Early modern reception in Europe

38 EARLY MODERN RECEPTION IN EUROPE Translations and transmissions Eric Marié The frst transmissions of medical knowledge from China to Western Europe were initiated as early as the end of the sixteenth century,1 but the most important developments happened in the second half of the seventeenth century and during the eighteenth century. Strictly speaking, I refer to the importation of theories and practices from China to the Europhone world. Since the publication of the frst treatises on Chinese medicine in Western languages, they continuously aroused interest, so much so that they gave rise to intellectual and doctrinal conficts between ‘sinophile’ and ‘sinophobe’ physicians. At that time, pulse diagnosis was a recurring question. It would even result in a fve-year correspondence (1784–89) between a French and a Chinese practitioner, transmitted thanks to the Jesuits of the French mission of Beijing (Mission française de Pékin). The texts which mediated these exchanges also constitute a catalogue of the various problems that followed the confrontation between two diferent systems of body representation, as physicians from across the globe tried to understand one another. This study aims to show how medical knowledge circulated between China and Europe in the early modern period; to estimate how it was received; to reveal the difculties of translating the terminology and their consequences, and fnally, to analyse the confrontation between the two types of knowledge; its repercussions on medical practice and its general consequences for history and epistemology. The two main categories of sources we have access to are testimonials from travellers and scholarly treatises. Most of these documents come from Catholic missionaries ( Jesuits) and physicians from naval companies. Tales and testimonials from travellers During the seventeenth century, a great deal of information about China reached Europe, brought by Catholic missionaries and merchants. Although their testimonials are of great anthropological interest, their views on the medical system were more from the perspective of curious neophytes or occasional patients than that of specialists in the medical feld. Three observers are illustrative of this contribution to the introduction of Chinese medicine in Europe. DOI: 10.4324/9780203740262-45 551 Eric Marié The Spanish missionary Don Francisco de Herrera Maldonado, writer of a book printed in Madrid in 1621 and translated into French, then published in Paris the following year, expressed his admiration while giving some practical information: unlike European physicians, Chinese practitioners neglected the observation of urine but focussed more on the palpation of the pulse, which they classifed, according to Herrera, into seventy diferent forms that were felt on diferent areas of the body (Herrera 1622: 169–70). Johan Nieuhof (1618–76) dedicated to the practice of medicine in China two pages of a voluminous work which records the impressions of the representatives of the Dutch East India Company. Father Alexander of Rhodes (1591–1660), a French missionary who had travelled in China, including hard-to-reach areas, wrote with admiration the skill of the Chinese physicians which he witnessed as a patient, having received particularly efcient care preceded, naturally, by a long and thorough examination of the pulse. His detailed and personal description evokes particularly well the process of a consultation in seventeenth-century China. One will laugh at these people if I say that he becomes a Physician who wants to, and one will believe there’s no good in trusting people that deceive their patients. But I, who have been in their hands, and who witnessed their abilities, I can say they easily bear comparison with our Physicians and even surpass them in some ways. (…) They particularly excel in knowledge of the pulse, from which they must learn all the subtleties. As soon as the Physician comes to see the sick, he feels his pulse and refects on it for more than a quarter of an hour, then he has to tell to the patient where he is ailing and all the incidents which occurred since he fell ill. (Rhodes 1653: 189–94) In addition to their interest as testimonials, these accounts from travellers hold some technical information. Thus the division of the radial pulse into three segments and the anatomical correspondence attributed to each part are partially described, even though there is some confusion: Alexander of Rhodes remembered little more than a vertical repartition in three parts from up to down, without perceiving more subtleties. The amount of seventy diferent pulses, according to both Herrera and Nieuhof, is surprising and inconsistent with older and contemporary