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Dissecting modernity : anatomy and power in the language of science in China Luesink, David Nanson 2012

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      DISSECTING MODERNITY: ANATOMY AND POWER IN THE LANGUAGE OF SCIENCE IN CHINA  by  David Nanson Luesink  B.A. (Hons) Trinity Western University, 2002 M.A. University of Alberta, 2004   A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF  DOCTOR OF PHILOSOPHY  in  The Faculty of Graduate Studies  (History)   THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver)  August 2012   © David Nanson Luesink, 2012        ii Abstract  This study analyzes the construction of modernity by looking at a set of problems that began to be posed in a striking connection in China in the 1910s, related to anatomy, technical language and power. It does so by focusing on a network of people who created and standardized translations for scientific terminology in Chinese, beginning with the terminology for anatomy. This network, lasting from 1915 to 1927, extended to three hundred members, but this study keeps the focus on a much smaller number. Anglo-American physicians were represented by Philip Cousland and Yu Fengbin. Mediating between missionaries and Chinese elite physicians were members of the Jiangsu Provincial Education Association like philologist Shen Enfu, but also Yu Rizhang, also head of the YMCA. Overshadowing these men was Dr. Tang Erhe, government representative and leader of Japanese-trained physicians. Only several years earlier, Tang had almost single-handedly established legal, routinized dissection as the basis of medical education in China. The activities of these men reveal the problems of how scientific modernity would be established as a new orthodox epistemology in the Chinese context. This study examines the rapid shift, in China, from a cosmology centered in Confucian orthodoxy and the institution of the imperial examination system toward a scientific worldview based on material practices like anatomical dissection and bolstered by a vast new technical terminology. In China in 1910 China was still the Qing empire, anatomy was illegal and medical education occurred only in master-disciple relationships. By 1920, these conditions had changed. Even as politics deteriorated, new forms of mundane power were established. The JPEA-Joint Terminology Committee network coincided with, and accelerated trends towards professionalization, first among anatomically-based physicians, but also scientists and educators. Professional groups formed in 1915, publishing the results of the committee and related attempts to regulate the medical field. This regulation led directly to attempts to abolish Chinese medicine. By following members of this committee, we see the institutionalization of anatomically-based medicine in China through its technical language and anatomical practice. We also see a new form of power that sought to eliminate ambivalence through reductionism.    iii Table of Contents  Abstract .......................................................................................................................................... ii Table of Contents ......................................................................................................................... iii List of Tables .................................................................................................................................. v List of Figures ............................................................................................................................... vi List of Abbreviations ................................................................................................................... vii Acknowledgements ..................................................................................................................... viii Introduction: dissecting modernity ............................................................................................. 1 Modernity ................................................................................................................................................. 8 Problem: China as “the sick man of Asia” ......................................................................................... 15 Modernity and the problem of state-building .................................................................................... 20 From anatomy to anatomo-politics ...................................................................................................... 28 Dissertation overview ............................................................................................................................ 36 Part I: Language, networks and power ..................................................................................... 42 1 Mundane activities: the work of the Joint Terminology Committee in China ................... 43 Scientists in action ................................................................................................................................. 44 A suitable nomenclature in Chinese .................................................................................................... 54 Zhengming/rectification of names ....................................................................................................... 57 Building trust ......................................................................................................................................... 60 Overview of the Joint Terminology Committee, 1916-1927 .............................................................. 78 Anatomic modernity meets semiotic modernity ................................................................................. 85 2 The social network: generalists and professionals between the Jiangsu Provincial Education Association and the Joint Terminology Committee .............................................. 88 Networking to build new institutions .................................................................................................. 91 Engineering the shift from “the principle of heaven” to scientific epistemology ............................ 93 “The education lords” ........................................................................................................................... 94 Scope of the JPEA networks circa 1925 .............................................................................................. 98 A Shanghai-based web extends through modernizing institutions ................................................. 105 The JPEA-Joint Committee nexus and professionalization of physicians and scientists ............. 114 Conclusion: How the JPEA-Joint Committee nexus anticipated the Nationalist state ................ 120 3 Rockefeller capital, missionary labor: the gospel of translation in China ........................ 124 Introduction: “just the right sort of scholars” ................................................................................. 124 Missionary medical terminology labor from Hobson to Cousland ................................................ 130 Medical education in Chinese ............................................................................................................ 135 From medical aid to missionary medical schools ............................................................................. 139 Philanthropy and the language of medical work in China .............................................................. 