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In the early 1900s, some students in Ontario, Canada, attended school on railroad cars that traveled to them every month.
In the early 1900s, some students in Ontario, Canada, attended school on railroad cars that traveled to them every month.
Narrated by Highlights for Children
Ruth Tenzer FeldmanUnabridged — 6 minutes
Narrated by Highlights for Children
Ruth Tenzer FeldmanUnabridged — 6 minutes
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In the early 1900s, some students in Ontario, Canada, attended school on railroad cars that traveled to them every month.
Lei’s book is full of sophisticated analyses, cogent arguments, and illuminating insights. The brilliant use of the diary of Nationalist officials to be read alongside official documents and media reports opens up a window on private perceptions of largely public events.
"Neither Donkey nor Horse is intensely argued and contains a great wealth of materials and information. It offers both a panoramic view and strong theses. Its analysis is sharp and stimulating. Although Lei is theory-minded, his prose is clear and accessible. The book is easily the best scholarly work on the history of Chinese medicine of the Republican period. It will be essential reading for anyone interested in the history of modern Chinese medicine and indeed should be an important reference for students of the history of Republican China."
"Going beyond the simplistic polarities of modern versus traditional, or biomedical science versus traditional Chinese medical knowledge, Lei claims that Chinese medicine practitioners, struggling in the field of the state, were the agents of a profound transformation of Chinese medicine, creating a mongrel medicine that may or may not be able to reproduce itself in the future. By discussing the development of bilateral and organic relations between the state and medicine, Lei has vividly described the reassembling of Chinese medicine as a part of the realisation of China’s own version of modernity. The great contemporary relevance of this book lies in pointing out diverse aspects of the ideas and phenomena that we have often taken for granted as being homogeneous, such as modernity and science."
"Whereas previous studies have tended to shy away from delving directly into the encounter between Chinese-style and Western-style medicine, this book represents the most innovative and magisterial treatment to date of the transformation of Chinese medicine in the first half of the twentieth century."
"Neither Donkey nor Horse is an important book for the global community of traditional medicines. It deserves to be accompanied by countless more scholarly works about coevolution and adaptation by traditional medicine. this book is an important read for all types of medicine practitioners. Everyone will find something of interest regarding research design, policy development, healthcare administration, medical education, professional organization, or infectious disease control and response. These areas are as relevant today as they were a century ago. As new global health issues, such as the outbreak of the Zika and the Ebola viruses, emerge and require continued adaptation of healthcare policy and research methods, the lessons revealed in this story will no doubt continue to be essential."
In this insightful and provocative book, Lei shows us what it meant to practice ‘modern’ medicine in Mao Zedong’s semicolonial and semifeudal society. Drawing on rich historical sources, Neither Donkey nor Horse reveals that modern medicine will always be mongrel medicine. Importantly, Lei gives us the critical postcolonial genealogy for ‘Traditional Chinese Medicine,’ the epitome of Chinese modernity, now a global phenomenon.
Neither Donkey nor Horse is a major work by the leading scholar in the field of modern Chinese medical history. Lei argues that what we now know as traditional Chinese medicine as it emerged as a discourse in the early twentieth century was fundamentally shaped by the encounter with Western medicine and the relationship with the state that this dictated. Chinese medicine was something new that was created during this period in response to themes with Western biomedicine as traditional practitioners sought social mobility through participation in the state. Lei’s argument is backed up by research of the highest standard: his knowledge of the historical sources is outstanding, and he is impressively familiar with the secondary and theoretical literature in both English and Chinese. His book will be of interest not only to historians of Republican China but also to those interested in the history of science more widely.
Neither Donkey nor Horse is a tour de force of how both Western and Chinese medicine played central roles not only in Chinese modernity but also the formation of the state in Republican China. Lei thus adroitly relates the politics of medicine and debates over making Chinese medicine more scientific to the big themes of nationalism, the state, and modernity that dominated the political struggles of early twentieth-century China.
Reaching far beyond the history of modern China, Neither Donkey nor Horse challenges conventional understanding of modernity, science, and state power through an intellectual and social history of medical debate and development in East Asia from the late nineteenth century forward. This is a thoughtful and meticulously researched investigation of transnational modernizing processes in the twentieth century as they touched down and transformed worlds in China. The book demonstrates that medical knowledge and practice, whether ‘modern’ or ‘traditional,’ historicized or fixed as policy, are nowhere innocent of politics, culture, and social hierarchy. It offers surprising historical lessons for everyone interested in science and local knowledge, socialism and capitalism, institutions and ideas about nature as they weave together in modern regimes of health and population governance.
