Switching between Traditional Chinese Medicine and Viagra: Cosmopolitanism and Medical Pluralism Today 1

This article has come a long way from the very first draft I presented on the panel “Medical Pluralism Revisited”at American Anthropological Association’s annual meetings in New Orleans in 2002. Comments given by Byron Good and Paul Brodwin on the panel and the encouragement from Judith Farquahar and Charlotte Furth are much appreciated. In revising this article I benefited from Vincanne Adam’s careful critique and from comments by Aihwa Ong, Xin Liu, Alberto Sanchez, Lydia Liu and the audience at the University of Illinois Urbana-Champaign. I am particularly indebted to Stacy Leigh Pigg for the significant transformation of this article. My thanks go to her, the three anonymous reviewers of MA, and the copy editor. Finally, on this whole project, I am grateful to Arthur Kleinman and Lawrence Cohen for their inspiration. I owe a great debt to all the doctors and interviewees I have worked with in China.

Everett Yuehong Zhang Department of Anthropology , 380 MFAC Ellicott Complex, the State University of New York, Buffalo, NY, 14261 Correspondence [email protected]
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Switching between Traditional Chinese Medicine and Viagra: Cosmopolitanism and Medical Pluralism Today

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Based on the fieldwork in China in the Viagra era, this paper examines the reluctance to embrace Viagra as well as the willingness to switch back and forth between taking Viagra and taking Chinese medicine among impotence patients. Through the notion of “switching” as a framework, this paper discovers the conflict between Viagra and herbs not only as two types of medicine but also as representing two types of economy of potency and ethics of sexuality, and the difficulty in replacing the latter by the former. Nonetheless, switching back and forth so as to absorb them together in the body creates possibilities to cross the line between the Viagra regime revolving around desire and the regime of Chinese medicine revolving around the cultivation of life. Out of switching is the possibility of hybridization of Chinese medicine and biomedicine as well as a hybridized economy of sexual potency and ethics of sexuality.

Notes

I also conducted fieldwork in various departments of urology, which are found in biomedical hospitals (some of these departments may be referred to as departments of sexual medicine or even departments of men’s medicine). Before going to a hospital, a patient must decide between seeing either a TCM doctor or a biomedical doctor. Similarly, a patient suffering from impotence makes a choice between seeing a doctor of nanke (men’s medicine) and seeing a urologist. However, in practice, the divide between nanke and urology, like that between traditional Chinese medicine and biomedicine, is far from stable. This article looks at the conditions that destabilize this division as well as at the political and ethical implications to which this destabilization gives rise.

This projection was laid out on Pfizer’s webpage, which I viewed in 2000. The Massachusetts Male Aging Study involved a series of studies on male aging conducted by the New England Research Institute from the late 1980s to the mid-1990s. This research quantified the quality of sexual life among the aging male population. It was the largest epidemiological research project ever to focus on impotence, and it led to the production of a vast amount of material on sexual dysfunction. Clearly, it played a key role in turning impotence into a fertile field of research.

I use pseudonyms to protect the identity of patients. In one case I also change the name of the doctor. Throughout this article Dr. Zhuang is a pseudonym.

See Zhu and Duan 2004 Zhu , Xiaochao and Duan Hongqing 2004 The Journey of the Blue Pill to China . Finance , July 20 , p. 4 . [Google Scholar] , and Xu 2007 Xu , Hao 2007 Foreign Companies Won 60 Percent of 670 Cases of Intellectual Property Involving International Parties over the Past 5 Years Handled in Beijing . China Economic Weekly , January 8th, http://www.zgjjzk.cn/more.asp?TN_NID=2007-01-08-1010 [Google Scholar] .

For example, shenxuejiao (a small medicinal ball), was one such chunyao that allegedly helped men gain one night of pleasure (Liu 1998 Liu , Dalin 1998 Zhonguo Lidai Fangneikao [A Historical Examination of Chinese Sexuality] . Beijing : Zhongyi Guji Chubanshe . [Google Scholar] :423).

