Introduction
Between 1903 and 1952, there was a Jesuit and French university in Shanghai called l’Aurore, the French word for dawn, known in Chinese as Zhendan Daxue (Zhendan also meaning dawn in Chinese).Footnote 1 Its students and staff were nicknamed the Aurorians. This article focuses on l’Aurore’s medical faculty, which operated from 1912 to 1952. Compared to other medical education institutions in China, this faculty was relatively modest. It was not the only French medical training institution in the country, but it may have been the most influential. For forty years, in a particularly unstable political and military context, l’Aurore trained hundreds of medical students, mainly Chinese students, in the French language and under Jesuit supervision. Some Aurorians went on to hold high offices in the Republic of China (1912–1949).Footnote 2
The number of students in all the faculties of l’Aurore remained consistently above 500 from the time women were admitted in 1937.Footnote 3 In the last fifteen years of l’Aurore’s existence, when enrolment was at its highest, medical students ranged from 26% to over 48% of the total student body, that is, between about 100 and 300 medical students in any one year.Footnote 4 Those who completed their medical studies went on to work throughout China and abroad.Footnote 5 The longevity, scale, and international scope of this medical faculty warrant a closer look, especially because there is a rich historiography on the English-speaking medical institutions in China, but much less on the French-speaking ones, with important exceptions on which this article builds.
We argue that l’Aurore’s medical faculty had a significant and lasting impact in China and beyond because it simultaneously benefited from Jesuit missionary activity and the French quest for imperial influence, without fully identifying with either. Through this ‘strategy of ambiguity’, in the words of Yi Ren and Mingzhe Zhu,Footnote 6 the faculty could present itself as a purely scientific institution whose main function was neither religious nor political. It emphasised the usefulness of its professors and medical graduates, particularly in times of armed conflict or epidemics, while catering to the professional aspirations of a certain class of Chinese society.
The first part of this article traces the actions of the Jesuits in the history of the faculty.Footnote 7 The medical faculty had a missionary dimension which it was careful not to advertise in order to avoid criticism. On the one hand, Christians, let alone Catholics, were never a majority at the faculty. There was no religious obligation attached to enrolment. Proselytising was officially extracurricular. On the other hand, the university’s administration kept a record of the religious composition of the student body and Catholic baptisms among Aurorians. It also immersed students in an environment guided by Christian values so that later in life, they would at least not be hostile to the Christian religion and European missionaries in Asia.Footnote 8 At the medical faculty, teaching more directly bore the mark of Jesuit proselytism in the form of mandatory courses on ‘medical ethics’, which condemned the growing birth control movement from the 1920s onwards. This extended to the obligation for medical graduates to take an oath in which they pledged to resist birth control as doctors.
The second part argues that l’Aurore’s medical faculty was a key element of French imperial policy in Asia. It operated in the French Concession of Shanghai (1849–1943), a loosely controlled quasi-colony. Its funding came mainly from French diplomatic subsidies and Jesuit land holdings to give it a competitive edge over other imperial powers operating medical institutions in China, including Britain, the United States and Germany, as well as Protestant missionary organisations and private foundations, most notably the Rockefeller Foundation. The majority of the students at l’Aurore’s medical faculty were Chinese, although there was significant international diversity in the student body, extending the faculty’s reach beyond China. Staff consisted of doctors from France, Chinese doctors who had been trained by the French in Shanghai, some doctors from other nationalities and a few Jesuits. The fact that the medical degrees awarded by the faculty were recognised outside China enabled many Aurorians to continue their medical training or work abroad, particularly in Europe and North America, forming associations of Aurorians. This strengthened French and Catholic networks internationally, just as the French imperial presence was at its geographical and demographic peak.Footnote 9 It also set this faculty apart from the medical schools in empires that offered only basic training without entitling doctors to practise outside a strictly defined colonial territory.
The third and final part examines the last years of the faculty’s existence, marked by the outbreak of the Second Sino-Japanese War (1937–1945) and the abolition of l’Aurore as a university under French and Catholic administration in 1952. During the war, the faculty increased its enrolment and built new premises. With the departure of many French students and staff for military service, the influence of Chinese faculty members in medical education and health care grew. This facilitated experiments combining what was increasingly called traditional Chinese medicine with the bacteriological methods of the Pasteur Institute founded in 1938 in Shanghai. The influence of l’Aurore’s medical faculty lasted after the Communist Party came to power in 1949. Some Aurorian doctors continued to work in China to meet the country’s urgent medical needs despite criticism of the religious and imperialist framework of their training. Many Aurorians maintained contact with each other, and an association of alumni was later formed.
