Over the past few decades, scholars of East Asia working with new transnational frames, have been remapping the territory of medical history. Elman's edited volume represents a bold attempt to do medical history within that newly mapped terrain, working on the interpretation of ancient texts across time and place, from the ground up, and from the relationship between texts, practitioners and practices. This is the second edited volume to emerge from a series of research seminars at Princeton University. The Series “East Asia and the Early Modern World: Fresh Perspectives on Intellectual and Cultural History, 1550–1800”, ran from 2009–2012 and aimed to de-centre the old dichotomies between science and non-science which locate authoritative medicine in a modern West, and also to throw light on new forms of evidential scholarship in early modern East Asia which sought new medical practices in a re-evaluation of ancient texts.
The introductory chapter on rethinking the Sino-Japanese medical classics is a formidably scholarly endeavour to draw together the threads of what the editor bravely admits is rather a disparate volume of chapters. It tackles the difficulties of making necessary linkages without falling into a priori assumptions about, for example, the nature of medicine, periodization of technology, and the way texts have moved around and been received and used in practice; and the considered compromise is chronological, rather than thematic. Philology has long been on Elman's agenda, although in this chapter he never attempts a clear statement of what philology is, isn't or might be. At times his tone is exasperated, unnecessarily apologetic about the supposed shortcomings of the volume, but the result is certainly engaging and informative.
There follows a stellar line-up of distinguished and established, as well as rising young, scholars. The book contains virtuosic examples of close reading, based on extensive readings of the secondary literature in East Asian and European languages. Several chapters focus on particular individuals and are fine-grained, context-rich, analyses of their writing and reading practice. The volume opens with Asaf Goldschmidt's study of Xu Shuwei's 許叔微 (1079–1154) Cold Damage trilogy: 100 verses on Cold Damage manifestations; the subtleties of Cold Damage (shang han) revealed and his collection of 90 personal case histories, arguably the earliest of a Chinese physician. Following Charlotte Furth, Goldschmidt notes that with the rise of printing and the establishment of an imperial medical education system, a new role emerged for text in the transmission of medical know-how that aimed to resolve the dissonance between the new printed medical canons and contemporary practice. A central focus of Xu's clinical case history writing was the re-discovery of the ancient Cold Damage literature and its applications in the new epidemic environment of the Song. Cold Damage is a recurring subject throughout the volume.
Fabien Simonis' chapter takes us forward to the Yuan period when the name of Danxi, aka Zhu Zhenheng (1282–1358) embodies the paratext of his unique synthetic process. Claims made more broadly about the existence of “schools” in China have come under scrutiny in contemporary scholarship. Innovations attributed to the schools of the “Four Masters of the Jin and Yuan”, of which Danxi is one, are accordingly represented as having obscured the interpretive strategies of 14–16th-century physicians and their anthologies of excerpts.
Daniel Trambaiolo introduces two Japanese Confucian philologists, Itō Jinsai 伊藤仁齋 (1627–1705) and Ogyū Sorai 荻生徂徠 (1666–1728), and their rejection of post-Song traditions of philosophical interpretation as a lens for reading the medical classics. Returning to the ancient authority of Zhang Zhongjing 张仲景, originator of the Cold Damage theories, “Ancient Formula” (kohō 古方) doctors of the eighteenth century subsequently sought to bring about a parallel transformation in practice, criticizing medical orthodoxy as the degenerate medicine of a “Later Age”. One paradoxical consequence of this attempt to restore the medicine of antiquity was the development of an entirely new approach to the epistemic foundations of medicine that combined direct observation with the philological study of early texts.
In the spirit of the volume's aim to examine critically the movement of medical practices across the political and cultural regions of East Asia, Mathias Vigouroux explores the neglected history of the Circulation Channels Theory in Japan (1500–1800). What happens to a tradition so specifically Chinese as it transplants into a new cultural environment, especially in Japan where the negotiation with a Western anatomical modernity produced hybrid explanations of efficacy, and how does that differ from the subsequent trajectory for the same practices in the place of origin?
Turning to the enduring epistemologies of more popular Japanese practice Susan L. Burns fulfils the medicine-from-below remit of this volume. She reads the nineteenth-century theoretical and case history writings of Nanayama Jundō 七山順道, who practised a medicine inspired by Cold Damage theories in the castle-town of Yūzawa (Akita Prefecture), for how it increasingly incorporated and valued practitioners' observation, experience and experimentation over text-based knowledge.
Proceeding chronologically, Federico Marcon explores the nature of antiquarianism in Mori Risshi 森立之’s analysis of classical Chinese and early Japanese medical texts following the successful institutionalization of modern biology in Early Meiji Japan. This is a nuanced story of the philological practices of contestation and adaptation that mediated conflicting worldviews, as intellectuals and practitioners alike deployed the search for a “national essence” in ancient texts against and beside the more powerful political forces of modernity.
Any hard and fast division between an East Asian tradition and modernity is bridged by Angela Ki Che Leung through a detailed description of the lingering disease category known as Kakké/Jiaoqi 腳氣 in Japan and China respectively. Focusing on its varied manifestations and interpretations as simultaneously an ancient pathology and a new “national” disease of the wealthy, or a new problematic of migrants and migration, Leung analyses how the very mutability of its explanatory power led to some delay before the term's modern manifestation attached to a theory of malnutrition associated with beriberi, its enduring modern translation.
In a characteristically detailed analysis Mayanagi Makoto et al. round off the volume with a fascinating story of the value of transnational antiquarianism and philology as it survived into the twentieth century. Yang Shoujing 楊守敬, capitalizing on the discredited tradition of traditional medicine in Meiji Japan, bought, in four years, some 1,700 rare and not-so-rare Chinese and Japanese medical texts, and published many on his return to China. Large quantities of the most valuable were purchased from the Kojima family, generations of whom had held high medical offices, and had participated in the Edo Japanization of traditional medicine.
All originality naturally derives from complex interwoven syncretic processes, and this point is well made throughout the volume in relation to the ever-emerging challenges faced by medical practitioners who engaged with the theoretical foundations of their work. A highly specialist volume, there is nonetheless great intellectual breadth and diversity of content. The challenge for the editor was clearly in making the chapters speak to each other and this fact raises some serious questions for the field. On the one hand the issue plays out at a micro level where inconsistent terminology across the volume (Cold damage, Cold injury…) might be a source of confusion for non-specialist readers. On the other hand it is of enormous interest and value for scholars working at the cutting edge of the transnational history of East Asian medicine who are well-versed in such anomalies. We, in this field, have long outgrown a belief in modern European medicine as the central reference point for the history of medicine, but the challenge of coherence demands that scholars of East Asian medicine, working in diverse departments around the world and across separate linguistic fields devise new and sustainable means to communicate with each other and the larger academic community effectively. If, to use an Elman trope, they did it on their own terms so can we!