The caution against the harm yu ( , desire) can do to ming ( life) is an important theme in many Daoist scriptures as well as in many classics of Chinese medicine. And this is not surprising as Chinese medicine and Daoism share many ideas about the body (e.g., the yin-yang balance, qi [vital energy], jing [seminal essence], etc.). This can be seen in Huangdi Neijing, one of the earliest medical classics in China (Zhang 2002 Zhang , Yinan 2002 Huangdi Neijing Suwen Jizhu [An Anntated Exegesis of Yellow Emperor’s Inner Canon] . Beijing : Xue yuan Chubanshe . [Google Scholar] ). A later example of this is the teachings compiled by Li Pengfei during the Yuan Period (1206–1368) in a work entitled Sanyuan Canzang Yanshoushu (A Life-lengthening Treatise Jointly Vaulted by Heaven, Earth and Humanity). As one may see from its subtitles, this work devoted much space to giving advice on how to prevent excessive desire: “One cannot Live without Having Desire.”; “One Must Not Display Desire at Too Early an Age”; “One Must Not Indulge in Desire”; “One Must Not Force One’s Desire”; “One Must Abide by Some Inhibitions on Desire”; “One Must Know What to Avoid in Order to Regulate Desire.”

Again, many ancient Chinese medical classics as well as Daoist scriptures promote this type of understanding of potency. The etiology of impotence in TCM is complex; however, in general, impotence is a result of the loss of the yin-yang balance of qi in different locations, of an excessive loss of jing, or of the clogging of qi, and so on. These symptoms are all signs of a decline of vitality. This stands in stark contrast to the etiology of impotence as set out in biomedicine.

It is necessary to point out that this view of potency is often male-centered. In the Daoist tradition, the nourishing of male potency, or vitality, is concerned with ensuring the longevity of the male. This involves the complex practice of “plucking yin to nourish yang,” in which the female sexual partner functions to cultivate the potency of the male at the expense of her own potency and/or sexual pleasure. For a feminist critique of this practice, see Furth’s ( 1994 Furth , Charlotte 1994 Rethinking van Gulik: Sexuality and Reproduction in Traditional Chinese Medicine . In Engendering China: Women, Culture, and the State . Christina Gilmartin , Gail Hershatter , Lisa Rofel , and Tyrene White , eds. Pp. 125 – 146 . Cambridge , MA : Harvard University Press . [Google Scholar] ) analysis of van Gulik. However, Daoist studies also discuss the practice of shuangxiu ( , duo cultivation), which features an equal relationship between the male and the female—one that very much contrasts with the aforementioned vampiristic image (Liu 2003 Liu , Xun 2003 To Enter the Chamber: The Ethos of Duo Practice in Late Ming Inner Alchemy . Presentation at Association of Asian Studies annual meetings , New York , March . [Google Scholar] ). In other words, the view that potency has to do with the cultivation, or enhancement, of life is not necessarily male-centered.

Viagra pills come in 50 and 100 milligram dosages.

See Loe 2004 Loe , Meika 2004 The Rise of Viagra . New York : New York University Press . [Google Scholar] .

Some professional psychoanalysts express similar concerns with regard to their own experiences of treating impotence. One of these concerns is that Viagra may divert attention away from problems in the interpersonal relationship between the two sexual partners—problems that may well be responsible for erectile failures. See Melchiode 1999 Melchiode , Gerald 1999 Beyond Viagra . New York : Henry Holt and Company . [Google Scholar] . There are contrasting views concerning whether or not Viagra enhances the dominance of phallocentricm. Mamo and Fishman ( 2001 Mamo , Laura and Jennifer R. Fishman 2001 Potency in All the Right Places: Viagra as a Technology of the Gendered Body. Body and Society 7 : 13 – 35 . [Crossref] , [Google Scholar] ) argue that the dominant discourse around Viagra reinforces the heterosexual norm of sexuality, whereas Potts ( 2004 Potts , Annie 2004 Deleuze on Viagra (Or, What Can a “Viagra-Body” Do?) . Body and Society 10 : 17 – 36 . [Crossref] , [Google Scholar] ) argues that Viagra might enhance efforts to seek non-phallocentric ways of making love and satisfying desire. The relationship between Viagra and the use of desire in gaining pleasure requires a thorough discussion of the relationship between technology and the construction of desire. All this is beyond the scope of the current article.

