Book Review: Neither Donkey nor Horse: Medicine in the Struggle of China’s Modernity

Neither Donkey nor Horse: Medicine in the Struggle of China’s Modernity. Sean Hsiang-lin Lei, Chicago: University of Chicago Press, 2014, 376 pp.

In Neither Donkey nor Horse: Medicine in the Struggle of China’s Modernity, the historian Sean Hsiang-lin Lei offers an intriguing account of the political, institutional, and epistemological struggle and syncretism through which a new crossbred “species” of traditional Chinese medicine—zazhongyi, which the author translates as “mongrel Chinese medicine”—acquired a distinctive professional identity in the first half of the 20th century.

Adding to a steadily growing body of historical and anthropological literatures on how traditional Chinese medicine is made through rather than prior to or in spite of translocal encounters with modernity, Lei urges his readers to shift attention away from the dichotomy between traditional Chinese medicine and scientific Western medicine and to refocus on how the two medicines compete with each other for alliances with the Chinese state. Thoroughly researched and smartly written, the author’s historical examination of the modern reforms of
Chinese medicine resonates with anthropological interests in the relations of medicine, science, modernity, and the state.

Neither Donkey nor Horse is a departure from “historicist” (Chakrabarty 2000)—or culturalist—representations of traditional Chinese medicine. The book documents a series of events in the formation of mongrel Chinese medicine primarily between the outbreak of the Manchurian plague in 1910 and the communist takeover in 1949—a period that roughly corresponds to the Nationalist’s Party’s rise and fall as the ruling party of the newly emerging and strife-ridden Chinese nation-state.

Organized thematically instead of following a strict chronological order, each of the nine substantive chapters closely examines a particular event or topic—the rise of the regime of public health, efforts in mapping the immaterial qi onto the anatomical body, the impact of germ theory on the solidification of “pattern differentiation and treatment determination” (bianzheng lunzhi) as a central principle in Chinese medicine, the development of anti-malaria drugs out of traditional herbs, and so forth. Even though scholars and students of traditional Chinese medicine would find these topics quite familiar, the level of detail and nuance offered in the current volume is arguably unprecedented.

The case in point is Chapter 6: Visualizing Health Care in 1930s Shanghai. In this short chapter, Lei purposefully breaks from “the chronological development of a historical entity or a central theme” (p. 123) by walking the readers through the medical environment of Shanghai, a wheel-like representation of the city’s myriad medical services. Constructed by the critic of Chinese medicine Pang Jingzhou, the wheel visualizes movements across a wide (and wild) variety of medical practices and organizations, while the state is firmly placed at the very center of the multitude of actions. This spatial analysis effectively demonstrates that neither Chinese medicine nor Western medicine was a unified system. They were highly fluid, heterogeneous, and politically structured. In staying clear of a linear chronology of Chinese medicine, Lei lays out a rich and varied history of the “coevolution” (p. 13) of medicine and state that challenges the Eurocentric narrative of progress in which science and modernity overcome tradition.

Arguing against the idea that Chinese medicine was the passive victim of the powerful Chinese state, Lei writes an actor-centered history in which leaders of Chinese medicine and their opponents actively mobilized state resources for their own purposes. The focus on the state—or rather, strategic negotiations for alliances with the state—allows the author to offer a number of interesting perspectives on modernity and modernization.

Most importantly perhaps, the state is shown not as a monolithic bloc but rather operates through public health, war, and other modern regimes and discourses. One of the valuable insights coming out of this multilayered model of the state is Lei’s observation of the remarkable continuity between the Nationalist government and the Communist government of China concerning health care policies. The key difference between the two governments, Lei argues, lies in their ideological stances toward the concept of science-as- modernity, which, in contrast to the “ideological middle ground” sought by the Nationalists, allowed the Communists to refashion Chinese medicine as an “alternative science to the bourgeois science of the West” (pp. 275–276).

What about the experience of the actors in these policy and ideological struggles? Lei argues for the continuity of their experiences during painful explorations of the new Chinese modernity. The phrase “neither donkey nor horse” is invoked and explained throughout the book, highlighting the fact that, like mules, this new monstrous Chinese medicine is seen by its critics as incapable of reproducing itself. Lei points out that “neither donkey nor horse” and “mongrel medicine” index the humiliation—and, I should add, a profound sense of anxiety and even hopelessness for the future—deeply felt by the practitioners of Chinese medicine.

But I think there is also a potential supplementary or alternative argument here to be made about modernity. Crossbred monsters may not have as much of a chance at mechanically reproducing themselves. Crossbreeding—or rather, the cultural practice of continuously and creatively mixing and hybridizing—surely does. It not only changes the local variety of the stock, but also what it means to be a species in the first place.

In sum, Neither Donkey nor Horse is a much-anticipated and warmly welcomed addition to historical and anthropological studies of traditional Chinese medicine. It is thoroughly enjoyable to read. The rich materials and insights are surely of great interest to those enmeshed in their own struggles with the state, science, and other modern things.

Reference Cited

Chakrabarty, D.
2000 Provincializing Europe: Postcolonial Thought and Historical Difference. Princeton, NJ: Princeton University Press.

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