The Expressiveness of the Body and the Divergence of Greek and Chinese Medicine

by Shigehisa Kuriyama

The true structure and workings of the human body are, we casually assume, everywhere the same, a universal reality. But when we look into the past, our sense of reality accounts of the body in diverse medical traditions often seem to describe mutually alien, almost unrelated worlds. How can perceptions of something as basic and intimate as the body differ so? In this book, Shigehisa Kuriyama explores this fundamental question, elucidating the fascinating contrasts between the human body described in classical Greek medicine and the body as envisaged by physicians in ancient China. Revealing how perceptions of the body and conceptions of personhood are intimately linked, his comparative inquiry invites us, indeed compels us, to reassess our own habits of feeling and perceiving.

The Expressiveness of the Body was awarded the 2001 Welch Medal by the American Association for the History of Medicine.

Genres: History, Nonfiction, Philosophy, Science, Medicine, Health, Medical

344 pages, Paperback

First published July 23, 1999

Reviews

[Dagezi · Rating 5 out of 5]

If I could give this 4.5 stars I would. Exhibit 1 in the case that I really should read Birth of the Clinic already. Fascinating and unusual book this is. That expert on TCM whose name begins with a U (slips my mind) (4/12: Paul Unschuld) says Kuriyama plays a bit fast and loose with the Chinese side of things, but even if he is overstating the separation of the two traditions, the book is still a remarkably cool thought experiment. And a real pleasure to read, real poetry in places. For me the most interesting issues raised are twofold--first the difference in the way the Greeks and the Chinese reconciled disagreements between anatomy and sensation. In the former case, the interior structure of the (dead) body is taken as the ultimate reality in the later, the sensations and connections of the surface of the living body trump internal structure. This difference derives in part from the differing status of dissection and anatomy in both traditions. Kuriyama makes a compelling case for putting the anatomizing gaze at the root of western knowledges about the body. Some truly fascinating discussions of the similarities between early dissectors and that set of priests who measured the future by way of animal entrails. Anybody, med anth types, etc., able to recommend a good history of science or med anth take on the history of dissection and anatomy in the west? (4/12: the Body Emblazoned by Sawday is now on the to read list)

Revisited 4/12 -- this is a five star book. One that stays with you.

[Angela · Rating 5 out of 5]

Easily astonishing, astonishingly easy. My dream Ph.D. thesis in an alternative timeline. CURRICULARIZE THIS NOW IDC HOW!!

[JC · Rating 4 out of 5]

An interesting comparative work on the history of medicine between Greek and Chinese medical theorists and practitioners. A grad student in history recommended this book to me during our conversation on metabolism. Kuriyama has elsewhere written some excellent stuff on early metabolic studies, particularly his paper The Forgotten Fear of Excrement. This book itself does not really discuss 'metabolism' directly, but is significantly about conceptions of 'flow' within medical conceptions of the body, most fascinatingly discussed with respect to blood flow (and circulation, itself a central subject in this book) and its comparison to moving rivers through ecological landscapes. Some interesting excerpts:

"Such descriptions speak to the central intuitions guiding Chinese palpation. The character mo ( ) combines the flesh radical ( ), marking a part of the body, with a pictograph ( ) for branch- blood in place of the flesh radical- a variant which the Shuowen jiezi (ca. 100 c.E.), the first etymological dictionary in China, analyzes as the "branching flow of blood:' We picture vital fluids streaming through the body.lOO Slipperiness and roughness mirrored the excessive fluency or faltering hesitations of its coursing. Analogies between the earth's rivers and the currents of blood and breath in the body recur worldwide in the poetics of microcosm and macrocosm, and we encounter them more than once in writings of pre-Qin- and Han-dynasty China. The Guanzi thus calls water "the blood and breath of the earth,"101 and the Lingshu more specifically pairs each of China's six major rivers with the six principal mo of the body.102 Wang Chong (27-100?) explains: "The hundred rivers of the earth are like the streams of blood (xuemo) in man. Just as the streams of blood flow along, penetrating and spreading, and move and rest all according to their natural order, so it is with the hundred rivers. Their ebb and flow from dawn to dusk is like the expiration and inspiration of breath (qi):'" (p. 50)