Van Gulik was probably among the earliest Western scholars of Chinese culture to come close to recognizing the importance of the cultivation of overall potency (1974). His limitation lies in what Kristofer Schipper refers to as his failure “to appreciate the macrobiotic and cosmological beliefs that link [people] to cultic visions of longevity or immortality rather than to the goal of sexual pleasure for either women or men” (quoted in Furth 2005 2005 Rethinking van Gulik Again . Nan Nü 7 ( 1 ): 71 – 78 . [Google Scholar] :72).

I discuss cosmopolitanism later in this article. There is no consensus about what it means. It could mean “an ethos of macro-interdependencies, with an acute consciousness (often forced upon people) of the inescapabilities and particularities of places, characters, historical trajectories, and fates” (Rabinow 1996 Rabinow , Paul 1996 Representations Are Social Facts: Modernity and Post-Modernity in Anthropology . In Essays on the Anthropology of Reason . Pp. 28 – 58 . Princeton : Princeton University Press . [Google Scholar] :56). Or it could refer to an allegiance to “the worldwide community of human beings” (Nassbaum 1996 Nassbaum , Martha C. 1996 Patriotism and Cosmopolitanism . In For Love of Country: Debating the Limits of Patriotism . J. Cohen , eds. Pp. 3 – 20 . Boston : Beacon . [Google Scholar] :4). In Cosmopolitics, edited by Cheah and Robbins ( 1998 Cheah , Pheng and Bruce Robbins , eds. 1998 Cosmopolitics: Thinking and Feeling beyond the Nation . Minneapolis , MN : University of Minnesota Press . [Google Scholar] ), we find discussions of central issues, including the relationship between transnationalism and nationalism, various postcolonial conditions, and so on. Ferguson ( 1999 Ferguson , James 1999 Expectations of Modernity . Berkeley , CA : The University of California Press . [Crossref] , [Google Scholar] :82–122), who focuses on cultural styles of performance, discusses the relationship between localism and cosmopolitanism.

See CCTV International ( 2004 CCTV International 2004 Interview with Dr. Jia Jinming. 23 December . [Google Scholar] ).

How women feel about Viagra is a very important issue. Most of my interviews were conducted with men. The limited information I obtained from a very small number of women shows that they were split in their attitude toward Viagra. For example, A 45 year old woman in Chengdu said that she did not feel aroused even after her husband was able to penetrate her after taking Viagra. She felt that her husband concentrated on the erection per se more than on how she felt about the penetration. This feeling bothered her. I heard a woman in her thirties also in Chengdu said that Viagra did boost her sexual partner’s erection and she felt that his erection lasted longer, which was good. The ethical implications of Viagra may depend on how it is used. For example, whether or not a man who takes Viagra cares about the feelings of his sexual partner could make a huge difference in a woman’s attitude toward Viagra. Women’s experience with Viagra should be an important topic for further research.

