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Learning and Teaching Medicine in Late Imperial China

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Scientific Sources and Teaching Contexts Throughout History: Problems and Perspectives

Part of the book series: Boston Studies in the Philosophy and History of Science ((BSPS,volume 301))

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Abstract

Describing the processes and pedagogical activities that took place within the framework of medical apprenticeship in late imperial China raises a number of issues that have already been addressed in this volume. Firstly, we know very little on the practical processes of teaching in pre-modern traditions and even less on how pupils or beginners actually learned. While teaching schedules were at times defined by masters, we have very little evidence of how teachers and beginners put them into practice. Secondly, when sources related to a teaching/learning situation do exist, a second problem is one that derives from attempting to understand these sources and the activities they support from the point of view of our modern experience of learning and teaching. Against this latter problem, the posture Pierre Hadot adopted in his analysis of the philosophical texts of Antiquity, illustrated by his well-known injunction “toute oeuvre doit être placée dans la praxis dont elle émane” (every work must be replaced in the praxis from which it emanates) appears attractive when analyzing the sources that were written in relation to medical apprenticeship in pre-modern China. This is why while focusing on one particular text, devoted to teaching medicine at the beginning of the nineteenth century in China, I have found it important to reconstruct the social, material, cultural environment in which this text is thought to have been written and to replace the modalities of teaching and learning to which this particular text attests into the wider landscape of medical instruction in late imperial China. As it will appear in the discussion, this landscape was complex even though an imperial institution existed that was intended to set the rule.

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Notes

  1. 1.

    Hadot (2001, 116).

  2. 2.

    Siu (2004).

  3. 3.

    The most comprehensive study of this institution is (Gong 1983). See (Goldschmidt 2009; Hinrichs 2003; Shinno 2002) for a particular focus on the Song (960–1279) and Yuan (1277–1367) dynasties, (Chang 1998; Guan 2008) for the Qing (1644–1911).

  4. 4.

    Shinno (2002, 100–103).

  5. 5.

    Ren ([1863]1923, 11–12 and 18–24).

  6. 6.

    Gong (1983, 129).

  7. 7.

    Hanson (2003).

  8. 8.

    Ren ([1863]1923, 11).

  9. 9.

    Gernet (2003).

  10. 10.

    Mizayaki (1976, 16), Elman (2000, 260–271), Elman and Wooside (1994, 111–149 and 525–560).

  11. 11.

    According to Li (2003), reading aloud and recitation still played crucial role in children education in the 1970s.

  12. 12.

    Gong (1983, 118–120 and 127–130).

  13. 13.

    Ren ([1863]1923, 18).

  14. 14.

    Zhang (1995).

  15. 15.

    Zheng and Zheng (2005).

  16. 16.

    Gong (1983, 113).

  17. 17.

    On the court’s policy for local official medical instruction, see (Gong 1983, 130; Leung 1987). The situation was probably different before this time. The medical manuscripts discovered in Dunhuang give evidence that local imperial schools of medicine existed as early as the Tang dynasty in the remotest areas of the empire (Despeux 2010). Shinno (2002, 109) found a biography of a local doctor who had learned in a medical school with an officially appointed instructor, during the Yuan dynasty. Gong Chun (1983, 116) reports the establishment of three medical schools in Guangxi, three others in Guangdong and six schools or six imperial physicians in Yunnan during the fifteenth century.

  18. 18.

    On these sources (Will 1992).

  19. 19.

    Ch’ü (1962, 156–164).

  20. 20.

    Wang (1901, 187, 25).

  21. 21.

    Wang (1901,187, 31), Liu (1886, 50, 288), He (1991, 2, 32), and Guo (1987, 2027).

  22. 22.

    Bretelle-Establet (2011).

  23. 23.

    Chao (2000). For an analysis of the size of the medical community in late imperial times, see (Chao 2009; Bretelle-Establet 2002).

  24. 24.