Chinese sources. On that point, the similarity between the two writings is also surprising. Did Nieuhof draw on the account of Herrera to complete his description? At any rate, the impact of this information was to be felt for a long time in European medical circles, some infuential members of which would sometimes consider Chinese sphygmology impracticable because of the extreme diversity of its pulse. Another source of interest is the allusion to peripheral pulses and the central role of palpation in clinical examination. The length of time devoted to palpation that they report, excessively long, is probably of a subjective nature. However, the European physicians who read them took the information they held as strictly correct. This helps to understand how some myths about Chinese medicine emerged in scholarly circles, up to the eighteenth century, with two opposing standpoints: for some, it was a scholarly medicine; for others, an empirical medicine, without philosophy or theoretical foundations, like some sort of worker’s know-how learnt by practice. First scholarly writings on Chinese medicine Several monographs about theoretical and practical aspects of Chinese medicine, the frst written by Westerners, were published during the second half of the seventeenth century. 552 Early modern reception in Europe Their infuence was to be decisive for the interest and knowledge of Far Eastern health practices in Europe, as well as for the initial opinions, favourable or unfavourable, and consequently for the frst medical debates on the value, purpose, validity and possible exploitation of Chinese theories and methods in Western medicine. The frst work was composed by Jacob de Bondt (1592–1631), a practitioner working for the Dutch East India Company. Lu Gwei-Djen and Joseph Needham quote this book, adding that it was the frst real treatise written by a Western author on Chinese medicine and acupuncture: [...] The very frst writer, so far as we can see, who spoke about acupuncture, was the Dane Jacob de Bondt who, in his capacity as surgeon-general for the Dutch East India Company at Batavia, had come into contact with Chinese and Japanese physicians [...]. (Lu and Needham 1980: 260) Jacob de Bondt had already written De Medicina Indorum, published in 1642, but the work in question here is another posthumous treatise, Historiae Naturalis et Medicae Indiae Orientalis, dated from 1658. Another practitioner from the Dutch East India Company, Wilhem Ten Rhyne (1647– 1700), having also lived in Batavia from 1673, made mention of that last work from Jacob de Bondt in his own book, published in 1683 in London, La Haye (the Hague) and in Leipzig. These two authors, especially Ten Rhyne, are worth keeping in mind as they would be used as sources by physicians of the nineteenth century (Dujardin, for example) in their works on Chinese medicine, most notably when it came to acupuncture. The frst monograph specifcally dedicated to pulse diagnosis was published in Grenoble (France) in 1671. It is an anonymous book entitled Secrets of the Medicine of the Chinese that lie in the perfect knowledge of the Pulse, Sent from China by a French, A man of great merit. The identity of the author is not the only enigma that surrounds this book. The origin of the knowledge constitutes another question of major interest. It does not contain any quotation or reference, and also no information concerning its sources. For more than three centuries, historians and sinologists have tried to solve this question with various conclusions. I endeavoured to study this little book, to try to fgure out its author and the circumstances of its creation and, more importantly to me, to identify its main Chinese source, unknown at that time.2 Actually, the main part of the book is a translation, sentence by sentence, of some parts of the Zhenjia shuyao 診家樞要 (Conducting principles of the Masters of diagnosis), written in 1359 by Hua Shou 滑壽 (1304–86), also known by his style name Hua Boren 滑伯仁. Te compilation of a travelling physician At that time, the most able Jesuit regarding Chinese medicine was Michel Boym. The son of the frst physician of Sigismond III (1566–1632), King of Poland, he chose, at the age of seventeen, to join the Society of Jesus where he undertook his studies instead of embracing the career of his father, although he kept an interest in the medical arts and developed an excellent knowledge of this discipline. His advanced mastery of Chinese language and culture allowed him to gather documents and to compile several works on botany and medicine. In Siam in 1658, one year before his death, Michel Boym fnished writing his work on Chinese medicine and entrusted his manuscripts, all written in Latin, to his companion Philippe