If you are going to read just one book on the modern history of Chinese medicine, this is the work to read. Lei’s analysis of the entwinement of medicine, science, modernity, and the state is brilliantly original and persuasive, and argued with admirable clarity. Neither Donkey nor Horse is a major contribution to science studies and the history of global health, as well as to the study of twentieth-century China.
"In conceptualizing how the insights of critical interdisciplines—postcolonial studies or science studies—might be incorporated into the field of Asian history, two possible scenarios come to mind: in one, critical vocabularies are selectively adopted but the overall enterprise remains unmoved; in another, the foundational issues at stake in the interdiscipline become themselves the subject of the Asia historian, thus transforming the questions that are asked and the way research is carried out. It is the latter approach that Lei brilliantly demonstrates in Neither Donkey Nor Horse."
"Neither Donkey Nor Horse is a tremendous accomplishment that marks Lei as a leading historian of Chinese medicine and a major thinker in acience and technology studies. With this book, Lei has set a conceptual framework that will shape all future work on the subject."
"This book is equally about the surprising and dynamic history of Chinese medicine, Western medicine, and the modern Chinese state, and it deserves the careful attention of historians of China and state-building as much as historians of medicine and science. . . . Lei's intervention provides the most sophisticated and clear explanation yet of the issues involved."
"It is difficult to overestimate the value of this book. Empirically rich and theoretically sophisticated, it presents the most comprehensive analysis to date of medical developments in twentieth-century China. This book delights at every turn; every chapter uses exhaustive research to build a sophisticated argument. It will be duly recognized as a masterpiece."
"Neither Donkey Nor Horse is thoroughly engaging, theoretically informed, and impeccably researched. This complex story, though acknowledging the intricacies and vagaries of history, does not get bogged down in its own detail. Instead, Lei’s skillful narrative hand remains positioned above the fray, ready to guide the reader across thematic and temporal divides. It is a fascinating story, and one that will do much to advance the field of medical history in the non-West."
"Lei provides an extremely useful method for thinking about and constructing research on Chinese modernity, one that has engaged, on a very deep level, the critical frameworks developed by science and technology studies and, to some extent, postcolonial thought. From Lei’s example, we learn that the most productive way of approaching twentieth century China is to think relationally, looking not at dichotomies of modernity and tradition but, rather, at the new hybrid species that their relationships produce."
"Lei provides an extremely useful method for thinking about and constructing research on Chinese modernity, one that has engaged, on a very deep level, the critical frameworks developed by science and technology studies and, to some extent, postcolonial thought. From Lei’s example, we learn that the most productive way of approaching twentieth century China is to think relationally, looking not at dichotomies of modernity and tradition but, rather, at the new hybrid species that their relationships produce."
"This book is equally about the surprising and dynamic history of Chinese medicine, Western medicine, and the modern Chinese state, and it deserves the careful attention of historians of China and state-building as much as historians of medicine and science. . . . Lei's intervention provides the most sophisticated and clear explanation yet of the issues involved."
"Neither donkey nor horse is thoroughly engaging, theoretically informed, and impeccably researched. This complex story, though acknowledging the intricacies and vagaries of history, does not get bogged down in its own detail. Instead, Lei’s skillful narrative hand remains positioned above the fray, ready to guide the reader across thematic and temporal divides. It is a fascinating story, and one that will do much to advance the field of medical history in the non-West."
