Historian Charlotte Furth's groundbreaking study of 700 years of Chinese gynecological tradition presents an intricately detailed picture of another civilization's ideas of sex and gender, viewed through the lens of its medical practice.
"A Flourishing Yin: Gender in China's Medical History, 960-1665" (University of California Press, 1999) is the result of more than 15 years of scholarship in primary source materials that in large part had never been explored by English-language researchers. These sources came from the brushes of scholar- doctors who, beginning in the Song dynasty (960-1279), centuries before Gutenberg, published their clinical wisdom in printed books.
More than 8,000 medical titles from the period studied in Furth's new book survive, virtually none of them translated. In many cases, she was the first American scholar ever to read these works.
Furth, a professor of history in the University of Southern California College of Letters, Arts and Sciences, first learned about this huge body of material in 1982 as a visiting Fulbright professor at Beijing University. Following the 1949 revolution, the Chinese government had made an energetic effort to find, preserve and catalog early writings on medicine, regarding the tradition as a national treasure. But the Cold War had kept Western scholars largely unaware of the material, and even had they known, the subject was far from the interests of most researchers in the field during those years.
Not so for Furth, who in 1982 was already interested in the then-emerging field of gender studies, as well as being deeply involved in the history of thought and of science. "When I found an original edition of an 18th-century manual on childbirth," Furth later wrote, "the direction [of my research] was set."
As a feminist scholar, Furth was challenged by the project of exploring ideas about the body and bodily gender in such an unfamiliar culture as China's. "I wanted to see how far I could push the arguments that the human body is known and experienced through the lens of culture, as historically contingent," she said.
Her thoughts about her mother lode of documents were stimulated by the landmark work of fellow historian Thomas Laqueur on the pre-Enlightenment European medical tradition, notably in his book "Making Sex: Body and Gender from the Greeks to Freud." Where Laqueur showed how Renaissance intellectual and medical beliefs about maleness and femaleness came out of religious and cultural assumptions that the male sets the standard for the human, Furth argues that the Chinese medical body was understood as androgynous.
Chinese culture, developing independently of Western Europe, assembled its preconceptions using the classic duality of yang (brightness, activity, dryness, heat, the sun) and yin (darkness, receptivity, latency, moisture, coolness, the moon). The origins of Chinese medical thought on yin and yang could be traced back to the classic "The Yellow Emperor's Inner Canon" compiled over several centuries in the first millennium CE. Where Laqueur saw a European "one sex" patterned on a male norm, Furth argues that "the Yellow Emperor's human body is more truly androgynous, balancing yin and yang functions in everyone."
"The very term 'sex,'" she notes, "which in Laqueur's analysis names a physical difference between males and females interpreted through the lens of gender ideology, appears a misnomer. The Yellow Emperor's body has no sex, only gender."
Furth writes that "rather than labeling a gender which is defined on other grounds, yin and yang are the foundation on which the language of gender rests."
That foundation, Furth argues, was based on cosmology that linked human reproduction and the creative powers of the universe at large. By appealing to cosmology as the source of bodily truth, Chinese medicine challenges our modernist belief that the body alone must be the basis of gender differences, or that bodies must be understood as sharply individuated rather than bound up in collective life.
Chinese physicians had long worked within the framework offered by yin-yang theories to classify and systematize patterns of disease and their cures, treating the sick with herbal infusions, moxibustion (burning powdered herbs on the skin to produce heat) and acupuncture in particular. It was in the Song dynasty, however, that they turned their attention to specifically female complaints, and gynecology -- under the name of fuke, from fu for married woman -- emerged as a separate medical discipline.
This emergence was spurred, according to Furth, by the spread of printing to create books, so that procedures that had been transmitted directly from master to disciple or by private manuscripts came to be widely circulated, and even subjected to official standardization. Furth's book traces the evolving forms this medicine took between the Song and the Ming dynasties (down to 1665), exploring the remarkable documentation of human interaction preserved in print -- theories and practice recorded in hundreds of case histories, recording encounters between specific patients and their doctors.
While recording the rise in status of learned physicians and their efforts to differentiate themselves from vulgar popular healers, including "medical grannies" and midwives, Furth has also stressed that knowledge of medical texts and of the art of prescription was not a professional monopoly. Rather, for the period under study, most medical practice was located in the home. Male doctors had to negotiate the class and gender boundaries of everyday family life in their clinical encounters. Wives and mothers supervised medical consultations with female patients and children, and medical books attracted a general readership that included women.
In discussing the contributions and careers of outstanding medical authors, mostly men writing for men, Furth introduces figures like Wang Qi (1600-1688), who inherited a family publishing business printing "fiction, travel guides for merchants, examination aids, medical works, model letters and other how-to books for daily living." Wang expanded his house's offerings with a line of health books aimed expressly at a new market of literate women.
Also noteworthy was the woman physician Tan Yunxian (1461- 1554), granddaughter of a well-known physician who had married the daughter of another famous doctor. The young Tan later recalled reciting poems for her grandfather, who "laughed and said, 'The girl is very clever, quite out of the ordinary. When she is grown she will be able to practice my medical arts.'" She did, and left a memoir of her practice, including her favorite cases, which Furth retells in compelling, annotated detail.
In reading Furth's work, one finds that beneath the vast differences in theory and the great differences between the development of European and Chinese civilizations, there was a surprising similarity in the social practice of medicine on opposite sides of Eurasia in the 15th and 16th centuries.
Medicine was sex-segregated, its science was close to daily life, professionalism was limited and classical learning was prestigious but of limited clinical value. Competing groups of healers included literate physicians and paramedical practitioners like midwives, granny healers and apothecaries, and itinerant acupuncturists in China and barber-surgeons in Europe.
East-West differences abounded too. Abortion, for example, was recognized in Chinese practice as something that might be desirable, if not by a woman acting on her own, then as a decision arrived at in consultation with a patient's family: "However precious descendants were to a family, there was no absolute right to fetal life overriding a mother's health, nor were women who were weary of repeated childbirth necessarily stigmatized."
Furth also reports on the sad history of unavailing efforts to understand and treat epidemic smallpox in children -- just as deadly and widespread in China as it was in early modern Europe. Drawing upon folk traditions about the pollution of menstrual blood and the blood of childbirth, physicians suggested that smallpox was the result of "fetal poison" -- filth induced by sexual passion during conception and transmitted to the child in utero. Since passion was inevitable, they concluded, so was disease.
Furth's researches were not all in dusty archives. Many of the traditions she writes about are still alive in some form, and she recalls with pleasure tracking down practitioners and patients both in the People's Republic and Taiwan.
The result is an exploration of territory largely unfamiliar to most Westerners. As Thomas Laqueur put it, "This is the book to own for students of the history of the body in other cultures who want to learn about Chinese thought on this vast topic."
Furth's research for "A Flourishing Yin" was funded in part by a grant from the National Library of Medicine of the National Institutes of Health. The Committee on Scholarly Communication with the People's Republic of China underwrote a key travel grant.