Transcultural Medicine: A Multi-Sited Ethnography on the Scientific-Industrial Networking of Korean Medicine

Abstract

Through a multi-sited ethnography of three different types of organization—a traditional medical clinic, two laboratories, and a biotech company—this article examines how Korean medicine (KM) scientizes, globalizes, and industrializes its clinical knowledge. By tracing the complex networking process among multiple places, I aim to understand how KM reinvents its knowledge, identity, and boundaries in a global situation. In particular, I pay attention to how this process involves multiple dimensions of power relations, economic interests, and scientific authorities. This article concludes that heterogeneous and unequal encounters between KM, science, and industry lead to simultaneous productions of new culture and power without reducing them to a single logic or center in a global age.

Key Words:

• actor-network theory
• multi-sited ethnography
• scientization
• sociotechnical relation
• transcultural medicine

The author wishes to thank Hyun-Soo Bae, Ung-Se Lee, Bo-Up Choi, Chul-Hoon Son, and the many members of Ye Oriental Clinic, Kyung Hee University, and Purimed Company who helped him conduct fieldwork and interviews. Without their kindness, this research would not be possible. He also wishes to thank Gardner Rogers for editing this paper several times. Finally, he thanks four anonymous referees for their valuable comments and criticisms. This research was supported by the Kyung Hee University Fund in 2008 (KHU-20081443).

Notes

In South Korea, this type of medicine is called Hanŭihak, literally meaning “Korean medicine.” I prefer this term to “Korean oriental medicine” and “Korean traditional medicine,” which are plausible alternative translations; reference to “oriental” medicine risks provoking orientalism or misrepresenting the oriental as Middle East Asia, while reference to the “traditional” obscures Korean medicine's modern transformation as it has interacted with biomedicine and Western science. At the same time, I recognize that the term “Korean medicine” is itself imperfect, since it disregards the fact that KM was imported from China around the sixth century, shares cosmological tenets and practices with traditional Chinese medicine (TCM), and cannot be fixed within a single location with any accuracy. Doctors who practice KM are officially known as “oriental medical doctors.”

According to Korea's Work Information Center (2003), KM doctors' monthly average income ($4,370) is slightly higher than that of biomedical doctors ($4,350). The three doctors' income and wealth are still extraordinary even after we consider average KM doctors' annual income ($52,440).

The concept of culture as a bounded and homogenous unity has been refuted. For the relexification and revision of the term “culture,” see Brightman (1995) and Welsch (1999).

It should be noted that social and technical elements cannot be separated in the reinventing process of KM. Cultural studies of science and technology emphasize that modern material culture is based on the mixture between human elements and material elements. For example, Haraway's cyborg (1991), Hayles's posthumanism (1999), Latour's actor-network (1987), and Pickering's mangle (1995) provide new analytical tools to understand the mixed relationship between the cultural and the material. The term “sociotechnical” also captures the inseparability between the social elements and material elements in KM's hybridization process.

Hans-Jorg Rheinberger (1997) emphasized differential reproduction in experimental system that generates constant destabilization of transcultural science. In this regard, my article pays attention to the continuous stabilization and destabilization in the emergence of KM-science-industry network.

In addition to the Asian region, the relationship between traditional medicine and science has been analyzed in several continents including Africa (Langwick 2007) and South America (Miles 1998).

In my article, hybridity does not mean a mechanical combination or simple juxtaposition of different knowledges. As a part of science studies tradition, this concept aims to emphasize the complex “sociotechnical” relations among KM, biomedicine and science, which prevents “reducing” creative KM therapies to “a single medical tradition” and a pure social or technical dimension. At the same time, as I will show, hybridity means the destabilization of fixed identity that creates the spaces of in-betweenness and subtle identity politics (Bhabha 1994; Langford 2002).

For examples of multi-sited ethnography by other scholars, see also Cannon (1999), Caputo (2000), and Knowles (2000).

My fieldwork focused on the contemporary transformation of Korean medicine. This case study is a major part of my field research conducted for 22 months during a five-year span (1999–2003). For the entire project, I interviewed 76 people, including KM professionals, scientists, patients, and businesspersons. I also conducted several rounds of in-depth interviews with key players like Professor Bae, the three doctors, the CEO of Purimed, the managerial staffs of Purimed, and the scientists in the two laboratories.

