Speaking of Epidemics in Chinese Medicine: Disease and the Geographic Imagination in Late Imperial China (review)

Speaking of Epidemics in Chinese Medicine is the latest book by Marta Hanson, historian of Chinese science and medicine at the Department of the History of Medicine at Johns Hopkins University. This book draws on her PhD dissertation and on the many research projects that have followed it (Hanson 1997, 2001, 2006, 2011). It explores the Chinese medical discourse on epidemics in Chinese history and highlights the changes and bifurcations of this discourse elaborated not only in the face of a changing epidemiological reality but also of shifting political, social, economic, and cultural realities which have always played a significant part in the conceptualization of the body and its ailments. To capture the different tenets of this discourse, Hanson focuses on one disease concept, “warm disease” (wenbing 温病), that Chinese authors linked to epidemics in the most ancient medical texts and examines how the diseases associated with this label have been considered, treated, and described by the Chinese doctors throughout Chinese history. In fact, the term wenbing has remained important throughout the history of Chinese medicine and still continues to be used in People’s Republic of China’s traditional Chinese medicine, today conveying the biomedical idea of acute infectious diseases.

In applying the idea of writing a “biography” of this long-lasting disease concept (1), Hanson chooses not to fall into the trap of the teleological narrative that often featured the biographical enterprise, with a beginning, an end, and, between, some sequences all oriented toward a single end, in both meanings of this term: “termination” and “purpose” (Bourdieu 1986). It is precisely against this type of teleological synthesis, often tainted by nationalism and positivism, such as those of the twentieth century made by some medical historians caught between historiographical enterprise and the need to situate and, at times, to legitimate ancient knowledge into their medical practice, that Hanson’s project stands. As the introductory chapter 1 stresses, in reconsidering the concept of wenbing, from the beginning to its latest uses (in the SARS epidemic, notably), Hanson follows what Adrian Wilson (2000: 276) called a “historicalist-conceptualist approach,” according to which disease concepts are always historically situated, socially defined, and culturally meaningful; hence, they must be taken as objects of historical analysis. Hanson’s approach is to understand how warm diseases have been considered, “on their own terms, within their own framework, and as changing their meanings over time” (9). Hanson’s biographical enterprise on the wenbing also departs from the internalist approach that dominated the historiography of disease concepts throughout most of the twentieth century and that consisted in analyzing the evolution of meanings associated to disease concepts by relying solely on the grounds of medical definitions, as if medical thinkers lived in a hermetically sealed bubble. By exploring much Chinese literature, medical or not, and by paying close attention to nonmedical themes that nonetheless intersected this disease concept, such as space, physical as well as imagined, Hanson sheds light upon the political, social, and cultural dimensions that led to the many bifurcations of this concept throughout its long history. She also highlights the different social uses that were made of the term, notably, when the concept of wenbing and the discourse about it became, in the nineteenth century, associated with a particular current of learning, nay, a tradition, and served, in those days, as an identity marker, delineating the membership of doctors into competitive groups.

The result of this biographical enterprise is a very dense book, organized into three parts, with eight chapters, along a chronological axis that brings the reader from the Inner Canon of the Yellow Emperor (Huangdi neijing), the first set of medical doctrines transmitted by the written tradition, to the twenty-first century and its SARS epidemic, conceived by today’s Chinese medical practitioners as belonging to wenbing, and treated accordingly. From chapter 2, “A Deep History of the...