143 How Cousland enrolled Rockefeller capital ..................................................................................... 146 If you support the work, show me the money! ................................................................................. 149 The importance of enrolling the publishers ...................................................................................... 152 Missionary and pundit labor .............................................................................................................. 155 Have pundit, will travel .................................................................................................................... 156 The translation bureau ....................................................................................................................... 161 Lexicology ............................................................................................................................................ 165  iv 4 Things are named by agreement: Joint Terminology Committee debates and the public  ..................................................................................................................................................... 167 Shending/approval .............................................................................................................................. 171 Jíepouxue/anatomy ............................................................................................................................. 186 Jiepou/dissect ....................................................................................................................................... 195 Enrolling opinions from all China’s professionals ........................................................................... 197 “Concerning the medical terms approved by the Ministry of Education” .................................... 201 If China wants to have science, science must first speak Chinese .................................................. 206 Part II: Anatomy and power .................................................................................................... 210 5 Dissecting bodies in Chinese: medical authority and the state in Beijing, 1912-1919 ..... 211 The study of dead things and the study of live things ...................................................................... 214 Why a proper understanding of the body is essential to proper rule ............................................. 220 Tang Erhe and the birth of modern China (-ese biopolitics) .......................................................... 226 To anatomize a corpse is to see with new eyes .................................................................................. 235 Supplying corpses and the birth of practical anatomy in China .................................................... 236 Anatomizing words: textbooks and standardized terminology ...................................................... 242 Biopolitics—profession—state—historian ........................................................................................ 244 6 Anatomical Tours: Japan, China, Europe and America .................................................... 248 Tang Erhe’s diary compared to contemporary accounts of anatomy in the Japanese empire ... 250 Tang Erhe enters the heart of hygiene .............................................................................................. 258 Anatomy in Japan ............................................................................................................................... 261 Materializing anatomy ........................................................................................................................ 263 Teaching anatomy ............................................................................................................................... 270 Research in anatomy ........................................................................................................................... 275 Anatomy and power ............................................................................................................................ 278 Conclusion ............................................................................................................................................ 284 7 Lacking political power, scientific medicine is not able to become popular in China ..... 285 Introduction: the body of Yuan Shikai ............................................................................................. 285 Sublimation and preservation: Chinese Medicine as national essence .......................................... 292 Coercion: The Japanese medical police method .............................................................................. 295 The diary of a madman and critique of the triple burner .................................................................. 298 The medical revolution and the Joint Terminology Committee ..................................................... 300 (Self)-governmentalizing of Chinese medicine ................................................................................. 312 Conclusion: The Devil is in the details .................................................................................... 318 Bibliography .............................................................................................................................. 328 Appendices ................................................................................................................................. 365 Appendix 1: Complete list of fields of science covered by the Joint Terminology Committee, 1916-1925 ............................................................................................................................................. 365 Appendix 2: Map of Shanghai and networks centered on the JPEA. ............................................ 367 Appendix 3: Physical anthropology in China c. 1921 ...................................................................... 369 Appendix 4: Thirty-two super-networkers of the Joint Terminology Committee. ....................... 373 Appendix 5, Joint Terminology Committee participants, 1915-1927 ............................................. 375 Appendix 6: Union missionary medical schools in China as of 1914 ............................................. 391 Appendix 7: Contextual items by Tang Erhe and E. V. Cowdry (and others) demonstrating the range of activities associated with Anatomy in the 1910s ................................................................ 392   v List of Tables  Table 1 Organizations represented at February 21, 1915 symposium on medical terminology ... 67  Table 2 Numbers of Chinese studying in Japan ............................................................................ 69  Table 3 Appearance of “medical terminology” (yixue mingci 醫學名詞) in Republican journals, 1915-1925 .......................................................................................................................... 76  Table 4 Appearance of “scientific terminology” (kexue mingci 科學名詞) in Republican journals, 1914-1926 .......................................................................................................................... 76  Table 5 Organization of activities of Jiangsu Provincial Educational Association, c. 1925 ......... 99  Table 6 Some subcommittees and cooperating organizations of the Jiangsu Provincial Educational Association .................................................................................................. 