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I. A Face Withheld From the shadows of an undefined space, a room featureless in its darkness, a shrouded, semirecumbent figure reluctantly presents itself to the viewer (figure 1). The nineteenth-century Cantonese artist known to westerners as Lam Qua (Guan Qiaochang), who painted this portrait in the late 1830s, chose a restricted palette. It is a study in black, brown, and dull, mellow flesh tones. A dim source provides the bare minimum of light necessary to discern the flowing folds of the figure's dark, unstructured garment and one or two bricks (or perhaps pillows) for support. This is a medical illustration, putatively made to aid in the understanding of the patient's condition, portraying two arms (one horribly diseased, one normal) and an obstructed view of the patient's face. The distinctive visual economy of Lam Qua's composition invites the viewer to compare the arms, the normal and the pathological, but no other information, not even the sex of the patient, can be determined.1 The patient conceals his or her face with the good hand and arm, and the fingers splay from temple to temple across its features in a timeless gesture of grief and mortification. It may take several moments for the eye to orient itself, to be sure of what one is looking at, because the diseased hand scarcely looks like a hand at all. The growth takes on a life of its own. Fungoid, disklike protuberances give it a porcine appearance as if the patient held, improbable as it must seem, a pig-faced puppet. Then in the top far-left corner, one sees the trapped thumb and fingers, dangling like a helpless claw, crowded out by the tumor, establishing the basic visual sense of the painting. Perhaps the most extraordinary of a remarkable series of at least 114 paintings made between 1836 and 1852 in Lam Qua's studio, it depicts one of the Chinese patients of a leading medical missionary, Rev. Dr. Peter Parker, an American Presbyterian minister and physician.2 [End Page 134] In late 1835, Parker opened the Ophthalmic Hospital in Canton (Guangzhou). He soon acquired a reputation as a surgeon of such skill that his eye infirmary became a general hospital in which he treated thousands of cases. Arguing that medicine could be the "handmaid of religious truth," he offered free medical care as a way to bring the Chinese to God and held regular services in the hospital.3 Among the thousands of patients were a number afflicted with mature tumors (as much as thirty-five years old), which Parker had Lam Qua, who was trained in both Western and Chinese styles of painting and maintained a busy studio very close to Parker's hospital, paint in the days before photography.4 When viewed in the context of Parker's corresponding case notes, Lam Qua's paintings become even more complex images of cultural confluence and exchange, of East and West, Orient and Occident, portraiture and clinical documentation, Christian and heathen, rich and poor. In this essay, I will address the ways in which the clinical and aesthetic values of Lam Qua's paintings are intimately bound up in that confluence, in the fragmented histories of patients, a cross-cultural collaboration between a doctor and a painter, and a period of momentous political and medical change. Analysis of these images, when linked to Parker's case histories, reveals the collaboration and contestation of the Chinese and the American at a moment when notions of these terms were in embryonic stages of development. Lam Qua's portrait of a patient concealing her face stands as a rarity in the history of nineteenth-century painting and in the annals of medical representation. The conventions of modern clinical representation preserve anonymity by cropping the face or blacking out the eyes; here the patient obscures identity by withholding the gaze, the visage. Despite celebrated examples such as Rembrandt's Dr...
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