"Ten Times More Difficult to Treat" - Female Bodies in Medical Texts From Early Imperial China

Sabine Wilms

Introduction

This article contributes to the study of women and gender in post-Han China by focusing on the female body as it was treated and interpreted in medical texts between the Han and Song periods (third to tenth centuries CE). In other words, it investigates the way in which male authors of technical medical literature dealt with the physicality of the female body and the fundamental problem of its otherness in the context of medical diagnosis and treatment.

As long as women have given birth, the female body has served as an obvious yet multidimensional source of a culture’s metaphors for cosmology, creation, gender and family relations, and even politics. At the same time, medical, moral, religious, and other discourses on the female body have used it as a vehicle for expressing larger cultural values and agendas, whether consciously or not. The direct and reciprocal relationship between conceptions of the female body and gender roles hardly needs to be stressed. Naturally, ideas about the female body are, in any culture or context, closely connected to a society’s view of childbirth, since the most obvious difference between the sexes is that women give birth and men don’t. But, as Thomas Laqueur pointed out in his study of reproductive biology in seventeenth-century England, “the cultural construction of the female in relation to the male, while expressed in terms of the body’s concrete realities, was more deeply grounded in assumptions about the nature of politics and society.”

Medical discourse, in early imperial China as elsewhere, is unique in that it presumes to address the body’s “concrete realities” for the sole purpose of alleviating its suffering, rather than as an indirect metaphor for cosmological, political, moral, or other themes. Thereby, it provides a window into a culture’s values and ideas on the deepest level of embodiment. Recognizing the potential of the female body as both a source and a site for the expression of ideology, this article therefore approaches post-Han Chinese medical texts with the following questions: What functions of the female body did the authors consider as natural, as ideal, or as pathological, and as weakening or as strengthening for the general constitution of women? What conditions did they recognize as specifically female pathologies in need of gender-specific treatments? Or, more broadly, what aspects of the female body were regarded as specifically female and therefore as instrumental in defining and justifying male physicians’ specialized approach to women’s bodies? Last but not least, the question which has occupied innumerable healers and thinkers in all ages and cultures since the alleged creation of Eve out of Adam’s rib: How is the female body related to the male, and implied in this, how is woman related to man?

To answer these questions, the core of this article traces the stages by which the male authors of a technical literature of furen fang 婦 人方 (prescriptions for women) gradually came to conceptualize the female body as separate from the male in post-Han China. For this purpose, I will first review the medical model of androgyny by which male and female bodies were related to each other in the early Han medical classics. This androgynous view of the human body was elaborated most succinctly in theoretical medical classics like the Huangdi neijing黃帝內經 (Inner classic of the Yellow Emperor). The tight correlations and parallel functioning of human, cosmic, and political bodies in the theory of systematic correspondences from the Han dynasty on offered, in the abstractions of yin and yang, an evocative metaphor from which to interpret the difference between the sexes. Challenging the gender-neutral view of the human body in the early classics, already in the seventh century, Sun Simiao (孫思邈 581?-682) wrote in a famous collection of prescriptions that “women’s disorders are ten times more difficult to treat than men’s.” In the two main sections of this article, I will compare and contrast the early Han theoretical model of androgyny with a clinically applied discourse on what the authors saw as the lived experience of the female body as it emerged over the following centuries in a technical literature of “prescriptions for women.” First, I will analyze the development of female pathology, as it is reflected in the categorizations and etiological interpretations of women’s conditions. Second, I will look more closely at the origin of ideas about female Blood and menstruation.

During the Song dynasty, the recognition that women required therapeutic strategies that were categorically different from men’s resulted in the formation of a true gynecology or fuke 婦 科. For the purposes of this article, I employ the term “gynecology” in the sense of a professionalized medical field that specializes in the treatment of women and exists separate from and in addition to obstetrics, or chanke 產科. In China, the key factor in this process was the realization of the central role of xue 血 (Blood) and, directly related to this, menstruation, in the female body, which replaced earlier notions of women as defined by conditions of daixia 帶下 (below the girdle).

This innovative approach allowed for a holistic and theoretically grounded conception of the female body. It also stimulated the development of the sophisticated diagnoses, complex treatments, and preventative measures, which traditional Chinese gynecologists employ to this day. (...) continue to full article