Couplet who handed them to the Jesuits of Batavia so they could be published in Europe. But the documents were confscated by the Dutch of the Dutch East India Company 553 Eric Marié by way of reprisal for the position of the Jesuits in China, whom they accused of causing prejudice against their commercial interests. Boym died in 1659, at the frontier between Tonkin and Guangxi, without any news about the fate of his writings. In 1681, Philippe Couplet was sent to Europe. He left Macao on the ffth of December but had to stop at Bantam (or Banten, on Java island) because of a storm. He probably met there a famous character who would play an important role in the spread of Chinese medicine in Europe: Andreas Cleyer (1615–90). This Prussian surgeon had lived for a long time in Batavia, studying the local fora and pharmacopoeia. He probably never set foot in the Chinese empire. Corresponding with several European scholars, including the sinologist and physician Christian Mentzel (1622–1701) and Georg Eberhard Rumphius (1628–1702), Cleyer worked for years on gathering documents about Eastern medicine. When they met, Philippe Couplet handed over to him some of Michel Boym’s works he had kept with him. Cleyer integrated these new writings into a compilation he addressed to Mentzel which was published in 1682 in Frankfurt, entitled Specimen medicinae Sinicae. The fact that Boym wasn’t quoted, although a part of his work was probably used, led some historians to accuse Cleyer of plagiarism. The polemic started at the beginning of the eighteenth century with the sinologist Bayer, when he discovered the borrowing by the Prussian physician. This was followed and amplifed by Chabrié, then by Rémusat, who both called it a scandal, accusing Cleyer of being a plagiarist, or even a thief. This accusation of plagiarism deserves, with the beneft of hindsight more exhaustive analysis, some nuancing and even requalifcation, for Cleyer always introduced himself as editor and not as author of the Specimen medicinae.3 It’s precisely due to him that the treatise of Boym was published four years later, under another title. Furthermore, it’s obvious that the two books are very diferent, as much in their general composition as in their style. Strictly speaking, the Specimen medicinae Sinicae isn’t a treatise but a collection of diferent texts on several subjects. The composite nature of the publication is clearly revealed by the variations in style of its diferent parts. It’s probable that Cleyer simply put together several writings on oriental medicine. Six parts can be formally identifed. De Pulsibus Libros quatuor e Sinico translatos, De eplanatione pulsuum regulae The frst two booklets of this part are dedicated to the rules of the palpation of the pulse, attributed by Cleyer to ‘Wam Xo Xo’. It’s easy to guess that the latter is Wang Shuhe, author of the Maijing 脈經 (Pulse Classic). The pulses are associated with pharmacopoeia formulæ, most of them taken from the Shanghan lun 傷寒論 (Treatise on Cold Damage) (Chapter 9 in this volume). Tractatus de Pulsibus ab erudito Europaeo Collectus This part is a sort of commentary on the ‘Nuy kim’ ([Huang di] Neijing [黃帝]內經 [Inner Canon]), including a system of correspondence between pulse segments and the viscera. Mostly a compilation of various theories, the text is sometimes difcult to identify due to the lack of references and Chinese characters. Fragmentum Operis Medici ab erudito Europaeo conscripti This selection is a collection of texts and commentaries on diverse subjects, taken from the Neijing, the Maijue 脈訣 (Secret of the Pulses), based on some commentaries derived from the 554 Early modern reception in Europe Shanghan lun and various other writings. The content is very disparate, including explanations of the seasons and the Chinese calendar, indications of specifc pulses or combinations of pathological pulses, references to pharmacopoeia treatments, various aphorisms on fever, diarrhoea, life and death and so on. Excerpta Literis eruditi Europaei in China Four letters written in Guangdong in 1669–70 are presented in this chapter. The frst one is dated February 12, 1669. It notably contains information on the diferences between the pulses of men and women, a comparison of the correspondence between viscera and pulse segments as they were previously mentioned, on the one hand, and as they appear in the Inner Classic, on the other hand,4 an interesting analysis of the concepts of mingmen 命門 (gate of life) and sanjiao 三焦 (three burners) and a presentation of the number of pulsations in a day and its ensuing physiological consequences. The second letter (1669, October 20) mainly consists of a diagram of ‘blood circulation’ in the twelve vessels according to the twelve Chinese