20 A FEMALE DOCTOR’S LIFE AND WORK Preface and postfaces to a book by Tan Yunxian 談允賢 (1461–1556)
This is the story of Tan Yunxian, one of the most famous female doctors in imperial China. She and her relatives narrate the story of her professional career as well as her legacy in her family and within the medical profession.
Chinese medicine drew not only on a series of canonical works, beginning with The Yellow Emperor’s Classic of Internal Medicine (Huangdi neijing), but also on great practitioners and pharmacologists, such as Zhang Zhongjing (ca. 150s–215), Hua Tuo (d. 208), Sun Simiao (d. 682), and Li Shizhen (1518–1593). Some established themselves through formal education with a master; others continued a family profession or were self-taught. Almost all of these esteemed medical specialists were men, but historical sources do occasionally mention elite women becoming interested in medicine after witnessing loved ones suffering from illnesses or observing incompetent doctors. By the Ming period, there is more evidence of women practicing medicine professionally and playing an active role in the transmission of medical knowledge.
Perhaps the best known of these women doctors is Tan Yunxian. Born into a family with a long tradition of practicing medicine in southeastern China, Tan received her medical education from her paternal grandmother. It was not until she fell ill, however, that she began to put her knowledge to actual use. Over time, not only did she acquire a reputation for her skills in her native place of Wuxi (Jiangsu), but she also compiled her own casebook, Miscellaneous Record of a Female Doctor (Nüyi zayan). This book provides detailed descriptions of her patients’ symptoms as well as her diagnoses. Tan concluded that many of her patients’ illnesses could be traced back to physical exertion and mental stress that resulted from problematic family relationships, especially those between in-laws and husband and wife. Mainly using herbs and acupuncture, Tan treated women unwilling to see male doctors. Tan lived well into her nineties, so she must have treated a great number of patients. Tan’s experience offers a concrete example of a strong grandmother-granddaughter relationship and the impact of women’s education on women’s lives.
The first selection below is Tan’s narrative of her education and professional experience. This is followed by a postscript to Miscellaneous Record, in which her younger brother expresses his admiration for his sister’s intelligence and accomplishments. The third piece was composed by Tan’s grand-nephew on the occasion of the reprinting of her book.
Preface to Miscellaneous Record of a Female Doctor, by Tan Yunxian
The Tans have been known for their scholarship in Wuxi for generations. My great-grandfather (known by his honorary titles of the gentleman litterateur and investigating censor of Nanjing and the Huguang Circuit) married into fellow native Huang Yuxian’s family, a clan with a long tradition of practicing medicine. My grandfather (whose titles were grand master for governance and director in the Ministry of Justice of Nanjing) acquired a reputation as a good doctor. The next generation (my uncles, who held the ranks of secretary and gentleman for managing affairs at the Ministry of Personnel, and my father, prefect of Laizhou [Shandong] with the rank of lesser grand master of the palace) all earned the jinshi degree. As a result, the family stopped practicing medicine.
When my father was serving in the Ministry of Justice, he brought my grandparents to his post in order to take care of them. I was a little girl at the time. Once when I was with my father, for amusement he asked me to chant some five- and seven-character poems and recite from Instructions for Women (Nüjiao) and The Classic of Filial Piety (Xiaojing). Pleased with my performance, my grandfather said, “My granddaughter is very intelligent and should not be restricted to learning only women’s work. Let her study medicine with us.” I remembered what he said but did not fully understand how kind those words were. After that, I began to study The Classic of Difficult Cases (Nanjing), Rhymed Formula on the Pulse (Maijing), and other books, keeping at it day and night. When I was taking a break, I would ask my grandmother to explain the gist of those works and felt that all my questions were quickly resolved. At the time, I already knew how useful her instruction was but had not yet tried to use anything I had learned.
When I grew up and married [into the Yang family], I frequently suffered from qi- and blood-related illnesses. Before the doctor came, I would examine myself, then compare my diagnosis with the doctor’s. When I got my prescription, I would handpick certain herbs to determine whether or not they suited me. Later I gave birth to three daughters and one son while ill but did not take anyone else’s prescriptions. I simply asked for advice from my grandmother, then tried to come up with my own prescriptions. Even though I was gaining experience in making medical decisions, I still was not sure whether medical treatments were effective.
When my grandmother was dying, she left me all the prescription manuals and herb-processing tools, saying, “Study these diligently. Then I can die at peace.” I accepted those items on my knees. Then excessive grief left me so sick for over seven months that my mother secretly made preparations for my death. In my stupor, I dreamed that my grandmother told me, “You will not die from this illness. The cure is in a certain chapter of a certain book. If you follow the treatment, you’ll soon recover. You’ll live to seventy-three and be able to carry forward my techniques to save people. Do not worry!” Waking from the dream in a state of alarm, I forced myself to get up and find the prescription to begin my treatment. I fully recovered soon thereafter. Only then did I have proof that medicine works.