""Streams of blood" is surely the more natural, more exact translation here. Xuerno were the body's vital currents. In medical texts the mo sometimes "moves" (donn) and only rarely "beats" (bo). Most often, it arrives (lai), departs (qu), travels (xinn), and flows (liu).105 Three cun with each inhaling of breath; three cun with every exhaling. The grammar of the term thus resists any facile identification of mo with blood vessels. But rendering mo as "pulse" is also awkward." (p. 51)

Instead of the vertical rise and fall of the arteries toward and away from the body surface, Chinese doctors sought to feel the horizontal streaming of the blood and breath parallel to the skin. The Suwen thus glosses slippery and rough in terms of the opposition of "following" (conn) and "resisting" (ni), and the Linnshu relates both pairs - slipperiness and roughness, and cong and ni - to the lessons of hydraulic engineering. to? To conn was to be in the flow, or to go with the flow; to ni was to go against it. The eagerness to ascertain slipperiness or roughness mirrored the belief that life flowed. Yet what does grasping flow really entail? How does the touch that tests the streaming of vitality differ from that which interrogates the pulsing artery?" (p. 51-52)

"Qi Bo, for his part, contrasts the unknowable immensity of the universe to the finite measurable body, and hints that we might yet glimpse the former in the latter. Just before this passage he had already related each of the major conduits of the body to one of the large rivers of China... o blind chance matched the number of a person's limbs with the four seasons and the four directions, the five zang with the five planets, the twelve conduits streaming through the body with the twelve rivers bearing life to the land of the Central Kingdom. The dissection of Wangsun Qing took place in a culture where numbers confirmed the resonance between macrocosm and microcosm and summarized the lawful orderliness of the world." (p. 157)

Endnote 102: "Similarly in the Taisu (treatise 5) we find, "The twelve jinsmo correspond in the outside world to the twelve rivers, and inside the body to the five viscera and six hollow organs;" and again, "In the human body there are also four seas and twelve rivers, and these rivers all flow into the seas:' See Unno Kazutaka, "The Geographical Thought of the Chinese People: With Special Reference to Ideas of Terrestial Features," Memoirs ofthe Tayo Bunko 41 (1983): 90-95." (p. 284)

Endnote 107: "Suwen 28/86; Lingshu 38/372. On the importance of the analogy to hydraulic engineering, see the excellent article by Kana Yoshimitsu, "Isho ni mieru kiron," in Onozawa Seiichi et al., eds., Ki no shiso (Tokyo: Tokyo Daigaku Shuppankai, 1978),281-313 (esp. 289-94). Also see Lu and Needham, Celestial Lancets, 22-23; Joseph Needham, Clerks and Craftsmen in China and in the West (Cambridge: Cambridge University Press, 1970), 291." (p. 285)

[casey · Rating 4 out of 5]

Read for History 103F, Fall 2021.
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The conclusion that Kuriyama draws in The Expressiveness of the Body is that task of discovering the truth of the body is inseparable from the challenge of discovering the truth about people, and as such, different peoples experience their bodies distinctly because we conceive our senses -- in particular, those of touch, sight, and hearing -- differently to understand what is fundamentally the same reality. Communication philology and medical epistemology is really at the heart of Kuriyama's book, which is a refreshing departure from many academic papers on similar topics due to the digestibility and ease at which his almost-poetic prose breaks down the key bifurcations in the development of medicine in ancient Greece and China.

[Lukey Ellsberg · Rating 5 out of 5]

One of the best books I’ve read this year. I would recommend it to academic or popular audiences interested in medical epistemologies. The scholarship is close and compelling, the arguments drawn carefully but with such infectious enthusiasm. I found my heart leaping as one idea forks into the next. I’ve heard some say this isn’t properly a work of “history of science.” Maybe it’s more accurately a work of evidentiary phenomenology, but I would still call it a masterwork of conceptual history.

