REVIEWS
“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.”
— Henrietta Harrison, University of Oxford
“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.”
— Judith Farquhar, University of Chicago
“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.”
— Warwick Anderson, University of Sydney
“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.”
— Marta Hanson, Johns Hopkins University
“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.”
— Shigehisa Kuriyama, Harvard University
"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."
— Chinese Literature and Culture
"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."
— Studies in History and Philosophy of Science
"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."
— Social History of Medicine
"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."
— East Asian Science, Technology and Society
"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."
— Bulletin of the History of Medicine
"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."
— Meridians
"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."
— Journal of the History of Medicine
"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."
— Medical History
"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."
— Frontiers of History in China
“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.”
— Studies in History and Philosophy of Biological and Biomedical Sciences
TABLE OF CONTENTS
Chapter 1. Introduction - Sean Hsiang-lin Lei
DOI: 10.7208/chicago/9780226169910.003.0001
[Chinese Medicine, modernity, Western medicine, nationalist state, China’s modernity, mongrel medicine, hybridity]
Chapter 1 introduces the central puzzle of the book: How was Chinese medicine transformed from an antithesis of modernity in the early twentieth century into a potent symbol for China’s exploration of its own modernity half a century later? To answer this question, this book strives to go beyond the conventional framework of dual history, that is, a clear-cut separation between the modern history of Chinese medicine and that of Western medicine in China. Far from being a “remnant” of pre-modern China, Chinese medicine co-evolved with Western medicine and the Nationalist state, undergoing a profound transformation that qualified it to be recognized as modern Chinese Medicine. While this newly created modern Chinese medicine was stigmatized by its opponents as a mongrel form of medicine that was “neither donkey nor horse” it helped to shape the notion of modernity that came to be historically realized in China, that is, China’s modernity. (pages 1 - 20)
This chapter is available at:
https://academic.oup.com/chica...
When Chinese Medicine Encountered the State
Beyond the Dual History of Tradition and Modernity
Toward a Coevolutionary History
China’s Modernity
The Discourse of Modernity
Neither Donkey nor Horse
Conventions
Sovereignty and the Microscope: - Sean Hsiang-lin Lei
DOI: 10.7208/chicago/9780226169910.003.0002
[pneumonic plague, Manchurian Plague, Wu Liande, Lien-teh Wu, laboratory revolution in medicine, germ theory, Manchuria, Infectious disease, public health, sovereignty]
Chapter 2 addresses one question: why did four relatively independent developments of concern in this book—China’s increasing exposure to Western medicine, the greater control of epidemic diseases, the state’s responsibility for public health, and the gradual acknowledgement of Chinese medicine’s inferiority—have to wait for the Manchurian plague (1910-1911) to reach their points of departure all at once? By way of assimilating this local history, especially the role played by its hero Wu Liande, into the global history of “laboratory revolution in medicine,” this chapter documents the formation of the alliance between the state and Western medicine since this plague. Along with the geopolitical context of this form of pneumonic plague, its specific characteristics played a crucial role in creating this watershed event. As its containment involved the institutionalization of a new category of disease—chuanranbing (infectious disease)—by the state, it irreversibly made the Chinese state the subject of the history of Western medicine in China. (pages 21 - 44)
This chapter is available at:
https://academic.oup.com/chica...
Not Believing That “This Plague Could Be Infectious”
Pneumonic Plague versus Bubonic Plague
“The Most Brutal Policies Seen in Four Thousand Years”
Challenges from Chinese Medicine: Hong Kong versus Manchuria
Chuanran: Extending a Network of Infected Individuals
Avoiding Epidemics
Joining the Global Surveillance System
Conclusion: The Social Characteristics of the Manchurian Plague
Chapter 3. Connecting Medicine with the State: From Missionary Medicine to Public Health, 1860–1928 - Sean Hsiang-lin Lei
DOI: 10.7208/chicago/9780226169910.003.0003
[missionary medicine, China Medical Board, John B. Grant, public health, Rockefeller Foundation, National Medical Association of China, Ministry of Health, state]
Chapter 3 explores how the Chinese state, unconcerned with medical matters until the outbreak of the Manchurian plague, metamorphosed in only twenty-five years into a government that built a Ministry of Heath in 1927. The answer is related to the fact that what represented Western medicine in China shifted radically from foreign medical missionaries and their surgical practice to the Chinese practitioners of Western medicine and their public health measures. In an attempt to connect Western medicine with the state, the advocates of Western medicine made the construction of public health an integral part of the Nationalist’s state-building efforts. As a result of their efforts and the crucial support thereof by John B. Grant, the Rockefeller Foundation changed it policy from not involving itself with China’s public health construction (1914) to becoming the driving force for establishing China’s first Ministry of Health. (pages 45 - 68)
This chapter is available at:
https://academic.oup.com/chica...