106  Table 7 JPEA members at JTC Meetings, Science Society of China ......................................... 110  Table 8 JPEA members at JTC Meetings, Science Professors Reasearch Association .............. 110  Table 9 JPEA members at JTC Meetings, JPEA/Medical Association ...................................... 110  Table 10 JPEA members at JTC Meetings JPEA/Major Press Press .......................................... 111  Table 11 JPEA/Nanjing Teachers College (from 1921 Southeastern University) ...................... 111  Table 12 JPEA members at JTC meetings, Only JPEA .............................................................. 112  Table 13 Editions of Cousland’s Lexicon ................................................................................... 166  Table 14 Verticalis, 1919  ........................................................................................................... 179  Table 15 Alveolus, 1919 ............................................................................................................. 179  Table 16 1919 Approved list for anatomy: osteology ................................................................. 181  Table 17 Corresponding term lacking, according to category .................................................... 184  Table 18 Composition of the Joint Terminology Committee in August 1916 ............................ 186  Table 19 Anatomia, 1919 ............................................................................................................ 187  Table 20 Comparing Tang’s “Diary of an Eastern Journey” (1917), and Cowdry’s “Anatomy in Japan” (1920). ................................................................................................................. 260     vi List of Figures  Figure 1 The giant disease “Medical work in China is like a little child trying to wrestle with the giant disease.”  …………………………………………………….…………………………….17 Figure 2 Cousland’s historical note, 1908 ................................................................................... 132  Figure 3 Grant applications from the publication committee of the CMMA .............................. 150 Figure 4 Medical terminology I, anatomy: osteology, 1919 ....................................................... 173  Figure 5 “The human body: inaccurate (Chinese); accurate (Western)” .................................... 289  Figure 6 Picture of committee members of the Joint Terminology Committee .......................... 320            vii List of Abbreviations   Beida Daily Beijing daxue rikan 北京大學日刊 [Beijing University Daily] BMA  Beijing shi dang’an guan 北京市档案馆 [Beijing Municipal Archives] CMB, Inc. China Medical Board, Inc. Archives [located at RFA]. CMC  China Medical Commission of the Rockefeller Foundation. 1914. Medicine in China. Chicago: Univeristy of Chicago Press. JPEA Jiangsusheng Jiaoyu Hui 江蘇省教育會 (Jiangsu Provincial Education Association, Education Association, Association) JPEAM Jiangsusheng Jiaoyuhui Yuebao 江蘇省教育會月報 [JPEA Monthly] JTC Yixuemingci shenchahui 醫學名詞審查會 [Joint Terminology Committee, Joint Committee, Committee] NMA Zhonghua Yixuehui 中華醫學會 [National Medical Association, 1915-1932; Chinese Medical Association, 1932-present] NMJ Zhonghua Yixue Zazhi 中華醫學雜誌 [National Medical Journal, 1915-1932, Chinese Medical Journal, 1932-present] PUMC  Peking Union Medical College RFA  Rockefeller Foundation Archives. ROCMPA Zhonghua Minguo Yiyao Xuehui 中華民國醫藥學會 [Republic of China Medico- Pharmaceutical Association] ROCMPAJ Zhonghua Minguo Yiyao Xuehui Huibao 中華民國醫藥學會會報 [Journal of the ROCMPA] Science Kexue 科學 [Journal of the Science Society of China] SSC Zhongguo Kexueshe 中國科學社 [Science Society of China] Shen Wenji Shen Xinqing xiansheng Wenji 沈信卿先生文集 [Collected Writings of Mr. Shen Xinqing]       viii Acknowledgements  I have come to truly believe that it takes a village to write a Ph.D. My primary village, if you will, was the University of British Columbia and the unique group of scholars and graduate students who found their way there between 2004 and 2012. First of all I would like to thank institutions, the Department of History which was my home, but especially the Center for Chinese Studies at the Institute of Asian Research which gave me a desk where I could pile my library books, photocopied documents and bicycle gear while working on the most beautiful university campus in the world. Thank you to Timothy Cheek, Alison Bailey, Tsering Shakya and Paul Evans for making me feel like I belonged there. That desk, in the C.K. Choi building, the most eco-friendly building on campus, was the beginning of many of the greatest parts of my graduate education. It was from that desk, in the naturally-lit hallways and by the espresso machine, that supportive friendships developed, and ideas were tested.  Two kinds of village groups were established in that building: Chinese document reading groups, and a graduate student peer review group. For the former, I wish to thank my advisor, Dr. Timothy Brook. Tim Brook leads graduate students by example—out of the classroom through his prodigious output of award-winning books during our overlapping time at UBC, and in the seminar room through his devotion to primary sources. Some of this training came in formal graduate seminars, but most of it continued in unofficial, pro bono (for faculty) document reading groups. There was the Ming documents group that Tim Brook brought with him from Toronto, and then there was the twentieth-century China documents reading group led by Tim Cheek and infiltrated by Tim Brook: a true collaboration.  It was in one of these groups that I first presented a document I’d found while doing preliminary research in the Shanghai Library. It recorded the discussions of more than twenty persons debating how to unify the terminology for anatomy in Shanghai in 1916. Tim Brook’s response assured me that I had a dissertation topic, when he said it was the most fascinating document he’d seen from Republican China. It was in those reading groups with “Big Tim” and “Little Tim” that I gained confidence in reading Chinese documents.  It was in a second group that I came to gain confidence in my ideas about what I would say about that document (and hundreds more), a group called Wangshe 望社. This group was formed out of connections built in seminars and the Choi building document reading groups. The energy and commitment to our work and each other lead to deep friendships and collaborations. I would like to thank Dai Lianbin, Zhang Dewei, Tim Sedo, Desmond Cheung, Malcolm Thompson, Huang Xin, Craig Smith, Anna Belogurova, Frederick Vermote, Dominic Meng-hsuan Yang, Robban Toleno, Kelly Hammond, Paola Iovene, Karl Wu, Guo Weiting, Tom Woodsworth, Sophia Woodman, Leslie Hsieh, Nick Simon, Noa Grass, Heidi Kong, Alex Ong, and Yoel Kornreich. Many graduate students crossed my path at UBC, but especially supportive has been Chelsea Horton. Thanks also to Kelly Whitmer, Phil Van Huizen, Eva and Yvan Prkachin, Patrick Slaney, Jaimie Sedgewick, Henry Trim, and Cory Fairley, Allen Chen, Erin Williams, Steve Ney, Jack Hayes, Wu Yang, Kelly Cairns. Congrats to all those who are already Ph.Ds and Godspeed to those still working!   