In 1595 the wars of religion came to an end. France embarked on the road to recovery under Henri IV and his minister Maximilien de Sully. The limits and extent of this economic revival at the end of the sixteenth and beginning of the seventeenth century are suggested by a study of the textile industry in the north of the kingdom by Pierre Devon. According to Deyon, a recovery began at the end of the 1590s which quickly brought the level of production back to the highest points of the sixteenth century. Expansion, although more irregular after 1600, continued until 1628. Agrarian crises in 1617–18 and 1625 interrupted production, as did a brutal commercial collapse in 1614 which was linked to a Europe-wide crisis. But growth, however interrupted, continued until the late 1620s, when a definitive tendency towards decline set in.

Deyon's view is reinforced by Pierre Jeannin's study of the mining industry in the southern Vosges. A vigorous economic revival is visible there during the closing years of the sixteenth century.

To what extent can we speak of the French economy of the sixteenth century as capitalist? If we confine ourselves to looking at the heights of the economy, namely, banking and international commerce, the answer is an unqualified affirmative. Quite clearly, the circulation of credit and commodities at the highest level was more and more under the control of bankers and merchants from Paris and Lyons. The issuing of rentes on the Hôtel de Ville of Paris and the creation of that vast financial syndicate known as the Grand Parti of Lyons bespeak an ability to organize credit operations on a grand scale. Paris and Lyons were centres of international commerce on the level of Antwerp, Florence and Venice in the first half of the sixteenth century. Moreover, French banking and commercial activities were increasingly linked with those of the rest of Europe. On the other hand, it is not enough to confine our perspective simply to that of the circulation of large amounts of money, credit and commodities when speaking of capitalism. However much a necessary condition, the development of the European market into a world market in the first part of the sixteenth century is not a sufficient condition for us to speak of France as a capitalist economy.

France in the sixteenth century was hardly a unified state, let alone a national market. Although the monarchy was more powerful than it had ever been, the balance of political power still lay with local elites. Likewise, the overwhelmingly largest part of trade and manufacture was locally consumed. Indeed, this ongoing political and economic localism helps to explain the striking vitality of small and medium-sized towns in France in the first part of the sixteenth century. In this period of the Renaissance, the monarchy was nevertheless more powerful than it had ever been. The expanding capacity of the state was facilitated by a surge of economic expansion which promoted a growing economic interdependence between different parts of the kingdom at the higher levels of trade and exchange. One of the two focal points of this economic expansion – second only to Lyons in importance – was Paris. Taking advantage of its strategic location between Mediterranean and Atlantic and its growing importance as the political capital of the kingdom, the growth of the capital was a reflection of the economic dynamism and political integration of sixteenth-century France as a whole.

Paris was by far the largest city in France in the sixteenth century.

In the 1560s, as we have seen, many initiatives were taken to try to reverse the onset of economic crisis. Indeed, the initial crisis of the early 1560s was followed by a partial recovery. It is only from 1575 to 1580 that one sees the full onslaught of economic depression. By then there is no question that the combination of the ravages of war, the burden of heavy taxation, the decline in population, and the lowering of profit margins was responsible for a serious economic regression. Le Roy Ladurie characterizes the period of the religious wars as a crisis of the second degree. By crisis of the second degree, he means one that was more serious than an ordinary cyclical downturn, but less severe than the total collapse of the fourteenth and fifteenth centuries. No doubt the difficulties of these concluding years of the sixteenth century were somewhat less serious than the catastrophic decline of the late middle ages, a crisis of the first magnitude. Still, there is little question that we are dealing with a severe economic setback.

WAR AND ECONOMIC DECLINE

One of the most serious aspects of this economic regression was the migration of skilled craftsmen, merchants and small-scale manufacturers out of the kingdom. The value of fixed capital in early modern industry was generally negligible.

Bernard Palissy is the hero of the final chapter of The Conquest of Poverty: The Calvinist Revolt in Sixteenth Century France which I published in 1986. In that book I represented Palissy as an isolated figure who, while appalled by the tragedy of the onset of civil war, was nevertheless unique in his understanding of the economic and social problems which had helped to provoke the crisis. While retreating into a religious vision in the face of an increasingly uncertain future, Palissy nevertheless singled out the agrarian problem as a key to France's troubles. Under-investment in agriculture, responsible for the grain shortages and the high cost of food, was at the heart of the difficulties which were exacerbating the political and religious crisis into which France had fallen.

I portrayed Palissy as more or less a lone voice and saw his proposed remedy of an agrarian capitalism as Utopian in the French context. As I depicted it, the ongoing strength of seigneurialism and the absorption of the middle class into the ranks of the notables of the expanding state, foreclosed the possibility of a capitalist breakthrough in agriculture and a resolution of France's economic problems.