In other words, the male’s switching back and forth between herbs and Viagra as a way of balancing the cultivation of overall potency with the satisfaction of sexual desire is not necessarily of interest to the female. First, it might be the case that the relationship between the cultivation of overall potency and the satisfaction of sexual desire in the female is not as contentious as it is in the male, perhaps partly because of the lesser salience of jing in the well-being (longevity is part of this) of the female body, and partly because of the positive impact of sexually satisfying the female body. Second, it might be the case that male switching does not interest women precisely because their well-being, regardless of how the male relationship between the cultivation of overall potency and the satisfaction of sexual desire is configured, is often neglected. Interestingly, with regard to the satisfaction of sexual desire, sexual intercourse was to be performed according to the procedures set out by the bedchamber arts (Furth 1994 Furth , Charlotte 1994 Rethinking van Gulik: Sexuality and Reproduction in Traditional Chinese Medicine . In Engendering China: Women, Culture, and the State . Christina Gilmartin , Gail Hershatter , Lisa Rofel , and Tyrene White , eds. Pp. 125 – 146 . Cambridge , MA : Harvard University Press . [Google Scholar] ; Tao 1997 Tao , Hongjing 1997 Yangxingyanminglu . In Zhonghua Xingxue Guanzhi [An Ultimate Collection of Chinese Sexual Medica] . Fan , Youping , Z. Shi , Z. Chen , and F. Zhao , eds. Pp. 54 – 58 . Guangzhou : Guangdong People’s Press . [Google Scholar] ), which regarded the fully aroused and satisfied female body as a precondition for achieving the optimal cultivation of the male body (Bai 1997 Bai , Xingjian 1997 Tiandiyinyangjiaohuan Dayufu . In Zhonghua Xingxue Guanzhi [An Ultimate Collection of Chinese Sexual Medicine] . Fan , Youping , Z. Shi , Z. Chen , and F. Zhao , eds. Pp. 59 – 71 . Guangzhou : Guangdong People’s Press . [Google Scholar] ; Anonymous 1997). Under these circumstances women benefited from being sexually satisfied, despite the fact that this was not the primary concern. In other words, women benefited from the practice of the bedchamber arts rather than from their ultimate goal. Third, it might also be the case that male switching between herbs and Viagra is not an issue for people involved in same-sex relationships or in relationships in which sexual desire is the motivating factor. Clearly, this is an area that demands more study.

Volker Scheid ( 2002 2002 Chinese Medicine in Contemporary China: Plurality and Synthesis . Durham : Duke University Press . [Google Scholar] ) documented how the practice of zhongxi huitong pai (assimilating Western medicine to Chinese medicine) represented by Zhang Xichun, a doctor during the late Qing period (1644–1911) and the early Republican Period (1911–49), influenced the practice of TCM under socialism.

I use the term “moral symptomatology” to describe how what counts as a disease has been shaped by moral economies in different social and cultural climates. Moral symptomatology provides an explanation for the increase in outpatient visits for impotence in postsocialist China.

Since the 1990s, urologists in China have tried to apply therapies such as prosthetic implanting (which originated in the West). However, this application was limited by many factors, particularly by its less than ideal efficacy and by the reluctance of the Chinese to accept what we now refer to as cyborgenic therapy (i.e., a therapy that combines the mechanical and the human).

In China impotence is now commonly called yangwei ( , the shrinking of yang). However, in the early Chinese medical literature, before the Yuan period (1206–1378), impotence was predominantly referred to as yinwei ( , the shrinking of yin), yinwei buqi ( , the shrinking of the yin so that the penis cannot rise), or yinqi buyong ( , the prolonged inactivity of the penis due to the shrinking yin) (Qin 2000 Qin , Guozheng 2000 Yangwei Bingming Yu Guishu Ji Bianbing Yanbian Kao [A Historical Investigation of the Nosological Evolution of Impotence] . Chinese Journal of Medical History 30 ( 1 ): 28 – 31 . [Google Scholar] ; Wang and Cao 1988 1988 Zhongyi Nankexue . Tianjin : Tianjin Science and Technology Press . [Google Scholar] ; Wang 1997 1997 Wang Qi Nanke Xue . Zhengzhou : Henan Science and Technology Press . [Google Scholar] ). It was first called yangwei in the Yuan Period (1206–1368 CE), but since the Ming Period it has predominantly been referred to as yangwei. Impotence was first referred to as yinwei because the lower part of the body is yin (as opposed to the upper body, which is yang), and the penis is thus called yinqi (yin organ). The shift from yinwei to yangwei occurred in light of the tendency to equate the latter with yang deficiency, which led to overemphasizing yang deficiency rather than looking at a more complex grouping of etiological factors.