    For Kunming and Canton, see (Feray 1910; Liu 1986). For Zhejiang, see (Lin 1983). Scheid (2007, 193–198) reports the creation of such schools in Shanghai.

  25. 25.

    Bretelle-Establet (2009).

  26. 26.

    Bretelle-Establet (2009).

  27. 27.

    Guo (1987, 2025, 2019, 2031, 2032).

  28. 28.

    Scheid (2007, 251). Menghe was a small town of the Yangzi delta which hosted a medical lineage that flourished in late imperial China.

  29. 29.

    Hymes (1987). Medicine, from the Song dynasty onwards, was considered a good alternative to a career in officialdom.

  30. 30.

    Guo (1987, 2245, 1934–1935).

  31. 31.

    Guo (1987, 1931).

  32. 32.

    Guo (1987, 2032 and 1983).

  33. 33.

    Guo (1987, 1991).

  34. 34.

    Cheng (1920, 1684).

  35. 35.

    Huang (1933, 10).

  36. 36.

    Guo (1987, 2028) and Liang ([1881] 1936).

  37. 37.

    See in this order (Guo 1987, 1960, 1939, and 2019).

  38. 38.

    He ([1751]1994, 1).

  39. 39.

    Guo (1987, 2033).

  40. 40.

    As (Li 2003, 49) stresses, the ability of memorizing and reciting great portions of texts is a constant praise in Chinese biographies.

  41. 41.

    Bretelle-Establet (2011).

  42. 42.

    See notably (Hsu 1999; Scheid 2007).

  43. 43.

    Local gazetteers provide evidence that this phenomenon took place everywhere in the empire. See (Hanson 1997, 35 and 332, on the basis of Guo 1987).

  44. 44.

    Bensaude-Vincent et~al. (2003, 10, 26) and Choppin (2008).

  45. 45.

    Miles (2006, 65, 92, 107, 136).

  46. 46.

    Huang ([1800] 1918, Wen Baochun’s post-face, 1).

  47. 47.

    Huang ([1800] 1918, dufa, 7).

  48. 48.

    Gernet (2003, 44–45) and Siu (2004).

  49. 49.

    Durling (1990, 185, 191).

  50. 50.

    The term li理 has been the subject of much controversy in the history of Chinese philosophy. Neo-Confucians understand li as the “principle” of all things. Each thing has its own li, or principle, but all of these principles are in fact one Principle. Li was thus considered an omnipresent universal principle that maintained a sort of consanguineous link between all things.

  51. 51.

    Huang ([1800] 1918, dufa, 1–2).

  52. 52.

    Hsu (1999, 103).

  53. 53.

    On the question of the practice of medicine and medical experience often referred to by jingyan經驗, see (Lei 2002; Sivin 1995; Farquhar 1994).

  54. 54.

    See notably (Waquet 2003).

  55. 55.

    In spite of the reforms undertaken under the Maoist regime to regulate and control the field of Chinese medicine, it was still possible, in the 1980s to learn in these different environments, namely, state college or private offices.

  56. 56.

    Hsu (1999, 165, 228).

  57. 57.

    Huang ([1800] 1918, 2).

  58. 58.

    Bretelle-Establet (2011).

  59. 59.

    Huang ([1800] 1918, 1–5).

  60. 60.

    Huang ([1800] 1918, 3).

  61. 61.

    Depots and Palaces are used to avoid, in translation, viscera or organs, and to be closer to the ideas lying behind these terms: “depot” renders the idea of a storage unit in the body, (liver, heart, spleen, lung and kidneys) and “palace” for the idea of a processing unit in the body (gallbladder, small intestine, triple burner, stomach, large intestine, bladder). See (Unschuld 1985; [1988]2005, 400 and 467).

  62. 62.

    Huang ([1800] 1918, 3).

  63. 63.

    Huang ([1800] 1918, 3–10).

  64. 64.

    Huang ([1800] 1918, 10).

  65. 65.

    One must bear in mind that the anatomical and pathophysiological terms in Chinese medical literature cannot always be directly inferred from the English terms.

