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In 1739 China’s emperor authorized the publication of a medical text that included images of children with smallpox to aid in the diagnosis and treatment of the disease. Those images made their way to Europe, where they were interpreted as indicative of the ill health and medical backwardness of the Chinese. In the mid-nineteenth century, the celebrated Cantonese painter Lam Qua collaborated with the American medical missionary Peter Parker in the creation of portraits of Chinese patients with disfiguring pathologies, rendered both before and after surgery. Europeans saw those portraits as evidence of Western medical prowess. Within China, the visual idiom that the paintings established influenced the development of medical photography. In The Afterlife of Images, Ari Larissa Heinrich investigates the creation and circulation of Western medical discourses that linked ideas about disease to Chinese identity beginning in the eighteenth century.Combining literary studies, the history of science, and visual culture studies, Heinrich analyzes the rhetoric and iconography through which medical missionaries transmitted to the West an image of China as “sick” or “diseased.” He also examines the absorption of that image back into China through missionary activity, through the earliest translations of Western medical texts into Chinese, and even through the literature of Chinese nationalism. Heinrich argues that over time “scientific” Western representations of the Chinese body and culture accumulated a host of secondary meanings, taking on an afterlife with lasting consequences for conceptions of Chinese identity in China and beyond its borders.
In "The Afterlife of Images", Larissa N. Heinrich “traces the development and origins of the medical rhetoric and iconography that linked Chinese identity with bodily pathology at the onset of modernity” (pg. 4). This serves to trace the origin of the Sick Man of Asia trope. Heinrich does this through a series of case studies, including an examination of the Western imagination linking China with smallpox, the paintings of Lam Qua and their use in spreading missionary goals and Western medicine, the role of photography in cementing China as a place of disease, and the discourse of creating a Chinese body based on Western medicine rather than traditional Chinese understandings of the body. Regarding historiography, Heinrich draws extensively upon the work of Shigehisa Kuriyama in the final chapter. The “afterlife” of which Heinrich writes describes the impact of the images on cultural imaginings of China.Describing the linkage between China and smallpox, Heinrich writes, “Narratives of disease could be said to exist in a coaxial relationship to narratives of national identity, complicated by both the colonial imperatives that shaped relations between China and the West at this time and the highly contextual scientific functions that emerged to describe and to determine these relationships” (pg. 16). The images reinforced Western missionaries’ beliefs in their cultural supremacy while simultaneously serving as justification for imperial activities in the context of civilizing missions to a people characterized by “a lack of modernity” (pg. 16). Examining the joint Peter Parker/Lam Qua paintings, Heinrich writes, “Unlike the smallpox images of more than half a century earlier, [these] functioned explicitly to link notions of pathology with ideas about Chinese identity” (pg. 42). Discussing the cultural ramifications of Lam Qua’s paintings and Peter Parker’s descriptions of the subjects, Heinrich writes, “If one keeps in mind that the hospital performed most of the surgeries before the introduction of ether-based anesthesia to China (by Parker) in 1847, it becomes clear that Parker’s journals again and again reveal his fixation with, and awe of, what he perceived as a peculiarly Chinese ability to cope with extreme pain” (pg. 60). This echoes other imperial observations used to justify barbaric treatment, such as Europeans’ belief that Africans had a higher tolerance to pain. (A belief that Julie Livingston described in "Improvising Medicine: An African Oncology Ward in an Emerging Cancer Epidemic" [Durham, NC: Duke University Press, 2012], pages 135-139. Much like the afterlife of images, Livingston describes how imperial descriptions of pain continue to shape Africans’ social practices in medicine.) Finally, Heinrich describes how “Parker’s reports repeatedly relate stories of frustrated attempts to ply his trade on obstinate Chinese patients whom he believes are more handicapped by cultural prohibitions against Western surgical procedures than by the tumors, goiters, and fractures that afflict them” (pg. 65), further linking Western medicine with a “civilizing” force. Heinrich argues that photography demonstrates “a clear transition from a more biographical or culturally descriptive mode of representing Chinese identity…to a more thoroughly racialized mode indicating a primarily metonymic relationship of disease to host” (pg. 76). Not only did the photographs further the generic link of disease to culture rather than describe individual cases, they also spread beyond the field of medicine with tourists collecting and exchanging them as exotic souvenirs. Beyond their souvenir value, Heinrich argues “that inevitably still there was another protogenre at play by the time of early medical photography in China: the erotic” (pg. 102). The posing of the models coupled with the collecting and exchange of the photographs represented a fetishization of the Chinese as exotic through medical/scientific definitions of their otherness. In the final chapter, Heinrich draws extensively upon Kuriyama’s work to examine how the Chinese adoption of Western ideas of the body shaped the national conception of that body, even in literature. Though Heinrich works with case studies, these studies do demonstrate how, in certain cases, notions of China and of disease became linked in the Western imagination.