hours. The third one (1670, November 5) includes a presentation of the system of correspondences of the Five Agents and a study of the pulses of vital prognosis according to various illnesses. The fourth letter (1670, November 15) presents the theory of the ffty uninterrupted pulsations: the pulse of a healthy person must beat regularly and without break for at least ffty pulsations, thus meaning that the fve organs are healthy. It then deals with two pulses located on the foot, ‘chum yam’ (chongyang, 42nd point of the meridian zuyangming of the stomach, on the dorsalis pedis artery) and ‘tai hi’ (taixi, third point of the meridian zushaoyin of the kidneys, on the posterior tibial artery), the absence of which means death. A sketch of the theory connecting radial and carotid pulse, ‘ki keu’ (qikou) / ‘gin ym’ (renying) is also mentioned. Finally, a last extract originates from an undated letter without place, which contains another, more explicit, schematic on the circulation in the vessels according to the hours of the day. Cleyer indicates that the author of the letter quotes the Neijing (written Nuy Kim in the document), without any more precision but, according to the content of the passage, we can assume that this theory originates from Lingshu 靈樞 (Divine Pivot), 18. This part of Cleyer’s work ends with a succinct presentation, which he quotes as taken from the Neijing, on the ‘eight extraordinary vessels’. Schemata ad meliorem praecedentium Intelligentiam This ffth part consists of eight pages of schematics recapitulating diverse information on the pulses, in a synoptic and fairly well-structured way, and of thirty medical illustrations mainly depicting viscera and vessels. These are of Chinese style and can be found, in almost identical form, in some treatises edited in China towards the beginning of the seventeenth century; it’s probable that Cleyer simply copied these illustrations while adding annotations and captions in Latin. Two illustrations constitute an exception, being of European style. The frst shows the positions of the fngers for taking the pulse (Figure 38.1); the other represents a body annotated with strategic medical points. In the same part of the book, there is a compendium of Chinese drugs, described by phonetic equivalents of their Chinese names (Figure 38.2).5 De Indiciis morborum ex Linguae coloribus & afectionibus This last part is dedicated to the examination of the tongue and its coating, notably on the basis of their diferent colorations, with the main corresponding pathological indications (Chapter 10 in this volume). 555 Eric Marié Figure 38.1 Pulse diagram, Specimen Medicinae Sinicae, p. 20. Courtesy of the New York Academy of Medicine Library The treatise written or, more precisely, ‘compiled’ by Cleyer is of major interest, especially because of its composite nature, as it combines information from his own researches but also with fragments of studies by sinologists living in Europe and one anonymous writer living in Guangdong: it defnes a state of knowledge on several aspects of Chinese medicine. Among the three mentioned treatises on Chinese sphygmology, it is the only one to have been produced by a renowned professional. It is probable that Cleyer gave more authority to Chinese medicine. His work rapidly became a reference and had a substantial infuence among physicians and scholars interested in China, until the nineteenth century. 556 Early modern reception in Europe Figure 38.2 Confation of acupoints and pulse points, Specimen Medicinae Sinicae, p. 68. Courtesy of the New York Academy of Medicine Library A scholarly treatise on Chinese sphygmology In 1658, shortly before his death, Michel Boym completed a book entitled Clavis medica ad Chinarum Dotrinam de pulsibus. After many tribulations, it would eventually be edited in Nuremberg, in 1686, paradoxically several years after the two other previously mentioned texts. Despite attempts to reconstitute the text through historical research, a certain mystery still hovers over the circumstances of its belated evolution. Boym’s work is a true scholarly treatise, being constructed in a rigorous and coherent manner and redacted in a uniform style which distinguishes it clearly from the mosaic of disparate texts compiled by Cleyer. 