In Prescribing Colonization, Michael Shiyung Liu makes a significant contribution to recent scholarship on colonial medicine. Liu combines equally strong narrative and quantitative analysis to examine Japanese colonial medical practice, the Taiwanese experience in the international diffusion of medical knowledge, and the factors influencing the adoption and implementation of Japanese colonial medical policies in Taiwan. By reassessing the history of Japanese colonial medicine in Taiwan, he complicates the views that it is best understood as a tool of empire or as scientific modernization. Instead, he demonstrates that colonial medical practices and policies in Taiwan evolved from a combination of events, policies, and historical contingencies. His interpretation questions how Japanese colonial medicine shaped and was shaped by its Taiwanese environments. By extension, Liu highlights the commonalities and divergences between the experiences of Japanese colonial medicine and Western colonial medicine, positioning the work as a contribution to the fields of Japanese colonialism and Taiwan history, while challenging scholarship on Western colonial medicine to consider alternative models.
The introduction presents a discussion of definitions and a useful literature review in order to discuss medical westernization in Japan, review colonial medical practice in Taiwan, and test current interpretations. Liu questions the assumptions about the nature of colonial medicine that have arisen with the primacy of the British India paradigm. Japanese colonial medicine in Taiwan, he posits, presents a stage to examine an alternative model based on the transformation of German Staatsmedizin (state medicine), as it was first adopted and adapted in Japan and then adapted again in Taiwan.
Chapter 1 explores medical westernization in Japan, with particular focus on the influence of Bismarck's Germany and the Japanese interest in Staatsmedizin, which promoted the State as primarily responsible for protecting public health and also having the right to actively regulate hygiene and sanitation to improve the public good. Meiji officials also adopted the German emphasis on the study of bacteriology and the implementation of social hygiene. German influence, however, forms only part of the story. Liu also demonstrates how Japanese social practices mitigated the evolution of German ideas in Japan; in particular, he points out that the influence of Meiji elites and traditional medicine resulted in the Japanese experience diverging from the German.
In Chapter 2, Liu explains how, in a time when talented personnel and resources were in short supply, capable and talented Japanese officials transported and further adapted German Staatsmedizin to Taiwan. He gives particular credit to Gotô Shinpei, appointed head of civilian affairs in Taiwan in 1897, and Takagi Tomoe, the man Gotô invited to implement his vision of Staatsmedizin in Taiwan. Gotô, by virtue of his family's low samurai status, could never become part of the medical elite in Japan. Had he not been recognized as a talented administrator during the Sino-Japanese War and sent to Taiwan, his vision of state medicine would not have had a venue. Moreover, due to frictions between the two leading medical research institutes in Japan, Gotô successfully wooed top-tier medical researchers like Takagi to Taiwan. These two key personnel in colonial medicine in Taiwan, then, came to Taiwan due to historical contingencies, rather than by state design or central policy.
Chapters 3 and 4 continue the story of contingency and particularities and show how the system that Gotô and Takagi put in place further evolved in ways that mirrored the Japanese experience yet met the needs of the indigenous Taiwanese population. The 1920s and 1930s, for instance, saw Japanese colonial medicine advance far beyond Gotô's original intent of benefitting the colonizers, as programs moved to the rural areas. The success of the anti-malarial programs and efforts to wipe out epidemics of cholera and plague convinced Taiwanese of the value of modern medicine. In addition, the large numbers of clinical Taiwanese doctors and relatively small number of Taiwanese research doctors reflected the racial hierarchy of Japanese colonial medicine in Taiwan, as laboratory medicine continued to have primacy over clinical medicine in Japan. Nonetheless, clinical medicine allowed the Taiwanese elite a valuable place in Japanese colonial medicine and colonial society. More important, the cooperation, compromise, and real improvements in public health in Taiwan made it a model of Japanese colonial medicine when Japan looked to further expand its empire.
While Liu himself recognizes that he is not making an entirely new argument, he does broaden our understanding of Staatsmedizin in Japan, its adaption to its first colony, and the growth of modern medicine in Taiwan. Moreover, Liu synthesizes an impressive array of primary and secondary materials in Chinese, Japanese, English, and German. He succeeds in questioning dominant paradigms, in inserting the importance of individuals and place in the development of centralized policies, and in establishing the significance of the interface between colonizers and colonized in how those policies impacted local society and public health.
