School Newsletter 2019 - An Interview with Elisabeth Hsu by Chenxue Jiang
Chenxue Jiang (CXJ): Your anthropological research on Chinese medicine is well-known in China. It evidently accounts for a large part of your academic career. So, what led you to Chinese medicine? Are there any particular reasons for your choice of Chinese medicine as the subject of your anthropological research?
Elisabeth Hsu (EH): I had a humanistic education in high school, so I decided to broaden my horizon by studying biology at University-level. In my gap year I went for twelve months to China to learn modern standard Chinese. That was when I saw my grandfather for the first time; I later spent one whole month just visiting him and during that time read a lot on the history of China. It was then that I realised that I wanted to learn more about my Chinese ancestors and history, and anyway, China was such an interesting place. It came naturally to want to know more about it.
At that time, I saw that biology was increasingly moving into the lab. I have to say, I did find the setup of the experiments in molecular biology ingenious but ethically very questionable. So, I decided I wanted to train my ecological thinking instead, although the ecological methods classes we had at the time were a disaster, our instruments were unreliable and our measurements made no sense. It was also as late as then, when already at University, that I got to know about the existence of anthropology. I felt anthropology was very much a field which allowed one to be an honest scientist, and I instantly took to its insistence on the awareness of one’s positionality as researcher. In the 1980s postmodernism prevailed. Admittedly, the postmodernist movement in anthropology encouraged a lot of naval gazing research with the result that researchers talked about themselves rather than about the people they studied. However, its critical reflections on science are invaluable.
I got interested in the study of Chinese medicine as science, not because I am from a family of Chinese medical doctors or of medical doctors, for that matter, but mainly because of Taoist philosophy. I think as a teenager you very often are far more philosophical than later in life. Some teenagers think very deeply about being, about god, about the universe. At that age I read the Tao Te Ching (Dao de jing 道德經) in translation, of course, but it made me think. So, at graduation from biology, I actually wanted to study Taoist philosophy.
But, I had already a degree in biology, and I liked the subject and had done well in it. Then a friend said, why don’t you combine your interests? Why don’t you study knowledge that’s hands-on and practical, and also scientific, a system of knowledge that relies on minimal technology and maximal scientific philosophical insight and knowledge about human beings and the world. So, I think, that was what attracted me to Chinese medicine (and acupuncture, in particular). To me it was an alternative scientific system in that it could have an effect on the world with minimal violent intrusion. This was possible because it did not foreground the human alone but the human as part of its ecology (similar, perhaps, in orientation to what is today known as post-humanist or multi-species ethnography). My doctoral training at Cambridge taught me how important history is to make sense of anthropological findings. I learned that Chinese medicine does have something to do with Taoist philosophy, but it is so basic, it might be more adequate to say that what Taoist philosophy shares with the general natural history of ancient China, it also shares with medicine.
CXJ: In the past three decades, you have written and edited many books about your anthropological research of Chinese medicine. Could you introduce some of them?
EH: Ok, so The Transmission of Chinese Medicine (1999) has six chapters. Half of the book is about TCM (Traditional Chinese Medicine), the medical theory and practice promoted by the government in the People’s Republic of China, and the last two chapters make up the big bulk of the words in the book. This book addressed the question: if we take secretly transmitted knowledge into the classroom, how will the knowledge be transformed? Many contemporary historians of science have compared these two ways of learning, the secret versus the open, scientific, professionalised or standardised transmission of knowledge. My special contribution was to point to a third way of transmitting knowledge, which happens in a highly personalised relationship between tutor and student, or mentor and follower. Throughout Chinese medical history, an aspiring physician would learn the art not only from his father, but formally apprenticed himself also to other physicians. This happened based on personal inclinations, and the sort of discursive knowledge it produced deserves to be recognised in its own right as relevant to scientific/medical inquiry. My argument was that the mode of learning affects the kind of knowledge acquired; the same technical term may have an entirely different performative significance in different social settings.
