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Bulletin of the History of Medicine 75.3 (2001) 595-597



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Book Review

The Life and Times of Sir Kai Ho Kai: A Prominent Figure in Nineteenth-Century Hong Kong


G. H. Choa. The Life and Times of Sir Kai Ho Kai: A Prominent Figure in Nineteenth-Century Hong Kong. 2d ed. Hong Kong: Chinese University Press, 2000. xii + 305 pp. Ill. $20.00 (962-201-873-4). (Distributed by University of Michigan Press.)

The past two decades have witnessed renewed scholarly interest in the history of Western medicine in China. Influenced by innovative approaches to the study of colonial medicine in Africa and other parts of Asia, as well as by the shift away from the triumphalist narrative that characterized earlier interpretations, China scholars have reexamined the nineteenth-century encounter between Western and Chinese medicine. This newer work seeks to place both systems into historical context, and does not assume the superiority of Western knowledge and practice. The Chinese appropriation of Western medicine is now viewed as a complex and ever-shifting process of negotiation and selective assimilation, undertaken by multiple actors for diverse purposes. Chinese resistance to Western medicine is no longer interpreted as a consequence of lingering xenophobia and cultural conservatism, but rather as a reasonable response to an alien and intrusive medical system that had not satisfactorily demonstrated its therapeutic superiority to the indigenous one.

These insights are unfortunately not evident in G. H. Choa's revised biography of Sir Kai Ho Kai, first published in 1981. As one of the first Chinese physicians to be medically trained in Britain, Ho Kai was a central figure in the history of Western medicine in China. His public service on Hong Kong's [End Page 595] Legislative Council from 1890 to 1914, his role in helping to found the Tung Wah Hospital, and his numerous essays on governmental reform make him significant for Hong Kong's modern history as well. As in the first edition, Dr. Choa ably chronicles Ho Kai's life while also providing information about Hong Kong between 1841 and 1914. Yet while he has rearranged some chapters and incorporated new material, the basic analytic framework remains unchanged: in both volumes, Western medicine is presented as more advanced and efficacious than it actually was at the turn of the century, while Chinese medicine is described as monolithic, static, and relatively ineffective (pp. 51-52).

Dr. Choa's narrative of the 1894 bubonic plague epidemic illustrates the interpretive pitfalls of this approach. He suggests that antiplague measures carried out by the British were designed to rid the territory of rats and, as such, were carried out with full scientific knowledge of plague etiology (p. 113). Yet a few lines later, he notes that the relationship between rats, rat fleas, and the human disease was not yet understood. As Rajnarayan Chandavarkar has argued for the Indian case, British colonial plague policies in the 1890s had less to do with solid epidemiologic knowledge than they did with preconceptions about the hygienic practices of colonial subjects and the wider orientalist discourse within which nineteenth-century tropical medicine was embedded. 1 Similarly, Choa views Chinese rejection of these measures as evidence of the continued resistance of cultural conservatives (p. 114). Yet in fact, European physicians at the time readily admitted that they could do little to help plague victims, and case-fatality rates for Chinese patients treated in Western clinics topped 90 percent; 2 under such circumstances, Chinese rejection of ineffective state policies and Western therapies seems inherently rational.

To be sure, Choa offers evidence that Chinese resistance was not merely an illogical rejection of a transparently superior medical system. He notes, for example, the very high incidence of sepsis and mortality in foreign wards (p. 55), as well as the harmful practices, from the Chinese point of view, of bloodletting, blistering by leeches, and purgation by enemas. Moreover, he acknowledges that patients might have been reluctant to abandon Chinese medicine because it may have been...

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