Over the past decade, there has been a pronounced interest among historians and anthropologists in the psy-complex in China. While many writings have touched upon insanity during the Republican period, a systematic examination of this important topic has unfortunately been missing. Emily Baum, associate professor of history at the University of California, Irvine, recently accomplished this overdue task with her book The Invention of Madness: State, Society, and the Insane in Modern China.

Baum's book draws on three major intellectual sources. First, without denying madness as a real corporeal condition, Baum borrows insights from medical anthropology to investigate how such conditions were conceptualized, treated and regulated in highly diverse ways. From this perspective, madness was not natural but historically invented. Second, drawing on critical scholarship on madness as represented by Foucault's writings, Baum examines the growth of psychiatry not as primarily resulting from its intrinsic scientific value or demonstrated clinical efficacy, but more due to conducive historical circumstances. Having rejected a linear tale of scientific progress toward modernity, third, Baum applies postcolonial thinking to demonstrate that China's psychiatric modernization had its own logic and contingency, so that where it differed from the Western template should not be interpreted as deficiency. Guided by these three intellectual sources, Baum seeks to establish a genealogy of madness in China's path to modernity.

Baum opens chapter one by discussing the conceptualization of madness in late imperial China. Instead of seeing madness as a discrete biological condition, Chinese understood it to be a result of various mental, physiological, environmental and supernatural influences. Corresponding to this heterogeneous aetiology, the treatment of madness did not fall in the territory of a single profession, and instead called for efforts as diverse as from literati physicians, herbalists, shamans, faith healers and fortune-tellers. The mentally afflicted individuals faced lax regulation from the state bureaucracy as they were typically taken care of by families and local communities.

Chapter two enters the first two decades of the 20th century, when the Qing government gave way to the Republican regime. Government officials and foreign medical professionals found a common ground of adopting scientific treatment of madness as a step toward modernity. The resultant asylum, however, was administered by the police system to pre-emptively institutionalize unstable individuals who had not necessarily broken the law. Thus, the police applied the madness label to a wide range of individuals deemed socially deviant, such as vagrants, sojourners and religious zealots. In other words, the asylum served the maintenance of public order more than mental rehabilitation. If this chapter appears to emphasize a top-down process in which state power intruded into individual lives, chapter three provides an antidote by revealing the other side of the story: poor urban families actively sent their mentally troubled members to municipal services in order to rid themselves of the financial, practical and emotional burdens. Re-joining the expanding police system, families and neighbourhoods in the low class broadened the scope of madness.

Chapter four takes an excursion from the previous story that intertwines the state, police and family to enter a narrative of professional entrepreneurism during the 1920s and the 1930s. The “psychiatric entrepreneurs” adopted Western-style advertisements to promote among wealthy elites, petty urbanites and the intelligentsia the use of private hospitals and proprietary medicines to treat mental problems. As illustrated in the case of neurasthenia, these psychiatric entrepreneurs shrewdly sold a new image of mental illness to exclusively manifest among cultured elites. Thus, to a certain degree, advertisements divorced mental problems from the stigma of social deviance and rendered them something more culturally acceptable. While this chapter makes highly captivating arguments about the commodification of mental illness as a social identity, it does leave readers to wonder how the commercially produced new image of mental illness intersected with the ascending scientific sensibility among the elites – an issue the author provides occasional hints but could further elaborate on.

Chapter five traces the growth of neuropsychiatry between 1928 and 1935, attributing it to the alliance between the Rockefeller Foundation-sponsored Peking Union Medical College, which sought official endorsement, and the Nationalist government, which attempted to alleviate financial burden and to boost its political legitimacy with a scientific aura. If neuropsychiatry expanded the notion of “madness” to “mental illness,” the mental hygiene movement, which is discussed in chapter six, furthered this trend and brought the prevention of mental illness to the national agenda. The difference is that while neuropsychiatry confined mental illness to the biomedical sphere, the mental hygiene movement tied individual mental health to the country's salvation, reflecting an explicit political concern shared by the state and Right-wing intellectuals. Guided by the goal of nation-building, the mental hygiene movement frequently pathologized disobedient citizens and displayed eugenic thinking.

To close the book, Baum returns in the final chapter to the postcolonial question of how the Chinese and the Western conceptions of mental illness converged. Her answer lies in four vignettes: practitioners of Chinese medicine reconciled the biomedical “brain” with the Chinese “heart” as the locus of the mind; Chinese translators invoked indigenous theories to make sense of foreign psychiatric neologisms; ordinary Chinese experimented with biomedical approaches without forsaking their views of mental illness; and neuropsychiatry gradually adopted the Chinese holistic notion of mental illness as a condition simultaneously involving the mind, the body and the environment.

Throughout the book, Baum examines how various actors – the state bureaucracy, the Western-trained psychiatrists, the “psychiatric entrepreneurs,” the families of the mentally troubled individuals, and so on – applied various worldviews and strategies to achieve a diverse array of needs. At various historical locales, madness became stigmatized, naturalized, commodified and regulated under the influences of intersecting medical, political, moral and commercial forces. Gradually, madness reached a broader scope, acquired new meanings and entered the purview of the state and the psychiatric profession. Baum locates her studies primarily in Beijing but nimbly expands to the whole country as well as intellectual exchanges on the international stage. This methodological decision is well coordinated with her objective: using psychiatric modernity as a lens to illuminate China's modernization as a whole. Overall, Baum's book is highly informative, intriguing and elegantly written, deserving attention from all historians and social scientists who study relevant topics.