Missionary Medicine
Western Medicine in Late Qing China versus Meiji Japan
The First Generation of Chinese Practitioners of Western Medicine
Western Medicine as a Public Enterprise
“Public Health: Time Not Ripe for Large Work,” 1914–24
The Ministry of Health and the Medical Obligations of Modern Government, 1926–27
Conclusion
Chapter 4. Imagining the Relationship between Chinese Medicine and Western Medicine, 1890–1928 - Sean Hsiang-lin Lei
DOI: 10.7208/chicago/9780226169910.003.0004
[Yu Yan, Tang Zonghai, K. K. Chen, Zhnag Taiyan, Yu Jianquan, qi-transformation, meridian channels, ephedrine, Chinese drugs, ontology]
Chapter 4 discusses how Chinese people imagined the relationship between Chinese medicine and Western medicine, and traces how this conception evolved, from the popular idea of “converging Chinese and Western medicine” championed by Tang Zonghai in the 1890s to the emergence of a radically different modernist discourse advocated by Yu Yan in the late 1910s. Based on a globally circulated discourse of modernity, Yu Yan partitioned Chinese medicine into three distinctive categories: theory, Chinese drugs, and experience. On the one hand, this tripartite characterization encouraged the abandonment of what many then considered the erroneous theories of Chinese medicine; on the other hand, with the help of the internationally renowned research on ephedrine at PUMC, it helped to generate a national consensus on the study of Chinese drugs. Until the eve of the 1929 confrontation, practitioners of Chinese medicine had managed to resist this modernist discourse, which effectively denied the possibility of the co-existence between two medical traditions. (pages 69 - 96)
This chapter is available at:
https://academic.oup.com/chica...
Converging Chinese and Western Medicine in the Late 1890s
Non-Identity between the Meridian Channels and the Blood Vessels
Yu Yan and the Tripartition of Chinese Medicine
To Avoid the Place of Confrontation
Ephedrine and Scientific Research on Nationally Produced Drugs
Inventing an Empirical Tradition of Chinese Medicine
Conclusion
The Chinese Medical Revolution - Sean Hsiang-lin Lei
DOI: 10.7208/chicago/9780226169910.003.0005
[Yu Yan, Tan Yankai, Chinese Medical Revolution, National Medicine, school of Chinese medicine, state, abolishing Chinese medicine, National Goods]
Chapter 5 documents the key historic events that led to the rise of the National Medicine Movement. In March 1929, the National Board of Health unanimously passed a resolution to abolish the practice of traditional Chinese medicine. In response, proponents of Chinese medicine held a massive public demonstration in Shanghai and, for the first time ever, organized themselves into a national federation. This mobilization gave birth to the National Medicine Movement, effectively starting what would become a decade-long collective struggle between two styles of medicine. Instead of resisting the state, however, the proponents of this movement developed the vision of a “national medicine” and actively struggled to create a closer alliance between Chinese medicine and the Nationalist state. As they fought for the new professional interests that had been created and sanctioned by the state, this Movement was dedicated to pursuing upward mobility for practitioners of Chinese medicine by way of the state. (pages 97 - 120)
This chapter is available at:
https://academic.oup.com/chica...
