In lieu of an abstract, here is a brief excerpt of the content:

Chapter 19 Chinese and Western Medicine in Hong Kong: Some Social and Cultural Determinants of Variation, Interaction and Change (1975)* Hong Kong is a British Crown Colony lying just inside the tropics, to the south-east of China adjoining the province of Kwangtung [Guangdong]. Its 400 square miles includes the island of “Hongkong”, and the peninsular Kowloon, ceded to Great Britain in 1841 and 1860 respectively; and the New Territories, a settled rural area, added by a 99-year lease in 1898. Both traditional and modern, or “Chinese” and “Western” medicine, as they are commonly called, are officially recognized; they have always been officially regarded and administered as separate systems. Since the end of the Japanese Occupation however, although they continue to be clearly distinguished by legal and other officially sanctioned rules, changes have taken place. Western and Chinese therapy or drugs are combined; new categories of “Western” and “Chinese” practitioners have emerged, and they interact with each other. Many new practices and practitioners are illegal, but the innovations, legal and otherwise, add to the range of choice people exercise in seeking out and providing health care. Anthropologists studying traditional medicine and assessing its role in health care, often focus on a particular set of beliefs and practices. But it is also important in modernizing societies, particularly when governed by a people culturally different from the majority, to understand the whole context within which traditional institutions operate — how far traditional, and traditional and modern, institutions, compete, complement, or interact * First published in Medicine in Chinese Cultures: Comparative Studies of Health Care in Chinese and Other Societies, papers and discussions from a conference held in Seattle, Washington, U.S.A., February 1974, ed. by Arthur Kleinman, pp. 241–71. Washington, D.C.: U.S. Dept. of Health, Education, and Welfare, Public Health Service, National Institutes of Health; for sale by Supt. of Docs., U.S. Govt. Printing Office, 1975 [1976]. 490 Chapter 19 with one another; what their official statuses are; and how different people use and evaluate the alternative services. Hong Kong is a modernizing industrial society where 98 percent of the population is Chinese, and the government consists of British expatriates and Westernized Chinese. It may be some time before we have detailed data on all its medical institutions; study of popular beliefs and practices is just beginning. Nevertheless it is possible to present a general picture on the basis of existing information, and in this essay I examine what I know of the medical system; the changes that have taken place, some major reasons for these changes, and their importance for the people. My material for analysis is derived from documentary and field research.1 I use the term “system”, which is a natural science metaphor commonly used by social scientists in the analysis of social and cultural behaviour. Here I take it to mean a set or assembly of phenomena connected, associated, or interdependent so as to form a complex unity (Onions 1955). Systems are governed by norms — rules and laws. They are the statics of the system, setting a precedent and representing the principle of continuity. But as the anthropologist Raymond Firth points out, the observer is faced with the problem of accounting not only for continuity but also change (Firth 1951: 35–40). Firth locates the principle of change in the dynamics of the system — the variety of ways relationships are ordered and events put together and which depend upon decisions and choice. “Structure” and “organization” are terms often used synonymously to describe the continuous aspect of a system; but Firth used “structure” for norms, reserving “organization” for this dynamic activity. He points out that while structural forms limit the range of alternatives possible, it is the possibility of alternatives that makes for variability. I have adapted this conceptual framework for my analysis. Firth uses it for the analysis of social behaviour; but decisions and choices are cognitive events. People may be influenced in their decisions and choices by their perceptions of conditions outside the system, but they are also influenced by their conceptions and evaluations of the system itself. One might also talk of a cognitive system, and of cognitive structure and 1 Data for this essay come principally from a study of the development and functioning of the Hong Kong medical system sponsored by the Centre of Asian Studies, University of Hong Kong. It began in 1971 and will be completed in 1974. In-depth interviews were conducted either in Cantonese by myself...

Share