In addition to the historiography of medicine in Republican China and of l’Aurore University, various sources, mainly in French and English, but also some in Chinese, are used, particularly the archives of the French empire in Aix-en-Provence (the Archives nationales d’Outre-Mer), the Bulletin (1919–1949) published by l’Aurore’s medical faculty, and the archives of the French Jesuits in Vanves (France).Footnote 10
Creating a Jesuit university in Shanghai
The project that led to the creation of l’Aurore University began to take shape in the early 1870s when the Chinese Jesuit Ma Xiangbo (1840–1939) sought to establish an educational institution that would combine the study of classical Chinese texts and culture with a Western-style liberal arts education.Footnote 11 He was the headmaster of the elite Jesuit Saint-Ignace College in Shanghai’s Xujiahui district. In 1876, due to disagreements with the French Jesuits who ran the Kiang-nan (Jiangnan) mission – for the region south of the Yangtze River where Shanghai is located – over the educational use of classical Chinese texts, Ma left Saint-Ignace College and the Jesuits. However, he maintained links with the order and a desire to see his bicultural, syncretic curriculum realised. After working for Li Hongzhang (1823–1901), a very prominent political leader in the late Qing period, and travelling extensively, Ma returned to Shanghai around 1898. He reconciled with the Jesuits and ultimately donated most of his property to them to build an elite academy in keeping with the idea he had been nurturing for more than two decades.Footnote 12
The Jesuits supported Ma’s project, and the French ambassador was contacted about it. During a strike, some of Ma’s students and colleagues at Nanyang Polytechnic College, where he was then teaching, encouraged him to set up an institution of higher education, for which Ma provided land and some of the initial funding. The inauguration took place in early 1903, and l’Aurore (dawn) was chosen as the institution’s name to express a desire for renewal driven by a spirit of mutual enrichment between Europe and China.Footnote 13 However, in 1905, Ma and the Jesuits again locked horns over various aspects of administration and curriculum. Ma led a group of teachers and students to found a new institution, Fudan University, whose name could be translated as ‘revived Zhendan’, an implicit criticism of the Jesuits.Footnote 14
After Ma’s departure, l’Aurore was re-established with a French-style curriculum and moved in 1908 from Xujiahui to Lujiawan, an area that later became part of the French Concession of Shanghai. Its longest-held address was on Dubail Avenue.Footnote 15 Admission to l’Aurore required a good command of French, the language of instruction, and therefore French secondary schools in China became one of the main pools for recruiting students.Footnote 16 It was also possible to gain admission to the university by completing the in-house preparatory course.Footnote 17
While l’Aurore was founded in 1903, its medical faculty was not created until 1912. Physics, chemistry, and science courses became pre-medical courses in 1909. Two French doctors were recruited to teach medical courses from 1912 and take the students to the nearby Catholic Sainte-Marie Hospital for clinical training.Footnote 18 As it grew to treat thousands of patients (5869 hospitalised in 1933–1934, 68.2% of them were Chinese), this hospital became instrumental in the development of the medical faculty.Footnote 19 Also nearby was the French Saint-Antoine Hospital, which served the poorest inhabitants of the area and was involved in the teaching of medicine at l’Aurore. Footnote 20
Through what Jean-Paul Wiest, and more recently Yi Ren and Mingzhe Zhu, have aptly described as ‘indirect evangelisation’, l’Aurore was designed to selectively recruit students from well-placed families to instil a Christian ethos in the Chinese elite, without explicitly serving as a means of conversion to Catholicism.Footnote 21 Despite its Jesuit administration, l’Aurore was open to students of any religion or none. However, the Jesuits kept statistics on the religious affiliation of their students, celebrating in particular Catholic conversions. Between 1919 and 1946, there was an average of about ten baptisms annually among students across the university, for a total of 274 baptisms in twenty-eight years.Footnote 22 This figure does not include students who were already Christians before enrolling. According to partial data from the 1940s, Catholics and catechumens together accounted for between 29% and 38% of all students at the university. The proportion of Catholics was higher among those who graduated, ranging from 38% to 58% over the same years.Footnote 23 The number of Orthodox, Jewish, Protestant, and Muslim students was also recorded, but it was the category of ‘pagan’ that was consistently and by far the largest, exceeding all Christian denominations combined.
Although not a majority, Catholic students received special support from the administration, notably through the campus church and associations such as the St. Luc Association for Catholic doctors.Footnote 24 Graduates also had access to Catholic missionary networks throughout China. The Bulletin of the medical faculty regularly published advertisements targeting Aurorians seeking to work in Catholic hospitals in various parts of the country.Footnote 25 These medical positions seem to have been open to all Aurorian doctors, Catholic or not. Thus, l’Aurore became a major supplier of general practitioners and staff for Catholic medical institutions across China. Some Aurorians even went so far as to join Catholic orders, including Alice Pan Ing-cheng, who abandoned her medical studies after six years to become a Carmelite nun in Shanghai.Footnote 26
Religious openness and restraint in Catholic proselytism broadened the university’s recruitment base. It was also a way of not provoking anti-clerical sentiment among elements of the French Foreign Ministry, from which l’Aurore received much of its funding. The French Third Republic (1870–1940) was going through a particularly anti-clerical period when the university was founded.Footnote 27 Nevertheless, the French government was not averse to using the infrastructure and resources of well-established Catholic missions for colonial expansion when it seemed the best option available.
