In this meticulously researched history of Chinese medicine in the Republican era, Sean Lei begins with two events that took place nearly 50 years apart at the Peking Union Medical College hospital. These events epitomize the remarkable shifts in attitudes about Chinese medicine from the Republican era to the early People's Republic. In 1925 as a patient at PUMC, Sun Yat-sen allegedly refused to be treated with Chinese medicine for his liver cancer. To modernizers like Lu Xun, Sun's rejection of Chinese medicine solidified a staunch belief in a modernity fundamentally based on Western biomedical sciences. In 1971, New York Times reporter James Reston received acupuncture treatment at the very same hospital. Reston introduced to the world a “very different kind of modernity,” an alternative medicine in which Chinese acupuncture was key (p. 2). To elucidate these historical changes in conceptions of health and modernity, Lei weaves a fascinating story of the interplay of Chinese medicine, Western biomedicine, and politics in Republican China. A “mongrel medicine” that was “neither donkey nor horse” in the 1920s, Chinese medicine became entirely modern and new under the PRC as it was translated into the language of biomedicine. Lei effectively argues that Chinese medicine transformed from a system of “unscientific” methods to sustain and improve health into a primary symbol of a new kind of modernity imbued with intonations of cultural pride. In this story, he deftly shows that Western and Chinese medicine, indeed all cultural constructs including tradition and modernity, are ever-changing. Medicine and ideas about health and illness forever affect and are affected by politics and culture.
Lei draws on secondary literature of medicine in China and has reformulated traditional arguments to create a groundbreaking work, a fresh and new way of looking at its history. This includes careful research on all the key players, including Yu Yan and brothers Chen Lifu and Chen Guofu. Lei has a deep understanding of the primary sources, tracing the writings as well as biographical data on their authors to bring life to the narrative. The overall story is likewise very thorough, offering a broad political and cultural context of the Republican and wartime eras; one of Lei's key arguments is that medicine cannot be studied in isolation. Also provided is a good general overview of Chinese medicine dating to the Song period.
This book's nine substantive chapters are roughly chronological, beginning with the 1910 Manchurian plague epidemic that introduced public health as a meaningful tool for sovereignty of the Qing state. Lei elucidates the changing conceptualization and categorization of infectious disease that led to far-reaching biomedical plague control measures like quarantine, a contradiction of the traditional Chinese practice of exodus from infected areas. He provides a beautiful interpretation of how missionary medicine contributed to the very structure of health care in China, a particular focus on individual curative medicine rather than on broader preventive public health measures that were standard in the German model of Meiji Japan. Only later, after the successful Manchurian plague control measures and a shift in emphasis from surgery to infectious disease control, did the Qing and later Republican states begin to utilize public health as an apparatus of modern governance.
Though politics is indelibly intertwined throughout, Lei shifts our attention away from political history to the broader struggle over medicine and Chinese modernity. A “scienticization” movement was a crucial part of the modernizing efforts of Chinese medicine physicians and supporters, as well as of the Kuomintang's broader goals, linking medical modernization with political modernization. The hegemony of germ theory had left Chinese medicine without appropriate “scientific” diagnostics, but Chinese medicine could offer effective treatment and materia medica. Acupuncture was reintroduced into the Chinese medical canon during this time, while exorcism was excluded because it lacked the language of biomedicine to support it. New acupuncture charts incorporated Western biomedical anatomy and physiology, providing a key example of medical syncretism. The anti-malarial drug changshan combined science with an economic argument and the cultural nationalism of supporting the production and purchase of local goods. Lei emphasizes a continuum of Chinese medicine post-1949, though he stresses that there was a much more dedicated institutionalization of Chinese medicine in the PRC than there had been under the Kuomintang.
Criticism of this marvelous book is difficult. However, a bibliography and Chinese glossary are notably absent. This is very much an intellectual and political history that will serve as a basis to ask questions about the patients of these practitioners, who are also missing from this story.
In conclusion, Lei shows us a Chinese medicine that was reassembled by the 1940s and included an appropriation of biomedical science. He calls into question the presumed inevitability of Western biomedicine dominating or eliminating traditional healing practices. Lei demonstrates how many different actors, practitioners and devotees of Western and Chinese medicine alike, and some who supported an intertwining of both, used ideas of nature and culture, modernity and nationalism to advance their goals. This book is an absolute necessity for anyone interested in the history of medicine, Republican and Kuomintang history, and science and technology studies.
