Neither Donkey nor Horse: Medicine in the Struggle over China’s Modernity by Sean Hsiang-lin Lei (review)

Neither Donkey nor Horse is a tremendous accomplishment that marks Sean Hsianglin Lei as a leading historian of Chinese medicine and a major thinker in STS. The book draws together years of Lei’s research and publications, but it is far more than a simple summary of past work. Lei places Chinese medicine in an ambitious new framework and offers an insightful examination of the nature of Chinese modernity.

The book is not exclusively about traditional Chinese medicine, nor is it entirely a book about Western medicine. Instead, each of the work’s eleven chapters probes different aspects of the complex interweavings of medicine, science, and politics in the first half of the twentieth century. Its central concern is to highlight processes through which Chinese medicine transformed in the twentieth century to become a different “species,” a species that coevolved, through pointed engagements with science, along with the emerging modern Chinese state.

The unusual title, Neither Donkey nor Horse, harkens directly to this process of speciation, albeit in a way that takes some explaining. Indeed, it is quite a bold move to use a Chinese saying that has no exact English translation as the title of the book. The aphorism feilü feima—literally, “neither donkey nor horse”—refers to something that is a mix of disparate things, but the result is not quite right; it is a bit off, and like a mule, it is impotent, essentially a failed project. Lei explains that the phrase feilü feima was used by critics to suggest that the project of scientizing Chinese medicine was destined to be a failure. Capturing the negative connotation of the phrase, Lei translates this feilü feima medicine as “mongrel medicine,” suggesting something bastardized, neither entirely authentic nor entirely reformed. Lei intentionally uses the term mongrel to contrast it with the more positive term hybrid, which is used by contemporary postcolonial scholars to describe the productive, generative blending of indigenous and colonial cultures. By appropriating the phrase used by Chinese medicine’s detractors—those modernizers who sought to abolish it as being incompatible with Chinese modernity—Lei highlights the remarkable irony that Chinese medicine in the twenty-first century has gone on to become the very symbol of that modernity.

The book does not really present a discernable narrative or a clear chronology of change over time; instead, each chapter explores a particular meaningful moment or a particular debate. The book itself is a bit of a hybrid in that it alternates chapters on the social structures related to Chinese medicine with chapters that focus on questions of Chinese medicine’s epistemology and meaning. Chapter 3 (“Connecting Medicine with the State”), chapter 5 (“The Chinese Medical Revolution and the National Medicine Movement”), and chapter 10 (“State Medicine for Rural China”) describe the ways that the emerging republican/Nationalist state took up medicine as a crucial issue. These chapters provide important information about the building of China’s public health bureaucracy, physicians’ professional groups, and rural health infrastructure, but they are far from being straightforward presentations of dry organizational or political history. Chapters dealing with state formations all weave structure and meaning in skillful ways that give vibrancy and import to each.

For example, the book opens with a chapter on the Manchurian plague of 1910–11, a much-studied episode in the political history of medicine in China. Many scholars have focused on the way that the plague demonstrated to the Qing government that the epidemic control techniques of Western medicine were an essential tool in maintaining sovereignty over territory—plague as essentially a political tale. In Lei’s skillful handling of the plague, the Manchurian epidemic also highlights the different ways that Western medicine and Chinese medicine conceptualized infectious disease. By relying on the microscope to pinpoint a clear single cause (and thus a specific disease), and by successfully discerning the airborne nature of the plague, Wu Liande...