There was, however, one aspect of teaching at l’Aurore in which the Jesuits asserted their views more openly. It was the course on ‘medical ethics’, particularly when it came to birth control. The professor of ‘medical ethics’ from 1919 was the Jesuit Father Georges Payen, who taught moral theology at the French Seminary in Shanghai for thirty-five years.Footnote 28 The faculty’s focus on ‘medical ethics’ was based on Payen’s lengthy 1922 textbook titled Déontologie médicale d’après le droit naturel: devoirs d’état et droits de tout médecin (‘Medical Ethics According to Natural Law: the Duties and Rights of All Doctors’). The target audience was Aurorians, but the textbook was widely distributed in China and beyond, with two new editions in French (1928, 1935) as well as translations at least into Spanish and later Chinese.Footnote 29
Payen’s teaching and writings were mainly aimed at medical students and encouraged opposition to birth control. The birth control campaign was taking shape around the world and emerged in China when its most visible American advocate, Margaret Sanger, founder of the American Birth Control League, visited Beijing and Shanghai in April 1922.Footnote 30 Sanger’s case for birth control was based on arguments linked to eugenics and what was known as ‘neo-Malthusianism’, whereby a selective approach to reproduction was seen as beneficial to society as a whole. This, according to Mirela Davis, ‘gave the birth control movement an aura of future-oriented progressivism’.Footnote 31 Public debates about overpopulation were intensifying around the world, particularly in medicine, and the notion of eugenics was being introduced and discussed in the Chinese scientific sphere, as elsewhere.Footnote 32 In France, reflecting the growing movement, the French Eugenics Society (Société française d’eugénique) was founded in 1913.Footnote 33 ‘Although brief’, writes Michelle T. King, ‘Sanger’s visit launched a flurry of coverage in Chinese newspapers and periodicals, introducing urban Chinese audiences to neo-Malthusian theories on the importance of limiting population growth according to eugenic principles, as well as disseminating contraceptive information’.Footnote 34 From that point on, the teaching of medical ethics at l’Aurore became increasingly focused on Catholic opposition to birth control.
Around 1936, Margaret Sanger was expected to visit China again. Although this second trip was eventually cancelled, l’Aurore’s medical faculty prepared a special issue of its Bulletin devoted entirely to denouncing birth control, to be published in time for Sanger’s planned visit.Footnote 35 All the articles in the issue were written by Jesuits: two in French and the other three in Chinese, English, and German, respectively.Footnote 36 Just the previous year, in 1935, a revised edition of Payen’s textbook on medical ethics had been published. In the new chapters, Payen condemned euthanasia and what he termed ‘false eugenics’, recommended medical examinations before marriage but dismissed the idea of a state-guaranteed premarital certificate and strongly opposed sterilisation except for vital therapeutic reasons. François Veuillot was one of the leading French Catholics to praise the new edition.Footnote 37 The main principle Payen sought to defend was that the Christian religion alone provided a moral framework that made it possible to uphold the sanctity of life. Consequently, he argued that the state could only intervene in matters of procreation in accordance with natural law, which he saw as rooted in religion.
This led Payen to believe that no birth should be prevented once a child had been conceived if it was viable for the mother and the foetus, regardless of whether it would result in a child known by the doctor to be disabled.Footnote 38 Citing doctors in the United States, Switzerland, and England, Payen worried about the persuasiveness of eugenic arguments in his time. This edition appeared just after Adolf Hitler came to power, prompting Payen to mention in a footnote on sterilisation: ‘we know what is happening in Germany as we write’.Footnote 39 In arguing that eugenic sterilisation was immoral and unscientific (distinguishing it from therapeutic, punitive, or voluntary sterilisation), Payen cited the papal encyclical Casti Connubii of 31 December 1930, in which Pope Pius XI condemned various aspects of eugenics and reaffirmed Catholic doctrine on the family. Payen’s moral outlook was thus shaped by Catholic morality, yet it was also informed by his contact with clinical practice at l’Aurore. He argued, for example, that abortion could be morally justified in certain cases, such as when the uterus was affected by a tumour during pregnancy or during an ectopic pregnancy, when surgery was the only way to save the mother’s life, provided that the primary purpose of the procedure was not to remove the foetus.Footnote 40
The medical students at l’Aurore, whether Catholic or not, had to make an active commitment to these ideas. When they graduated, l’Aurore required them to take an oath specific to the institution, which included this passage: ‘I will use all my influence to combat the theories and practices of birth control. Life being a sacred thing, I will treat it with a sovereign respect in all my patients. In particular, I will take care to save the life of the mother as well as the child.’Footnote 41 Many medical graduates of l’Aurore went on to become public critics of any form of birth control.Footnote 42 An early prominent graduate was Song Kouo-ping (Guobin in pinyin, 1893–1956). Aside from translating Payen’s textbook into Chinese, Song published a number of works on medical ethics as well as works on the translation of medical terminology.Footnote 43 He was among the most prominent physicians in Shanghai in the 1930s and a staunch opponent of abortion and birth control, which he associated with the practice of infanticide that was widespread among the rural poor but somewhat exaggerated by foreign missionaries and inaccurately determined to be a uniquely Chinese phenomenon.Footnote 44 Song was effective at drawing on Confucian texts to link ‘infanticide’ (i.e. birth control) to the discourse of ‘national weakness’ that was pervasive among Chinese intellectuals at the time. Therefore, Aurorians were able to have an outsize influence on the discourse of medical ethics in China.Footnote 45
In short, l’Aurore was composed of and dependent on a majority of students and funders who were not Catholics, and it did not present itself as a Catholic missionary institution. However, in their administrative records, the Jesuits running the institution took an active interest in its ability to convert students, especially Chinese students, to Catholicism. The main exception to this missionary discretion was the ‘medical ethics’ courses, particularly in their condemnation of birth control about which the Jesuits took the liberty of expressing assertive views that had to be embraced by the students.
