18 Chapters
Medium 9780253014856

Conclusions: The History of Medicine in Twentieth-Century China

Bridie Andrews Indiana University Press ePub

AT THE START of this project, we knew we were attempting something unusual in scholarly terms, for at least three reasons. Firstly, we asked historians who were specialized in one half of the twentieth century—either before or after the foundation of the Peoples’ Republic of China in 1949—to consider their topics across the “long” twentieth century. We were interested to see the contours of continuity and change over the longer time frame in order to avoid the teleologies of any one political regime. Secondly, we asked scholars from different scholarly communities to collaborate, so that our synthetic project would make visible the importance of different national and cultural perspectives on the interpretation of medical history. Fortunately, the last few decades of relative open exchange between China and the West means that we were able to call on experts based in China, Hong Kong SAR, Singapore, Taiwan/Republic of China, Britain, Canada, Australia, and the United States. Lastly, we decided not to limit ourselves to the development of “modern” medicine in China, even though that was the original remit of the China Medical Board. The engagement of the state with Chinese medicine was most pronounced during the Maoist era (1949–1976), but the whole history of modern medicine in China has been framed by the contrast and competition with indigenous medicine. We felt that any survey of medicine in twentieth-century China needed to take this encounter into account.

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16 The Evolution of the Hospital in Twentieth-Century China

Bridie Andrews Indiana University Press ePub

IN 2010 CHINESE hospitals consumed 76 percent of national health spending, whereas in the United States 31 percent was spent on hospitals and in Australia, 33 percent. The first port of call for most Chinese patients is a hospital outpatient department staffed by specialists, while for 80 percent of Americans and Australians it is a general practice physician. The hospital is so dominant an institution in the Chinese health care system that 90 percent of all in- and outpatient services in the country occur in one—a remarkable feat for an introduced institution with no indigenous counterpart.

Like a successfully introduced plant species, the hospital found its niche in nineteenth-century China and was well-established by the turn of the century. As dramatic changes in the political, economic, medical, and social environment have played out over the past hundred years, the institution has proved remarkably adaptable. It has both outperformed and crowded out potential competitors.

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6 Schistosomiasis

Bridie Andrews Indiana University Press ePub

Farewell to the God of Plague

Mao Zedong

While reading the June 30th edition of the People’s Daily, I found that Yujiang County has rid itself of schistosoma. With my mind racing, I could not sleep. A light breeze brought its warmth, as the rising sun approached my window. Looking at the southern sky in the distance, I happily set my pen to paper.

I.

II.

Crystal-clear water

And emerald hills

Are many,

But of what use?

So many poplars and willows

Dangle in the spring wind.

The people of China

Number six hundred million,

Even Hua Tuo, the legend,

Was helpless

Before this little bug.

Each one as great as Shun or Yao.

Under our command,

Red rain flows like waves,

In thousands of villages

Bursting with weeds,

Men are dying.

Whirling in the wind.

With great effort, we can turn

Green mountains

Tens of thousands of homes

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7 Tuberculosis Control in Shanghai: Bringing Health to the Masses, 1928–Present

Bridie Andrews Indiana University Press ePub

TUBERCULOSIS (TB) WAS one of the most widespread and deadly diseases in China in the early part of the twentieth century. The Chinese people had a saying about turning pale at mention of the disease, which they believed killed nine out of ten of its victims. This may have been an exaggeration; however, in the first half of the twentieth century, China’s TB mortality rates were much higher than those in Europe, North America, and other Asian nations. Throughout the century, scientific discovery advanced TB control efforts worldwide, but given China’s massive population, developing a system to bring scientific advances to the wide population presented a special challenge. In Shanghai, the speed of the city’s urbanization, and the resulting size and heterogeneity of the population, amplified these challenges.

This chapter examines eighty-five years of efforts to control TB by connecting the population to the health and public health system in China’s largest city. The chapter is based upon archival documents and interviews with providers and recipients of health care. The archival documents include clinic reports and numerous documents from government archives such as the Shanghai Municipal Archives (SMA). Interviewees included thirty-five providers of health care, including six retired doctors who attended medical school in the 1950s, and fifty-three recipients of health care, including forty-five TB patients at a municipal-level facility. Health care providers were identified through snowball sampling and care recipients were identified through respondent-driven sampling.

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14 A Case Study of Transnational Flows of Chinese Medical Professionals: China Medical Board and Rockefeller Foundation Fellows

Bridie Andrews Indiana University Press ePub

COMPELLING QUESTIONS ABOUT human health have motivated the transnational flow of physicians for millennia. Egypt was seen as the font of medical knowledge by the Greeks, Persians, and Turkic kingdoms from the thirteenth century BCE to the Roman era. Egyptian physicians were dispatched to the ancient courts of Europe and the Middle East while medical writers plumbed ancient Egyptian texts for knowledge of ancient Egyptian pharmaceutical formulas. In the first millennium AD, Arabic physicians first retrieved and then reinterpreted the classical Greek medical traditions of Hippocrates and Galen. In Asia, trade routes between the Middle East, the Indian subcontinent, and China facilitated the flows of medical practitioners and ideas from west to east and east to west. In her book Needles, Herbs, Gods, and Ghosts: China, Healing, and the West to 1848, Linda Barnes (2000) details the multiple Chinese influences on European medicine in the early modern era. During the sixteenth and seventeenth centuries the Jesuits included medicine in the intellectual repertoire they brought to the late Ming and early Qing courts.

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