557 Eric Marié The text mainly consists of seventeen chapters (actually eighteen, two distinct consecutive chapters bearing the same number). The frst one presents an unusual (folk?) etymology of the character ren 人 (man, human being), stating that the left oblique stroke expresses the idea of yang and the right stroke represents the notion of yin. Thus, according to the author, for the Chinese, man would be defned as the reunion of the yinyang. This may be an abstruse interpretation originating from Chinese calligraphic theory: the frst stroke, pie 撇 (left descending), thick at the top and thin at its end is considered as yang and the second stroke, na 捺 (right descending), thin at the top and thick at its end is considered as yin. The second chapter defnes, in a succinct but meticulous way, the notion of ‘cam & fu’ (zang fu 臟腑), that is to say the Chinese theory of visceral physiology, while the third chapter deals with the classifcation of the vessels, presented as ways of circulation inside the body. The fourth chapter is dedicated to the Five Agents. From the ffth chapter, the author delves deeper into sphygmology, starting judiciously by explaining the movements of the qi, to which he gives the name of ‘spiritus’, probably by making an inappropriate semantic link with the Galenic concept of vital spirit, and those of the xue 血 (blood) which he translates as ‘sanguis’ (On Galenic medicine, Ballester 2002). The sixth chapter contains slightly surprising data: the author enunciates twelve major body locations for palpating the pulses, which he seems to have confated with a set of major acupoints as, for some of them, there is no palpable artery. This set is reproduced by Cleyer in one of his anatomical illustrations (Figure 38.2). The seventh chapter deals with the theory of the Three Burners, presented as an anatomical division of the viscera in three levels, from top to bottom, which the author links to Heaven, Earth and Man; then he returns on other aspects of the yin-yang and the vessels. In the eighth chapter, Boym evokes the relation between the viscera and their respective orbs of infuence, notably on the body tissues, by giving examples rather than dealing with it exhaustively. In the ninth chapter, he explains that the pulses cannot be taken only on the left wrist, but have to be palpated bilaterally; then he broaches the infuence of time cycles (daily, monthly and annual) on the circulatory movements in the human being. In the ninth chapter, he justifes the reasons for radial palpation by clarifying how it is possible to perceive the general state of the body solely at the areas of the wrists, a reading which he deepens in the tenth chapter by defning the three segments. Chapters eleven to thirteen develop the relationship between the pulses and the measure of time, with the stages of circulation and the calculation of the number of daily pulsations. The fourteenth chapter mentions the physiological and pathological relations between respiratory rhythm and pulse frequency, which is completed in the ffteenth by the diferences between adults and children, men and women, according to fat or slender constitutions, etc. The author explains how to distinguish the constitutional or physiological variations and the pathological alterations. The sixteenth chapter contains a list and descriptions of the twenty-four pulses, according to the well-known classifcation of the seven externals, the eight internals and the nine ways, frst established by Wang Shuhe in the Maijing, and widely used since. The treatise then turns to the question of the functions of the qijing bamai 奇經八脈 (eight extraordinary vessels), that the author integrates into the pulses theory. The second ‘chapter sixteen’ gives various instructions on the interpretation of the pulses at the three segments of the radial artery. Finally, the seventeenth and last chapter presents the modifcations of the pulses according to seasonal and climatic variations. It appears clear, from reading his book, that Boym had carefully studied the Chinese medical treatises. However, on several occasions, we also notice knowledge based on oral transmission. The iconography illustrating his tractate is precise and explicit enough to be employed for practical purposes. Finally, Boym insists on the autonomy and completeness of the Chinese system which is totally independent from ancient Greek medicine, even though, 558 Early modern reception in Europe in some places, he fails to escape from the risk of syncretism between the two doctrines, such as when he translated yang (written yam) into calor primigenius (primordial heat) and yin (written in) into humidus radicalis (radical humidity). European scholars inspired by Chinese medicine The above-mentioned writings inspired several European scholars to take an interest in Chinese medicine. We can mention a translation of Nieuhof ’s book from the Dutch original into English by John Ogilby, and the almost complete translation of the Specimen Medicinae Sinicae by William Wotton (1660–1726). Like Wotton, Sir William Temple (1628–99) and Isaac Vossius (1618–89) drew inspiration from this book. But their enthusiasm did not build on clinical experience. However, at least two British physicians, who