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12 The Institutionalization of Chinese Medicine

Bridie Andrews Indiana University Press ePub

THE COMMUNIST VICTORY in the Civil War of 1945–1949 and the proclamation of the People’s Republic in October 1949 did not augur well for the future of Chinese medicine as an independent medical tradition. Under the slogan “cooperation of Chinese and Western medicine” (zhongxiyi hezuo), the Communist Party (CCP) in Yan’an had utilized Chinese medicine to gain the support of the rural population and to meet health care needs in settings where Western drugs and technological resources were scarce. Ideologically, however, the party’s leadership was committed to establishing a health care system modeled on the West, particularly Russia, in which there was little room for a medicine considered to be a remnant of feudal society and its irrational superstitions. In Nationalist-controlled areas, meanwhile, the Chinese-medical infrastructure created during the 1920s and ’30s had been all but dismantled (Deng 1999, 176–191). And yet, less than ten years later a large-scale effort was underway to rebuild Chinese medicine as a modern tradition that would make a unique contribution to the health care of China and even the world. On October 11, 1958, Mao Zedong famously declared Chinese medicine to be “a great treasure-house” and demanded that its resources be forcefully developed. Another quarter of a century later, in 1982, the principle of “paying equal attention to Chinese and Western medicine” was enshrined in the PRC Constitution. Ever since, the country has enjoyed the fruits and problems of an officially plural health care system. (For foundational accounts of Chinese medicine in contemporary China, see Cai, Li, and Zhang 1999; Meng 1999; Taylor 2004; Wang and Cai 1999; Zhang 1994; Zhen and Fu 1991.)

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10 John B. Grant: Public Health and State Medicine

Bridie Andrews Indiana University Press ePub

JOHN B. GRANT (1890–1962) was the “spirit of public health” for modern China, said Franklin Ho (1895–1975) when he was interviewed by Mary Bullock on July 22, 1970 (Bullock 1980, 134n2). Ho, former director of the Nankai Institute of Economics, shared with Grant an interest in analyzing statistics and economics of public health.1 Ho’s view was further supported by those who worked with Grant at the Peking Union Medical College (PUMC). Marion Yang (1891–1983) recalled in her memoirs that Grant would talk to anybody and everybody about public health when few paid attention to it during his early days in China (Yan 1990, 143–153). For almost twenty years (1921–1939), Grant worked tirelessly with his Chinese colleagues in training a cadre of public health professionals and in creating a modern public health administrative system under the Nationalist government. His enormous work had a profound impact on China’s modern health system. Recent publications on Grant indicate that his ideas on public health have valuable relevance to the current debate on the efficient delivery of health care (Litsios 2011; Bu 2012a).

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2 Changing Patterns of Diseases and Longevity: The Evolution of Health in Twentieth-Century Beijing

Bridie Andrews Indiana University Press ePub

WHILE BEIJING, THE capital of China, cannot be said to be typical of the country as a whole, the relatively ample documentation of the health of its citizens will be used in this chapter to provide a window into the process of health modernization in China over the twentieth century.

The process of health modernization in Beijing began during the late Qing reforms, or “New Policies” era (1901–1911). In 1905 the Board of Police, set up under the new Ministry of Police, had three departments, one of which was the Department of Health Services (weisheng shu). The department was divided into four sections:

1. Street Cleaning: cleaning streets, public toilets, garbage disposal, and controlling sewage and litter.

2. Disease Prevention: preventing epidemics by vaccination and surveillance of hospitals, slaughterhouses, and food shops.

3. Medicine: administering medical schools and hospitals, certifying doctors, publishing medical books, and keeping statistics of births and deaths.

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8 The Development of Psychiatric Services in China: Christianity, Communism, and Community

Bridie Andrews Indiana University Press ePub

THE STORY OF the introduction and growth of psychiatric services in China is by no means a linear progression toward the achievement of practices based on science. The narrative is one in which culture, foreign intrusion, economics, familism, and politics (especially politics) all form part of the framework within which the goal of providing accessible, affordable, and effective psychiatric care for all of China’s citizens who require it is pursued. As we shall see, it is a goal that has not yet been achieved, although the efforts to do so continue. The chapter’s content that covers the development of formal institutional care for psychiatric patients from 1898 is built around material from medical missionary sources prior to 1949. For the later periods the discussion is structured using formal policy documents (where available) and published analysis and research, supplemented by the author’s own experiences and observations in China over three decades. We start, however, with a consideration of the question at the core of understanding the development and structure of psychiatric care—epidemiology.

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3 Maternal and Child Health in Nineteenth- to Twenty-First-Century China

Bridie Andrews Indiana University Press ePub

The welfare of childbearing women and children has been a prominent concern in Chinese culture from ancient times to the present. Historically, maternal and child health was a family-directed, household-centered issue. Beginning in the late nineteenth century, however, China’s pursuit of modernization significantly changed the context and content of medical practice. For late imperial reformers, as well as the Nationalist and Communist regimes that followed the dynasty’s fall, maternal and child health became a crucial component of state building, modernization, and economic growth. While demographic data is spotty or nonexistent for the earlier part of this period, modern statistics show that individual and state initiatives have effected dramatic drops in maternal and child mortality over the past few decades. But as China today seeks to attain a standard of health care consistent with its level of economic development, it must also negotiate systemic health problems engendered by the very policies that have driven its breathtaking economic growth.

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