A Doctor of the Highest Caliber Treats an Illness Before It Happens

Abstract

“A doctor of the highest caliber treats an illness before it happens,” a seemingly antiquated doctrine in traditional Chinese medicine, is enjoying surging popularity among practitioners in urban China and the United States today. In this essay, I examine how the meanings and contours of traditional Chinese medicine have shifted in recent decades as it is molded into a “preventive medicine” through translocal encounters. From the 1960s and the early 1970s, the emphasis China's socialist health care placed on preventive health among the rural poor shaped the practice of Chinese herbal medicine and especially acupuncture. This version of preventive medicine was also exported to the Third World, which China strove to champion. Since the end of the Cold War and especially during the 1990s, as China strives to “get on track with the world” (specifically, affluent nation-states, especially in North America and the European Union), traditional Chinese medicine has been rapidly commodified and reinvented as a new kind of preventive medicine tailored for cosmopolitan, middle-class lifestyles. The emergence of this radically new preventive medicine resuscitates certain stories of antiquity and continuity, emphasizing that traditional Chinese medicine has always been “preventive” while obliterating recent memories of the proletariat world and its preventive medicine.

Key Words:

• Africa
• China
• commodification
• globalization
• politics of difference
• preventive medicine
• spatiotemporality
• the United States

ACKNOWLEDGEMENTS

The author is grateful to Elisabeth Hsu and Gunnar Stollberg for inviting her to the panel Chinese Medicine and Ayurveda Outside Their Home Regions at the 22nd International Congress of History of Science in Beijing, China, in 2005, where an earlier version of this article was presented. Thoughtful feedback and stimulating discussions from Linda Barnes, Judith Farquhar, Charlotte Furth, Elisabeth Hsu, and Gunnar Stollberg helped mold this article into its current shape. She is indebted to Steve Ferzacca and Lisa Kozleski for their guidance throughout the revision process. The National Science Foundation Dissertation Fellowship, the Social Science Research Council International Dissertation Research Fellowship, and the Wenner-Gren Foundation Dissertation Fellowship supported the research for this article.

Notes

See Farquhar and Zhang (2005) for an in-depth discussion of how to understand yangsheng, cultivation of the self, through questions about biopolitics in contemporary China. Farquhar and Zhang argue cogently that life cultivation in contemporary China is not about overt socialist state power or the freedom from it. Rather, it is a form of the tactics of everyday life and especially pleasure that renders life itself an object of capillary power.

See Hsu (1999) for a detailed and in-depth discussion of the organization of textbooks of traditional Chinese medicine.

It is unclear when exactly Nan Jing was written and who wrote it. Scholars of traditional Chinese medicine believe that it was compiled during Han Dynasty (202 B.C.–220 A.D.), although part of the text might have originated from Bian Que himself. Nan Jing is nowadays considered one of the foundational texts in Chinese medicine. See Unschuld (1988) for a detailed discussion of the history of and medical concepts in Nan Jing.

On August 7, 1950, at the first National Conference of Health of the newly founded People's Republic of China, Mao Zedong wrote a preface declaring that China's healthcare policy should “serve workers, peasants, and soldiers, focus on prevention, and promote the solidarity of Chinese and western medicines.”

These policies had profound impact on the practice of traditional Chinese medicine. First, beginning in 1956, by adopting the institutional, pedagogical and clinical standards of biomedicine, state-run traditional Chinese medicine colleges and hospitals came to replace family clinics and small academies (Farquhar 1994; Leslie 1977). At the same time, local priests, itinerant healers, and amateur literati doctors (ruyi) were ordered to abandon their “superstitious” or “unprofessional” practices, and thus excluded from the official version of traditional Chinese medicine.

Elisabeth Hsu specifically points out that the Chinese medical teams typically consisted of 9 to 10 biomedical professionals of different specialties and 1 acupuncturist (2007).

Hutchison further notes that the idea of a common China-Africa radial identity was met with skepticism in Africa as the Chinese who worked in Africa did not really mingle with the locals (1975).

Major insurance companies and HMOs that cover acupuncture include Blue Shield, Kaiser Permanente, and Lifeguard, among others. Stanford University and the University of California at San Francisco Medical Schools both offer courses on acupuncture and other alternative therapies. Bay Area hospitals that have acupuncture clinics or services include California Pacific Health Center, Chinese Hospital, and St. Luke's Hospital. At the same time, practitioners of traditional Chinese medicine, patient groups, biomedical professionals and politicians are working together to include acupuncture as a regular service at the San Francisco General Hospital.

Chau has a degree in traditional Chinese medicine from China but does not have a Medical Doctor degree from the United States. In China, there is no legal distinction between a biomedical and a traditional Chinese medical “doctor” (yisheng). In the United States, patients refer to practitioners of traditional Chinese medicine as “doctors” in everyday discourse to show their high esteem for the practitioners and the profession.

U.S. Census 2000 figures show that over the past decade California's non-Hispanic white population shrank to 46.7 percent, while Hispanic and Asian minorities grew at rapid rates. The size of African American population changed little. California also had the highest proportion of people in any large state who said they were of more than one race, 4.7 percent.

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Mei Zhan

MEI ZHAN is an associate professor of anthropology at the University of California, Irvine. Her research focuses on the intersection of medical anthropology and science studies, transnationalism, and globalization. Recent publications include Other-Worldly: Making Chinese Medicine Through Transnational Frames (Duke University Press 2009), and “Wild Consumption: Privatizing Responsibilities in the Time of SARS” in the edited volume Privatizing China (Cornell University Press 2008).