小型研討會 --「健與美的歷史」研討會

This paper analyzes the concept of "ghost fetus" (guitai) in traditional Chinese medical texts and argues that it provides productive insights into Chinese medical conceptions of normality, monstrosity, and gender differences in illness and healing. In recent decades, historians of medicine have focused their attention on how culture "frames" disease. What medical and social meanings do people assign to different bodily states? When and why is a certain physical condition defined as pathological? What are the strategies used to define and manage illness? The relevance of such questions extends far beyond the medical realm, since they touch on broader intellectual and social norms. For example, in order to fully understand medical responses to illness and healing, one must also understand how a society conceptualizes the relationship between humans and their environment, and between an individual and the cosmos. Thus, a society which explains AIDS as a punishment from God will respond very differently from one which sees it as a viral infection. In the mix of cultural factors which frame disease, furthermore, constructions of gender difference are critically important.

The concept of guitai is a useful tool for examining these issues in traditional Chinese medicine. The basic definition of guitai is a pregnancy which results when a woman's body is invaded by demonic or ghostly forces. Instead of giving birth to a human child, however, the woman produces misshapen bloody lumps or noxious creatures, often described as "worms" or "snakes". As one deconstructs this deceptively simples concept, one finds that it touches on a number of important issues in traditional Chinese medical conceptions of disease and gender. The concept of guitai touches on the very foundation of human life-- sexual reproduction, fetal gestation, and birth-- and is therefore also concerned with women's key role in reproduction. Traditional Chinese medical literature has long been concerned with teaching women how to behave in order to conceive and produce healthy children. While existing scholarly studies have analyzed these prescriptive norms, many of the individual ailments seen as specific to women have not yet been explored in depth. A discussion of guitai, therefore, can provide useful insights into how chinese medicine gendered disease. At the same time, the elite Chinese medical tradition represented in the textual sources was constantly competing with folks and popular ideas about women's bodies and acceptable female behavior. The concept of guitai can thus also serve as a case study of how elite scholars tried to "medicalize" popular notions of ghostly invasion by by subsuming it into a discourse on internal harmony or imbalance.

This paper will examine the concept of guitai from three interrelated angles. First, it will examine how the concept of guitai draws on different traditional Chinese disease categories, especially those that pertain to external agents invading or infesting the human body. As Li Jianmin has pointed out, guitai can be considered a form of "possession illness" (suibing) where ghostly or demonic influences invade a person's body. Li shows that "locationality" is an important factor in the onset of such diseases: a person can become ill if he or she goes to a place where supernatural forces congregate. At the same time, however, guitai also constitutes what scholars of medical folklore call a case of "animal-in-body". Such ailments are caused and characterized by the presence of wormlike creatures of other foreign life forms in the body. At the most mundave level, "animal-in-body" illnesses arise when creatures enter the human body through ingestion of contaminated food or through a bodily aperture. Such infestations can also arise, however, as a result of a curse or spell cast by another person. A full understanding of guitai, therefore, must also include an analysis of traditional Chinese conceptions of parasites and general infestations of "worms" and "insects" (chong).

The second part of the paper will analyze the ways in which guitai constituted a gendered illness linked to traditional medical concepts of the female body. As Charlotte Furth has shown, classical Chinese medicine saw the free flow of Blood (xue) as a key factor in women's health and fertility. This section will argue that concerns about guitai went beyond simple fears about abnormal pregnancies: on the most fundamental level, guitai represented a perversion of women's reproductive essences in which Blood was diverted from its normal functions and channeled into the generation of foreign life forms inside the woman's body. This fear that Blood could be misdirected was related to the perceived relationship between female blood and ritual pollution, as well as to general association between blood and possession-illnesses. Recorded cases of gu poisoning, for example, often describe the patient being purged of bloody substances prior to being cured.

Finally, the paper will analyze how traditional medical writes sought to shift popular understandings of guitai from the supernatural realm to the medical realm. Writes such as Zhang Jiebin argued guitai had nothing to do with spirits and ghosts, and everything to do with lack of internal regulation. At the same time, these discussions of guitai reveal elite anxieties about female behavior and sexuality. Women might conceive guitai after travelling to places outside the home, expecially temples. Immiderate female emotions or misdirected erotic disires could also cause internal blockages. Regardless of their opinions as the cause of guitai, therefore, male medical authors sought to regulate female health by regulating female behavior.

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