I reveal the real names of institutions by permission of the laboratory directors, the three traditional doctors, the CEO of Purimed, and my informants and interviewees.

It should be noted that KM professionals' global experiences are mainly shaped by Korea's relationships with the United States and East Asian countries, a by-product of the postcolonial conditions of South Korea. After 1945, the United States imposed its system on South Korea as a satellite to prevent Chinese and Russian communisms (Johnson 2000: 20). Over the following 50 years, the United States became the most influential country in all realms of Korean society. To ordinary Korean people, the United States is not only the strongest ally but also the most globalized nation to be modeled (Kang 2000). In the post-Cold War era, interactions between KM, Chinese, and Taiwanese doctors dramatically increased to facilitate exchanges of raw materials, researchers, Oriental medical treatments, and Oriental medical commodities, partially because the Chinese and the Korean governments officially established foreign relations in 1992.

Bourdieu (1975) claims that the scientific field is basically a field of struggle where scientists compete to gain social recognition and to impose one interpretation on others. Yet his analysis pays attention to the “socio”-logical aspect of the scientific field, which needs to be revised and refined in transnational and trans-scientific contexts.

The layout of the clinic demonstrates that the signifier (image of a thing: KM) and the signifed (meaning: modernity) are arbitrarily constructed (Saussure 1966). This modern image of KM also functions as advertisement.

Judith Farquhar (1994) describes Chinese medicine's diagnostic and therapeutic processes in detail. She analyzes “syndrome differentiation and therapy determination” as the center of the process. KM doctors also use this clinical method. Compare the differences between Farquhar and KM practices that I describe in this section. Here, I argue that despite sharing main components among Oriental medical doctors, the multiplicity of Oriental medicine emerges due to KM doctors' combination of different medical elements. For the multiplicity of Chinese medicine, see also Scheid (2002).

The modernization of KM clinics has been increasing recently. Not only the interior of the KM clinic, but also various diagnostics devices (not the same as biomedical devices), have been updated to fashion an urbanized and modernized image of KM.

In 2003, the Physiology Lab installed the second DNA microarray system in South Korea.

For the construction of scientific fact, see Latour and Woolgar (1986) and Knorr-Cetina (1999).

For the verification of weight-loss remedies, scientists conduct an in vivo (animal) experiment. The scientists transform the herbal formula provided by the doctors in a process similar to one described above. Rats are randomly divided into three groups: normal, control, and treatment groups. For six weeks, the normal group is fed a standard pellet chow. The control group eats a high fat diet while the treatment group eats a high fat diet supplemented with the treatment. Scientists measure anti-obesity effects in terms of changes in body weight, kidney fat weight, and blood biochemicals. The treatment group shows lower levels of body weight, cholesterol, free fatty acids, total lipids, and triglycerides. To determine the significant effects of the treatment, scientists rely on a computer program for statistical analysis. The scientific data revealed that the weight-loss treatment has a statistically positive effect to curb obesity in the animal model.

In this article, I do not pay attention to KM epistemology in detail. What I am arguing is that despite its new combination, synthesizing KM with science is an unequal process in which KM epistemology is disregarded. As Scheid argues (2002: 54), the synthesis of different medical and scientific elements involves “simultaneous emerging and disappearing.” Also, it should be noted that epistemology does not have priority in the making of science and medicine (Kim 2006b; Pickering 1995; Galison 1997). Rather, material practices, epistemology, and social elements are mutually resisted and accommodated in the making of transcultural science and medicine without recourse to a single dimension.

For a unique process of scientization of TCM, see also Lei (1999).

Ong (1999) emphasizes the role of Chinese fraternal networks in the transnational business of Chinese people. Also, Seagrave (1995) shows that Chinese diaspora population in the Pacific Rim countries collaborate for the creation of the market and the production of a profitable economy.

For more on Korean immigrants' business activities, see Yoo (1998).

Additional information

Notes on contributors

Jongyoung Kim

JONGYOUNG KIM is an assistant professor in the Department of Sociology at Kyung Hee University, Seoul, South Korea. His research interests include East Asian medicines, science and technology studies, and modernity and globalization studies. His recent publications include articles on contemporary transformations of Korean medicine in Social Studies of Science, Social Science & Medicine, and Journal of Korean Studies. He may be reached at the Department of Sociology, Kyung Hee University, Hoegi-Dong, Dongdaemun-Gu, Seoul 137-701, South Korea. E-mail: [email protected]