Disease, Disorder, and the Longue Durée in China

Saturday, January 7, 2017: 1:50 PM
Centennial Ballroom G (Hyatt Regency Denver)
Hilary Smith, University of Denver
Disorders discussed in pre-modern Chinese medical texts, such as tianhua, shanghan, and jiaoqi, came in the nineteenth and twentieth centuries to be equated with modern disease entities: in the examples above, smallpox, typhoid fever, and beriberi, respectively. But ideas about medical disorder in pre-modern East Asia differed from the laboratory-informed ideas about disease that emerged in the late nineteenth century. Classical Chinese physicians had tended to see illness as a disruption of the body’s healthy order, and to describe patterns of symptoms as the most important characteristics of specific disorders. Later doctors, by contrast, tended to equate a disease with its causative microorganism. One consequence is that an older concept of disorder is often too multivalent to equate with a single modern disease entity. Pre-modern tianhua likely indicated eruptive skin disorders of many types, not just smallpox caused by the Variola virus; shanghan a variety of acute febrile diseases, not just the typhoid fever caused by Salmonella Typhi. And the symptoms of early jiaoqi resemble modern diseases as diverse as gout and athlete’s foot, not only the vitamin deficiency disorder beriberi.

Considering how fundamentally ideas about medical disorder changed starting in the late nineteenth century, does it make sense to try to write longitudinal histories of classical Chinese disease concepts? Or does examining such concepts over the longue durée necessarily lend them a false coherence that subordinates the knowledge of the past to the discoveries of the nineteenth and twentieth centuries? This paper will explore how examining classical disease concepts over a longer or shorter time scale changes the way we think about pre-modern medicine. It is an issue of particular relevance for Chinese medicine, with its large reservoir of pre-modern texts, but that applies equally to classical medical traditions elsewhere, such as in the West or South Asia.