  66. 66.

    The use of natural substances for therapeutic purposes goes back to the Zhou dynasty (1121–256). In the first materia medica written under the Han dynasty, natural substances, classified in three categories, were granted thermal properties and flavors. In the twelfth century, a science of the properties of drugs developed within the theoretical framework of yin, yang, and Fives Phases wuxing. However, because of its great complexity and numerous contradictions, it was often abandoned by physicians who continued to prescribe remedies by relying on ancient formulas and on empirism (Unschuld 1985, 114–115).

  67. 67.

    Huang ([1800] 1918, dufa, 1).

  68. 68.

    Huang ([1800] 1918, dufa, 1). See Bréard, in this volume for more details on how verses and rimes were vocalized.

  69. 69.

    Pan ([1864] 1935, 3).

  70. 70.

    Bensaude-Vincent et~al. (2003, 32–35).

  71. 71.

    Bretelle-Establet (2011). In their comparative analysis of science and medicine in early China and Greece, Lloyd and Sivin noted: “Scientific pursuits in China […] did not aim at stepwise approximations to an objective reality but at a recovery of what the archaic sages already knew” (Lloyd and Sivin 2002, 193).

  72. 72.

    Huang Yan cites 42 different texts, authors, local masters, from the most ancient times to his latest contemporaries.

  73. 73.

    Drège (2007).

  74. 74.

    Blair (2007) and Chartier (2007).

  75. 75.

    On the issue of books’ accessibility in late imperial China, see notably (Brokaw 2005; MacDermott 2006; Rowe 1994, 440; Bretelle-Establet forthcoming b).

  76. 76.

    De Weerdt (2007, 82).

  77. 77.

    Bretelle-Establet (1999, 562).

  78. 78.

    De Weerdt (2007, 82).

  79. 79.

    Huang ([1800] 1918, 2).

  80. 80.

    Sivin (1995).

  81. 81.

    Huang ([1800] 1918, chap. 3, p. 13; chap. 2, p. 14; chap.1, p. 11).

  82. 82.

    Sivin (1995) and Waquet (2003, 9).

  83. 83.

    Such as the Yijing xiaoxue医经小学 written by Liu Chunyu in 1388 or the Yixue rumen医学入门 written by Li Chan in 1576 from which Huang Yan reproduces some parts. See (Gong 1983, 113; Leung 2003).

  84. 84.

    He Mengyao’s biography is known through official biographies recorded in local gazetteers and several prefaces to his books. For He Mengyao’s biographies and his disciple Chen Guodong, see (Guo 1987, 1933–4).

  85. 85.

    He ([1751]1994: 54).

  86. 86.

    According to Banks (2005, 40–43) typographical change constitutes a linguistic marker of the author’s presence to the same extent than the use of personal pronouns.

  87. 87.

    On discourse markers, see (Schiffrin 1988).

  88. 88.

    Bretelle-Establet (forthcoming a).

  89. 89.

    Bensaude-Vincent et~al. (2003, 59, 64) who also reported that in spite of the government’s efforts to impose an official book, the French chemistry textbooks written in the first years of the nineteenth century remained highly personalized.

  90. 90.

    On the attempts made to regulate medicine under the republican and nationalist regimes, see (Croizier 1968; Xu 1997; Yip 1982, 1994, 1995); on the reforms undertaken under Mao’s regime, see (Taylor 2005).

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  1. Laboratoire SPHERE, CNRS & Université Paris Diderot, Paris, France

    Florence Bretelle-Establet

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    Alain Bernard

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    Christine Proust

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Bretelle-Establet, F. (2014). Learning and Teaching Medicine in Late Imperial China. In: Bernard, A., Proust, C. (eds) Scientific Sources and Teaching Contexts Throughout History: Problems and Perspectives. Boston Studies in the Philosophy and History of Science, vol 301. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-5122-4_11

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  • DOI: https://doi.org/10.1007/978-94-007-5122-4_11

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