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Glocalizing Medicine in the Canton–Hong Kong–Macau Region in Late Qing China

Published online by Cambridge University Press:  10 December 2019

ANGELA KI CHE LEUNG*
Affiliation:
University of Hong Kong Email: angela-leung@hku.hk

Abstract

This article looks at how globalization in the nineteenth century was inextricably entangled with localization in the Canton–Hong Kong–Macau nexus on the southern fringe of China by tracing the growth of its unique medical culture. It explains the ‘glocalizing’ process by tracing the development of this medical culture, which consists of knowledge construction and institution building, in the context of highly volatile epidemiological conditions aggravated by increasingly heavy inter-regional trade and migration. It traces the dynamic circulation of people, materials, ideas, and practices in this southern edge of China, which was traditionally connected to southeast Asia and shared ecological backdrops that produced similar epidemiological experiences. The Canton nexus in the nineteenth century saw the growth of native medical knowledge that focused less on theoretical innovation than on the efficacy of therapeutic strategies. These ideas were likely to have been informed or reinforced by new anatomical knowledge disseminated by Western medical missionaries on the ground early in the century. The medical culture in the region was also marked by the formation of a series of local institutions that were fusions of Western-style hospitals and native merchant-run charity halls where diseases were studied and treated, and new public health management negotiated and implemented by experts from different traditions.

Type
Forum Article
Copyright
Copyright © Cambridge University Press 2019

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Footnotes

*

This article is a partial output of project no. 745613, ‘The construction of nutritional knowledge in modern China (circa 1850–1950)’, funded by the Hong Kong Research Grants Council.

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17 Lu Xun (1881–1936) reminisced in 1933 that when he was two to three years old, the only two medical books kept in his family in Shaoxing (Zhejiang province) were Dasheng pian (達生篇 On Smooth Child Delivery) and Yanfang xinbian. See ‘Wo de Zhong dou’ (My Vaccination) 1933, ‘Shihua zhiyu’ (拾花之餘 Sequel to the collection ‘Picking Flowers’), in Lu Xun zuopin jinghua (The Best of Lu Xun's work), Joint Publishing, Hong Kong, 2003, Vol. 2, pp. 237–39.

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19 Among these were Ji zong lu (濟眾錄 Record for Providing Relief to the Masses, 1903), Yanfang beiyong (驗方備用 Efficient Recipes to be Used, 1902), Jingyan liangfang (經驗良方 Good Recipes Based on Experience, 1889), and Jingyan zafang (經驗雜方 Miscellaneous Recipes Based on Experience, 1903). For a complete list, see Lu, ‘Qingdai Guangdong yishu chuban zhuangkuang chutan’, pp. 21–26.

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26 Luo, Shuyi huibian, p. 9a.

27 Ibid., pp. 7b–8a, 20a, 22a, 23a.

28 In January 1894, Mary Niles (1854–1933), a Presbyterian missionary, witnessed a woman thought to be dying from the plague recover after being treated with several doses of ‘bear's gall’: Niles, M., ‘Plague in Canton’, China Medical Missionary Journal, 8.2 (1894), p. 116Google Scholar.

29 For the chronology of the Balmis expedition (1803–06), see https://hsl.ecu.edu/wp-content/pv-uploads/sites/103/2017/09/Chronology-Smallpox-and-Balmis-Expedition.pdf, [accessed 18 September 2019].

30 At least 62 editions were published under the same title Yindou lüe (引痘略 A Brief Account on the Technique of Releasing Pox), and many more under different titles, during the nineteenth and early twentieth centuries. See Quanguo zhongyi tushu lianhe mulu (全國中醫圖書聯合目錄 United Catalogue of Medical Books in China), Zhongyi guji chubanshe, Beijing, 1991, Vol 1, pp. 517–19.

31 Leung, A. K. C., ‘The business of vaccination in nineteenth century Canton’, Late Imperial China, 29.1 (June 2008), pp. 739CrossRefGoogle Scholar. The use of other animals, especially the buffalo, to replace the cow was also apparently common in parts of Southeast Asia after the vaccine was introduced in 1805. In Indochina, it was done by Pastorian doctors. See Guénel, Annick, ‘Lutte contre la variole en Indochine: variolisation contre vaccination?’, History and Philosophy of the Life Sciences, 17.1 (1995), pp. 6970Google Scholar.

32 Elman rightly describes this work as the ‘first sustained introduction of the modern European sciences and medicines’ of this period. See Elman, B., On their Own Terms: Science in China, 1550–1900, Harvard University Press, Cambridge, 2005, p. 57CrossRefGoogle Scholar.

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39 Ibid., Chapter 2, pp. 52a–53a; Chapter 4, p. 65a. He notably invented a category called ‘ailments of the blood vessel’ in his fourth chapter.

