2012 New History
P. O. Box 1-44, Nankang, Taipei 11529, Taiwan, R. O. C.
02-2782-9555 # 226

“Even a Virtuous Hero Would Fall Short”:
The Development of Pediatrics and Its Status during
the Jin-Tang Period (265-907)

Chia-feng Chang

Department of History, National Taiwan University

This paper examines the establishment and development of pediatrics from the Jin to the Tang dynasties (265-907), focusing on contemporary attitude toward pediatrics and the hesitation of male medical experts to become pediatricians. Pediatrics was apparently a rising field in Chinese medicine during the Jin-Tang period. Although pediatricians still had to compete with gynecologists and obstetricians in serving their clients and offering pediatric advice, the Jin-Tang period witnessed an increase in pediatric texts, and experts and pediatricians started to assert an independent voice. During the Tang dynasty, pediatrics even became a required subject in official medical training.

However, in practice, the number of male pediatricians remained small. The reasons for this were multifold. First, medicine was regarded as less than a respectable occupation and faced fierce competition from witches and religious healers. Second, because children were “frail and feeble,” the success rate in pediatrics was believed to be comparatively low. It therefore was regarded a difficult field in which to seek fame and reward. Moreover, since taking care of children was traditionally regarded as women’s task, and its related medical knowledge and skills mostly passed down between female generations, male pediatricians had to recreate a new professional image and renegotiate the gender divide. Furthermore, the medical culture at the time was still androcentric and discriminated against the “stinking breast qi(ruqi xingsao) of new-born babies and “contaminated” mothers, elements that would compromise the “virtuous and heroic” (caoxing yingxong) male qualities associated with the profession.

These reasons, particular to the medieval China, in addition to such intrinsic difficulties of the field as the extra diagnostic skills needed for treating young patients incapable of articulating their symptoms, practioners’ reluctance to enter into the field. Despite the Tang government’s establishment of a pediatric division in medical training, pediatrics remained a marginal domain within the practice of medicine. It was against this professional environment that Sun Simiao called on medical practitioners to attend the beginning of life and to assist the mission of “cultivating the small/youth to accomplish the big/adult.” These various dimensions of medical culture informed the complex process of the formation of pediatrics as an independent field in medieval China. Yet this complexity must be recovered from extant medical writings, which often communicate only the “virtuous and heroic” male physicians’ viewpoint. In the end, the children’s own voices were not loud enough to make their way into the historical record.


Keywords: pediatrics, child, medicine, Sun Simiao, virtuous hero (caoxing yingxong), stinking breast qi (ruqi xingsao)