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  • Health and Hygiene in Chinese East Asia: Politics and Publics in the Long Twentieth Century ed. by Charlotte Furth and Angela Ki Che Leung
  • Hilary A. Smith
Health and Hygiene in Chinese East Asia: Politics and Publics in the Long Twentieth Century. Edited by Charlotte Furth and Angela Ki Che Leung (Durham, NC: Duke University Press, 2010. viii plus 337 pp. $23.95).

The concepts of hygiene and the regimes of public health that emerged around the world over the past hundred and fifty years reflected both universal biomedical principles and local knowledge and custom. Untangling the relationships between imperial power and indigenous knowledge has been the contribution of [End Page 1097] historians such as David Arnold and Warwick Anderson, who have illuminated public health in the context of Western imperialism. The ten essays in the present volume re-orient our perspective on imperial power and public health by taking as their focus Chinese East Asia, including mainland China, Taiwan, and Hong Kong. They represent the work of some of the best Taiwanese, mainland Chinese, and American scholars in this field, in some cases bringing to an Anglophone audience the work of scholars already widely known for their work in Chinese. The "long twentieth century" of the title begins in the 1860s and continues through the SARS epidemic of 2003, with contributions grouped into three approximately chronological sections, one from the 1860s through the end of the Qing Dynasty in 1911, another from the late nineteenth century through World War II, and the third from the 1950s to the twenty-first century.

East Asia in the late nineteenth and early twentieth centuries was a world between empires, as the agrarian Chinese empire that had long exerted such influence there declined, and the industrializing Japanese empire flourished. Similarly, elite medical practice in the region was between paradigms. Along with Japanese power grew the influence of Western medicine, and as China floundered, practitioners of classical Chinese medicine found themselves stimulated and challenged by new ideas and new competitors. After the Second World War, Japanese power receded, but Western medicine remained influential, and in Chinese East Asia today the dominant public health paradigm is biomedical. It leaves room for the alternative diagnoses and therapies that Traditional Chinese Medicine (TCM) offers, however, as Marta Hanson illustrates in her chapter on TCM doctors' participation in the fight against SARS on the mainland.

As in theWest, China's early public health efforts reflected both political concerns and biological reality, a fact most dramatically highlighted by the coincidence in 1910-11 of a terrifying plague epidemic in Manchuria with the collapse of the Qing, China's last imperial dynasty. Sean Hsiang-lin Lei's chapter shows how the epidemic resonated with broader concerns about China's sovereignty, since the Qing government worried that plague containment might serve Japan or Russia as an excuse to take over Manchuria. That anxiety prompted the government to defensively adopt a Western- and Japanese-style public health regime of surveillance and monitoring. Angela Leung's contribution further suggests that the outbreak was also a key moment in the evolution of chuanran, an ancient Chinese medical term which in modern Chinese is used to translate the biomedical concept of contagion. And the 1910-11 epidemic casts its long shadow over the Manchuria that Ruth Rogaski describes in the 1920s through 1940s, when Japanese anti-plague campaigners wielding needles inspired as much fear as the plague itself. In short, this epidemic seems to have had the kind of transformative effect on public health in China that nineteenth-century cholera epidemics had in Western cities, though in a very different political context.

In her earlier book, Hygienic Modernity—which established the definitive history of how the modern Chinese concept of public health emerged—Rogaski demonstrated that if one wants to understand how imperialism in Asia affected public health, treaty-port China is another productive place to look. Shang-jen Li and Yu Xinzhong accordingly explore hygienic modernity in treaty ports from opposite ends, as it were: Li focusing on diet and Yu on human waste. Li's article is one of the best in the book at capturing the political and intellectual complexity...

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