Dominique Hoizey and Marie-Joseph Hoizey
Translated by Paul Bailey
Edinburgh Press, 1993
Paperback £12.95, Hardback £38.50

(Reviewed by Bridie Andrews, EJOM Vol. 1 No. 3)

This is the first attempt at a comprehensive history of Chinese medicine to appear in English for some years, and is therefore the only one currently available in most book shops. As such it is certainly to be welcomed. Both the price (£12.95) and the size (205 pages, approximately A5 format) are standard for academic paperbacks, and the binding is excellent.

The subject matter is the development of Chinese medicine from the Stone Age to the mid-1980s, which is asking a great deal of any one volume. The authors fit it all in by conducting a very brief trawl through the writings of the major characters in the Chinese medical tradition, and spicing their account with generous gleanings from Chinese literature, western eye-witness accounts, and scientific experiments. The result is admirably readable for most of its length, although there are occasional page-length lists of major authors and their works with little commentary, and this causes it to lose both pace and interest in places. The book contains many illustrations, including several useful reproductions from the Chinese works cited in the text. The imaginary ‘portraits’ of some of the major medical figures are pretty, but less informative. The reference material at the end includes a chronology of major events in the history of Chinese medicine, and indices to both persons and medicinal plants cited in the text.

In order to cover the whole of the history of medicine in China it is of course necessary to pick and choose from a huge variety of sources and approaches to the writing of history. This choice is important, because very many different historical stories can be told, depending on the way the authors decide to edit and organise the subject matter. The Hoizeys’ choice of material reflects their particular competences: Dominique Hoizey is a professor of Chinese at the University of Reims in France, who specialises in literary translations, and Marie-Joseph Hoizey is a professor of pharmacology at the same university, and clearly has a great interest in pharmacological studies of the Chinese materia medica, the bencao. In compiling their History, the Hoizeys have used the existing western-language histories of China, mainly Chinese-language histories of Chinese medicine, and Chinese accounts in English of scientific advances in both modern and Chinese medicine, from such sources as the magazine China Reconstructs and the scientific Journal of Ethnopharmacology.

While this choice of sources is entirely appropriate for a history of this size and scope, it involves the acceptance of the points of view represented in those sources. For example, the book assumes that scientific medicine represents fact, and tends to award praise for Chinese medical developments according to whether they coincide with what is now accepted in western medicine. While this bias in favour of western scientific opinion is undoubtedly shared by most readers, it means that many medical treatments that were considered important to the Chinese people throughout history have been dismissed as anomalous historical curiosities. Ritual, religious, and shamanistic healing ceremonies fall into this category, as do various cures based on sympathetic associations now dismissed as ’superstitious’ (although the authors graciously concede that the psychological function of the medical speciality of ‘incantations’ during the Tang dynasty ‘should not be overlooked’ (page 64).

The book also reserves special praise for those authors who are deemed by the Chinese to have contributed in important ways to the type of Chinese medicine taught today in medical colleges, an approach which reproduces the Chinese medical and political orthodoxies of our own time without questioning how they have been brought about. For instance, in a discussion of the organs described in the Huangdi Neijing (translated as The Yellow Emperor’s Classic of Internal Medicine) on page 28, there is the remarkably uncritical reproduction of the current orthodoxy that: ‘The ‘triple burner’ does not refer to a real organ but describes the digestive, cardiorespiratory and urinary functions’. This completely ignores the very real disagreements about the nature and location of the ‘triple burner’ that have occurred ever since the term was first written down. Similarly, praise for Hua Tuo (?141-?208 AD) for ‘never hesitating to learn from popular medical traditions’ (page 44) merely parrots the Communist Party line of the 1960s and 1970s that popular knowledge is more valuable than elitist book learning. (The assertion is also completely unverifiable with such a mythical figure.) This uncritical copying from mainland Chinese literature occurs repeatedly, and is a bias that readers should bear in mind. On the other hand, it allows us to share the same understanding of Chinese medical history as that available to most Chinese people.

There is a further problem with the authors’ assumption that modern disease terms in Chinese still have the same meanings when they occur in classical writings. This overlooks the fact that we nowadays distinguish between, say, typhus, typhoid and malarial fevers with blood tests that were completely unknown anywhere in the world before the late nineteenth century. Even in English, all of these diseases were often described collectively as ‘the ague’ until their causative agents were identified by twentieth-century pathologists. Readers should therefore insert the phrase ‘a disease with symptoms similar to’ before every mention of modern disease names such as malaria, cholera, diabetes, tuburculosis and so on.

The above objections are those of a medical historian commenting on ways in which the general reader might be misled. Sinologists will find the index of names a useful way in to a first description of a particular author in an English text, although one would expect readers of Chinese to find Chinese sources more useful. The slight inconsistencies in the renderings of Chinese names are therefore of little consequence. The translation from French into English by Paul Bailey of the University of Edinburgh is lively and readable, although there are one or two hiccups, the most serious being a confusion between the Chinese technique of variolation (use of smallpox material from a person suffering a mild infection to inoculate a mild form of the original disease into others) and the western technique of vaccination (introduction of lymph from a recent cowpox infection in order to confer immunity to smallpox).

For practitioners of Chinese medicine in the West, this history offers an interesting first guide to the way the Chinese view their own tradition. The inclusion of extracts from a popular comic strip history from the mainland are particularly interesting from this point of view, and had the brief explanation of the ‘anti-revisionist’ comic strip on page 198 been expanded to include an assessment of more of the historical literature used in the writing of the book, most of my previous comments would be unnecessary. The Hoizeys have also uncovered so much interest in Chinese medicine, among western and Chinese authors alike, that we are left in no doubt of the significance of medicine in both cultures. I would have liked to see a bibliography at the end, or at least a list of suggested further reading. The other conclusion that follows from this discussion is that it would be very interesting to find out more about the creation of the orthodox Chinese medicine that is presented to visitors to mainland China today. Not least because it is increasing in popularity in the West.

Bridie Andrews
Bridie Andrews has spent 2 years in China studying Chinese and the principles of Chinese medicine. She is currently completing a Ph.D at the Cambridge University Wellcome Unit for the History of Medicine, on the emergency of modern medical systems (Chinese and western) in China in the early 20th century.