endeavoured to understand and test Chinese medical practice, must be mentioned. David Abercromby (1621–95) took an interest in the Chinese theories and drew inspiration from them and attempted to experiment with them. In his book, he states that the Chinese pulses bring an ‘insight of the illness’ and do so that the doctor, ‘like a lynx, will scrutinize every change in the patient’. Another British physician devoted himself to the study of Chinese pulse diagnosis, with an undeniable enthusiasm. Sir John Floyer (1649–1734) was a complex blend of conservative gentleman, erudite physician (he studied medicine and sciences for sixteen years in Oxford), prolifc baroque writer and nonconformist researcher. This picturesque personality, passionate for the ancient civilisations of the Far East, contacted several sinologists, searched the libraries, and ended up discovering Chinese medicine and more especially, its pulse doctrine. He obviously knew the Specimen medicinae Sinicae (it was even probably his main source) of which he composed an English adaptation in the addenda of his most important publication on the matter: The Physician Pulse Watch. The explicit objective of Floyer was to propose a synthesis of Galenic and Chinese methods, completed by some personal contributions. In fact, he gives prominence to the Chinese method, considering that it was ‘more evident, surer and more concise’ than the Greek. In France, it was mostly the physicians of the Vitalist school who collected and exploited the theories of Chinese medicine, most notably Jean-Jacques Menuret de Chambaud (1733–1815) and Henri Fouquet (1727–1806), who analysed Chinese pulse diagnosis in their writings. Te contribution of the Jesuits in the eighteenth century Interest in Chinese medicine reached its peak after the 1730s. One of the main actors in this development was a French Jesuit, even though he never saw China: Jean-Baptiste Du Halde. He received from his superiors the task of collecting and redacting all the scientifc reports of the missionaries sent to China, which he fulflled with the publication of a remarkable encyclopaedic work in four folio volumes, ornate with a great number of engravings and containing, in the third volume, some information on Chinese medicine. It should be mentioned that some of them came from another Jesuit, Julien Placide Hervieu (1671–1746), who arrived in China in 1701 and stayed there for forty-fve years, until his death. His contribution to Du Halde’s work is a partial translation of the Tuzhu maijue bianzhen 圖註脈訣辨真 (Discerned Truth of the Secrets of the Pulses, Illustrated and Commented), written during the Ming by Zhang Shixian 張世賢 (dates unknown), also known by his style name Zhang Tiancheng 張天成and published in China in 1565. It contains information on methods of 559 Eric Marié palpation, on the description of a number of pathological pulses and on the prognosis of various illnesses by the pulses. Throughout his explanations, Du Halde interprets Chinese theories and transcribes them into Galenic medical terminology. For him, yang corresponded to ‘vital heat’, yin to ‘radical humidity’, k’i (qi) to ‘pneuma’, etc. In this way, Far Eastern medicine became easily understandable for the European reader, but only under a dim light. The work of Du Halde, translated and published in English, German and Russian, would have a considerable infuence on European physicians until the nineteenth century, who would borrow his descriptions and opinions, neither verifying them nor submitting them to arbitration of their own judgement. In this way the argument was often repeated, that the Chinese were ignorant of and had no interest in anatomy, to justify the opinion that their medicine could not ever reach the level of the European’s one. Towards the end of the eighteenth century, the contribution of the Jesuits would take another shape. At that time, Chinese medicine was not solely of interest to practitioners. It is sufcient to read some articles from the Encyclopédie of Diderot and d’Alembert, notably the one entitled ‘Pouls’ whose contents can also be read in a book, Nouveau traité du pouls (New treatise on the pulse, 1768) by Menuret de Chambaud on the subject: an important part of the book is dedicated to Chinese theories and practices. One can also observe in Parisian scholarly circles a deep curiosity for all that comes from Oriental civilisations. A high ofcial, Henri Bertin (1720–92), at that time Controller-General of Finances and Secretary of State, initiated a correspondence between Paris and Beijing. Surrounded by a team of scientifc collaborators, among whom Louis Oudard de Bréquigny (1761–95), a member of the French Academy, should be particularly mentioned, Bertin permitted an important quantity