- Body, Society, and Nation: The Creation of Public Health and Urban Culture in Shanghai by Chieko Nakajima
This book is a welcome addition to the bourgeoning scholarship on the development of urban China in the first half of the twentieth century. Nakajima's focus is on health and urban culture in Shanghai, one of the first treaty ports to experience the influx of foreign ideas and influences that had been facilitated by the presence of foreign concessions and colonial communities. By examining the development of private health care providers and institutions, public health administration, hygienic campaigns to educate and mobilize the people to create a clean and healthy city, health movements to combat disease outbreaks, and a consumer culture that embraced foreign and local hygiene products, Nakajima shows how the interaction of Shanghai's local social, cultural, and political elements with foreign ideas and practices helped to create the city's modern urban culture. It is noteworthy that the book also examines the period of Japanese occupation and how the Japanese and the Shanghai elites who stayed collaborated to continue the introduction of various public health programs and campaigns to keep the city clean and free from communicable diseases. The study is well-organized, meticulously researched, and based on primary source materials such as newspapers, magazines, and medical journals, as well as archival collections, including those in the Shanghai Municipal Archives and the Ministry of Foreign Affairs in Japan.
The embracing of Western medical and health ideas, as Nakajima points out, took place within a distinctive local context and involved a process of appropriation, adaptation, and reinterpretation that enabled the new methods and practices to serve local needs. The study shows that it was the modern discourses of the intellectuals and urban elite who had rationalized their understanding and adoption of Western medical science "in their own terms," and "acting on this understanding, they developed and elaborated strategies to protect and improve individual, municipal, and national health and hygiene" (p.13). This is an important point. The nationalistic concern of many scientists might be more complex than the mere desire to strengthen China through medical and hygienic modernization; they were also internationalists who were interested in the advancement of science in general and their frame of reference also included the international scientific community and scientific universalism. In other words, Shanghai's urban elites were not alone or unique in their "strong desire to participate in global modernity …" (p. 226). What set them apart is the way they pursued their strategies for change within a local setting that was dissimilar to other cities in Republican China. As Nakajima [End Page 50] points out, we find in Shanghai a tradition of active local voluntarism and philanthropy, the prevalence of mass media and material aspects of Western culture, social networks that would provide civic support, and commercial firms that shrewdly combined the discourses on patriotism and hygienic modernity in their promotion and sale of health care and other products. With more work being done on the development of urban China, it would be most instructive to examine and compare how urban elites in other cities operated within their respective milieus and urban cultures in their pursuit of global modernity in the first half of the twentieth century.
While the study has analyzed the aspirations and activities of the urban elite and interest groups, it has not probed into the roles and perceptions of the denizens at the basic level, especially the urban working classes: for example, the human waste collectors, the rickshaw pullers, or the factory workers. They participated in hygiene campaigns, voluntarily or having been coerced to do so, and they, as Nakajima points out, might use part of their household income to purchase such personal hygiene items as soap and toothpowder. But were the ordinary people an undifferentiated entity as portrayed in the book? Are we ignoring the agency of the common folks and their contribution to the urbanization...