40 Ibid., Chapter 2, p. 27a.

41 Ibid., p. 30b.

42 Ibid., p. 52a. See also a fuller presentation of the different uses of the decoction during the 1894 plague in Canton in Lai Wen 賴文 and Li Yongchen 李永宸, Lingnan wenyi shi (嶺南瘟疫史 A History of Epidemics in the Lingnan Region), Guangdong remin chubanshe, Guangzhou, 2004, pp. 731–38.

43 Gao Chengyuan 高承元, ‘Chen daji yu Kong xiaoji’ (陳大劑與孔小劑 Chen the bigdoser and Kong the smalldoser), in Guangzhou wenshi ziliao cungao xuanbian (A Selection of Papers on Historical Materials on Guangzhou City), Zhongguo wenshi chubanshe, Guangzhou, 2008, Vol. 6, pp. 352–55.

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50 Ibid., pp. 188–89.

51 Cadbury, At the Point of a Lancet, pp. 174–81. The lucrative private practice of Kwan Ato and some others was reported in Kerr, ‘Report of the Medical Missionary Society's Hospital in Canton for the year 1872’, p. 19, notes 48 and 49.

52 Lu Zhaoji 陸肇基, ‘Zhongguo zuizao di guanli xiyi xuexiao’ (中國最早的官立西醫學校 The earliest state Western medical school), Zhongguo keji shiliao, 12.4 (1991), pp. 25, 28. The reason for privileging Cantonese students was unclear, but was probably related to their superior English ability and possibly also to the long tradition of medical teaching in the Canton Hospital.

53 Leung, A. K. C., ‘Charity, medicine, and religion: the quest for modernity in Canton (ca. 1870–1937)’, in Goossaert, V., Kiely, J. and Lagerwey, J. (eds), Modern Chinese Religion II, 1850–2015, Brill, Leiden, 2015, Vol. 2, pp. 579611Google Scholar. Liang Qizi (Angela Leung) 梁其姿, Shishan yu jiaohua (施善與教化 Charity and Moral Transformation), Linkin Publishers, Taipei, 1997, shows that traditional late imperial charitable institutions mostly focused on homes for foundlings and widows, and hospices for the elderly.

54 Sinn, E., Power and Charity: A Chinese Merchant Elite in Colonial Hong Kong, Oxford University Press, Hong Kong, 1989Google Scholar. Similar institutions were established in Macau (for example, Kiang Wu Hospital was also set up in 1872) and China in major cities like Shanghai and Canton in the 1870s.

55 The minutes of the board meeting of the Tung Wah Hospital of 26 January 1904 recorded the board's appreciation of the repatriation of jiaoqi patients back to Guangdong province as they believed they would have a better chance of cure at the Fangbian Hospital. On the latter, see Leung, ‘Charity, medicine, and religion’, pp. 579–611.

56 For a history of this hospital, see Paterson, E. H., A Hospital for Hong Kong. The Centenary History of the Alice Ho Miu Ling Nethersole Hospital, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, 1987Google Scholar.

57 R. M. Gibson, ‘Beriberi in Hong Kong, with special reference to the records of the Alice Memorial and Nethersole Hospitals and with notes on two years’ experience of the disease’, manuscript dated 16 March 1900, p. 2.

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63 Xie, Zhongguo yixue yuanliu lun, pp. 47a–b. Commenting on Zeng Chaoran's 1887 book, Xie stated that the disease disappeared in China after the Song dynasty and was ‘re-introduced’ into China from overseas.

64 Zeng, Jiaoqi chuyan, pp. 11a–b, 12b–13a.

65 Donghua Hospital Archives (hereafter DHA), 1919–1920 ‘Waijie laihan’ (外界來函Letters received) 130-B19/20-214, pp. 172–73, Doctor Yu Baochu to the Tung Wah Hospital refusing to take up the position in Tongshan Hospital in Kuala Lumpur as arranged by the two hospitals.

66 DHA, Letter from the Donghua Hospital to the Colony's Medical Officer, 16 February 1933, pp. 432–38. Out of 75 people listed, 29 were either passing through Hong Kong or had resided in Hong Kong for less than two years.

67 I would like to thank Wilt Idema for drawing my attention to a genre of modern Hakka and Minnanese Songs and Ballads about Overseas Migration (guofan ge 過番歌 ‘Songs on traveling to foreign land’) from late-Imperial and early Republican China that highlight the dread of catching all kinds of strange diseases in the Southern Seas.

68 Benedict, Bubonic Plague, note 25.

69 Luo, Shuyi huibian, pp. 12a–b.

70 Ibid., pp. 12b–13a.

71 See, for example, Farrar, Reginald, ‘Plague as a soil infection’, The British Medical Journal, 2.2172 (August 1902), pp. 454–56Google Scholar. Farrar, a British doctor, believed that the bubonic plague observed in South Asia was dependent on ‘infection with a specific microbe of soil contaminated with the excreta of rats or other animals that have suffered with the disease’.

72 yuyi, Xian 冼玉儀 and runhe, Liu 劉潤和, Yishan xingdao (益善行道 To do Good and to Practice the Way), Sanlian shudian, Hong Kong, 2006, pp. 4558Google Scholar.