of data from China to be gathered, more precisely collected by the best special envoys at his disposal: the Jesuits of the French mission in Beijing, and especially Jean Joseph Amiot (1718–93). The regular reports they addressed to Paris are the basis of ffteen volumes of memoirs, without taking into account a number of unpublished letters. The mail that sent from France was added to by a Parisian physician who wished to delve deeper into the Chinese pulse method with which he had experimented for twenty years. He was Charles Jacques Saillant (1747–1814), who in his youth authored a thesis on pulse diagnosis, and went on to become Docteur-régent of the Faculty of Medicine of Paris and a member of the Royal Society of Medicine. On November 16, 1784, he wrote a letter to the missionaries of Beijing in which he interrogated them on precise points of Chinese pulse diagnosis. He notably mentions the confusion resulting from the various interpretations transmitted by works written or translated by Europeans. The answer would reach him only in 1787, on the basis of the explanations of a Chinese doctor in Beijing interviewed by Amiot. At frst, he specifed the attributions of the various locations of the pulse. Encouraged by this frst answer, Saillant continued his epistolary relationship with his informer by addressing him, this time in a memorandum composed of personal thoughts dated from September 22, 1787, under the title ‘New questions about the pulse’. The French physician proposed an equivalent system between the Chinese pulses and those used by Europeans. Amiot answered on June 26, 1789. His letter is interesting because it contains a personal account of an illness of which he was cured by Chinese medicine. He does his best to translate the explanations of his Chinese physician while expressing the difculties he meets in the process. As soon as he comes to delve into technical subtleties, the epistemological gap between the two medical doctrines becomes obvious: how can a European physician understand the meaning of a ‘shanghan pulse’ and how can a Chinese physician answer the questions about the pulses of the ‘crisis’ in reference to theories of medical vitalism of eighteen-century France? 560 Early modern reception in Europe We learn in the rest of Amiot’s letter that the Chinese physician sent to Saillant a medicinal powder for treating headaches. The Jesuit missionary ends his message by repeating a general history of the development of medicine in China and by strongly criticising the translations of Chinese medical treatises made by Europeans. The epistolary relationship between those two practitioners could probably have continued and led to readjustments and exchanges of a major interest. Unfortunately Amiot, sick and ageing, complains that he is unable to continue to act as an intermediary. Te difcult confrontation between two medical cultures At the beginning of the seventeenth century, Chinese medicine was seen as an exotic knowledge that aroused the curiosity of scholars. The frst travellers to witness Chinese medicine were not interested in its theories. However, they bore witness to its practical efciency. A physician reading their accounts could not fail to be intrigued, especially if sensitive to the exotic attraction of these foreign lands. One should not conclude that Europe was ready to welcome Chinese medicine and to spontaneously adopt it. There was at the same time a strong resistance and a real attraction. On one side, there was no question of giving up the idea of the pre-eminence of the European medical model. Travellers returning from China thought that Chinese physicians were efcient but that they did not have any academic education; although they thought that their know-how was excellent, they erroneously assumed that their theories did not rest on any philosophy. However, some Europeans ended up wondering if it was reasonable to think that such a good practice was possible without theoretical foundations. This investigation, frst stirred up by travellers’ accounts, played out in more sophisticated ways through the theoretical considerations and translations in the three books that have been introduced. The publication of the Secrets de la médecine des Chinois constituted the frst practical contribution as a book of popular science. Furthermore, just because a subject was fascinating in its own right, it did not provide a reason to overthrow Western medical reasoning. It is clear from this that a European physician could learn these ‘admirable secrets’ without having to question the epistemological foundations of his own system. The theoretical approaches that fascinated Europeans were those that were contingent on existing medical debates in Europe, or easily