| BN ID: | 2940170217250 |
|---|---|
| Publisher: | Boyds Mills Press |
| Publication date: | 11/01/2018 |
| Series: | Read With Highlights |
| Edition description: | Unabridged |
| Age Range: | 10 - 13 Years |
Introduction
During the last months of his life, Sun Yat-sen (1866–1925), the founding father of the Republic of China and a practitioner of Western medicine, was forced to take a personal stand on the issue of traditional Chinese medicine. Faced with the possibility of losing his life to liver cancer, his deliberation on and ultimate acceptance of treatment with Chinese medicine became a highly symbolic event, followed with great interest by countless observers from early January to his death on March 12, 1925. If Sun had refused to accept Chinese medicine even in this most vulnerable and hopeless situation, his decision would have been interpreted as a testimony to his steadfast belief in modernity, which he personified. According to the account provided by Lu Xun (1881–1936), one of the fathers of modern Chinese literature and once a student of biomedicine himself, the dying Sun in the end reasoned this way: "While some Chinese drugs might be effective, knowledge of a [biomedical] diagnosis is lacking [in Chinese medicine]. How can one take drugs without a trust-worthy diagnosis? There is no need to take them." After hearing that Sun had consistently refused to take Chinese medicine (which turned out not to be true in the end), Lu could not contain his feelings and stated that Sun's decision "moved me so much that it is no less [important] than his life-long commitment to revolution." As revealed by Lu's comment, to many of Sun's comrades and progressive intellectuals of the times, the very act of taking Chinese drugs amounted to a public betrayal of the notion of modernity.
An equally symbolic event, albeit with totally different meanings, took place at the same Hospital of Peking Union Medical College nearly half a century later. In 1971, the New York Times journalist James Reston (1909–95), who had traveled to China as part of an advance team before President Nixon's historic visit, underwent an emergency appendectomy there. As ordered by Premier Zhou Enlai (1898–1976), a team of leading medical specialists cooperated in the management of his case. The surgery went well, but Reston suffered serious postsurgical pain. After that pain was alleviated with acupuncture, he published a report in the Times on both his personal experience and his observations of the effectiveness of acupuncture on other patients. For many Westerners, this was the first time they had heard about acupuncture. Reston's groundbreaking report was later credited for "help[ing to] open the doors in this country [United States] to an exploration of alternative medicine." Reston was keenly aware of the historical irony of the event he had helped to create. The hospital where he had received surgery had been established by the Rockefeller Foundation in 1916 to serve as an elite model to instill "the scientific spirit" in Chinese minds, but Reston's report noted that "like everything else in China these days, it is on its way toward some different combination of the very old and very new." While Chinese medicine had been seen as the antithesis of modernity at Sun's deathbed, fifty years later, in the same hospital, it had become a message to the world that China had developed a very different kind of medicine and, by implication, a very different kind of modernity.
Progressive intellectuals in the early twentieth century would undoubtedly have found it appalling that the view of Chinese medicine had been transformed in these fifty years from a burdensome tradition into an inspiration for the acceptance of alternative medicine around the world. They would have been even more puzzled had they known that during the same period China had dramatically increased access to modern health-care services for its citizens. By the time that Reston published his report, China had developed a primary health-care system that, in "achieving 90% coverage of a vast population, was the envy of the world," according to Dr. Margaret Chan, director-general of the World Health Organization. Thus it was precisely in the process of the global expansion of modern (i.e., "Western") medicine into China that traditional Chinese medicine went through its historic transformation. Against the background of this surprising and puzzling history, I attempt in this book to answer an apparently simple question: How was Chinese medicine transformed from the antithesis of modernity to one of the most potent symbols for China's exploration of its own modernity?
When Chinese Medicine Encountered the State
It is a great irony that the turning point in the modern history of Chinese medicine was an event that was meant to put an end to it. In 1928, amid civil war, social unrest, and foreign occupation, the Nationalist Party (guomindang, also known as KMT) finally ended the political chaos of the Warlord period (1916–28) and formed a new government for China. Even though the Nationalist Party controlled only certain regions of the country, the regime nevertheless dedicated itself to the project of state building, establishing the Ministry of Health in the new capital of Nanjing. With the exception of the Song dynasty (960–1279), this was the first time that China had a national administrative center to take charge of all issues related to health care. In the next year, the first National Conference on Public Health, which was dominated by practitioners of Western medicine, unanimously passed a proposal to abolish the practice of Chinese medicine. To the great surprise of almost everyone concerned, this resolution mobilized the previously unorganized practitioners of Chinese medicine into a massive National Medicine Movement (guoyi yundong), formally instigating a decade-long collective struggle between the two factions of medical practitioners.