Lydia Liu ( 1995 Liu , Lydia 1995 Translingual Practice . Stanford : Stanford University Press . [Google Scholar] ) discusses the “condition of translation” as being key to understanding not only the transformation of meanings but also their invention. The concern over how social and historical conditions legitimate certain translations, and the circulation of the meanings invented in the translation in translingual practice, is crucial to this work. In their study of the “integration” of Tibetan medicine and biomedicine, Adams and Li (forthcoming) observe the translation between the Tibetan term bu and the Western terms “bacterial” and “virus.” They show a linguistic slippage where the two terms refer to rather different things but are somehow used interchangeably, thus maintaining a state of apparent (albeit forced) “integration.” In her study of how the Nepalese adapt the English vocabulary around HIV/AIDS, Stacey Leigh Pigg ( 2000 Pigg , Stacy Leigh 2000 Languages of Sex and AIDS in Nepal: Notes on the Social Production of Commensurability. Cultural Anthropology 16 ( 4 ): 481 – 541 . [Crossref], [Web of Science ®] , [Google Scholar] ) argues that code switching is not balanced but, rather, is invested in the power and social privilege displayed between speakers as well as between the two languages when constructing scientific knowledge.

See Wang 1985 Wang , Qi 1985 Lun Yangwei Cong Gan Lungzhi [On the Liver-Centered Perspective of Impotence] . Tianjin Zhongyi [Tianjin Journal of Traditional Chinese Medicine] , No. 5 . [Google Scholar] .

Among all the American sexological classics, the Kinsey Report by Alfred Kinsey, Human Sexual Response (Masters and Johnson 1966 Masters , William and Virginia Johnson 1966 Human Sexual Response . Boston : Little, Brown . [Google Scholar] ), and Human Sexual Inadequacy (Masters and Johnson 1970 1970 Human Sexual Inadequacy . Boston : Little, Brown . [Google Scholar] ) were the ones most often studied and cited by the doctors with whom I worked.

TCM’s etiology of impotence generally emphasized the deficiency of qi (vital energy) rather than the problem of blood. A doctor of nanke cited a work of literature (bencao gangmu) written during the Ming period (1368–1644) by Li Shizhen as saying “in women blood is the leader,” whereas in men qi is the leader. In other words, there is a gender difference with regard to what is of fundamental importance to a healthy body. But, within the general morphology of Chinese bodily cosmology, qi and blood have a complex relationship (Furth 1999 1999 A Flourishing Yin . Berkeley , CA : The University of California Press . [Google Scholar] ). For one thing, qi and several other key elements of the bodily cosmology (e.g., shen [spirit] and jing [seminal essence]), are mutually transformative. That is, one can transform into the other(s). As I understand it, blood has this transformability but is under more constraints than qi. Even though, in Chinese bodily cosmology, blood appears to refer to the same substance as it does in biomedicine, we cannot equate the two. This is similar to how, in China, seminal essence refers not only to semen but also to something else.

In the modern history of medicine in China, Western medical terminology has often been translated into Chinese through the borrowing of Chinese names (often via Japanese), thus creating a meaning that differs from the original. The assimilation of germ theory in China is an example (Andrews 1997 Andrews , Bridie 1997 Tuberculosis and the Assimilation of Germ Theory in China, 1895–1937. Journal of History of Medicine 52 : 114 – 157 . [Google Scholar] ), as is the assimilation of nerve theory (Shapiro 2000 Shapiro , Hugh 2000 Neurasthenia and the Assimilation of Nerves into China . Paper presented in Symposium on the History of Disease in Academia Sinica , Taipei, Taiwan , June 16 – 18 . [Google Scholar] ).

Judith Farquhar ( 1987 Farquhar , Judith 1987 Problems of Knowledge in Contemporary Chinese Medical Discourse . Social Science and Medicine 24 : 1013 – 1021 . [Crossref], [PubMed], [Web of Science ®] , [Google Scholar] ) demonstrated the problems involved in framing an object of investigation in a way that is considered in the West to be “scientific” (e.g., using categories such as “knowledge,” “theory and practice,” etc.) but that is intolerant of differences. This is what happens when Western epistemology is superimposed upon the study of traditional Chinese medicines.

