The history of medicine is a parameter to examine people's concepts of diseases, and how they have struggled to cure themselves. The making of traditional medicine provides a good conceptual basis for exploring Vietnamese history, as the country has encountered modernization through colonization, war, and political integration. Historians have paid attention to the social history of medicine in Vietnam for a few decades (Marr Reference Marr and Owen1987), and Thompson has also engaged in co-editing a fascinating volume (Monnais et al. Reference Monnais, Thompson and Wahlberg2012). However, her work is the first to show a comprehensive history of traditional medicine in Vietnam from the 19th century, primarily through text analysis.
Vietnamese traditional medicine has been investigated in the context of dichotomies, such as tradition/modernity as well as East/West or Vietnamese (Southern)/Chinese (Northern) medicine. This tendency is understandable given the fact that Vietnam has been historically threatened by influences from the “other”. It is also believed that traditional Vietnamese medicine has, in large part, been influenced by traditional Chinese medicine.
However, Thompson raises an interesting question about the content of both Chinese and Vietnamese medical literature with respect to smallpox. If the Chinese influence on Vietnamese medicine is as powerful as it is claimed to be, the most widespread Chinese theory and practice should appear in Vietnamese traditional medical texts published when smallpox was a major problem in both countries. Nevertheless, Thompson points out that this was not always the case.
Thompson begins by analysing the history of smallpox variolation in Vietnam. As the introduction explains, interpretation of the pathogenesis of smallpox and its treatment provides an appropriate case study to highlight “constructed” social and cultural aspects. The first element of originality and significance in this book hinges on the fact that Thompson focuses on Nom, that is, demotic Vietnamese script, to examine how Vietnamese traditional medical knowledge was transmitted in Vietnamese texts. Second, the entire book questions the extent of connections between Chinese and Vietnamese medicine. Using the smallpox example, it shows that Vietnamese therapeutic practices and theories were different from those in the Chinese model.
The Chinese theory explains that smallpox is transmitted internally from parents to children, which is based on the concept of tai du (fetal toxin). However, Thompson's study shows that even during the time when northern Vietnam was under the reign of the Ming Dynasty, this Chinese model was not dominant in Vietnamese Nom texts.
In Chapter 2, titled “Independent Vietnamese quest for smallpox vaccine”, Thompson demonstrates how Minh Mang, Emperor of the Nguyen Dynasty, nominated a French physician to bring the first vaccine from Macao in the early 19th century. In this context, Thompson examines why vaccination from the West was rather more acceptable than variolation around that time. She argues that it was because the explanations for the smallpox agents then given to the Vietnamese were attributed to external causes, which was contradictory to the Chinese explanation. Even after Minh Mang restricted the use of Nom in the court, the Vietnamese did not incorporate the Chinese model for smallpox prevention.
In Chapter 3, Thompson discusses the difference in the character for “toxin” between Chinese and Vietnamese writings, pointing out that the Chinese character for du (in tai du) differs from the Vietnamese Nom character. She also highlights the difference in meaning and usage between the Chinese and Vietnamese versions, suggesting that the difference may have contributed to the rejection of the Chinese concept of disease causation. Her study indicates that while the Vietnamese concept clashed with Chinese-style variolation, it did not conflict with vaccination, as both concepts attribute the etiology of the disease to external agents. Thompson also points out that the format of the script later led to a kind of social class divide among traditional doctors. After the restriction of the use of Nom in the Nguyen courts, doctors were urged to use Chinese script.
Chapter 4 examines plant nomenclature in Nom texts with various examples in Vietnamese materia medica, and transmission of medical knowledge after the 20th century. The discussion shows that while medical knowledge was transmitted from generation to generation through Nom texts among medical family healers, after Western-trained healers emerged, Quoc Ngu, a Roman transliteration of Vietnamese, began to be used in the medical field as a tool of the anti-French resistance and nationalist movements; this led to the rediscovery of traditional medical knowledge by Western-trained elites.
This book also illustrates the continuity in medical knowledge transmission in the 1990s through analysis of written texts, observations, and interviews in contemporary Vietnam. However, it is regrettable that the book does not provide an original analysis for the period from the end of French colonization to the 1990s, especially when the country was divided into two states.
In addition, despite diversity in terms of climate, materia medica, or culture, the book has little information on differences of the manner in which medical knowledge was transmitted in each area (or in each state of the North and the South). While the situation in the North has been studied by Thompson (Reference Thompson2003) and Wahlberg (Reference Wahlberg, Monnais and Cook2012), these points should be further explored in future in relation to the basis of this book.
Lastly, the book appears to create the impression that there is a division between chapters. The discussion on smallpox is presented from the beginning through the first two chapters, whereas Chapter 4 hardly presents an analysis of smallpox. This might be because the author attempted to paint a broad picture of the history of traditional medicine by making deductions on a case-by-case basis.
Nonetheless, this does not diminish the significance of Thomson's work, as it is the first to capture the essence of Vietnamese traditional medicine both in theory and in practice, through historical text analysis. This fundamental research reveals not only new findings of Vietnamese cultural/social history but also a wider scope within which to study the evolution of science or technology in the context of strong social autonomy.