Half a century later, the widely respected pioneer of public health in China, Chen Zhiqian (also known as C. C. Chen, 1903–2000), reflected on this historical confrontation as follows:
In the 1920s, modern physicians, including Chinese nationals, inadvertently delayed the diffusion of scientific medicine, probably by many decades, through their demands for the abolition of traditional medicine. Fear generated by their actions caused a powerful coterie of traditional scholar-physicians in the cities to organize for collective action and to seek the intervention of high officials on their behalf. Respected by officials and the public alike, the scholar-physicians were able not only to defend what they already had but even to expand their influence. More than fifty years later, the two systems of medicine stood on equal footing in China, each with its own schools, treatment facilities, and highly placed friends in the bureaucracy.
In short, from the viewpoint of biomedical practitioners such as C. C. Chen, an unforgivable miscalculation was made in proposing to abolish Chinese medicine in the spring of 1929. This miscalculation not only delayed the "diffusion" of Western medicine by decades, but it also gave birth to what we now know as a bifurcated medical field in China.
Presupposing the global diffusion of scientific medicine, Chen assumed that what he had witnessed in the 1920s was just a "delay," a local suspension of the necessary triumph of biomedicine and of the unavoidable extinction of an indigenous medical tradition. Although Chen made the comment on this event quoted above in the late 1980s, like so many others among China's modernizers, he still regarded the ultimate replacement of local medical traditions by scientific biomedicine as merely a matter of time. Nevertheless, the practice of traditional Chinese medicine is today legalized by the governments on both sides of the Taiwan Strait and has gradually spread into virtually all other parts of the world. The World Health Organization considers Chinese medicine a seminal field in the area of alternative and complementary medicine, and it is increasingly accepted into mainstream health-care services in nations around the world. Instead of treating this history as simply an unfortunate delay or transition stage in the inevitable progression toward scientific medicine, I intend to examine the modern history of Chinese medicine as an essential part of the Chinese exploration of modernity. For this purpose, the following pages explore the events through which traditional Chinese medicine crossed the threshold to modernity—politically, institutionally, and epistemologically. As I explain below, this was also the point in time (as noted in the heading for this section) when Chinese medicine encountered the state.
First of all, my subject matter is traditionally considered to have been shaped by a cultural confrontation between two knowledge systems: scientific Western medicine and premodern Chinese medicine. This confrontation is generally taken as an unavoidable local event in the global spread of modern science and technology around the world. Nevertheless, by the 1920s practitioners of the two styles of medicine had already coexisted for decades in China without directly competing against each other. I argue, therefore, that the struggle between these two medical factions would never have taken place, or at least would have taken a very different form, if the state had not intervened to abolish the practice of Chinese medicine in the late 1920s. In this sense, the historic confrontation did not take place directly between the two styles of medicine but between Chinese medicine and the modernizing Chinese state.
Second, the two historic events that took place in 1929—the declaration of the government's intention to abolish Chinese medicine and the rise of the National Medicine Movement—fundamentally transformed the logic of competition between Chinese and Western medicine in China. Instead of competing for individual patients, as they might have done before these events, practitioners of the two styles of medicine now occupied themselves with competing for alliance with the state. More importantly, these historic events provoked traditional practitioners to pursue actively and collectively the series of professional interests, institutional infrastructure, and governmental recognition that the state had just started to grant to Western medicine. In order to pursue the interests created and offered by the state, practitioners and advocates of Chinese medicine dedicated themselves to reforming Chinese medicine, thereby adapting it to the modernizing agenda of the state. To highlight their new vision, practitioners of Chinese medicine decided to call their style of medicine "national medicine" (guoyi). This name illustrates how the proponents of Chinese medicine, when forced to cope with the threat from the state, responded by striving to link the future of their profession closely to that of the state.
Third, I demonstrate that the 1929 confrontation also constituted an epistemological event for the remaking of traditional Chinese medicine. In addition to coping with the political challenges posed by the arrival of biomedical knowledge, Chinese medicine was confronted with epistemic violence when its leaders started to embrace what I characterize as discourses of modernity and committed themselves to reforming Chinese medicine on the basis of these discourses. Because these globally circulated discourses were designed to demarcate a divide between the modern and the premodern, reform-minded traditional practitioners encountered critical challenges in their efforts to reform Chinese medicine on the basis of these new conditions of knowledge. As their endeavors radically transformed the theories, practices, pedagogy, and social network of Chinese medicine, they paved the way for the full-scale creation of the standardized, textbook-based system of Traditional Chinese Medicine (TCM) that emerged in Communist China in the mid-1950s. In this sense, the creation of modern Chinese medicine began at the moment when Chinese medicine of the 1920s encountered the state.