French imperial strategies
Although part of a university founded and run by Jesuits, the medical faculty of l’Aurore could not have grown to the size it did without the support of the French state and its diplomacy, which at the time was very anti-clerical. The French Third Republic (1870–1940) was pursuing a policy of imperial expansion in Asia, with French Indochina, in what is now Vietnam, Laos, and Cambodia, as its main base. This was particularly true under Paul Doumer’s governorship of Indochina (1897–1902). A left-wing politician, Freemason and future President of the French Republic, Doumer sought to consolidate the French colonial administration by means other than military force, notably through infrastructure projects such as railways but also through educational institutions, including medical schools.Footnote 46 This policy extended particularly towards southern China, which had become a French zone of influence by the turn of the twentieth century.Footnote 47
Symbolising France’s imperial ambitions in China, the capital of Indochina was moved from Saigon to Hanoi, closer to the Chinese border, in 1902.Footnote 48 In that year, a French medical school was established in Hanoi in collaboration with the leading French physician Paul Brouardel.Footnote 49 From the outset, the French administration attached both geopolitical and medical importance to the creation of this medical school in Hanoi. Providing medical education and health care was seen as a way of winning the sympathy of the local population in the belief that ‘medical training […] would be as effective as the apparatus of our military force in establishing our domination on the banks of the Mekong and the Red River’Footnote 50. The Hanoi school aimed to train ‘health officers’ rather than doctors, as Laurence Monnais has shown.Footnote 51 In other words, the idea was not to create a school like those that existed in metropolitan France but rather one that would provide local students with basic medical training to meet the needs of the colony. The medical school in Hanoi was explicitly modelled on the French medical school in Pondicherry, the main French trading post in India.Footnote 52 It was also modelled on some of the British medical schools in India, which trained practitioners in basic techniques to provide care in small Indian towns.Footnote 53
From 1907, the French medical school in Hanoi planned to admit Chinese students who would then return to China to practise.Footnote 54 As Florence Bretelle-Establet has analysed, medical training of Chinese students by French doctors also began during this period in the French zone of influence in southern China, including in Kunming and Guangzhou.Footnote 55 Meanwhile, French medical education was introduced in Tianjin in northeast China.Footnote 56 It was in the context of the development of French medical education as a means of imperial influence that the project of a French medical faculty in Shanghai took shape.
The career of the French doctor Jean-Augustin Bussière (1872–1958) was the embodiment of this French policy of influence through medicine. Bussière graduated from the École de médecine de la Marine et des Colonies in Bordeaux. In 1900, he became head of the health service for French colonial establishments in India and director of the Pondicherry medical school. A follower of Pasteur who had worked in Senegal, Bussière was also sent to Saigon (1901–1902) and Tehran (1903–1909).Footnote 57 As early as 1902, he had contacted the French political authorities to propose the creation of a hospital to treat Chinese patients in Shanghai, but this proposal was rejected for lack of funds.Footnote 58 In 1913, Bussière moved with his family to Beijing,where he lived for most of his life. He played a key role in the development of l’Aurore’s medical faculty in Shanghai, quickly becoming its dean and remaining honorary dean until at least 1948.Footnote 59 This made him one of the few non-Jesuits on the administrative staff of l’Aurore, at least in the pre-war period.Footnote 60
In supporting l’Aurore’s medical faculty, the French authorities were particularly keen to compete with other imperial powers in China such as the British, Germans, and Americans, whose influence was partly due to their medical schools.Footnote 61 According to Pierre Huard, twenty-six European-style medical schools existed in China in 1916 with around 1,940 students. Thirteen of these had been established by missionary organisations, and many had grown out of courses first given in hospitals.Footnote 62 The hefty indemnity imposed on the Qing dynasty after the Boxer Rebellion (1899–1901) funded many medical institutions with American or European connections.Footnote 63
In practice, l’Aurore participated in the creation of an imperial medical market in Asia. Protestant missionaries and the Rockefeller Foundation played a key role in this market, particularly through the China Medical Board established in 1914.Footnote 64 In 1933, the vice-president of the Rockefeller Foundation, Selskar Gunn, announced plans to build a medical school on land adjacent to l’Aurore, a project that the Jesuits were only able to thwart by organising the purchase of the land.Footnote 65 It was difficult for the French to compete with such rivals. But this burgeoning medical market was also a source of income for l’Aurore, whose medical Bulletin published advertisements for medicines and medical equipment from German, British, American, and French companies with offices in Shanghai.Footnote 66