Women I knew who did not want to see male doctors came to me in an endless stream. My treatment often proved extremely effective. The years have gone by quickly, and I reached fifty this year. In terms of the life span my grandmother predicted, two-thirds has now passed. I cannot help but feel sad that life is as brief as a glimpse of a colt flashing past a crack in a wall. How many years do I have left? I have therefore carefully recorded what I have learned from my grandmother and my own experience and organized it as cases. Titled Miscellaneous Record of a Female Doctor, it adds to the works of practitioners. As I am a woman, it is inappropriate to go outside to see to its publication, so I have told my son, Lian, to copy it and have it carved on blocks for printing in the hope that it may help other doctors. I beg readers’ indulgence and ask that they not laugh at me.
Written by Yang Tan Yunxian on the sixteenth day in the third month of the gengwu year, the fifth year of the Zhengde reign period [1510].
Postscript to Miscellaneous Record of a Female Doctor, by Tan Yifeng
The entries in Miscellaneous Record were all cases treated by my sister, Child Nurturess Yang [Tan Yunxian]. My sister was more intelligent than her brothers. When young, she was the favorite of our grandmother, who made sure she had everything she needed. Their conversations were about nothing but medical treatment. My sister was able to remember everything and wrote down the most important points. When she reached adulthood, she further investigated thoroughly the secret and most important prescriptions of the various schools, combining and using them in her practice. For this reason, she always achieved outstanding results. When local women fell ill, they considered it fortunate to have her treat them.
As she grew older, she worried that her knowledge would be lost, so she wrote this book. Alas! The ancients said that a good doctor’s contribution can equal that of a good minister. This saying conveys how difficult it is to save lives. Looking back, not many of a generation’s ministers deserve to be called good. Similarly, how many good doctors were there in the past, or even in more recent generations! Not to mention female doctors! This book will surely find people who recognize its value. I am too ignorant to understand its subtle and profound insight. Besides, words are unreliable and incapable of conveying the most significant knowledge. Even so, how could I take words lightly? I have therefore written this postscript.
Respectfully composed by unworthy younger brother (juren 1503) Tan Yifeng on the first day of the fourth month in the xinwei year of the Zhengde reign period [1511].
Postscript to Reprint of Miscellaneous Record of a Female Doctor, by Tan Xiu
My great-aunt Madame Yang was a famous woman doctor in our county and lived to age ninety-six. She cured countless people throughout her life. As boy, I witnessed her treating sick women quickly and effectively. For this reason, doesn’t she deserve to be called the female Bian Que [5th c. BCE]? I heard that the descendants of one who saves many lives will flourish. Yet her son, Lian, died young; her grandson, Qiao, also lost his life after being implicated in a crime, bringing her family line to an end. Was what I learned from history unreliable? I sigh deeply for her.
Recently, I have had a lot of free time, so I got to go over the records left by my forebears. Among the documents I found were the writings of my grandfather, the lord of Dayi, which contained a postscript to Miscellaneous Record of a Female Doctor. I thought that if I could circulate this work, then my great-aunt’s name would become immortal. However, despite my best efforts, I failed to acquire a copy. A guest, Guo Hanjiang, brought me a copy and said, “I heard that you are compiling your ancestors’ work. Please take this to add to your collection.” I bowed and accepted his kindness. Opening the volume and reading it carefully, I realized that all the records were from the gengwu year in the Zhengde reign period [1510]. After that, as my great-aunt grew older, her skills became even more miraculous. Is this why she stopped making records? Or did she record more cases that haven’t survived?
This work had been carved onto woodblocks and published. Our local leading figures, Mrs. Shao Wenzhuang and Ru Shaotian, wishing to promote the famous and principled, not only supported the publication project but also authored postscripts, in which they showed full understanding of the origin and effectiveness of Madame Yang’s work and celebrated her contributions. Those woodblocks are no longer extant, which is very unfortunate. With her family line cut off, her legacy could easily be lost. I therefore have made a hand-copy and have seen it into print. This way, even if the good that Madame Yang did in saving people did not bring a reward in terms of descendants, at least her name will be passed down and she will achieve immortality that way.
Postscript respectfully authored by grand-nephew, Tan Xiu, on the third day of the third month in the yiyou year of the Wanli reign period [1585].
SOURCE: Tan Yunxian 談允賢, Nüyi zayan ping’an yishi 《女醫雜言》評按譯釋, ed. Wang Jian 汪劍 (Beijing: Zhongguo Zhongyiyzo Chubanshe, 2016), preface and postscripts.
Further Reading
- Furth, Charlotte. A Flourishing Yin: Gender in China’s Medical History, 960–1665. Berkeley: University of California Press, 1999.
- Leung, Angela Ki Che. “Recent Trends in the Study of Medicine for Women in Imperial China.” In Medicine for Women in Imperial China, edited by Angela Ki Che Leung, 1–18. Leiden: Brill, 2006.
- Wilms, Sabine. “Ten Times More Difficult to Treat: Female Bodies in Medical Texts from Early Imperial China.” Nan Nü 7, no. 2 (2005): 182–215.
- Yates, Robin D. S. “Medicine for Women in Early China: A Preliminary Survey.” In Medicine for Women in Imperial China, edited by Angela Ki Che Leung, 19–73. Leiden: Brill, 2006.