In commenting on Robert Anderson’s ( 1992 Anderson , Robert 1992 The Efficacy of Ethnomedicine: Research Methods in Trouble . In Anthropological Approaches to the Study of Ethnomedicine . Mark Nichter , ed. Pp. 1 – 18 . Switzerland : Gordon and Breach Science Publishers . [Google Scholar] ) study of the efficacy of ethno-medicines, Mark Nichter ( 1992 Nichter , Mark 1992 Ethnomedicine: Diverse Trends, Common Linkage . In Anthropological Approaches to the Study of Ethnomedicine . Mark Nichter , ed. Pp. 223 – 259 . Switzerland : Gordon and Breach Science Publishers . [Google Scholar] :226) discusses the problems that arise due to the fact that claims of efficacy are “subjective, provisional, [and] based on contingencies.” Successful claims for efficacy tend to depend on who gets to decide what counts as efficient in any given case.

There has been much discussion about hybridity, particularly in the areas of postcolonialism, transnationalism, identity politics, ethnic studies, and so on. The term “hybridity” is often used to describe the “in-between” status or “the indeterminacy of diasporic identity” (Bhabha 1994 Bhabha , Homi K. 1994 The Location of Culture . London : Routledge . [Google Scholar] ), the mixing of culture and nature (Latour 1993 Latour , Bruno 1993 We Have Never Been Modern . Catherine Porter , trans. Cambridge : Harvard University Press . [Google Scholar] ), the coexistence of tradition and modernity (Vasavi 1994 Vasavi , AR 1994 Hybrid Time, Hybrid People: Culture and Agriculture in South India . Man 29 ( 2 ): 283 – 300 . [Crossref] , [Google Scholar] ), and/or mixed identities within postcolonial situations (Young 1996), to name just a few. The debate about the advantages and disadvantages of using this term is quite intense. See Mahmood ( 1996 Mahmood , Saba 1996 Cultural Studies and Ethnic Absolutism: Comments on Stuart Hall’s “Culture, Community, and Nation.” Cultural Studies 11(1): 1 – 11 . [Taylor & Francis Online] , [Google Scholar] ) and Rosaldo ( 1995 Rosaldo , Renato 1995 Forward . In Nestor Garcia Canclini Hybrid Cultures . C. Chiappari and S. Lopez , eds. Pp. xi – xvii . Minneapolis : University of Minnesota Press . [Google Scholar] ) for criticisms of it, and see Pieterse ( 2001 Pieterse , Jan N. 2001 Hybridity, So What? The Anti-Hybridigy Backlash and the Riddles of Recognition . Theory, Culture and Society 18 ( 2–3 ): 219 – 245 . [Crossref], [Web of Science ®] , [Google Scholar] ) for a defense of it.

There is a long list of ethnographies concerning different medical systems and plural medical practices. And this list gets much longer if we count the ethnographies of religious or ritualistic healing practices produced before medical anthropology officially became a subfield in the 1960s. In a sense, medical anthropology came into being with medical pluralism. I cite just a few classic representatives of the tradition of medical pluralism: Foster 1976 Foster , George 1976 Disease Etiologies in Non-Western Medical Systems . American Anthropologist 78 : 773 – 782 . [Crossref], [Web of Science ®] , [Google Scholar] ; Leslie 1976 Leslie , Charles 1976 Asian Medical Systems: A Comparative Study . Berkeley , CA : University of California Press . [Crossref] , [Google Scholar] ; Kleinman 1980 Kleinman , Arthur 1980 Patients and Healers in the Contexts of Culture . Berkeley , CA : The University of California Press . [Google Scholar] ; and Lock 1980 Lock , Margaret 1980 East Asian Medicine in Urban Japan . Berkeley , CA : University of California Press . [Crossref] , [Google Scholar] . Two edited volumes—Anthropological Approaches to the Study of Ethnomedicine (Nichter 1992 Nichter , Mark 1992 Ethnomedicine: Diverse Trends, Common Linkage . In Anthropological Approaches to the Study of Ethnomedicine . Mark Nichter , ed. Pp. 223 – 259 . Switzerland : Gordon and Breach Science Publishers . [Google Scholar] ) and Paths to Asian Medical Knowledge (Leslie and Young 1992 Leslie , Charles and Allan Young , eds. 1992 Paths to Asian Medical Knowledge . Berkeley , CA : University of California Press . [Crossref] , [Google Scholar] )—provide an overview of how medical pluralism was being presented in medical anthropology up to the early 1990s.