Controversy over Legalizing Schools of Chinese Medicine
Abolishing Chinese Medicine: The Proposal of 1929
The March Seventeenth Demonstration
The Ambivalent Meaning of Guoyi
The Delegation to Nanjing
Envisioning National Medicine
Conclusion
Visualizing Health Care in 1930s Shanghai - Sean Hsiang-lin Lei
DOI: 10.7208/chicago/9780226169910.003.0006
[Pang Jingzhou, Ding Ganren, Shanghai, Institute of National Medicine, acupuncture, school of Chinese medicine, religion, Neo-Confucian Medicine, Western medicine in China]
Instead of treating “Chinese medicine” and “Western medicine” as well-established distinct groups, Chapter 6 argues that these two styles of medicine took shape only gradually as they competed with each other vis-a-vis the state. To support this argument, this chapter explores a fascinating diagram of the healthcare landscape in 1930’s Shanghai that was created in 1933 by Pang Jingzhou, a vocal critic of Chinese medicine. By way of discussing more than forty items listed in this diagram, Chapter 6 shows both the remarkable heterogeneity within these two styles of medicine, and the complicated inter-group dynamics among them. As this diagram includes folk medicine and religious practices, it furthermore shows how modern Chinese medicine purged itself of these healthcare practices and thereby re-emerged as a national entity from this historic confrontation. (pages 121 - 140)
This chapter is available at:
https://academic.oup.com/chica...
Reading a Chart of the Medical Environment in Shanghai
Western Medicine: Consolidation and Boundary-Drawing
Chinese Medicine: Fragmentation and Disintegration
Systematizing Chinese Medicine
Conclusion
Chapter 7. Science as a Verb: Scientizing Chinese Medicine and the Rise of Mongrel Medicine - Sean Hsiang-lin Lei
DOI: 10.7208/chicago/9780226169910.003.0007
[National Medicine, scientization, Mongrel Medicine, hybridity, Lu Yuanlei, China Scientization Movement, Chen Guofu, Chen Lifu, modernity, converging Chinese and Western medicine]
Based on the discovery that it was the Nationalist state that popularized the project of “scientizing Chinese medicine” by establishing the Institute of National Medicine in 1931, Chapter 7 analyzes two related developments. First, as an ideological tool, this project allowed Chen Guofu and Chen Lifu to reconcile the conflict between scientism and cultural nationalism for the Nationalist party. Second, as a vision for medical syncretism, it represented a decisive break from the pre-modern conception of “converging Chinese and Western medicine.” Because this project required traditional practitioners to take science seriously, it gave birth to a new and hybrid medicine, which came to be stigmatized by its opponents as a “mongrel medicine.” To document the emergence of this new medicine, this chapter examines how this project of “scientizing Chinese medicine” motivated, gave shape to, and at the same denied the possibility of such a species of “mongrel medicine.” (pages 141 - 166)
This chapter is available at:
https://academic.oup.com/chica...
The Institute of National Medicine
The China Scientization Movement
The Polemic of Scientizing Chinese Medicine: Three Positions
Embracing Scientization and Abandoning Qi-Transformation
Rejecting Scientization
Reassembling Chinese Medicine: Acupuncture and Zhuyou Exorcism
The Challenge of “Mongrel Medicine”
Conclusion
The Germ Theory and the Prehistory of “Pattern Differentiation and Treatment Determination” - Sean Hsiang-lin Lei
DOI: 10.7208/chicago/9780226169910.003.0008
[germ theory, Cold Damage, Warm Disease, scientizing Chinese medicine, infectious disease, pattern, TCM, pattern differentiation and treatment determination, ontological conception of disease, Japanese style of Chinese Medicine]
Chapter 8 examines the crucial debate on “the Unification of Nomenclature of Chinese Diseases,” the first and most important step in the efforts by the Institute of National Medicine to scientize Chinese medicine. The key issues of this debate were whether or not to assimilate the germ theory and the related ontological conception of disease into Chinese medical theory, and second, what the proper categorical relationship should look like between infectious diseases as defined by the germ theory and the two major traditional Chinese disease categories of Cold Damage and Warm Disease? Despite the fact that this debate failed to reach a consensus, the official category of notifiable infectious disease was incorporated into the organizing principles of disease classification in Chinese medicine. Drawing on the Japanese style of Chinese Medicine, practitioners of Chinese medicine developed the incipient form of what later became the defining feature of so-called “Traditional Chinese Medicine” (TCM), namely “pattern differentiation and treatment determination.” (pages 167 - 192)
This chapter is available at:
https://academic.oup.com/chica...
Do You Recognize the Existence of Infectious Diseases?
