AAS Annual Meeting

Interarea/Border-Crossing Session 172

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Session 172: Towards a Transnational History of East Asian Medicine: Tracing Pathologies of the Liver across East Asia

Organizer: Eric I. Karchmer, Appalachian State University, USA

Chair: Volker Scheid, University of Westminster, United Kingdom

Discussant: Bridie Andrews, Bentley University, USA

The history of medicine in East Asia is dominated by the nation state. Today scholars specialize in a national tradition: Chinese medicine, Korean medicine, Kanpo (Japanese) medicine, Vietnamese medicine, and so on. Their work tends to emphasize the deep roots of each medical practice within the history of an individual ethnic group. This paradigm persists despite the sophisticated critiques of nationalism and the nation-state that have emerged in recent decades. The cost of this unacknowledged bias has been to not only obscure the rich history of scientific and technical exchanges that have taken place across East Asia but also to foreclose a more nuanced understanding of the link between knowledge formation and imperialist aspirations – whether Mongolian, Manchurian, Chinese, Japanese, or European – in the region. The papers in this panel are part of a collective research project, funded by the Wellcome Trust, to move beyond this nationalist bias towards a transnational history of medicine in East Asia. Focusing on emergent pathologies of the liver since 1600, each author traces the movement of doctors, texts, concepts, herbs, or techniques to demonstrate how local innovations in China, Korea, and Japan were in dialogue with a broader universe of medical scholarship in East Asia. We believe this panel’s attempt to outline a transnational framework for the study of medicine in East Asia will resonate with the growing emphasis on border-crossing scholarship in the region.

Globalizing Hwabyong: How Does an Illness Become Korean?
Soyoung Suh, Dartmouth College, USA

Depression is a significant problem in Korea as elsewhere. Paralleling Korea’s highest suicide rate among OECD (the Organization for Economic Cooperation and Development) countries in 2005, popular and professional discourses that medicalize Koreans’ dysphoria gained currency in recent years. Along with the growing visibility of depression as disorder or disease, Fire-illness (or “Hwabyong”) also displays its nosological autonomy. Registered as a uniquely Korean culture-bound syndrome, Fire-illness is known as an internationally recognized category for somatic expressions of Korean anxiety, anger, and obsessions. In line with the popularity of Fire-illness, the liver came to be an important focus of diagnosis and treatment. More to the point, the etiology of Fire-illness touches upon “Han,” the Korean expression of accumulated resentment and grudges. The Fire-illness as a label for indigenous mental problems, hence, reflects the construction of a collective mentality for Koreans. This article scrutinizes this idea of the “uniquely Korean,” which interacts with the emotional health and illness under the advance of global flows. When did Fire-illness become uniquely Korean? To what extent did medical innovations from China, Japan, and the West frame a Korean-specific approach to emotional problems? Both Korean psychiatrists and doctors of traditional medicine have consolidated their professional autonomy through their research on Fire-illness. By examining the research papers, newspaper articles, and popular essays of both professions, this article traces the possibilities and problems of Koreans to define local culture under global flows.

All diseases arise from the liver: A Japanese medical theory in the Edo period
Keiko Daidoji, Japan Society for the Promotion of Science, Japan

This article examines how the pathology of the liver and blockage was developed during the Edo period, through the analysis of the medicine of Wada Tokaku (1742-1803). Wada observes that the blockage of qi in the liver and gallbladder is a widespread Japanese phenomenon during the peaceful reign of the Tokugawa regime. Wada’s concern about the liver is also shown by his unique pathology that ascribes all diseases to the liver. The pathology of blockage was first elaborated by Zhu Danxi (1281-1358) in China who was very influential in Japan. However Zhu medicine underwent various modifications by Japanese physicians, including Wada. Is the blockage in the liver really an Edo-Japanese phenomenon, or not? How did Wada’s liver pathology suit the contemporary medical trend in Japan? Looking for answers to these questions, this article situates Wada’s work in the history of Zhu Danxi’s influence in Japan. In China, blockage is primarily associated with the idea of fire, while Wada considers that the danger of blockage fundamentally lies in stagnationaccumulation. Wada draws on socioeconomic, biographic, and textual analysis in his clinical cases to elucidate this difference. These complementary stories about how Wada’s interpretation of blockage and the liver functioned in the context of Edo-period medicine deepens our understanding of the interrelationship between the localisation of diseases and the utilisation of past knowledge.

Virtues and Virtuosity: Knowing the Nation and Treating the Liver in Modern China
Eric I. Karchmer, Appalachian State University, USA

What are the ethical stances and techniques of self-cultivation that help doctors become virtuoso clinicians? This question was central to the debates within the medical community in China since the early 20th century. For many centuries, Zhu Danxi had provided the Neo-Confucian answer to this problem. Through the study of the classics, the physician grasps the patterns (li) of the cosmos and uses his judgment (yi) to tailor one’s treatment to the specifics of the clinical context. This orthodoxy seemed too subjective to the “evidential scholarship” movement in the Qing dynasty, leading to tensions between advocates of classic formulas (jingfang) and current formulas (shifang). By the early 20th century China, these debates became more complicated. Chinese intellectuals had begun to understand China as one nation in a world system of nations, and Chinese doctors began to recognize their indigenous medical practices as a national traditional not a universal form of medical knowledge. In forging this national medicine – Chinese medicine - doctors also drew on the epistemic virtues of empiricism in Japanese kanpo medicine, objectivity in European medicine, and materialism in Marxist thought. In this paper, I will explore the relation between political virtues and clinical virtuosity in the 20th century China. Focusing on the developments in the treatment of Liver pathologies, I will show how the innovations of early modern doctors, such as Zhang Xichun and Zhang Shanlei, were modified and adapted in the Communist era for the purpose of incorporating Chinese medicine into the national health care system.

Feminising the Chinese Body: A History of the Liver in Late Imperial China and Japan
Volker Scheid, University of Westminster, United Kingdom

In her influential history of women’s medicine in China, Charlotte Furth traced the emergence of a gendered discourse on the body in late imperial China. One strategy for doing this was to root the female body in the physiology of the Liver and that of the male body in the Kidneys. Beginning in the late Ming, physicians increasingly placed the Liver at the centre of all pathophysiology linked to illnesses arising from emotional and constitutional causes. By the Republican era the Liver had become so central that it was understood in some quarters as defining the Chinese body vis-à-vis the West. Liver disorders were usually traced to either a deficiency of yin essences and an inability to effectively manage one’s desires. In this paper I will situate the development of these ideas in the context of elite concerns about well-being that emphasized bodily deficiencies and extensive self-monitoring. I will contrast the “feminine” medicine that cared for these patients with the more masculine medicine practiced in the same period in Japan. Drawing on the same roots, this medicine emphasized the elimination of toxins from an essentially healthy body through sometimes violent regimes of purging and sweating. I will ask what we can learn about medicine in China by employing local and transnational perspectives that focus both on how medicine is practiced and on the contexts in which such practice takes place.