At a certain level there continues to be a certain truth to this view of France in the ancien régime.

The economic and political crisis into which the French kingdom was plunged in the 1560s spurred technological innovation and economic rationalization. Schemes and proposals to produce more food or to conserve or develop sources of energy were put forward. All kinds of machines and inventions were designed with the intention of producing manufactures which were cheaper and therefore potentially more profitable. A fascination with machinery became pervasive. An inventor came forward to offer the city of Rouen an underground diving bell of his own devising to repair a recently collapsed bridge. The Hermeticist bishop François Foix de Candale spent his leisure contriving all sorts of mechanical devices including wheels, levers and pulleys, clocks and measuring instruments. A mock castle with ninety-nine mechanical artifices toured the kingdom, its mechanically operated cannon, jousting knights, water fountains and windmill astounding the population. The mathematician Henri de Monantheuil, viewing this spectacle, took it as a portent of more important things to come. The monarchy, although hamstrung by its own insolvency and distracted by the civil wars, tried as best it could to encourage such initiatives.

Qualifications and lineages

What were the qualifications of physicians in ancient China? Who judged them? Were they unique to medicine? Few records survive from the centuries in which medicine emerged from the domain of the hereditary artisan to become a cumulative tradition, with its doctrines, not merely its techniques, transmitted in books. This process hardly began earlier than the unification of China in 221 BC, and was not fully accomplished before the first century. I will begin with two sources, one from the second century BC and one from perhaps a century later, that throw light on what made a doctor.

The first is a long memorial in the biography of Ch'un-yü I in the first of the Standard Histories, Memoirs of the Grand Historian (c. 100 BC). Ch'un-yü was descended from a noble family of presentday Shan-tung province that claimed to have held its fief for a millennium. He was Director of Granaries for the state of Ch'i. This position, if typical, was not a career but a sinecure passed down in his family. Fond of medicine in his youth, in 180 he began three years of study that made him the successor of an eminent doctor of his own village. He wandered from one court to another doctoring aristocrats and their women ‘rather than treating his home as a home’ as people of good family were expected to do. The historian makes the point that ‘in some cases he did not treat people's medical disorders, which aroused resentment in many sick people’.

The field of ‘Traditional Chinese Medicine’ which caused such a stir in Western public health circles in the 1960s and ‘70s, and on which a few anthropologists and historians have commented since then, came into existence in its current institutional form only after the 1949 revolution that founded the People's Republic of China. In the 1950s, within the newly organized or expanded colleges, research institutes, publishing houses, and professional associations, a rationalized ‘traditional’ medicine came into being as a discrete ‘system of knowledge’. This essay emphasizes both the modernity and the historical continuities of systematic Chinese medical knowledge by examining a genre of autobiographical writing that emerged in the 1980s after the close of the Great Proletarian Cultural Revolution (1966–76). It sees writing medical knowledge and medical lives as a form of social labour that both modernizes and stubbornly resists full appropriation to either global bioscience or state development projects.

The practitioners and cadres who organized the profession of traditional Chinese medicine after Mao Zedong's 1955 proclamation that ‘our motherland's medicine is a great treasurehouse’ worked largely anonymously. Though they authored medical books and papers in technical journals, taught a great many students, and served on countless committees, their fame was largely propagated orally. It was politically inappropriate at the time to claim personal authority or draw attention to one's authorship. The masses were taken to be both the source and target of traditional medicine's genius.

At the close of the Great Proletarian Cultural Revolution, after the death of Mao and the fall of the Gang of Four in 1976, this professional culture of selfless service suddenly changed.

Our approach in this volume is both epistemological and comparative. We are raising two types of questions. Since we are historians working on textual sources written in different languages, we are first of all engaging in comparisons, and raising questions about the validity of a comparative approach to classical medicine: ‘What are the relevant intellectual parallels and the possible historical connections between, for example, Āyurvedic medicine in India and Galenism in the West?’ This contribution to the debate is based on the historical evidence we have of extensive intellectual exchanges between India and the West in the first centuries of the common era. Although the detailed evidence must be kept in the background, the following pages will expose two features that relate Āyurveda with Galenism. The first section, which deals with stylistic and rhetorical features of medical Sanskrit texts, will describe an Indian version of scholasticism, comparable on many points with medical Galenism. Another feature common to both scholarly traditions is humoralism. But a comparative study of the humoral theory is dependent upon a second type of question that bears upon the ways knowledge is established and put into practice: ‘What are the criteria for regarding a given aetiology, diagnosis, or prognosis as valid in Āyurvedic medicine, or any other scholarly tradition for that matter, and, in therapeutics, what are the criteria for efficacy?’ I shall first address the question of knowledge and experience in the context of a classical tradition, emphasizing the role of language. Then, pursuing one concrete example, the aetiology and therapeutics of epilepsy, I expound some key concepts of Āyurveda that revolve around the themes of rationality, truth and efficacy.