Japan’s influence in the Chinese medicine world was becoming no less significant.Footnote 67 In addition, China was developing new antagonisms of its own when it came to medicine. Chinese medicine was then in the process of being redefined in the face of foreign forces, and by the end of the nineteenth century, it was institutionalised in a handful of medical schools before becoming more widespread in medical education from the early twentieth century.Footnote 68 Around the same time, as Bridie Andrews explains, there was a push by Chinese nationalists to limit the influence of traditional Chinese medicine, which they saw as a hindrance to China’s modernisation.Footnote 69
French diplomats were thus looking to increase their influence in China’s already crowded medical market. After the failure of attempts to establish a secular French medical school in Shanghai, the numerous and well-organised medical, educational, and charitable institutions of the Catholic missions seemed the best means of realising French ambitions for influence in Asia, despite the French government’s anti-clerical tendencies.Footnote 70 From 1913 onwards, therefore, l’Aurore and its medical faculty were largely funded by the French Foreign Ministry and, shortly afterwards, by the municipality of the French Concession in Shanghai. The condition was that l’Aurore promoted itself as a French institution and that its curriculum and staff served French interests – which it did.Footnote 71
Comparatively modest and facing stiff competition, l’Aurore’s medical faculty tapped into the desire of some Chinese to gain access to the French medical world at a time when the name of Louis Pasteur, for one, had an international resonance. French diplomacy enabled l’Aurore to recruit French professors of medicine.Footnote 72 Several professors at the medical faculty had studied in Bordeaux, perhaps due to the presence of a colonial medical school there.Footnote 73 In addition to the French professors, a number of Chinese individuals were mentioned as having contributed to the establishment of the medical faculty.Footnote 74 In 1917, Zhu Zengzong and Wang Zhenshi became the first to graduate in medicine at l’Aurore. Footnote 75
Anne Frédérique Glaise estimates that there were a total of eighty-nine medical graduates at l’Aurore between 1917 and 1934. By 1938, the number had risen to 154.Footnote 76 This was only a fraction of the number who enrolled, contributing to the university’s reputation for rigour and selectivity. In medicine, part of this reputation was based on the fact that, unlike many colonial medical schools, l’Aurore’s medical faculty did not aim to train subordinate medical personnel. Instead, it was designed to train full-fledged doctors who could travel and expect to work as doctors in other countries, including France, albeit perhaps with complementary training.Footnote 77 The university’s preparatory course was considered equal to the French baccalauréat. Aurorians could therefore be exempted from preparatory courses if they continued their medical studies in France.Footnote 78
The structure and content of the medical programme at l’Aurore soon became essentially identical to those in France.Footnote 79 The emphasis on learning anatomy through dissection certainly helped to legitimise the curriculum in the eyes of the French medical authorities. Within two years of the faculty’s establishment, human dissection was officially authorised in China.Footnote 80 By 1935, the University Bulletin could boast of the ‘large number of “subjects” the faculty is able to procure’.Footnote 81 The ‘Sacred Heart Hospital’, the ‘Franciscan Hospitals’, and the ‘Charitable Society’ in Shanghai were mentioned as sources of bodies for dissection, showing the interaction between the faculty and Shanghai’s Catholic and charitable organisations.Footnote 82 If there was one thing Shanghai had in abundance at the time, it was abandoned bodies. In the French Concession alone, an organisation dedicated to collecting them recorded no fewer than 73,698 abandoned human corpses between 1929 and 1938.Footnote 83 There seems to be no direct evidence of a link between them and dissection by medical students, but the fact is that Shanghai became known as a place where it was easy to dissect a human body during medical studies (unlike Taiwan, for example), which was essential to gain recognition in French medicine.Footnote 84
L’Aurore’s influence in China and abroad grew as it admitted more students and built new infrastructure, including the creation of a school of dentistry in October 1933.Footnote 85 A nursing school was added in 1934.Footnote 86 From 1937, women were admitted to study at l’Aurore, including medicine, although it is not clear to what extent their education was separate from that of male students. In medicine, the number of female students remained relatively small: eight in 1940 and fifteen in 1941.Footnote 87 Marriages between Aurorians, notably within the same cohort, were not uncommon.Footnote 88
From the outset, l’Aurore and its medical faculty were of international stature. L’Aurore’s medical programmes, tailored to French expectations, allowed it to develop close ties with Paris, Lyon, and other French cities, as well as with Catholic universities in Belgium and the French medical school in Beyrouth.Footnote 89 At least thirteen Aurorians studied medicine in Paris. Six Aurorians studied in Louvain, three in Brussels and at least one each in London, Edinburgh, and Marseille. Chinese Aurorian Ou Kouang-yin was awarded a silver medal by the Paris Faculty of Medicine for his thesis completed in Paris.Footnote 90 Some returned to take up teaching posts at l’Aurore, such as Dr Song Kouo-ping (Guobin), mentioned above, who graduated in medicine from l’Aurore in 1921 and then studied in Paris on a scholarship, including at the Pasteur Institute, before becoming professor of bacteriology at l’Aurore. Footnote 91 A small minority of Aurorian doctors went on to work in other countries, while usually maintaining close links with l’Aurore.