In the field of Chinese medicine alone, a number of ethnographies have raised the study of medical pluralism to new heights (e.g., Scheid 2002 2002 Chinese Medicine in Contemporary China: Plurality and Synthesis . Durham : Duke University Press . [Google Scholar] ; Hsu 1999 Hsu , Elisabeth 1999 The Transmission of Chinese Medicine . New York : Cambridge University Press . [Crossref] , [Google Scholar] ; Farquhar 1994 1994 Knowing Practice . Boulder , CO : Westview Press . [Google Scholar] ). In anthropology in general, in the 1990s the study of alternative modernities became a flourishing genre.

After carefully navigating through the terminology, I settled on “non-biomedicine.” Other choices might include “alternative medicine,” “indigenous medicine,” “non-Western medicine,” and so on, all of which contain overtones of “otherness.” For me, “non-biomedicine” acknowledges the differences between biomedicine and other medicines while minimizing the feeling of “otherness.” Anthropologists have shown that “biomedicine,” as such, is not free from culture and that, therefore, it is no longer feasible to oppose “ethnomedicine” to “biomedicine.” Precisely because of this transformation in the implication of the prefix “ethno” and the inclusion of biomedicine in ethnomedicine, the term “ethnomedicine” loses its ability to differentiate various healing traditions from biomedicine. I thank Margaret Lock and Vincanne Adams for discussing this issue with me. This discussion also benefits from rereading several works on the reflection of biomedicine, including Kleinman ( 1997 1997 What is Specific to Biomedicine.? In Writing at the Margins . Pp. 21 – 40 . Berkeley , CA : The University of California Press . [Google Scholar] ) and Lock and Gordon ( 1988 Lock , Margaret and Deborah Gordon , eds. 1988 Biomedicine Examined . Boston : Kluwer Academic Publishers . [Crossref] , [Google Scholar] ).

Kuriyama ( 1999 Kuriyama , Shigehisa 1999 The Expressiveness of the Body . New York : Zone Books . [Google Scholar] ) provides an elaborate discussion of how the notion of embodiment is crucial to the diagnostics of Chinese medicine in ancient times, and how it enabled a perspective on the body that diverged from the Greek perspective. For a discussion of why the embodied knowledge of Chinese medicine should qualify as an acceptable (albeit different) form of scientific empiricism, see Farquhar ( 1987 Farquhar , Judith 1987 Problems of Knowledge in Contemporary Chinese Medical Discourse . Social Science and Medicine 24 : 1013 – 1021 . [Crossref], [PubMed], [Web of Science ®] , [Google Scholar] ); Lei ( 2002 2002 How Did Chinese Medicine Become Experiential? The Political Epistemology of Jingyan Positions 10 ( 2 ): 2 . [Google Scholar] ); Zhan ( 2002 Zhan , Mei 2002 Does It Take a Miracle? Negotiating Knowledges, Identities, and Communities of Traditional Chinese Medicine . Cultural Anthropology 16 ( 4 ): 453 – 480 . [Crossref], [Web of Science ®] , [Google Scholar] ).

The other key figures include (suirenshi, the first person to discover the domestic use of fire) and (youchaoshi, the first person to build a shelter for humans).