ix I would like to thank my many teachers, especially Glen Peterson, who supported my work through many years since I took his undergraduate correspondence course on modern China. Thanks also to Robert Brain for introducing me to the history of science and of medicine and helping me think about how to use Bruno Latour in a work of history. Thanks to Carla Nappi for stepping on to my committee so late in my program and for giving such immediate and useful feedback. Thanks to Diana Lary for her formal and informal guidance over the years even beyond her retirement. In the UBC Department of History, thanks to Richard Unger, Tina Loo, and John Beatty (Philosophy) for their stimulating graduate seminars. Thanks also to John Roosa for use of his 12th floor office for a year, to Michel Ducharme for being a great office neighbor that year, to Jessica Wang and Alexei Kojevnikov for Hunanese dinner and practice job talk feedback. Thanks also to Coll Thrush and Leo Shin for support in my first year teaching at UBC. Also very supportive throughout my time at UBC were the History Office Staff: Gloria Lees, Judy Levit, Jocelyn Smith, Alicia Harder, and especially the late Jennifer Kho.  During my research year in Shanghai, Kelly Hammond put me in touch with a new group of graduate students marooned for a year or more in the trenches of the Shanghai library and archives. These men and women became a new village for me that eventually became “the Shanghai Neighbours.” There was a peer review group, and a bilingual discussion group with the wonderful Chinese graduate students at East China Normal University (华东师范大学). Thank you to Denise Ho, Patrick Deegan and Karrie Koesel, Toby Lincoln, Brooks Jessup, Cole Roskam, Laurence Zhang, Chris Leighton, Miriam Gross, Leon Rocha, Jennifer Altehenger, Ceren Ergenc, Matt Mosca and Juliane Jones: for birthdays, roller parties, drinks and dinners.  To my Chinese friends at ECNU and SASS, Song Ge (宏哥 Song Hong), Duan Lian, Tang Xiaobing 唐小兵, Xu Tao 徐涛, Deng Jun 军 邓, and Qu Jun 骏 瞿. Thanks especially to Professor Xu Jilin 许纪霖 for opening all the resources of ECNU. Thanks also to Professor Gao Xi 高晞 at Fudan for lunches with her family overlooking Suzhou Creek and introductions all around Shanghai, and to Zhang Zhongming 张仲民 for involving me in a Ph.D. symposium at Fudan. Special thanks to Professor Zhang Daqing 张大庆 at Beijing University for graciously encouraging me to keep studying a topic he had published on more than a decade previously, and to Dr. Zhang Jian 张剑 at Shanghai Academy of Social Science for similar encouragement while he was still publishing on terminological standardization.  In 2007 I was introduced to a new community of scholars, those who study the history of medicine in China. Daniel Asen and I were the only graduate students at that (for me) first conference in San Francisco, and Dan has become a close friend and scholarly collaborator . I cannot express my gratitude to Bridie Andrews for the support she has given over the years since that foggy San Francisco weekend, and to others like Hugh Shapiro and Marta Hanson who have supported me since then with meaningful words of encouragement in Baltimore and Cambridge. Sean Hsiang-lin Lei sparked dozens of ideas with his dissertation and published articles, and Sean has become a good friend and friendly critic of my work. From our first conversations at the 2009 Chicago AAS, Ruth Rogaski, Judith Farquhar and Yi-li Wu have been extremely encouraging of my work and ideas. Other people I will have to list: Benjamin Elman, Howard Chiang, Wayne Soon, Nicole Barnes, and Ying-jia Tan.   x During coursework and writing for this dissertation I was supported for three years by a Canadian Social Science and Humanities Research Council Canadian Graduate Scholarship, for two years by the Hannah Doctoral Fellowship funded by Associated Medical Services, for one year by the Chiang Ching-Kuo Foundation, and at key moments by UBC Department of History Summer Writing Grants, and travel funding to get me to China from the SSHRC research grants of Diana Lary, Glen Peterson and Timothy Cheek. I provided the labour, thank you for providing the capital.  Thank you also to all of the librarians and archivists: to Jing Liu and Shirin Eshghi at UBC Asian library, to the increasingly efficient Inter-library Loan at UBC, to the librarians and baristas at the Shanghai Library where I spent many days making myself dizzy with microfilms, to the archivists at Nanjing No. 2 Historical Archives, especially the one who asked me if I wanted uncatalogued documents on Tang Erhe, to the archivists at Beijing Municipal Archives and librarians at the National Library in Beijing. A special thanks is also due to Tom Rosenbaum and the other staff at the Rockefeller Archive Center in Sleepy Hollow, New York.  Since August of 2011 I have been comfortably hosted in Indianapolis by William Schneider and the IUPUI history department and program for medical humanities: thanks to the Luce Foundation for supporting our project, to Judi Izuka Campbell, to Emily Beckman, Kelly Gascoine and Jennifer Smedley. Thanks also to Bill and Laurie for opening their home to me in Indy. Thanks to fellow Canadians trapped in Indy, Sarah Neville and Glen Clifton for providing expat ears to complain to and beers to loosen my tongue. Thanks to Rachel Wheeler for allowing me to stay in her beautiful home and sharing her friends with me, Peter Schwartz and Shari Rudavsky who made their house an extension of my home. Thanks especially to Sam for sometimes letting me win Connect 4, and Solomon for taking me on many airplane rides.  Finally, to my family, a 300-page dissertation could not express my gratitude for support and putting up with almost eight years of me putting off many other things to work on this dissertation. Thanks first to Wang Fan, to Albert and Ruth Luesink, to Jonathan and Jill Luesink, and to four nieces and nephews who keep me thinking about the world I am leaving for the next generation and first taught me how to fly an airplane: Eric, Gregory, Mallory, and Ella.                 1 Introduction: dissecting modernity  Government is a problematizing activity: … [t]he ideals of government are intrinsically linked to the problems around which it circulates, the failings it seeks to rectify, the ills it seeks to cure. Miller and Rose, 20081  The methods of the new thought tide are the study of problems … the future tendency of the new thought … should be to lay emphasis on the study of problems important to life and society … to reorganize our national heritage with scientific method. Hu Shi 胡適, 19192   This study seeks to analyze the construction of modernity by looking at a particular set of problems that began to be posed in a striking connection in China in the 1910s, related to anatomy, technical language and power. It does so by focusing on a network of people who aimed to create and standardize translations for all scientific terminology in Chinese, beginning with the terminology for human anatomy. This network extended to about three hundred members (see appendix 5), but this dissertation keeps the focus on a much smaller number who are both representative and extraordinary at the same time. Anglo-American missionaries were led by Dr. Philip B. Cousland, while Anglo-American-trained Chinese physicians were led by Dr. Yu Fengbin (兪鳳賓 Voonping Yui). Mediating between missionaries and Chinese elite physicians were key members of the Jiangsu Provincial Education Association like philologist Shen Enfu 沈恩孚, but also Yu Rizhang (余日章 David Yui), who was one of China’s most prominent Christians as head of the YMCA. Yet almost overshadowing these men was Dr. Tang Erhe 湯爾和 who was not only named the government representative to the early terminology meetings, but was also head of the Japanese-trained group of physicians, and was the man who almost single-handedly established legal, routinized dissection as the basis of medical education  1 Miller and Rose 2008: 61. 2 Quoted in Chow 1960: 219.  