Notifiable Infectious Disease
Unifying Nosological Nomenclature and Translating Typhoid Fever
Incorporating the Germ Theory into Chinese Medicine
Pattern versus Disease
A Prehistory of “Pattern Differentiation and Treatment Determination”
Conclusion
Research Design as Political Strategy: - Sean Hsiang-lin Lei
DOI: 10.7208/chicago/9780226169910.003.0009
[scientific research on nationally produced drugs, changshan, Dichroa root, Chinese drug, malaria, research design, Great Divide, research protocol]
Chapter 9 focuses on the discovery of an anti-malarial drug from the Chinese herb changshan (Dichroa root) in the 1940s. While this research was celebrated as the second most important achievement for the popular program of “scientific research on nationally produced drugs” during the Republican period, it constitutes a salient anomaly for this program. It was only because participating researchers violated some key procedures in their research protocol that they were able to demonstrate the anti-malarial efficacy of changshan as quickly and efficiently as they did. By highlighting the crucial—but so far neglected—role of research design in shaping the modern history of Chinese medicine, the case of changshan reveals the political role played by this research program in re-inscribing and negotiating in practice the modernist Great Divide between Chinese medicine and Western medicine/science. To highlight the theoretical implications of this case study, this chapter carries the thematic title “Research Design as Political Strategy.” (pages 193 - 222)
This chapter is available at:
https://academic.oup.com/chica...
Changshan as a Research Anomaly
Scientific Research on Nationally Produced Drugs
Stage One: Overcoming the Barrier to Entry
Curing Mrs. Chu
Stage Two: Re-networking Changshan
Identifying Changshan
Two Research Protocols: 1–2–3–4–5 versus 5–4–3–2–1
Reverse-Order Protocol: 5–4–3–2–1
Research Protocol as Political Strategy
Conclusion: The Politics of Knowledge and the Regime of Value
Chapter 10. State Medicine for Rural China, 1929–49 - Sean Hsiang-lin Lei
DOI: 10.7208/chicago/9780226169910.003.0010
[State Medicine, rural China, Rural Reconstruction Movement, China Medical Association, Nationalist State, Chinese Communist Party, Chinese medicine, China’s Health Problem]
The alliance between the state and Western medicine culminated when the Nationalist government included in its first constitution of 1947 a commitment to the policy of State Medicine, a healthcare system through which the state guaranteed all Chinese citizens equal and free access to healthcare services. Specifically, I explore why the Nationalist government came to accept this daunting responsibility of providing State Medicine in the early 1940s. The key to this question lies in the emergence of rural China as the crucial arena for the political struggle between the Nationalist and Communist Parties in the 1930s. In their attempt to address this seemingly impossible task of providing modern healthcare to China’s rural residents, various historical actors—the Rural Reconstruction Movement, the China Medical Association, the Nationalist government, and the advocates of Chinese medicine—all arrived at the conclusion that State Medicine represented the only solution to China’s Health Problem. (pages 223 - 258)
This chapter is available at:
https://academic.oup.com/chica...
Defining China’s Medical Problem
Discovering Rural China
The Ding County Model of Community Medicine
State Medicine and the Chinese Medical Association
State Medicine and Local Self-Government
The Issue of Eliminating Village Health Workers
Chinese Medicine for Rural China
Chapter 11. Conclusion: Thinking with Modern Chinese Medicine - Sean Hsiang-lin Lei
DOI: 10.7208/chicago/9780226169910.003.0011
[Modern Chinese medicine, China’s modernity, Great Divide, Bruno Latour, science as modernity, state and medicine, hybridity]
To explore the general implications suggested by the early history of modern Chinese medicine presented in the previous chapters, Chapter 11 recasts these historical findings as a heuristic tool for reflecting on a series of ever-expanding issues: (1) the relationship between medicine and the state, (2) the (im)possibility of productive cross-breeding between Chinese medicine and biomedicine, (3) the notion of “China’s modernity,” and finally (4) the “Great Divide” between modern and pre-modern, as analyzed by Bruno Latour. Against the discourse of a “Great Divide,” this newly re-assembled modern Chinese medicine took the discourse of modernity (and related knowledge of biomedicine) seriously and yet managed to survived the resulting epistemic violence by way of negotiation and self-innovation. In this sense, the historic rise of this “neither donkey nor horse” medicine constitutes a local innovation of crucial importance for the notion of China’s modernity, challenging us to imagine different kinds of relationships between science and non-Western knowledge traditions. (pages 259 - 282)
This chapter is available at:
https://academic.oup.com/chica...
Medicine and the State
Creation of Values
Medicine and China’s Modernity: Nationalist versus Communist
Chinese Medicine and Science and Technology Studies
Acknowledgments
Notes
Index