Apparently, both in the United States and Europe, acupuncture does much better than herbal medical culture in attracting a following. Nonetheless, the struggle between two types of empiricism remains. See Barnes ( 2005 Barnes , Linda 2005 American Acupuncture and Efficacy: Meanings and Their Points of Insertion. Medical Anthropology Quarterly 19 ( 3 ): 239 – 266 . [Crossref], [PubMed], [Web of Science ®] , [Google Scholar] ) and Kaptchuk ( 2002 Kaptchuk , Ted J. 2002 Acupuncture: Theory, Efficacy, and Practice. Annals of Internal Medicine 136 ( 5 ): 374 – 383 . [Web of Science ®] , [Google Scholar] ). In the Chinese community, throughout the twentieth century the debate about the validity of Chinese medicine has never subsided, not even in the second half of the century. Now the debate is being renewed at an even higher intensity. See Zhang (2006); Wang ( 2006 Wang , Cheng 2006 An Appeal to China to Abolish TCM: On the Medical System of China from the Point of View of the U.S. Huxia Kuaidi [China News Digest (CND)], March 6. Electronic document. www.cnd.org [Google Scholar] ); Lü ( 2006 Lü , Jiage 2006 Saving TCM . Nanning : Guangxi Normal University Press . [Google Scholar] ); Ou ( 2005 Ou , Jiecheng 2005 When TCM Encounters Western Medicine . Beijing : Sanlian Publishing House . [Google Scholar] ); and Bai ( 2006 Bai , Jianfeng 2006 Will Zhongyi Be Still Called “Zhong” in Decades to Come? [Will Chinese Medicine Be Still Called “Chinese” Medicine in Decades to Come?] People’s Daily , June 8 : 15 . [Google Scholar] ).

Scheid ( 2002 2002 Chinese Medicine in Contemporary China: Plurality and Synthesis . Durham : Duke University Press . [Google Scholar] ) takes the notion of the “mangle of practice” from Pickering (1996).

Again, I cite as example Obeyesekere’s ( 1992 Obeyasekere , Gananath 1992 Science, Experimentation, and Clinical Practice in Āyurverda . In Paths to Asian Medical Knowledge . C. Leslie and A. Young , eds. Pp. 177 – 208 . Berkeley , CA : University of California Press . [Google Scholar] ) excellent work on the clinical practice of Āyurverda in Sri Lanka.

The edited volume New Horizons in Medical Anthropology (Nichter and Lock 2002 Nichter , Mark and Margaret Lock , eds. 2002 Horizons in Medical Anthropology: Essays in Honour of Charles Leslie . London : Routledge . [Google Scholar] ) is an example.

There are contradictory reports from China. For example, one report shows that a large number of AIDS patients were receiving TCM treatment through government-funded trial programs either in 11 provinces or in 15 health institutions in 19 provinces. See Xinhua ( 2006 Xinhua News Agency 2006 Over 5,800 AIDS Patients in China Receiving TCM Treatment . January 11 . [Google Scholar] ).

When, in the 1920s, doctors of traditional Chinese medicine petitioned China’s nationalist government to block the move to abolish TCM, their identification with TCM was crucial to their survival (Zhao 1982; Lei 1999 Lei , Sean Hsiang-lin 1999 When Chinese Medicine Encountered the State: 1910–1949 . Ph.D. dissertation, The University of Chicago , 1999 . [Google Scholar] ). Jean Langford ( 2002 Langford , Jean 2002 Fluent Bodies: Āyurverdic Remedies for Postcolonial Imbalance . Durham , NC : Duke University Press . [Google Scholar] ) shows how Āyurverdic practices became a site for articulating the identity of postcolonial India.

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Everett Yuehong Zhang

Everett Zhang is an assistant professor of anthropology at SUNY Buffalo. He received his Ph.D. from UC Berkeley and did postdoctoral studies at Harvard Medical School. He has published on sexuality, masculinity, the body, and Chinese medicine. He is working on the changing governance of life and the transformation of the ethos of sacrifice in China.