2 in China. These five men and their interlocutors will make many appearances in the study to follow, but biographies, prosopographies or even human agency are not the point of my account. Rather, their activities reveal the larger problems of how scientific modernity would be established as a new orthodox epistemology in the Chinese context. These problems and the activities related to diagnosing and attempting to resolve them do not comprise all of Chinese modernity, but, it will be argued, they comprise an essential, and understudied, component of it. Denigrated as the “Sick Man of Asia” 東亞病夫 (dongya bingfu) as it was forced into the competitive nation-state system characterized by industrial capitalism and industrial warfare, China adopted this series of problems defined by the globalizing system into which the late Qing imperium (1895-1911) and new Republican state (1912-1927) were compelled by force of arms and economic blackmail to enter.3 As we will see at various times in this study, the problems may not have been completely new, but the way they were posed and the solutions offered were radically new. Most important to this study, the language in which they were posed was new. The basic problem, to which all others were connected by one or two degrees, as posed by Yan Fu, was how to renew China’s wealth and power (fuqiang 富強). The new solution was to create a modern group (qun 群, Yan’s term), and then a society (shehui 社會, Japanese term), that could be counted and quantified and organized in such a manner as to extract new forms of wealth and power from nature, on the one hand, and from the individual and collective bodies of society, on the other. Science as a method of social organization and inquiry would accomplish this. The widely recognized basis of science and the scientific method was a well-honed method of reductive analysis—dissection.  3 The imperialist wars from 1839-1900 forced the Qing to its knees, while the subsequent indemnities broke its back, especially those resulting from the Boxer Settlement.  3 Anatomy and dissection were not just about scalpels and cadavers but came to be considered the necessary basis of medicine and of all of science. Anatomy as method, shorn of its medieval and early modern religious motivation of searching for the divine spark of life, and purged of the residue of an anatomical renaissance of the ancients (Aristotle),4 nonetheless retained the power of reduction. Reductionism, by isolation, identification, and classification, was, and is, a powerful method of increasing man’s understanding of and power over nature. Let me be clear, however: the scientific method, if there is a single method, should not be identified as merely a crude reductionism.5 The methods of Euro-American (now global?) science(s) have always included unifying theories, and attempts at scientific holism and interdisciplinarity, and certainly the pendulum in many fields today has shifted towards such attempts.6 But the power of the sciences to put things together is predicated on first reducing them to the smallest identifiable component: from Harvey’s dissected veins and arteries circa 1628, Bichat’s tissues circa 1800, Schleiden and Schwann’s cells circa 1839, Haeckel’s eggs and embryos circa 1870, Pasteur, Koch and Lister’s bacteria circa 1880, Morgan’s Drosphila fly genes circa 1910, to Hopkins’  4 Cunningham 1997; 2001. 5 Reductionism involves a series of debates among biologists themselves that can be simplified as ontological reductionism (each organism is governed by nothing but molecules and their intereactions, also called physicalism or materialism, a stronger version argues that each biological process is identical to a physico-chemical process), methodological reductionism (the idea that biological systems are best investigated at the lowest possible level), and epistemic reduction that argues that knowledge from one branch of science (studying lower forms) be used to better understand another (studying higher forms). Brigandt and Love 2008. My use of reductionism here is connected to ontological and methodological reductionism as described by Bridgandt and Lowe. My goal is not to invent a “nonexistent reductionist—the sort that everybody is against, but who exists only in their imaginations-- [who] tries to explain complicated things directly in terms of the smallest parts” as a straw man against “hierarchical” reductionists like Richard Dawkins. Dawkins argues for explaining each level of phenomena by the level below it, so we would explain a car by various parts in the engine like the fuel injectors, rather than reducing to the level of atoms, electrons and quarks. Dawkins 1986:13. 6 In science, environmental biology is one such field that necessarily crosses multiple boundaries dividing various sciences, and the much deeper divide between nature and culture. See the work of biologist Grace 2006 for a statistical account that uses multiple reductionist hypotheses to move beyond strict reductionism towards more biological realism. Thanks to Paul Weidman for this reference. For sociological accounts moving beyond reductionism in ecology and biology, see Beck 1995 and Latour 1999.  4 amino acids circa 1912.7 These scientists, some still driven by a search for the divine spark of life (vitalism), but the latter looking exclusively for biochemical and materialist explanations for the origins and maintenance of bios, nonetheless all sought the answers in small, even microscopic, reduction. So Schwann, in 1839 would use the smallest part (cells) to argue for a unified biology of animals and plants: “The object of the present treatise is to prove the most intimate connexion (sic) of the two kingdoms of organic nature, from the similarity in the laws of development of the elementary parts of animals and plants.”8 So anatomical reduction may, counter-intuitively, lead to interdisciplinarity and grand theories of nature and the place of humans within it.9 It is worth examining another example in some detail to illustrate the centrality of reductive dissection and taxonomic description to the life sciences—that of Charles Darwin and his collaborators. Among the many skills Darwin developed in his life were zoological dissection and taxonomic description and naming of anatomical parts. In 1834, while in South America, Darwin would lament about the imprecision of his dissecting skills: “I do so wish I was a better hand at dissecting.”10 Charles Darwin did not feel confident publishing his theory of evolution until after he had a large number of meticulously recorded examples of species level evolution. One of those  7 On Harvey see Harvey 1889 [1628]; on Bichat, see Bichat 1812; Ackerknecht, 1967; Foucault 1991 [1973]; on Schleiden and Schwann’s cell theory see Schwann, trans. Smith 1896 [1839]; Lawrence 2009; on Haeckel see Haeckel’s many works in full tex at Project Gutenberg, especially The Evolution of Man Vol. 1 and Vol. 2. (http://www.gutenberg.org/browse/authors/h#a2037); Hopwood 2009; Nyhart 1995; Richards 2008; for a summary of Pasteur, Koch and Lister on microbiology, see Amsterdamska 2009; on Morgan, see Morgan 1908; Kohler 1994; Burian and Zallen 2009; on Hopkins see Needham 1949; Kohler 1982. 8 Schwann, trans. Smith 1896 [1839]: ix. 9 The connection between anatomical reduction and interdisciplinarity or grand theories of nature is not, however, counterintuitive to scientists in action. Thanks to Dr. Daniel Pauly who made this clear to me, and for referring me to the Darwin Correspondence Project below, and to the more recent scholarship on Darwin that corrects the myth that Darwin himself dissected “Darwin’s Finches.” On this last point, see Grant 1999, but also Sulloway 1982. 