understood, and thus this was the reason for their selection of the ‘pulse’, ‘wind’, ‘vessels’ (Bivins 2000). On the other hand, elements that were spectacularly foreign, also attracted attention, albeit for other regions. These two modes of analysis and selection meant that European reception would never directly mirror the medicine being transmitted. When the Specimen medicinae Sinicae of Cleyer was printed, the discourse evolved. This compilation, written in Latin by an eminent surgeon, pointed to a much vaster knowledge, with its own representations of the body, its physiological conceptions, its diagnostic and treatment methods, its pharmacopoeia etc. Through this work, Europe discovered the scholarly nature of Chinese medicine. Finally, after the publication of Boym’s Clavis medica, written in a fuid and rigorous style which revealed the sophisticated understanding and philosophical approach which underpinned Chinese medicine, the European reception deepened to the point where it generated reactions from scholars far beyond the medical feld. Boym’s feat was showing that a good Christian can learn and use Chinese medicine, and that it possessed a real epistemological autonomy. This analysis reveals the beginning of thinking in Europe about the relative and subjective nature of the theoretical value of medical systems. From the end of the seventeenth 561 Eric Marié century, Chinese medicine found supporters as well as detractors. More importantly, it began to be considered as a comprehensive, systematic approach rather than a mere collection of techniques and exotic recipes. However, the confrontation between the two medicines wasn’t easy. One can imagine the difculty that Amiot and his Chinese physician, whose name is regrettably unknown, had encountered when translating medical terminology and, above all, concepts that were impossible to transpose from one medical system to the other. The confusions and mistranslations that occur are mainly the result of this impossibility of the transfer. Terms like ‘crisis’, which had an unambiguous and obvious meaning for a Western physician of the eighteenth century, were practically untranslatable in Chinese, except by using paraphrases assorted with explanations that only a specialist of both medicines could have produced. The opposite problem was met with medical expressions like shanghan which specifcally belong to Chinese nosology. Amiot was conscious of this translating difculty: he mentions and apologises for it on several occasions. However, this apparent linguistic obstacle hides another, even more pernicious one, less obvious at frst glance: behind some terms whose translations appear easy, are hidden completely diferent notions of meaning. Translating xin 心 as ‘heart’ and wei 胃 as ‘stomach’ is literally accurate when speaking in terms of Western medicine. But these words and many other are as such false friends when talking about Chinese medicine. To facilitate the scientifc exchange between Saillant and his Chinese correspondent, it would have been necessary to know not only both languages, but also both medical systems. Two centuries later, this problem is still topical in many medical exchanges between China and the West (Chapter 43 in this volume). Notes 1 There were European travellers in China long before this period and their early impressions of Chinese medicine aroused Western curiosity and imagination (Barnes 2005: 8–35), but these observers did not contribute to what might be precisely defned as a transmission of medical knowledge. 2 The method that allowed me to identify this source led me to a better understanding of how the Chinese medical texts were translated, understood and exploited by Europeans during that time. For more details about the method and the demonstration, cf. Marié (2011: 296–304). 3 The title page of Specimen medicinae Sinicae states ‘Edidit Andreas Cleyer’. The word ‘editor’, or ‘redactor’, in its contemporary meaning, is probably the closest to how Cleyer presents himself. 4 The restitution of the contents of the Neijing is perfectly accurate here, which shows that the writer knew very well this part of the text, which corresponds to a part of the chapter Mai yao jingwei lun 脈要精微論 (Treatise on the Main Subtleties of the Pulses), Suwen, 17. 5 The editors wish to thank the New York Academy of Medicine for rights to use these images. Bibliography Pre-modern sources Zhenjia shuyao 診家樞要 (Key Points for Diagnosticians) 1359 CE, Hua Shou 滑壽, in Gao Wenzhu 高文鑄 (ed.) (1997), Yijing bingyuan zhenfa mingzhu jicheng 醫經病源診法名著集成, Beijing: Huaxia chubanshe. Modern sources Abercromby, D. (1685) De Variatione, ac Varietate Pulsus Observationes, Londini: S. Smith. Allemand, L.-A. 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