While most of the students and an increasing proportion of the professors were Chinese, the student body included several other nationalities, mostly from Europe and Asia but also from regions as far afield as South America and the Middle East.Footnote 92 The largest national minority at l’Aurore, even surpassing the French, were the Russians.Footnote 93 The medical faculty’s library reflected this internationalism, offering the latest issues of medical periodicals in English, French, Spanish, Portuguese, and Dutch, and regularly receiving book donations from personal libraries or medical organisations from different countries.Footnote 94 The same internationalism was evident in the contributions to the medical faculty’s Bulletin and in the scientific events and medical associations in which the Aurorians participated in Nanjing, Hanoi, or Strasbourg or that they hosted in Shanghai.Footnote 95
Aurorians generally kept in touch with each other. This strengthened international Francophone and Catholic networks at a time when the French imperial presence was growing worldwide. Several alumni associations were formed, and an alumni newsletter was published in the early 1940s.Footnote 96 From 1941, the faculty held a monthly radio broadcast to provide news of its activities.Footnote 97 In the second half of the 1940s, the Jesuit and former missionary to China, Jean de la Largère (1905–1973), organised monthly meetings for Aurorians living in Paris.Footnote 98
To sum up, the French state, despite its anti-clericalism, largely financed l’Aurore to serve its imperial policy in Asia and beyond. Specifically, l’Aurore’s medical faculty competed with medical institutions run by other foreign powers in China, whether imperial, religious, or private, in a context where the Chinese government and those who were increasingly described as traditional practitioners also provided medical education. In this competitive medical education market, l’Aurore offered a medical curriculum equivalent to that available in France. Aurorians could look forward to rewarding careers with access to international Catholic and French-speaking networks. In turn, the university’s high-profile alumni were likely to support their alma mater.Footnote 99 Some Aurorians, particularly the Chinese, went abroad to study or work, whereas a significant proportion of students from other countries came to l’Aurore, strengthening the faculty’s international character. Schools of nursing and dentistry, as well as associations of Aurorians in China and overseas, increased l’Aurore’s influence in medicine.
Lasting impact on the medical world
With nationalism and opposition to imperialism on the rise in China, it was not obvious that the Chinese political authorities, of any persuasion, would allow l’Aurore to operate.Footnote 100 Nevertheless, l’Aurore’s medical faculty kept growing. Like its rivals, it could thrive because of a rapidly expanding public health environment in which it sought to become indispensable.Footnote 101 To maintain recognition by the Chinese authorities, the Jesuits focused on scientific education, avoided open proselytism, and tried to remain independent of both French and Chinese politics, while appointing Chinese members who were sympathetic to their cause to the university’s board of directors.Footnote 102 However, l’Aurore was not insulated from politics and periodically faced criticism from the students, particularly for accommodating changing political regimes and discouraging political dissent and engagement.Footnote 103
For the medical faculty in particular, the most effective way to navigate the profound political upheavals of the time, marked by hostilities between Republican and Communist forces, was to emphasise the usefulness of medical work especially in wartime. Sometimes the Aurorians travelled to where the fighting was taking place, such as the battles between warlord troops around Bengbu in Anhui Province in 1926, where they tended to the wounded.Footnote 104 But war could also come to them, as it did during the Sino-Japanese fighting in early 1932, when the Catholics’ relatively safe and neutral position enabled them to organise aid for soldiers and civilians.Footnote 105
When the major battle of the Second Sino-Japanese War (1937–1945) began in Shanghai in 1937, Aurorian medical and nursing students once again volunteered to treat the wounded.Footnote 106 This conflict led to a refugee crisis even worse than that of 1932.Footnote 107 By April 1938, Aurorians had treated hundreds of wounded soldiers and around 50,000 refugees, leading the Sainte-Marie Hospital to open up new wings and earning it the silver medal of the French Concession.Footnote 108 The refugee crisis exacerbated long-standing difficulties in preventing infectious diseases, causing the French Concession to rely even more heavily on civil society and international organisations.Footnote 109
These were difficult times for l’Aurore and indeed for China, especially during the Japanese occupation of the Shanghai Concessions from December 1941 to 1945. Daily life was made particularly difficult by unreliable rice supplies and inflation.Footnote 110 In 1943, the French Concession was dissolved by the Japanese occupying forces in order to strengthen the legitimacy of Wang Jingwei’s government, which collaborated with the Japanese Empire.Footnote 111 The most significant interruption to l’Aurore’s activities during the war occurred between March and August 1945 when the Japanese Army requisitioned the university buildings, leading to a massive relocation of the institution until the end of the war.Footnote 112
Nonetheless, this was also a time when l’Aurore’s medical, nursing, and dental sections (the latter forced to close between the outbreak of the war and 1940) tended to grow in student enrolment and prestige.Footnote 113 The medical faculty reported 145 students in 1939, 175 in 1940, and 196 in 1941, claiming to have awarded fifteen degrees in 1940, twenty-five in 1941 and ten in 1943. The number of nursing graduates also increased.Footnote 114