10 Darwin to Henslow, J. S. 24 July & 28 Oct & 7 Nov 1834, accessed on the Darwin Correspondence Project, (http://www.darwinproject.ac.uk/entry-251, 27 July 2012).  5 examples was based on collaboration with London ornithologist John Gould who was able to dissect and name the finches Darwin had collected in the Galapagos Islands.11 Another of those examples was demonstrated through painstaking comparative anatomy of barnacles. Over eight years, Darwin compared the anatomy of every specimen he could get his hands on with the abnormal Chilean barnacle nicknamed “Mr. Anthrobalanus.”12 By 1846 he was much more confident and had worked out much of the technical terminology that enabled him to identify minute differences, “I have had two mornings more of dissection & made out some points pretty well—the articulation under [the] mouth is one of the most distinct in whole body; the cheirotherium steps mostly point upwards, but some downwards & some obliquely.”13 According to some scholars, the anatomical reduction of barnacles made Darwin’s name in science with the four-volume work A Monograph on the Sub-class Cirripedia. Darwin apparently felt that without having published his painstaking work based on mundane manipulations with scalpel, preservation chemicals, and microscope his theory of evolution would not have been accepted.14 But aside from the processes of dissection, there was another crucial matter to the power of Darwin’s unifying theory: naming and classifying. In a section of his introduction to Cirripedia called “On the names given to the different parts of Cirripedes,” Darwin ruefully remarks that he had “unwillingly found it indispensable to  11 Grant 1999; Grant and Grant 2008; Sulloway 1982. 12 Sexual reproduction was a key part to understanding the evolution of the crustaceans, and in Mr. Anthrobalanus he discovered a genuine oddity, “The probosciformed penis is wonderfully developed… when fully extended it must equal between eight and nine times the entire length of the animal!” Darwin 1854: 26. 13 Darwin to John D. Hooker, 6 November 1846, (http://www.darwinproject.ac.uk/entry-1018), accessed 27 July 2012. 14 This may be taken as a controversial point for some Darwin scholars, but it seems reasonable to me that Darwin was able to succeed because of his well-established reputation producing solid empirical work: “Darwin’s reputation, already well established by his theory of coral-island formation, his work on the geology and natural history of South America, and the very solid mongraphs on barnacles, naturally took to itself the credit for the new theory [vs. Wallace]. It is easier to remember a well-known name than the name of a newcomer; thus reputation acts as a self-regenerative circuit.” Hardin 1959: 48.  6 give names to several valves, and to some few of the softer parts of Cirripedes.” This was because the existing terminology for barnacles was in “utmost confusion”: thus, the valve named in the woodcut the “Scutum”, has been designated by various well- known naturalists as the “ventral,” the “anterior,” the “inferior,” the “ante-lateral,” and the “latero-inferior” valve; the first two of these titles have, moreover, been applied to the rostrum or rostral valve of sessile Cirripedes. The “Tergum” has been called the “dorsal,” the “posterior,” the “superior,” the “central,” the “terminal,” the “postero-lateral,” and the “latero-superior” valve. The “Carina” has received the first two of these identical epithets, viz. the “dorsal” and the “posterior;” and likewise has been called the “keel-valve.”  The very success of science in the nineteenth century led to a profusion of Latin terms in the taxonomic sciences.15 Darwin went on: The confusion, however, becomes far worse, when any individual valve is described, for the very same margin which is anterior or inferior in the eyes of one author, is the posterior or superior in those of another; it has often happened to me that I have been quite unable even to conjecture to which margin or part of a valve an author was referring. Moreover, the length of these double titles is inconvenient. Hence, as I have to describe all the recent and fossil species, I trust I may be thought justified in giving short names to each of the more important valves, these being common to the pedunculated and sessile Cirripedes.16  Before Darwin’s theory of evolution was published and began to transform natural studies of life into the modern life sciences that now dominate medical schools and universities around the world, he first spent eight years dissecting stinking barnacles and attempting to standardize the mundane terminology for their most intimate and microscopic parts. This was the same situation in which Chinese physicians, educators, and scientists found themselves in the 1910s—before China could have science they must first establish regularized dissection and its terminology. John Locke (1632-1704) had said in his Essay concerning Human Understanding of 1690 that “ideas and words [are] the great instruments of knowledge,” and so “[i]n all discourses  15 Some such directional terms, and their Chinese equivalents, would be debated by the Joint Terminology Committee in China in 1916. Historians of science have tended to skate over the problem of nomenclature, or assumed that it was settled with Linnaeus in the eighteenth century. Nothing could be further from the truth. 16 Charles Darwin 1854: 3-4  7 wherein one man pretends to instruct or convince another, he should use the same word constantly in the same sense.”17 Such precision and standardization as the spirit of the new inquiries into nature, now known as the Scientific Revolution,18 is indeed what Linnaeus attempted in his various works with Latin terminology.19 Linnaean Latin binomial nomenclature was established as a principle since 1753 for the basic scientific task of classifying botany, and the apparent power of this method was applied in other fields also. One such field of classification that predated Linnaean nomenclature was anatomy. The tendency before Linnaeus was toward geographical particularities for anatomical terminology, where national medical heroes discovered new tissues and surfaces within a few years of those in another nation or empire. As we will see in some detail below, the resulting chaos of Latin anatomical nomenclature was recognized as being so severe by the 1890s that German anatomists began to standardize the terminology for anatomy. In response, over the next two decades projects with varying degrees of success were launched to standardize anatomical terminology for vernacular Japanese, English and Chinese, among other languages. To summarize the significance of this example, the power of Darwin’s later theory of evolution was firmly based in the mundane laboratory work of dissection, and of classification and naming. It would later be strengthened by its synthesis with Mendellian genetics, investigated in the microscopic dissection, naming and classification of genetic changes in the Drosophila flies of T.H. Morgan’s laboratories. All of the modern biological sciences can thus be said to originate in anatomy as a method, and terminological clarification as a tool for  17 Quoted in Stearn 1966: 34. 18 On the scientific revolution, see Kuhn 1996 [1962]; Shapin 1998; Henry 2008. 19 Botanical Latin since Linnaeus is considered a separate language from Classical Latin, “now so distant from classical Latin in spirit and structure as to require independent treatment;” “Increasing scientific need during the past 250 years for precision and economy in words has made it distinct from classical Latin and it should be treated as such.” Stearn 1966: vii, 3.  