Like all history, this paper is fiction. It is not a lie, it is an honest account of things the author has seen. In the act of seeing, each seer creates an image; in the act of telling, each teller creates a story. As stories go, this is a bad one, being static and having no characters in it. The badness of this story is not my fault, it is the fault of the things I must look at (some texts) and the conventions I must follow (some rules) which preclude my making a really good story to put in this edited volume.

There were two main texts I looked at when I first composed my bad story. The first was a book by Paul Unschuld called Medicine in China. I employed it because I am ignorant of China and Unschuld's book was the most comprehensive scholarly work on the history of Chinese medicine accessible to me at the time. The second was a Master's thesis written some time ago by a graduate student in Chicago. I was that graduate student and therefore I know most of what is worth knowing about her. I know nothing about Paul Unschuld, and I hope he will forgive me for setting his book on a par with my first effort at interpreting Indian medicine.

These two texts – one and two decades old, respectively – remain the basis of my story. Any reader who would dismiss them as dated had better stop here, for we are talking in terms of millennia. Objections concerning interpretive styles, social and linguistic theories, and choice of translations may also be raised.

Over the past few years, historians of Greek philosophy have become increasingly aware of the importance of the Greek medical tradition for the understanding of ancient philosophy. Of course, the voluminous medical literature of late antiquity, from Galen on, has long been recognized as invaluable as a second-hand source of information regarding the doctrines of philosophers, most notably those from the early Stoa, which have otherwise perished in the wreckage of history. But more recently scholars have turned to the medical writings as sources for philosophy in their own right. They have come to see the great epistemological debates that formed the core of Hellenistic philosophy as being prosecuted just as vigorously in the medical schools as in the groves of Academe. That debate is the principal focus of this paper: but it is worth first briefly sketching the long history of Greek philosophical medicine.

Among the earliest Presocratics, Alcmaeon of Croton (fl. c. 575 BC) was a man of both medical and philosophical interests, giving an account of the physiology of perception, and of concept-formation. A century later, Empedocles combined a reputation for abstract physical speculation with a certain réclame as a medical man, and he too was interested in cognition and perception. Equally, several early Hippocratic texts deal with philosophical questions concerning the nature of knowledge and explanation. Later doctors of importance to the development of philosophical methodology include Herophilus and Erasistratus (fl. c. 260 BC), Asclepiades of Bithynia (fl. c. 120 BC), and Galen.

But perhaps the strongest and most durable connections are those which developed between Empiricist medical epistemology and Scepticism.

In Jumādā II 441/November 1049, the Nestorian Christian physician al-Mukhtār ibn Buṭlān (d. after 455/1063) arrived in Cairo from Baghdad. Shortly thereafter, he sent an essay on a scientific topic to cAlī ibn Riḍwān (d. 460/1067–8), chief physician to the Fāṭimid caliph al-Mustansir (r. 427–87/1036–94), and invited him to comment. Ibn Riḍwān's response was two withering public critiques full of ad hominem invective (only one of these now survives), and quite predictably they provoked an equally abusive reply from Ibn Buṭlān. Ibn Riḍwān then countered with five further missives: a follow-up critique in reference to the issues already raised in the debate, a more general open letter to ‘the physicians of old and new Cairo’ in which he poured scorn and abuse on his adversary with even greater violence, and three other now-lost essays bearing titles suggesting the continuation of similar diatribes against his adversary. Ibn Buṭlān eventually left Cairo defeated and humiliated, but some time after his departure from Egypt he returned to the fray with a last shot of his own entitled Waqcat al-aṭibbā' (‘Battle of the Physicians’). This work too is lost.

This controversy was long remembered in medical and scientific circles, and the ten essays comprising its literary side were evidently in widespread circulation in later times. In 1937, the German orientalists Joseph Schacht and Max Meyerhof published the five extant works as ‘a contribution to the history of Greek learning among the Arabs’. The essays have been widely read ever since; and indeed, among historians of Islamic science and medicine the Ibn Riḍwān/Ibn Buṭlān polemic has become one of the best-known episodes in the field.

We used to imagine all of Āyurveda as a ‘system’, and now that the formalism, coherence, and synchronicity of a system do not seem to map well on to medical knowledge and practice in situ, we isolate that which appears most structured and coherent as the epistemology of the thing and trace it backwards and forwards to give ourselves back time. As in the work of the French sociologist of India Louis Dumont, structure here requires a residuum, a category of that which does not fit into the beautiful passivity of the object of inquiry.