EPILOGUE: FLUID MATTER(S)

Epilogue: Fluid Matter(s)

Shigehisa Kuriyama

The concept of ‘matter’ was originally inspired by a sense of the solid and enduring. Before it was taken up by philosophers, the Greek term hylē referred to wood—the stuff from which hard objects like tables and benches are made: the substance of lasting things.

Painted version of wood grain photograph

By contrast, the word ‘fluid’ derives from the Latin fluere, ‘to flow’. Since antiquity, flowing streams have been associated with ceaseless change. ‘Everything flows’ was how Heraclitus summed up the radical mutability of the world. ‘You can never step in the same river twice.’

The phrase ‘fluid matter’ thus verges on paradox, yoking together intuitions that pull in opposite directions. But this paradox neatly mirrors the duality of our embodied selves.

At the same time that we each have a sense of an enduring ‘I’, a persisting personal core, we observe this ‘I’ in ceaseless flux, continually changing its outer appearance and inner states, constantly fluctuating between pleasures and pains, ever drifting from mood to mood.

Once upon a time—and indeed, until at least well into the nineteenth century—much of this flux was explained by fluids: by fluids streaming into the body or out of the body; by fluids rising or falling, flooding or trickling; by fluids stagnating, sloshing or putrefying; by ingested liquids altering bodily fluids. Once upon a time, fluids and their flows lay at the heart of the imagination of life. In both Europe and Asia, fluids mattered.

Tradtional Chinese scholar with red face

Tradtional Chinese scholar with pale face

But no longer—at least, not nearly as much.

Although fluid flows still form part of our present accounts of human beings, their interest to doctors now is but a pale shadow of the constant, obsessive attentions that they commanded before. To most of us today, the preoccupations detailed in this volume—all the past worries about accumulating bile, sluggish phlegm or blocked qi, all the past exhortations to let blood or to open pores—seem not just mistaken, but profoundly alien. We can scarcely make sense of them.

To be sure, fluid matters still rule the contemporary theory and practice of Āyurvedic, Chinese and other traditional medicines—as the essays by Brooks, Fijn, and Köhle remind us. But it is precisely this persisting emphasis on fluids and flows that accounts, in large part, for why these medicines are now dubbed ‘traditional’ and are marginalised as odd vestiges.

Eighteenth century image of a woman being bloodlet

A monochrome, blurred version of the same bloodletting scene

What happened? How did we become so alienated from intuitions that were broadly shared (albeit with diverse local variations) across the Eurasian continent for over two thousand years? How did most of the medical past come to seem so strange and exotic? It is a compelling enigma—arguably, one of the deepest and most fundamental puzzles in the history of medicine. And it has yet to be solved.

Indeed, the puzzle has scarcely even been noticed, for the decline of the intense past preoccupation with fluid matters has gone hand in hand with a remarkable amnesia. The how and why and meaning of the decline have not been seriously queried, because the intensity and substance of these past preoccupations have largely faded from memory. After all, in the absence of awareness of how much flows once mattered, there is no reason to wonder at their current insignificance.

We hope that this collection will stimulate efforts to recall this forgotten past. We need many more studies of fluid matters. We still need to inquire more broadly into fluid traditions in history, and to understand more deeply why intuitions of flow seemed so vital and absorbing to so many for so long. Conversely, we also need to inquire more seriously into the peculiarity of our own present isolation, and to meditate on why the imagination of flows no longer seems so essential to the imagination of life—why the present feels so different from the past.

In the meantime, we hope that the volume will also inspire more active exploration of possible futures, more experiments with digital texts. Will the academic articles of the near future look something like one of these essays? Will there even be a single future for digital texts in the way that the printed page long defined a recognisable single past? One might question whether a feel for fluid bodies will ever again be part of medicine. But, in an age of digital reading, there seems little doubt that some form of fluid texts will be integral to the future of narrative.

IMAGE CREDITS

Listed in the order in which they first appear in the essay.

Wood texture lines. Taken from Libreshot. Public domain. Modified by author.

Heart clipart. Taken from Pixabay. Reproduced under Pixabay License.

Ming dynasty scholar. From Twenty-Five Bust Portraits of Famous Scholars (Ming dynasty). Metropolitan Museum of Art. Reproduced under a Creative Commons Universal Public Domain Dedication (CC0 1.0).

Bloodletting scene. Nicolas Gerard, the Younger, Les remèdes à tous maux, seventh century. Taken from the National Library of Medicine. Reproduced under a Creative Commons Universal Public Domain Dedication (CC0 1.0). Modified by author.

iPad photo and video. Shigehisa Kuriyama, 2020. Public Domain Dedication (CC0 1.0).

Woman vomiting. Isaac Cruickshank, A Woman Holding her Stomach and Vomiting into a Bucket after Self-Administering an Emetic, 1800. Wellcome Collection. Reproduced under a Creative Commons Attribution Share Alike International (CC BY-SA 4.0).