8 classifying. Anatomy as method and terminological clarification are, however, often minimized in many accounts of the history of science.20 The power of the laboratory over public health, government decision-making, business innovation and profit-making is to be found most basically in an assortment of methods of reduction and isolation (dissection) followed by unambiguous identification (fixing nomenclature).  Later in the introduction and in the chapters to follow, I will return to the details and significance of dissection and fixing nomenclature many times; for now I must pass on to develop a working understanding of modernity. In the next section, dissection is transformed from a material activity of steel piercing flesh into a metaphor for analysis. Modernity Among many ways that have been offered to study the amorphous category commonly called “modernity” or “modernization,” one particularly productive method is to analyze modernity as a set of problems as indicated in the epigraphs to this introduction. The starting point for this study is found in comparing these two approaches to “problems”. Rather than assume the content of modernity or attempt a definition, this study will examine the problems posed by a set of educators, professionals and intellectuals which they identified with the modern challenge. They, rather like Charles   fifty years earlier, occupied themselves with anatomy and nomenclature as a route to having their epistemology displace a previous one.21 Like Darwin, the mundane activities related to dissection and standardizing technical terminology were part of a larger project. But there were obvious differences. Darwin was a wealthy member of the world’s most  20 Surprisingly, in an otherwise wonderful account scientific translation, Scott L. Montgomery only discusses standardization in passing, Montgomery 2000: 197-199. So, like Montgomery’s prerogative to write the kind of book he wanted to see, the present account is my attempt to respond to my own “nagging desire for a type of book that I found did not yet exist,” Montgomery 2000: ix. 21 On Darwin’s conversion from creationism and subsequent argument against the predominant scientific theory of his day, see Sulloway 2006 and Mayr 1991.  9 powerful empire, his largest problem early in life was how to spend his time and make a name for himself while enjoying his family’s vast fortune. A queasy stomach and a doubting mind drove him from medicine and the church respectively and toward what would become (long after his death) a new source of wealth and power, the study of the genesis and transformation of life itself. Early twentieth-century Chinese elites, by contrast, looked at the vast edifice of British, German, French, Japanese or American power and sought to identify how to establish such sources of wealth and power for themselves and their nation as quickly as possible. The problems were addressed through a series of reforms after 1860 in the self-strengthening movement, and accelerated after the 1895 loss to Japan, and the debacle of the Boxer Uprising in 1900 and the forced reforms that followed after 1902.  Comparing the two epigraphs above, we identify two options for analyzing modernity in China as a set of problems. The historian or social scientist of China can choose to do one of two things: (1) she can take the perspective of historical actors like Hu Shi, taking this set of problems for granted, and then judge the effectiveness of a particular configuration of government officials and societal elites to achieve a solution to the problems thus enunciated, or (2) like Miller and Rose, she can problematize the whole endeavor of modernity + science + social science analysis and describe how they constructed each other. The first option is well represented in the secondary literature and tends toward books and dissertations with titles about the process of China becoming modern: “The X-process of modern China”; “Y-factor and modern China.”22 China either has, or has not, become modern, however much it is trying to do  22 This literature is potentially endless, driven no doubt by publishers and authors seeking a quick audience for their work among anyone interested in “modern China.” The following list includes some of my favorite books, and some I have not read, so there is no judgment in inclusion, I merely note that such titles tend to reify modernity. Some recent titles with the tag line “X and the making of modern China,” see Schneider 2011, MacKinnon 2008,  10 so. Many historians of my generation were deeply influenced by Jonathan Spence’s magisterial and empathetic textbook, which nonetheless left us pondering, “When will The Search for Modern China be complete?”23 Spence is explicit: “this remains a book about an ongoing search rather than about the conclusion of a search.” It is worth quoting Spence at length at this point, given that his book is the most widely read history of modern China in the past twenty years: I understand a “modern” nation to be one that is both integrated and receptive, fairly sure of its own identity yet able to join others on equal terms in the quest for new markets, new technologies, new ideas. If it is used in this open sense, we should have no difficulty in seeing “modern” as a concept that shifts with the times as human life unfolds, instead of simply relegating the sense of “modern” to our own contemporary world while consigning the past to the “traditional” and the future to the “postmodern.” I like to think that there were modern countries—in the above sense—in A.D. 1600 or earlier, as at any moment in the centuries thereafter. Yet at no time in that span, nor at the end of the twentieth century, has China been convincingly one of them.24  Yet Spence does have a substantial section on how Deng Xiaoping made the Four Modernizations (sige xiandaihua 四个现代化) of agriculture, industry, national defense, and science and technology into national policy in the 1978.25 But for many American China- watchers like Spence, China has not, and will not, become modern until it has achieved Wei Jingsheng’s fifth modernization, “democracy.”26 In the past century, China has arguably achieved every other mark of “modernity” or “modernization” put forward by Western social  Yeh 2007, Tuttle 2005, Craft 2004, Dunch 2001. For recent titles elucidating “Chinese modernity” see Qian 2011 and Fung 2010. For a very prominent revisionist history of Chiang Kai-shek that attempts to rehabilitate him in “the struggle for modern China,” see Taylor 2009. Thornton 2007 examines “state-making and modern China,” while Strand 2011 picks up on the Spence note of incomplete transformation by emphasizing an “unfinished Republic.” I do not miss the irony that my dissertation title may itself feed into the reification of “modernity.” 23 Spence 1990. 24 Spence 1990: xx (emphasis mine). 25 Spence 1990: 653-658. These were initially defined by Zhou Enlai in 1963人民日报 (31 January 1963). " 在上海举行的科学技术工作会议上周恩来阐述科学技术现代化的重大意义 [Science and Technology in Shanghai at the conference on Zhou Enlai explained the significance of modern science and technology]" (in Chinese). People's Daily (Central Committee of the Communist Party of China): pp. 1. Archived from the original on 2011-10-20 20:52:47. 