Imperfect Conceptions: Medical Knowledge, Birth Defects, and Eugenics in China (review)

Frank Dikotter is one of today's most imaginative and stimulating historians of modern Chinese thought and culture. The compact book under review is his third since 1992, and it shows him to be continuing his hot pursuit of a body of closely related issues on nation, race, gender, and eugenics that resonate from book to book. He also continues to find creative approaches to topics with fresh and unusual data and to exercise an astute, intuitive mode of analysis. This latest study also reveals the persistence of some rough-hewn writing that a reader could find trying and that could undermine some of the aforementioned qualities. (I note that this review is based on a copy of the "uncorrected proofs.")

Broadly speaking, eugenics is the concern for improving the hereditary qualities of new generations of people. In the twentieth century, some have claimed that their eugenic theories and practices were science based. As Dikotter notes, however, "eugenics was not so much a clear set of scientific principles as a modern way of talking about social problems in biologising terms" (p. 4). Conventionally, a "positive" or "negative" approach is taken in the practice of eugenics. The former considers, for example, ways of making a family line or nation physically stronger or more intelligent by determining who in the population has desirable characteristics and then having those people reproduce. Thus, Pan Guangdan (1898-1967), China's preeminent eugenicist, could seriously recommend in the 1930s that China would improve its government by breeding a pool of good administrators. This was to be accomplished through a program in which the best officials were selectively interbred.

Negative eugenics focuses on the elimination of undesirable human qualities: disease, physical weakness, "low intelligence," and even behaviors like criminality, alcoholism, or "immorality." Dikotter's provocative approach to eugenics in China is in this "negative" realm, where he explores the larger implications of eugenic attitudes by way of literature addressing the problem of babies born with severe defects, or what the vernacular has called "anomalies" or "monsters." The literature in question is fascinating. Apparently quite extensive, it was written for popular audiences (as opposed to the educated elite), who sought guidance in eugenic matters. Dikotter pointedly seeks here to shift the study of eugenics from the level of the cultural elite to "informal, popular, anonymous eugenics supporters." He looks beyond institutional boundaries of formal organizations to see how "eugenics discourse permeated the concerns of many ordinary men and women" (p. 6).

Dikotter's study is divided chronologically into three units: the first dealing with the eighteenth and nineteenth centuries, the second with the twentieth century to 1949, and the last with the PRC up to the government's recently announced eugenic policies. All three sections are informed with one set of arguments that are in effect the real subjects of this book. The author argues that eugenics in China is itself a manifestation of some very old, persistent, pernicious cultural syndromes. First and fundamentally is "patrilineal culture" and second is a "holistic" way of thinking that perhaps is a reflection of that culture. In his narrative, Dikotter's usage of these terms is not based on sound initial definitions, and the further we read the more freighted the terms become. Be that as it may, patrilineal culture is seen as the source of an inimical subordination of individuals to collectivities, and especially the subordination of individuals' reproductive rights to the rights of the lineage. Thus, producing healthy male children is essential to the continuity of the lineage, and women are obliged to do what is required to achieve that end.

Holistic thinking, Dikotter argues, "denies the existence of a disembodied and autonomous self" (p. 9). Not only does it demand that individuals be defined as part of a larger collectivity, it also requires the acknowledgment of an organic intimacy between individuals and natural or social environments. Further, "medical...