Novel Medicine: Healing, Literature, and Popular Knowledge in Early Modern China by Andrew Schonebaum (review)

Like an early modern Chinese novel, Andrew Schonebaum’s book Novel Medicine both informs and titillates. It offers insight into understandings of illness and healing in seventeenth-through nineteenth-century China alongside the pleasure of stories about sex, ghosts, and dysfunctional families. By examining diverse texts, from medical classics and manuscripts to novels, commentary, essays, plays, and transcribed oral tales, Schonebaum is able to show both how fiction writers deployed and reshaped medical knowledge for a broad audience, and how doctors borrowed narrative techniques and evidence from vernacular literature. The arrow of influence, in other words, was not unidirectional. Elite and vernacular genres influenced each other and reflected shared social and intellectual circumstances.

This is innovative scholarship. Schonebaum brings together primary texts that are usually segregated in distinct secondary literatures: in history of medicine, comparative literature, East Asian studies, and gender and women’s studies. In their own time, of course, the texts were not thus separated, and Schonebaum’s work helps re-create the highbrow-lowbrow variety of early modern China. This is especially illuminating for historians of Chinese medicine, who have mostly neglected popular literature in the vernacular. Aware that texts written in classical Chinese by and for the elite may not represent how most people understood health, illness, and healing, historians have lately begun to look outside the canon. Generally this has meant investigating the practices of religious healers, not the popular literature Schonebaum explores.¹

But as Novel Medicine shows, the medical content of such literature often corresponds well to what appears in medical texts. In this period print proliferated, education spread, and official positions grew harder to attain. Highly educated men unable to build careers in government began writing novels, and they stuffed their stories with their erudition, including their knowledge of classical medicine.

Some fiction writers used medical knowledge in ways that suggest they expected readers to know the same things they did. Lusty characters receive prescriptions whose ingredients real doctors used for symptoms caused by sexual overindulgence—a sly wink that would work only if the reader were familiar with the herbs named and the etiology implied. In other novels, drug prescriptions bear little relation to the plot or characters, and seem meant to redeem with useful information a genre regarded as frivolous and even immoral. Such efforts apparently worked, sometimes. Readers considered some novels so trustworthy as repositories of knowledge that they actually tried out prescriptions featured there. When one worked, a report of its successful use could migrate into a medical text, which duly credited the novel that had inspired the trial.

Schonebaum shows not only where medical texts and popular literature agreed but also how they differed. Ailments associated with sex and emotion, for example, were important in learned medicine, but on balance less so than epidemic disease and chronic conditions connected to weather, climate, topography, or diet. In novel medicine, by contrast, sex was apparently central. Novels are full of symptoms such as impotence and nocturnal emissions, as well as conditions attributed to sexual exhaustion (typically a man’s problem) or unsatisfied carnal desire (usually a woman’s). Likewise, although doctors and fiction writers agreed that ghosts could infect a body, such otherworldly causes of illness commanded much more attention in novels than in medical texts. And doctors almost never wrote of karmic retribution—reaping the punishment of past lives’ sins—as a cause of disease. In novels, though, it was a mainstay.

I have two reservations: First, while Schonebaum (appropriately, in my view) treats both fiction and premodern Chinese medicine as cultural products, he occasionally makes modern Western medicine look like Chinese medicine’s culture-free foil. For example, he often translates as “syphilis” the various Chinese terms for ailments associated with sexual transgression. This gives the misleading impression that the older words consistently described the disease we now know as syphilis, caused by a spirochete...