292 China Review International: Vol. 5, No. 1, Spring 1998 Yip Ka-che. Health and National Reconstruction in Nationalist China: The Development ofModern Health Services, 1928-1937. Ann Arbor: Association for Asian Studies, 1995. ix + 289 pp. Hardcover, isbn 0-92430-428-6. Paperback , isbn 0-92430-433-2. While so-called "traditional medicine" is fast becoming a fashionable field of research in the history of twentieth-century China, far less is known about the origins and development of medical science, despite its overwhelming importance in such wide-ranging contemporary issues as public health, preventive medicine, birth-control programs, and even legislation on eugenics. Yip Ka-che breaks new ground in providing a detailed examination of the emergence, organization, development , and consequences of modern health services in the Nanjing decade. A major contribution to an under-researched area, this meticulously researched book argues that there was no sharp break between the Nationalist efforts to build a modern health care system in the context of national reconstruction and the Communist endeavors after 1949. While this book remains explicitly confined to a social and institutional history of medical administrations under the Guomindang , it addresses a number of key issues in the development of public health. One line of inquiry focuses on the political, social, and economic problems with which the Nationalist planners were confronted: Yip shows that despite the severe constraints imposed by political infighting, lack of financial support, and massive poverty in the rural areas, the government had established central health institutions which were reasonably efficient by 1937. The tensions between different approaches to health care, in particular between foreign models of health planning and indigenous health experiments, are also an important theme that is fruitfully addressed by the author. Whether under the auspices of the Rockefeller Foundation or the League of Nations Health Organisation , foreign assistance in the building of a state medical service created contradictions between the research agenda of medical experts and the requirements of the rural population. In recognition of the need to develop an extensive educational infrastructure, the Nationalist government also attempted to promote training institutions, an effort that was only partially successful by the time it was interrupted by the outbreak of the Sino-Japanese War in 1937. Medical schools for the training and supply ofhealth manpower, ranging from nationally administered colleges to privately run institutions and mission hospitals, faced common 199» by University problems offinance, personnel, and facilities. Their geographical distribution was uneven, marked by an urban concentration and intense competition with unqualified doctors in cities like Shanghai and Canton. ofHawai'i Press Reviews 293 The Communists did not simply inherit the health infrastructure left behind by the Guomindang: continuities in the intentions ofboth leaderships are equally apparent, as the Communists also emphasize the subordination ofindividual health concerns to the national priorities ofstate building and economic might. There are substantial continuities in the philosophy, structure, programs, and even personnel ofhealth care between the two regimes, and, from that point of view, Yip Ka-che's study offers an important historical perspective to a better understanding ofdevelopments after 1949 that is urgently required. Finally, as the author thoughtfully points out in his conclusion, it would be misguided to assume that health planners in the PRC have solved the quality-versus -quantity or the urban-versus-rural dilemmas in the delivery ofhealth care: recent developments indicate growing disparities in which large sectors of the hinterland are politically and economically marginalized, as even the most basic medical facilities have become virtually nonexistent. This work is an invaluable contribution to a small body ofliterature on medical science, nationalism, and modernity that sheds much-needed light on the republican period, and, by refraction, on vital issues of the more recent history of China. Frank Dikötter School of Oriental and African Studies, University of London Frank Dikötter is Senior Lecturer in the History ofMedicine and Director ofthe Contemporary China Institute; he specializes in the study ofmedical science and ideas of 'race', nation, gender, sexuality, reproduction, criminality, and death. mm Bell Yung, Evelyn S. Rawski, and Rubie S. Watson, editors. Harmony and Counterpoint: RitualMusic in Chinese Context. Stanford: Stanford University Press, 1996. xii, 324 pp. Hardcover $49.50, isbn...
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Apr 1, 2001
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