. 64, 142), Thompson argues that the main Chinese etiology for smallpox, “fetal toxin” (an internal cause legitimizing variolation), was known to the Vietnamese but played no significant role in Vietnamese medical history. The Vietnamese preferred external causes to explain smallpox. Only after the introduction of Western-style vaccination (motivated by an external cause of disease) did Vietnamese doctors adopt Chinese variolation or develop their own mixed approaches. Thompson partly concords with previous scholarship on Vietnamese medicine and points out that Vietnamese doctors were much more practically oriented than their Chinese counterparts. Yet this does not mean that there was no theory at all in Vietnamese medicine. Thompson shows how Vietnamese medical authors who wrote in the Vietnamese vernacular script (Nôm) were preoccupied with taxonomical categories of herbs, which reflects an indigenous theoretical approach.

The choice for smallpox is a practical one. A high number of preserved medical texts in Vietnam, mainly written in Nôm or in a mixture of Nôm and Classical Chinese, were devoted to this disease. Moreover, in contrast to culturally constructed diseases (such as Koro), smallpox is clearly defined by biology, but it provoked different responses among diverse societies. Therefore, Thompson considers smallpox an ideal disease to investigate differences between Vietnamese and Chinese medical systems.

The prologue, preface, and elaborate introduction (chap. 1) acquaint the reader with the history of smallpox and the particularities of Vietnam, located at a crossroad of East and Southeast Asia. This makes the remainder of the book highly accessible for both medical historians unfamiliar with Asia and Asia scholars without backgrounds in medical history. Chapter 2 recounts the medical mission of the French physician Jean Marie Despiau to Macau (1820–21), who acquired the smallpox vaccine on behalf of the Vietnamese ruling family. Chapter 3 discusses historical texts on variolation and vaccination in Vietnam. Chapter 4 plunges into the linguistic complexities of Vietnam and shows how folk medicine was the last stronghold of Nôm script until late in the twentieth century, while the scholarly elite turned to the Latin alphabet and Western medicine. Although the book is clearly written, the proofreading could have been better. Vietnamese diacritics often go wrong, and Chinese words are not always consistently transcribed.

Although this book is pathbreaking and thought-provoking, a more careful analysis could have prevented some overgeneralizations. Let me give one example. According to Thompson’s findings, “A number of extant Vietnamese medical texts … contain sections on smallpox that can be directly attributed to Chinese medical works. The Chinese originals contain extensive discussions of fetal toxin; however, the Vietnamese versions mention it little if at all” (p. 21). This is illustrated by referring to a Vietnamese compiler who copied 495 recipes from the Chinese physician Zhang Jiebin but who “did not find Zhang’s detailed discourse about fetal toxin compelling enough to merit more than a bare mention” (p. 21). Yet I found a number of striking counterexamples. Fetal toxin is central to the discourse on smallpox of Lãn Ông (1720?–91), the most important doctor in Vietnamese medical history with whom Thompson otherwise is quite familiar. When she translates one of his external remedies (from a problematic modern Vietnamese translation of the original text!) in a section titled “Vietnamese Smallpox Etiology,” Thompson fails to observe that Lãn Ông copied this remedy from a Chinese source text.¹

The strength of Vietnamese Traditional Medicine lies in opening up the diverse field of actors engaging with smallpox between the eighteenth century and the twentieth. Especially Thompson’s discussions of medical literature in Nôm are truly fascinating. This work, the first book-length study on...