Reviewed by: Leprosy in China: A History Susan Burns Angela Ki Che Leung. Leprosy in China: A History. Studies of the Weatherhead East Asian Institute, Columbia University. New York: Columbia University Press, 2009. xi + 373 pp. Ill. $50.00, £35.50 (978-0-2311-2300-6). Since the 1990s leprosy has been the object of much research by historians of medicine and public health, an interest clearly related to renewed concern for the relationship between stigma and disease in the era of HIV/AIDS. Authors such as Warwick Anderson, Rod Edmond, and Michelle T. Moran have explored the intersection between medical discourse on leprosy and the racialized policies and practices of imperialism and colonialism. Other scholars, most recently Luke Demaitre and Carole Rawcliffe, have taken up the problem of leprosy in premodern societies and examined the cultural, social, and religious contexts that were productive of stigma before modernity. Angela Ki Che Leung's ambitious and groundbreaking work Leprosy in China: A History is an important contribution to this field, precisely because it seeks to bridge the premodern and modern divide and to examine the impact of international public health discourse on a society situated as the "source" of a dreaded disease. Tracing the history of leprosy in China from ancient times through the post-1949 period, Leung argues that Chinese and Western conceptions of the disease, in fact, reinforced each other in the nineteenth century, with the result that in the early twentieth century China's own modernizing elite began to portray the "leprous Chinaman" as a danger to Chinese society, one that had to be exterminated if China was to be rebuilt as a strong, modern nation. Leung devotes the first three chapters of her work to a meticulous and richly detailed discussion of the medical theories and social practices associated with leprosy in China before the mid-nineteenth century. Chapter 1 examines the various terms ri, rai, dafeng, and mafeng that would later be identified with true leprosy. Leung rigorously analyzes the traditional nosologies and demonstrates how dafeng, which was identified as one of many "wind"-induced disorders in the canonical The Yellow Emperor's Inner Canon, was gradually reconceptualized as a disease of the uncivilized south and one that lascivious southern women passed on to vulnerable northern men through sexual contact. Once acquired in this way, however, the disease was believed to be transmittable from an infected parent to his children, an issue of considerable concern within the Chinese system of patriarchy. Chapters 2 and 3 explore the social practices that accompanied this evolving understanding of the disease. While Leung notes that social attitudes were always complex, with class and regional variations, she argues that until the thirteenth century the victims of the disease were viewed as "cursed but redeemable." That is, bodily recovery was represented as achievable through spiritual devotion, virtuous acts, or ascetic practices within the religio-philosophical traditions of Buddhism, Confucianism, [End Page 515] and Taoism. However, after the thirteenth century, as ri/ rai/ dafeng/ mafeng was identified as a disease of marginalized regions and bodies, it began to evoke intense fear, anxiety, and disgust, giving rise to institutionalized practices of segregation. The publicly supported asylums of the Ming–Qing era, however, had the dual aim of protecting the healthy population from contagion and the sick from violence on the part of hostile neighbors. Chapter 4, which examines the formation of an international public health discourse on leprosy and its impact upon China itself, is the pivotal chapter in the book. Rather than simply situating China as the "victim" of Western imperialism, Leung stresses the agency of the Chinese themselves in the modern construction of the disease. Western missionary doctors and others in fact placed great importance on the Chinese understanding of the disease in the period before germ theory achieved hegemonic status, with the result that Chinese medical knowledge and Western public health discourse in fact reinforced each other. As Leung succinctly states, "[T]he idea that leprosy was a hereditary disease of specific, inferior races dwelling in miasmatic regions, which should have been distasteful to the Chinese, was, ironically, perfectly in tune with the Chinese traditional idea of the disease in the...
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