In many societies, the female body during pregnancy, childbirth and the post-partum period has always been a focal point of healing. The narrative of male physicians taking over the midwife’s role in overseeing childbirth has been a familiar one in the historiography of medicine in Europe and America. Yi-Li Wu’s study of how people in late imperial China (seventeenth–nineteenth centuries) managed female fertility and reproductive health makes a solid contribution to the field. Her fine-grained account captures the pluralistic and contentious nature of knowledge and practice in reproductive health during this period, and would be particularly useful in thinking of medicine and gender in various local contexts around the early modern world.
The book is organised into three sections. Chapters 1 and 2 tackle the prolific production of texts on fuke (women’s medicine) by analysing the sociology of their production, transmission and readership. Chapters 3 and 4 could be read as a history of the female body, as interpreted through the lens of dominant metaphors appearing in such texts. The last two chapters highlight two areas of major change in late imperial fuke: the notion that childbirth resonates with cosmological processes and is inherently safe, and the rising popularity of a popular remedy in managing post-partum health. The central claim throughout the book is that the late imperial period in question was marked by a more optimistic attitude toward childbirth, and that medical writings tended to treat the female body as bearing no fundamental difference from the male body. In Wu’s words, Chinese physicians saw the human body as ‘simultaneously sexless and sexed’ (p. 231). Borrowing from linguistic terms, Wu asserts that the ‘doctrinal body’ of traditional China could be seen as an ‘infinitive’, which was then ‘conjugated’ under particular circumstances. Sex difference remained but one among many factors for the physician to consider, as he practised his art of prescribing the right remedy that corresponded perfectly with this bodily grammar.
Here I will raise two more points that might help in outlining the author’s agenda in this book. First, this book is researched and written in close conversation with previous scholarship on women’s medicine in China – most specifically, Charlotte Furth’s A Flourishing Yin (1999) and Francesca Bray’s Technology and Gender (1997). Furth’s brilliant work charted the emergence of fuke as a distinct subfield of scholarly medicine and the concomitant notion that the female body, unlike the male, was dominated by an altogether distinct principle. Wu picked up from where Furth left off (c.seventeenth century) and argued that in fact, this notion of female difference was largely reversed, or at least counter-balanced during the seventeenth and eighteenth centuries by voices championing fuke as part-and-parcel of general medicine.
On the social map, Wu argued that the contention between the two views of the female body could be seen as the gentlemanly amateurs’ triumph over ‘lineage practitioners’, who learned their trade through familial instructions. While the former saw no reason to refrain from understanding childbirth within the general cosmological rubric taught in the classics, the latter defended their claim of expertise by emphasising female differences. In a society where no clear boundary existed between learned amateurs and expert practitioners, it took a particularly meticulous researcher like Wu to discern the competing motifs out of the cacophony of contemporary medical discourse. However, one might wonder whether the author is overly sanguine in praising the learned amateurs as having achieved the feat of ‘de-exoticisation of female difference’ (p. 14) in a patriarchal society. Isn’t it an irony that so many women suffered and died, as the numerous real-life stories illustrated throughout the book, out of their husbands’ and fathers’ ‘benign’ view that childbirth was an inherently safe process?
My second point is that this book is particularly valuable in its effort to study medical practice via a limited body of scholarly writings. Lacking primary sources generated directly by the vast majority of practitioners, Wu emphasises that even within the body of surviving fuke texts, there is much to learn by charting the areas of consensus and disputes, which turn out to be quite animated and divergent from the accepted tradition. For instance, elite physicians disdained the popular treatise Easy Childbirth (He Bian, c.1715, Chapter 5), which was attributed to a monk and embraced by lay readers. Her research on the ‘Generating and Transforming Decoction’ (Shenghuatang, pp. 204–10) was a particularly interesting case study of one recipe among the hundreds of thousands that entered the textual corpus. How, and why, did popularity of one remedy rise and fall in particular circumstances? Wu’s approach to answering this question would be of interest to historians of medicine who work with learned medical traditions elsewhere. I have no doubt that this book will be a valuable reference for many readers of this journal.
