| Practitioners have continually remade Chinese medicine as they evaluated the canons of antiquity with their clinical experiences. The history of medical discourse on diseases from the Inner Canon of the Yellow Emperor to the present reveals a continual process of refashioning the medical canon to adapt to local conditions, suit changing therapeutic preferences, and add to the accumulated corpus of medical knowledge. The discourse over epidemics in medical texts during the Qing dynasty, in particular, took the form of a debate about the contrasts between two febrile disorders--Cold Damage (shanghan) and Warm Factor disorders (wenbing). This debate illustrates a broad epistemological shift from placing truth in the sage writings of antiquity, as evidential scholarship in Confucian learning did, to repositioning authority in the local experience of the individual physician. This shift represents a transformation of the framework in which Chinese physicians understood disease and how they practiced medicine. Of parallel importance, it also reveals a significant new social development: the nineteenth-century invention of a new Jiangnan-centered wenbing tradition of medicine.; With the formation of this new wenbing tradition, the epistemological framework shifted from the Cold Damage tradition (which promoted universal medical knowledge, continuity with antiquity, and the canonical authority of the Han medical classics) to the Warm Factor disorders tradition (which proclaimed regional variation, discontinuity with the past, and locally tailored prescriptions for the more delicate southern body of the Jiangnan patient). This socio-intellectual fissure in medical thought occurred within the context of a heightened awareness of regional and ethnic differences from at least the Qianlong reign to the end of the Qing dynasty. I base these arguments on close readings of original editions of medical texts and their prefaces, imperial medical publications and local gazetteers, biographies of physicians, and unofficial anecdotes and jottings. I use methodologies from social history, the sociology of knowledge, and cultural studies to inform my reading in Chinese medicine.; The history of writings on wenbing unveils a trend of criticism and reassessment of the orthodox Cold Damage tradition that was based on practical experience, local medical knowledge, and native-place identity. The transformation of wenbing from a category of disorders under the Cold Damage umbrella, from the Han dynasty through the end of the eighteenth century, to a distinct medical tradition with a collected body of texts, over the course of the nineteenth century, was fundamentally about reasserting and reproducing a Jiangnan regional identity. |