Pulse Diagnosis in Early Chinese Medicine: The Telling Touch (2010) engaged with a philosophical problem, and also an academic political one of modern medicine in particular. People today have been indoctrinated to believe if you do not know the cause of the disease, you cannot give adequate treatment. Contemporary health services spend enormous amounts of research and monies on diagnosis, it’s highly disproportionate to the efforts spent on care. Historically, so-called ‘germ theory’ contributed to the breakthrough for modern medicine in the early twentieth century, and this happened by establishing a causal relation between the microbial pathogen and the disease. Meanwhile, paradoxically, contemporary medicine is often faced with chronic conditions, which are not monocausal in this direct way, but nevertheless, modern biomedicine is considered the most effective for treating them.
Now, traditional medicine practitioners and ordinary people seem to be more preoccupied with their futures than their past, and appear to pay more attention to therapeutic strategizing. Anthropologists have long noted that the attribution of blame and the cause of an illness happens often retrospectively, and it tends to be related to the legitimation of the treatment strategy. Furthermore, contemporary medicine often does know the cause, as in the case of malaria, but it does not have adequate treatment for it; all the antimalarial pharmaceuticals, for instance, either cause terrible side effects or have met with resistance. In other words, extensive research into the cause of a disorder does not necessarily guarantee adequate treatment.
So, this book investigates how to identify conditions of which we do not know the cause. Although I was doing translation work on an ancient text, it was in this context that I realized how important the body, as experienced through one’s relatedness to the other, is to anthropological analysis. Sensory anthropology became important to me, as it teaches us that touching implies getting close to each other; touch is considered to emphasize the present moment and generate ‘presence’. Once this idea from sensory anthropology is applied to researching pulse diagnostics, we find that feeling the pulse stresses the patient’s and doctor’s involvement with the present and thereby underlines the importance of that very moment in itself, and its future horizons. I investigated, in a linguistic anthropological way, over forty verbs of touch that have become technical terms in Chinese pulse diagnostics, and treated each as an idiom through which different qualities of presence can be generated.
CXJ: Now you are working on another monograph which is based on your research of Chinese medicine in Africa. What have you found in this study?
EH: When I started to do fieldwork for this third monograph, the field of China in Africa studies, Africa in China studies (CAAC) did not yet exist, but CAAC is now one of the fastest developing fields of Area Studies, involving mainly political scientists, geographers, economists and only few anthropologists. I did fieldwork between 2001 and 2008 but the book has still not yet been completed. I am now finally in the final stages.
There is a prevailing assumption that Chinese and African cultures are very different and that therefore conflict and contradiction are unavoidable. However, the study of African people seeking medical treatment from Chinese practitioners where both parties jointly work towards enhancing well-being involves a social entanglement that counters the above framing of cultures clashing. Although I have recorded specific instances of misunderstandings that possibly were even deliberately amplified, it is obvious that the relationship between patient and practitioner is transformed through healing procedures, particularly, if those are eventually deemed effective by those involved. In this process a new spatial constellation is created.
Holy, healing and holistic, these three words have a common root. “Uzima” in Swahili, likewise, means whole. If we revise our concept of culture so as to understand it to refer to the process of making whole rather than relating to it as a thing marked by attributes of sameness (of language, religion, territory, etc.), what happens? It depends of course on how we define wholeness. I found, for instance, that most Tanzanian and Kenyan patients who took Chinese medications believed that they were healthy and in a state of wholesomeness only if they could reinstate their substantial, material, physical connection to the land of their ancestors. However, most of them live now in urban areas. So, how did Chinese doctors tackle this problem? In order to answer this question, I expanded the remit of my focus away from the dyadic relationship between doctor and patient, to include, as tertium quid, so to speak, the material aspects of the spaces and techniques that shaped the clinical encounter. This makes healing to a technique of holding, and culture to a process of holding together.
CXJ: All your researches we have discussed so far are so different and impressive. I can’t help wondering about your research of Qinghao (青蒿). Prof. Tu Youyou got the Nobel prize for her great achievement in the study of Artemisinin (Qinghaosu青蒿素) against malaria. You have been studying Qinghao, the herb, for dozens of years too and you once visited Prof. Tu in Beijing during which you discussed your common research. So, why is Qinghao appealing to you? How do you conduct this research in an anthropological way?
EH: Now, the thing about qinghao is that the Chinese medical doctors with whom I had contact through the Needham Research Institute in Cambridge, and the groupe de recherche at the CNRS in Paris, and all the historians of medicine I mingled with, did not know about qinghao. It was only when I started my field research in East Africa that I realised that Artemisinin (qinghaosu) made up more than fifty percent of over the counter transactions in Chinese medical clinics during the rainy season. So, this was really interesting.