Beyond the Dual History of Tradition and Modernity
With a few notable exceptions, the majority of scholarly works on the history of medicine during the Republican period (1911–49) can be sharply divided into two largely independent categories: histories of biomedicine in China and histories of traditional Chinese medicine. Although no scholar has ever stated this explicitly, and most scholars might not be fully conscious of this fact, the rigorous divide between these two types of histories implies that Chinese medicine was of little relevance to the development of modern health care in China. It is certainly true that historians have been keen to document how modern institutions, values, and knowledge influenced the trajectory of Chinese medicine on many fronts. Much less, however, is known about how the advocates and practitioners of traditional medicine influenced either the introduction of Western medicine into China or the construction of public health and medical administration. Clearly, the historiography of medicine has reproduced a binary opposition between tradition and modernity, thereby preventing us from viewing Chinese medicine as a constitutive part of China's medical modernity.
This division of intellectual labor is a great pity, because what has made Chinese medicine unique is precisely its contested and ambiguous relationship with China's modernity. As Benjamin Elman concludes in his monumental study on science in China, among all the scientific fields of study in Imperial China, Chinese medicine was the only traditional discipline that "survive[d] the impact of modern science between 1850 and 1920." The word survive serves as a reminder that the arrival of modern science and biomedicine in China, as in almost every other part of the non-Western world, often meant the mass marginalization—if not extinction—of traditional knowledge. No matter how hard historians of modern science have striven to go beyond the linear, teleological framework of the Enlightenment, they almost inevitably end up with the familiar story that traditional practices were pushed to the periphery, if not replaced completely by modern science. Against the unfortunate fate of either extinction or marginalization that has been common to almost all traditional practices around the globe, Chinese medicine stands out as a unique case that not only survived the attack of science and modernity but also flourished and became accepted into state-sanctioned public knowledge.
Unfortunately, many people continue to view Chinese medicine as a "survivor" or remnant of premodern China. Although scholars like Elman have been careful to emphasize that the entity that survived the attack of science is "a modernized version of Chinese medicine," people often assume without much reflection that Chinese medicine has survived as an anachronism in the fragmentary enclaves of a modernized China. If we view the modern history of Chinese medicine merely as a history of the endeavor to preserve and even "modernize" Chinese medicine—done only for the sake of Chinese medicine itself and relevant only in such enclaves—this history would not have much to do with the development of modern mainstream health care in China. Conversely, if the contested history of Chinese medicine is purged from the history of medicine proper, the resultant "history of modern medicine in China" looks conveniently close to what medical historian Warwick Anderson has criticized as "local variations of a master narrative called 'the development of modern medicine.'" As Anderson points out, such a historiography of medicine merely reflects and reinscribes the general idea that the modern history of China, just like that of many other non-Western nations, "tends to become variations on a master narrative that could be called 'the history of Europe.'" That is, it suggests that every major aspect of modernity developed first in Europe and then everywhere else.
If we recognize that the modern history of Chinese medicine is an integral part of China's history of modern health care, this history will have the potential to challenge the above-mentioned Eurocentrism and historicism that Dipesh Chakrabarty criticizes in his influential book Provincializing Europe: Postcolonial Thought and Historical Difference. Although I emphasize this critical potential of the history of Chinese medicine, I certainly do not mean to romanticize the "surviving tradition" of Chinese medicine as a radical alternative to biomedicine. The romanticization of Chinese medicine presupposes, and thereby reinforces, a clear-cut separation between the modern history of traditional Chinese medicine and that of biomedicine in China—the former being what survives of a traditional discipline and the latter being an importation to China from modern Europe. I argue that neither of these two characterizations is historically true. As scholars, we must therefore go beyond the conventional framework that treats this complex and interwoven history as two separate historical processes: the survival of traditional medicine on the one hand and the development of biomedicine on the other.
Excerpted from Neither Donkey nor Horse: Medicine in the Struggle over China's Modernity by Sean Hsiang-lin Lei. Copyright © 2014 The University of Chicago. Excerpted by permission of The University of Chicago Press.
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