[Scott · Rating 5 out of 5]

This is one of the best books on Chinese Medicine. It compares the development of the "felt body" in Ancient Greece and in Chinese Cosmology and then shows how we got where we are today by looking at both art and medicine through history. Very highly recommended for students of the martial arts.

[Shuhui Shen · Rating 4 out of 5]

Reconsidering the comparative methodology...

[Katie C.]

great, smart, well-written

[Samantha · Rating 3 out of 5]

This is an interesting read that those in the medical field could benefit from. It discusses how ancient Chinese medicine differed from that of Greek and Western medicine, which provides important insights to how culture and approaches to medicine and health are different.

As someone who studies communication, this book was also interesting.

“My thesis is that the history of conceptions of the body must be understood in conjunction with a history of conceptions of communication” (Kuriyama, 2002, p. 107).

Communication theories and concepts are echoed throughout the book though they are never explicitly spelled out. It almost felt like a book of examples of communication concepts through the perspective of medicine and different cultures. However, at some points the book seems repetitive with how many examples there are. For me, I felt like saying, "okay, I got the point. Move on."

However, I know for non-communication studies people, the concepts being introduced were unusual in that they had never considered some of these concepts (like orientalism, fundamental attribution error, fields of experience, etc.) so the extra time and effort spent discussing it in the book was more worthwhile for these individuals.

[Archer · Rating 5 out of 5]

This book for me was remarkable, as it is always interesting to read the alternate reality of your own. (social imaginary) The body, of course, concerns our deepest understandings, and the ways in which these manifested later in Eastern and Western philosophy are fascinating; a simple example of which being the synergistic dominance of objective thought in the western sphere vis-a-vis anatomy vs. the more subjective but still constructed reality of the Eastern body. One is more about particles, one is more about waves. They both had results. We now have to understand the two as one.
The whole thing was fascinating to me. One of those books you pick up off a random shelf and open to a random spot just to test its worth. An answer is revealed, so you go on. Lots of pencil lines. Maybe I'll write a longer review later but I'd say if you're looking for the answer of how the world came to be as it is today, (as we understand it) this is a piece of the puzzle.

[Poppy · Rating 4 out of 5]

Very interesting approach to comparing, but mostly contrasting eastern and western medicine. Looks at what it means to examine the body in both cultures. What it means to be in the body. Why are greek visual representations of man so muscle bound and chinese ones so paunchy and chilled out?Very good if you are interested in the history of medicine, eastern medicine. The text is academic, full of citations, but it is not hard to read.

[Keisuke · Rating 5 out of 5]

Why the expressiveness of the body was so different between the East and the West? The brain was nothing but just a gray chunk of meat to the Oriental medicine. People didn't pay much attention to muscles that were not depicted in medical pictures in the East. Almost no anatomy. However, the oriental medicine is really effective. Why? The answer can be found in your body? Maybe....

[Nancy Nordenson · Rating 3 out of 5]

This book is an analysis of ancient Greek vs Chinese medicine in terms of their different perceptions of--and ways of perceiving--the body. Kuriyama's extensive discussion about pulse-taking in each of these traditions was fascinating, and I think I will always have it in mind when a clinician reaches for my wrist.

[Michele]

Very cool concept of comparing the view of the body from the different systems, but it's one of those hard-to-digest books with language of a beef-jerky style. It's probably one I won't ever fully read.

[M · Rating 5 out of 5]

Amazing work that opened my eyes to an entirely new perspective.

[Andee Nero · Rating 5 out of 5]

I had no interest in Chinese history and Chinese medicine until I read this book.

[Shannon Hong · Rating 4 out of 5]

Interesting.

[John G]

Discovered on Steve of Ballarat Australia's list of to-read.