This growth coincided with major changes in the faculty staff. Contact with Europe became more difficult during the war, and many of the French professors and students were called up to serve in France.Footnote 115 France was defeated and occupied by Germany between 1940 and 1944. Reports suggest that the vast majority of the 2,497 French residents in Shanghai’s French Concession in 1942 supported (not necessarily openly) Charles de Gaulle and the Resistance against Germany.Footnote 116 Indirect evidence indicates that Nazism and the fate of France under the Vichy regime were of serious concern to at least some members of the faculty.Footnote 117
The case of Dr Edith Mankiewicz (née Edith Marion Meyer) illustrates how l’Aurore could even become a place of refuge for doctors fleeing Nazism. Born in Leipzig in 1910, Mankiewicz fled Germany with her husband, the lawyer Harald Mankiewicz (1905–1993) after the Nazis came to power. Both were in danger because of their Jewish ancestry. They settled in Lyon, France and became French citizens in 1938. The following year they converted to Catholicism.Footnote 118 When France fell into the hands of the German army, Edith Mankiewicz’s medical studies enabled her to become professor of bacteriology at l’Aurore. She was one of the few female professors at the medical faculty, if not the only one. Mankiewicz moved with her husband to Shanghai in 1941 and they both worked at l’Aurore as professors until 1945.Footnote 119 They then moved to Montreal, Canada, where Edith Mankiewicz spent the rest of her life as a doctor and professor of medicine. Stripped of her French nationality by the Vichy regime in 1944, she was decorated by General de Gaulle’s representatives after the end of the war.Footnote 120
Still, l’Aurore received financial support from the Vichy government led by Philippe Pétain during the occupation of France. It also maintained a close relationship with the French ambassador, Henry Cosme (1885–1952), who had arrived in China before the occupation of France but remained in office under the Vichy regime. Cosme tried to protect French colonial interests in Asia, particularly in Indochina. In private, he declared that he personally sided with de Gaulle, but in his official capacity, he took measures against those who organised for the Resistance or went to join de Gaulle in London.Footnote 121 Cosme was very supportive of l’Aurore, which he visited as soon as he took office. In 1941, he created a prize in his own name for deserving students of the medical faculty.Footnote 122
Chinese faculty members took a more prominent role in the affairs of the institution as the war reduced the number of French faculty members. This was reflected in a greater interest in Chinese medicine, which had existed at l’Aurore at least since the 1930s but gained momentum during the war.Footnote 123 Articles on traditional Chinese medicine appeared in the faculty Bulletin, revealing some interest in exploring how laboratory medicine could transform traditional ways of healing.Footnote 124 This was in keeping with laboratory experiments carried out on ‘Chinese herbal drugs […] [i]n a process now known as ‘bioprospecting,’ [where] many drugs were analyzed for active principles that, once isolated, could be repackaged and sold as modern (i.e., Western-medical) drugs.’Footnote 125 Anne Frédérique Glaise notes that very practical reasons also made traditional Chinese medicine more attractive to Aurorians in wartime, ‘as medicines are scarce and expensive, attention turns to Chinese medicine in the hope that it will provide alternatives to these shortages’.Footnote 126 For ‘fixers’ in Shanghai, such as Xu Guanqun (1899–1972), producing and selling what they marketed as Chinese medicines approved by professional scientists became particularly lucrative.Footnote 127
Using their knowledge of the local environment and a vast pharmacopoeia, Chinese members of the medical faculty could develop treatments and make public health measures more palatable to local people.Footnote 128 For example, Liu Yongchun, an early Aurorian doctor and vaccination authority in Shanghai, studied the synthesis of acupuncture with neurology and vaccination. Regardless of the scientific validity of these methods, patients accepted vaccination more readily when injected at acupuncture points.Footnote 129 In 1942 and 1943, the Musée Heude (the Museum of Natural History of l’Aurore) opened an exhibition on Chinese materia medica, the impact of which was amplified by publications and lectures.Footnote 130 These tentative explorations of traditional Chinese medicine in some ways foreshadowed programmes in the Maoist period that combined Western and Chinese medicine.Footnote 131
In 1943, l’Aurore’s medical faculty entered into an agreement that allowed a Society for the Study of Chinese Medicine (Société de recherche sur la médecine chinoise) to use its laboratories.Footnote 132 This agreement was likely facilitated by the development of bacteriology around the new Pasteur Institute founded in Shanghai in 1938.Footnote 133 L’Aurore had always been close to the Pasteurians, not least because of the training of some of its professors, and had maintained links with the Pasteur Institutes in Indochina.Footnote 134 Inaugurated during a cholera outbreak, the Pasteur Institute in the French Concession of Shanghai became a vital public health facility, particularly for vaccination.Footnote 135
