Nüren de zhongguo yiliao shi: Han Tang zhi jian de jiankang zhaogu yu xingbie 女人的中國醫療史 — 漢唐之間的建康照顧與性別 [A Woman’s History of Chinese Medicine and Healing: Health Care and Gender in the Han to Tang Dynasties] (review)

This richly detailed book is a veritable master class in how to construct a “woman’s history of medical care” when the available primary sources are almost all written by men. Over the past two decades, Lee Jen-der has been a leader in the study of gender and medicine in Han though Tang dynasty China, and the chapters in this book are based on her previously published articles. With thoroughness and insight, she weaves together accounts of women and caregiving gleaned from a wide array of sources, including official histories, government documents, inscriptions, religious and ritual writings, moral treatises, and, of course, medical texts. She documents the central role that women played in caregiving and medical treatment, as well as the way that different imaginings of the female body shaped male medical theorizing. She also coaxes her sources to reveal the lived experiences of women as bearers of children and givers of care. The result is a compelling corrective to existing histories that focus on the development of classical medicine and its male practitioners.

Chapter 1 sets the stage with a childbirth case that dates from the late fifth to mid-sixth centuries and subsequently circulated in medical texts of the seventh and eighth centuries. A man named Qing feared that his daughter-in-law might die in childbirth, and he beseeched the help of Tanluan, a famous monk and recluse. Tanluan attributed difficult labor to inappropriate interference by female birthing attendants, and he ordered the woman to go through labor in a room alone by herself. She then gave birth easily. With this startling (to modern eyes) story as a point of departure, Lee’s subsequent chapters recreate the medical and social world that would have allowed people of the time to find the story of Qing’s daughter-in-law to be instructive and medically relevant. Two main themes structure Lee’s exposition: the “culture of childbearing” (shengyu wenhua) and the role of women as caregivers and healers. She also highlights the often ambivalent views that male medical authors, government officials, and other literati had toward women healers and the female body.

Chapter 2 argues that the desire to promote fertility fostered the development of fuke (medicine for women) as a field of male-authored, literate medicine. Women felt pressure to produce children, and childbirth was central to women’s lives. Fuke writings augmented their available resources, but male doctors now also claimed to understand the female body better than women did. Furthermore, while older fertility techniques also focused on the state of the male body, by the seventh century medical texts defined “childlessness” (wuzi) as a female problem. Successful childbearing depended on the woman’s body, mind, and behavior all being properly regulated at each stage of the process. This attention to female reproductive functions also led doctors to ponder how women’s bodies might differ from men’s. The seventh-century doctor Sun Simiao articulated the earliest explicit description of gender difference: women were fundamentally different from men because women menstruate. And while menstruation enabled women to bear children, it also made them more vulnerable to disease.

People viewed childbirth as a dangerous event that rendered a woman polluted and weak, and chapter 3 details the procedures that they could deploy to protect her before, during, and after childbirth. Such practices had existed since antiquity, but male doctors now expanded and systematized them. Women could take drugs to make the fetus come out easily, to resolve complications of labor, and to treat dangerous ailments of the postpartum period. People prepared “birthing huts” and “tents” (chan lu, chan zhang), consulting charts that told them how to orient and arrange...