Thinking differently with Chinese medicine: ‘Explanations’ and case studies for a postcolonial STS

In Mandarin, the English word ‘nature’ translates as ‘ziran’ (自然zìrán) in science, biomedicine and everyday life. At the same time, ziran indexes a second older set of meanings that make little immediate sense in English. Current in many Chinese medical practices as well as in classical Chinese philosophy, these include ‘what is spontaneously so’ or ‘let the character of the self unfold’. In this article we explore how these two families of meaning are related by particular Taiwanese Chinese medical practitioners as they describe how they negotiate the relations between biomedicine and Chinese medicine in daily professional practice. At the same time, inspired by related logic-shifting writing in anthropology, postcolonial studies and postcolonial STS, we draw on the ‘art of patterning’ (辨證 biàn zhèng) to understand how ziran-nature relations are specified in those accounts. Patterning is the art of specifying the shifting arrangements and misalignments that lead to ill health. Treating this as a way of thinking about ziran-related overlaps between biomedicine and Chinese medicine, we show that patterning attends not to objects ‘out there’ but to appearances (象xiang, xiàng). Put into use as an STS term of art it therefore shifts the epistemological basis of inquiry because case-stories no longer reveal underlying mechanisms, but instead narrate patterned appearances. One implication of this is that any particular pattern diagnosis lies alongside a galaxy of alternatives that might be equally good to think with. Within the limits set by referential academic conventions, we thus attempt a postcolonial shi (勢)-inflected STS in this paper by resisting the use of a single analytical framework, instead setting different forms of patterning alongside one another.