It was therefore through wartime, during the last fifteen years of its existence, that the medical faculty reached its highest stage of development. Immediately after the war, Aurorians established friendly contact with doctors arriving aboard American and British military ships.Footnote 136 The university benefited from post-war investment in reconstruction, but not necessarily from French sources as before. The French Concession in Shanghai had ceased to exist, and funding from the French government dwindled, but the Jesuits’ property holdings continued to provide a financial base for l’Aurore.Footnote 137 From this position of relative strength, l’Aurore continued to exist for seven years after the war, as China plunged into a civil war between the Nationalists led by Chiang Kai-Shek and the Communists led by Mao Zedong. Some French professors arrived, and relations with France were partially restored, but more and more Aurorians were leaving the country.Footnote 138 Shanghai fell to the Communists in late May 1949, and Mao proclaimed the People’s Republic of China in October of the same year. Soon after the Communists took Shanghai, l’Aurore came under financial and political pressure. The Communist view, which had become dominant in Chinese national politics, was that l’Aurore was a demonstration of Western cultural imperialism in China. A growing number of Aurorians were siding with the Communist regime.Footnote 139 Ideological and financial pressure intensified with China’s entry into the Korean War in October 1950.Footnote 140
As a result, in 1952, the faculty was dissolved and merged with St. John’s University and Tong De Medical College to form a new Chinese institution in line with the ruling regime’s priorities, the Shanghai Second Medical College – today the Shanghai Jiao Tong University School of Medicine.Footnote 141 By contrast, Fudan University, also founded by Ma Xiangbo, continues to operate separately to this day. Through the actions of Communist Party-affiliated groups, l’Aurore’s associated hospitals and clinics were brought under the control of the emerging bureaucracies of the Shanghai People’s Government. In the 1950s, there was an attempt to import a Soviet model of medical education, but this was largely abandoned after thousands of ‘Soviet specialists left China in 1960’ according to Xi Gao.Footnote 142 At that point, medical education throughout China had become more militarised and large scale. Its content reflected the Communist government’s policy of promoting Chinese medicine, leading to the opening of at least thirteen medical schools between 1955 and 1960 that explicitly taught traditional medicine.Footnote 143
Because of their expertise, most Aurorian medical, nursing, and dental graduates who had not fled to Hong Kong or Taiwan continued to work in the new People’s Republic, although they were monitored for suspected political disloyalty and had to attend ideological indoctrination sessions. Like other former missionary institutions, l’Aurore provided specialised training and services that the state could not fully replace.Footnote 144 In 1985, a group of Chinese alumni living in Shanghai founded an association of former Aurorians (Amicale des anciens Auroriens), based at the Second Medical University. Six of the eleven members of the association’s board worked in the medical sector in China.Footnote 145
The lasting impact of l’Aurore’s medical faculty was thus based on its ability to make itself indispensable to public health in a context of constant warfare in China, and on the work of its Chinese members in its administration and medical activities. The medical faculty weathered the years of the Second Sino-Japanese War by officially concentrating on the medical aid it could provide and trying to adapt to the regime changes in China and France. This enabled it to reach a peak in recruitment and build new infrastructure. The war reduced French involvement in the faculty, allowing Chinese Aurorians to take on more responsibilities at l’Aurore and devote more attention to Chinese medicine using laboratory methods. After the war ended and the Communists came to power, l’Aurore continued to operate until it was dissolved by the government in 1952. Even then, many Aurorians continued to work in the Chinese medical profession because of their expertise, despite the fact that their background seemed incompatible with the policies of the Communist regime. The memory of the university was preserved largely through the initiative of doctors, including in an association.
Conclusion
L’Aurore University in Shanghai was founded by the Jesuits in 1903, and it opened a medical programme in 1912. Over the next forty years, l’Aurore’s medical faculty trained hundreds of students, most of them Chinese. This article has argued that the durability and influence of l’Aurore’s medical faculty was due to its ability to rely on Jesuit missionaries in China without presenting itself as a missionary enterprise and to benefit from the support of the French imperial state without presenting itself as a formal imperial institution.
Although it was inseparable from the missionary work of the Jesuits, l’Aurore was only used as an instrument of explicit Catholic proselytism in one aspect: the medical ethics courses, which were rooted in Catholic principles and opposed birth control in particular. L’Aurore’s medical faculty also served the imperial ambitions of the French state, which at the time was particularly hostile to the clergy. The French authorities subsidised it to train students, especially Chinese, in French medicine in order to compete in medical education with the other imperial or private foreign powers active in China. The medical faculty consolidated its influence during the most perilous period of its existence: the years of war between China and Japan. Against a background of massive population movements, fighting, inflation, hunger, and the loss of staff to the military, the faculty increased its student numbers and built new infrastructure. Partly due to the more prominent role that the Chinese staff began to play during these years, teaching and research in Chinese medicine took on an unprecedented importance in the faculty. The Aurorians who remained in China after the Communist regime took over continued to be involved in public health, even founding an association in 1985 to bring together alumni and preserve l’Aurore’s legacy. Although not the most important foreign medical training institution in China at the time, l’Aurore’s faculty of medicine is therefore an odd case illustrating the complexity of the relationship between medical education and empire.
Competing interest
The authors have no Competing interest to declare.
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