One might say that Tu Youyou worked on qinghaosu. She worked on the chemical compounds that she extracted from a natural plant extract. A ‘cold extraction’ is a modern chemistry method. I soon realised that there is so much literature on qinghaosu, on the molecule’s structure, kinetics, effectiveness, etc., but there is hardly any literature on qinghao. So, I thought here was something to do for me. The field was vast and empty, I could do anything I wanted.
I first tasked myself with the translation of the entries on qinghao, and its synonyms, as recorded in all materia medica literatures from the time of Shennong’s Classic of Herbal Medicine (Shengnong bencao jing 神農本草經, ca. 1st century AD, now lost) to the Systematic Compendium of Materia Medica (Bencao gangmu 本草綱目, 1596) by Li Shizhen in a 25,000 word long chapter of Plants, Health and Healing (2010). Thereafter, thanks to a Memorandum of Understanding of our School with the TCM University of Shanghai, I initiated the research that should result in a Handbook for qinghao recipes. This project could not have been pursued without the very substantial help from several very dedicated, extremely hard working and competent Chinese scholars; it has also grown over the years. We have now translated over 200 qinghao formulae that have been recorded in 70 formularies (fangji方劑). Our handbook foregrounds the importance of polypharmacies (複方配伍), a research theme that has recently gained much attention in pharmacognosy. Naturally, the project raises many questions: How are these recipes to be read? Do they have a known reception history? To what extent can we assume that at least some of the plants mentioned in classical Chinese are identifiable according to modern botany? The project straddles the fields of medical and linguistic anthropology as well as those of ethnobiology and pharmacology. It may take a couple more years before reaching completion.
CXJ: You set up ArgO-EMR at Oxford in 2006 which aims to offer a meeting ground for researchers who wish to engage in the study of Eastern medicines and religions across geographical areas and theoretical perspectives. Would you like to give an introduction to it?
EH: The Anthropology Research Group at Oxford on Eastern Medicines and Religions (ArgO-EMR) was set up in 2006, with the support by the then Head of Department and a colleague in Oriental Studies, to promote doctoral and post-doctoral research on the topic in medical anthropology. It should promote researchers committed to doing long-term fieldwork and acquiring local language competencies. While funding for the history of medicine in China has been considerable, this does not apply to research into the anthropology of Chinese and related medicines. Hence the group’s fortnightly seminars provide an important interdisciplinary platform for, in particular, early career researchers within the UK and beyond. The seminars have included topics such as: “Botanical ontologies in Asian medicines”, “Staple foods in East Asia”, “Socialities of the hearth”, “Transforming the body through dance”, etc. Furthermore, bi-annually held international workshops have been on Tibetan, Chinese and Korean medicine, body techniques of the martial arts, qigong and ritual, selfcare, tea and taste, translation studies, formulae and formularies, and the like.
CXJ: Thank you so much!
Chenxue Jiang is Lecturer at the Nanjing University of Chinese medicine, and has been with us at the School as Academic visitor in 2019, in order to translate Elisabeth’s first monograph into Chinese. This interview is a revised version of the Chinese one in this year’s Special Issue of the Journal of Guangxi University for Nationalities that published select papers of the first conference on the medical anthropology of Chinese medicine in Changsha, Hunan.
This work is supported by Humanities and Social Science Foundation of the Ministry of Education of China in year 2017 (NO. 17YJCZH073) and The National Social Science Fund of China in year 2018 (NO. 18ZDA322)
The author declares no competing interests.
- Hsu, Elisabeth. The Transmission of Chinese Medicine. Cambridge Studies in Medical Anthropology 7. Cambridge: Cambridge University Press, 1999.
- Hsu, Elisabeth. Pulse Diagnosis in Early Chinese Medicine: The Telling Touch. Needham Research Institute Monograph series 3. Cambridge: Cambridge University Press, 2010.
- Hsu, Elisabeth. Chinese Medicine in East Africa. Forthcoming.
- Hsu, Elisabeth & Stephen Harris (eds). Plants, Health and Healing: On the Interface of Ethnobotany and Medical Anthropology. Epistemologies of Healing 6. Oxford: Berghahn Books