Healer-patient Relationships and New Healing Narratives in Song China

Abstract:

This essay examines healer-patient relationships and asks since when, and how, patients’ subjective bodily experiences became meaningful and crucial for diagnosis in premodern Chinese healing narratives. I begin by contrasting an older narrative with a newer one. The older narrative portrays a good healer as someone who knows exactly how the patient feels without asking; he knows the cause of the illness merely by looking at the patient or taking the pulses. What the patient says, if anything, simply serves to confirm what the healer already knows. The newer narrative, by contrast, emphasizes more aspects of the patient-healer interaction. A good healer asks questions and actively engages the patient in the diagnostic process, while a bad healer fails to listen to the patient’s account or disregards the patient’s understanding of their own condition. Patients, in turn, are expected to disclose as much as possible and not conceal symptoms in order to test the healer’s skill. This new narrative became visible in Song medical writings in the eleventh and twelfth centuries, even as the older model persisted. This essay compares healing narratives from early to mid-imperial China, including physicians’ biographies and healing episodes in dynastic histories, anecdotal records of clinical encounters, medical amateurs’ notes, as well as case histories authored by physicians themselves. It argues that the rise of the new narrative was a result of several interrelated developments in the Song society, including the wide dissemination of printed medical texts, the evolution of the genre of medical case history, the revival of the cold damage tradition, as well as the development of women’s medicine.