26 Spence 1990: 659-666. Democracy is usually defined as a system of electoral politics whereby local and national leaders are regularly deposed or reinstated by a majority of votes (or of electoral representatives) buttressed by a strong independent judiciary which limits the powers of detention of the government, party, army and police forces. Far too often the Western liberal “ideal” is held up against the perceived Chinese “reality” in such accounts.  11 scientists, including industrialization and control of industry by national elites, national sovereignty over its territory (despite simmering conflicts over Taiwan), urbanization, development of massive programs of science and technology including nuclear power and weaponization, development of complex systems of mass transportation, near universal education and a robust system of public health and medical care.27 Moreover, China itself claims to be democratic—a fact that cannot be dismissed out of hand by scholars throwing stones from the glass houses of highly imperfect democracies.28 Most scholarship about China is no longer in the grip of the “modernization” theory of postwar American sociologists like Talcott Parsons or Edward Shils that posited an idealized American development model for third world countries in its sphere of influence, where “quantitative studies of specific social patterns, in which U.S. realities of the moment were naively treated out of context as proxies for all of human social life.”29 Yet the field of China studies nonetheless remains more or less caught within the logic of judging China by the standards of what is now called modernity. Frederic Jameson has recently argued that this academic trend to discuss modernity in the 1990s and 2000s is an attempt to re-brand modernity away from its “only satisfactory semantic meaning” associated with capitalism, toward a new product, associated with “the information  27 Each area of modernization, especially health and medicine, faces tremendous challenges. As far as democracy, Taiwan has achieved the “fifth modernization” and, however imperfect, there are checks and balances in the PRC between government, party, army, police and judiciary. There is now a significant level of academic and artistic freedom, and even parts of the popular press enjoy freedom to critique and cajole, even if some of the openness has recently been rolled back. 28 On democratic institutions in China, see Ding 2001; on village elections, see He 2007; on democracy and the press in China, see Zhao (Yuezhi) 1998; on the possibilities of democracy or no democracy in China, see Friedman and McCormick 2000; Zhao (Shuisheng) 2000; Goldman 1994; Nathan 1985; On the limits of American democratic institutions, one can do worse than begin with Williams 2011 [1961] and Herman and Chomsky 1988. 29 Skocpol 1984: 2 “That prestigious work set forth a grid of abstract categories through which all aspects of social life, regardless of times and places, could be classified and supposedly explained in the same, universal theoretical terms.” Skocpol 1984: 3; Parsons 1951; Shils 1975.  12 revolution, and globalized, free-market modernity.”30 Such accounts participate in the discursive project of normalizing the neoliberal reforms begun in the 1980s by right-leaning governments and institutionalized by liberal-democratic governments of the late 1990s and 2000s. In other words, academic studies that perpetuate this new definition of modernity are participating in a political project. While such studies advance knowledge through exposure of hidden archives, they nonetheless tend to participate unwittingly in the very processes of governing which they claim to only observe. So anthropologists, long the stooges of imperialism and state power over the exotic subjects they claimed to study objectively, now warn all scholars to be aware of our privilege and power to change and represent the people, and the very “society” that we study.31 The way we frame our studies matters. If we become lost, as is so easy, in the logic of our primary sources, we will see only the problems their authors (inside or outside of the state) attempted to solve. To the degree the great project of modernity has been identified with the growth of the state, then scholarship tends to become stories about state-building. Indeed, much of the scholarship about modern China addresses issues of state and society and state-building. Bourdieu, ethnologist of France’s empire warns us, however, “[t]o endeavor to think the state is  30 Jameson 2002: 13. “What we have here is rather the reminting of the modern, its repackaging, its production in great quantities for renewed sales in the intellectual marketplace, from the biggest names in sociology to garden-variety discussions in all the social sciences … If free-market positions can be systematically identified with modernity and habitually grasped as representing what is modern, then the free-market people have won a fundamental victory which goes well beyond the older ideological victories.” Jameson 2002: 7, 9. In such a configuration, socialists, Marxists and other leftists are portrayed as somehow nonmodern and old-fashioned because they are still committed to state-centric modernist top-down planning. In academia, those on the right are inspired by the economics of the Chicago School, while the left has been largely swallowed by the apparently pragmatic “third way” of theorists of this new definition of modernity like Anthony Giddens and Jürgen Habermas. 31 This self-reflective literature of anthropologists is extensive, given the racist origins of anthropology and the ongoing use of (some) anthropologists by the military in America’s foreign wars, but see especially Bernard Cohn 1996; Stocking Jr. 1968; 1998. For a particularly scathing account of recent anthropological shenanigans that has had a wide response within anthropology to make distance with the perpetrators, see Tierney 2000; for an accessible summary of the sins of anthropological racism, see Marks 2002: 159-179.  13 to take the risk of taking over (or being taken over by) a thought of the state, i.e. of applying to the state categories of thought produced and guaranteed by the state and hence to misrecognize its most profound truth.”32 Bourdieu asks us, like Peter Miller and Nikolas Rose in the first epigraph, to become aware of the processes by which governing poses problems that state officials and public intellectuals like Hu Shi (he was both throughout his life), in the second epigraph, identify as “important to life and society.” As analysts, then, we will either participate to one degree or another, in the project Hu Shi identifies with “reorganiz[ing] our national heritage with scientific method,” or we can take a deep breath, take a long step back and consider the way that problems are forced upon governments and intellectuals. Such an analysis may open up space to see alternatives, but this is beyond the scope of the present work.  I must return to Bourdieu for a moment, and ask how we, as scholars, may become taken over (or ourselves take over) the state through our inquiry. His response to this question is obvious and clearly subversive: we are taken over by the state through our education in the modern school system. Yet as successful products of this system, we are now to doubt it: School is the state school where young people are turned into state persons and thus into nothing other than henchmen of the state … The state … made me compliant towards it … and turned me into a state person, regulated and registered and trained and finished and perverted and rejected, like everyone else.33  Bourdieu’s use of Thomas Bernhard’s “idiosyncratic rhetoric” of the state school is intentionally hyperbolic. It is hyperbolic doubt, a certain reflexivity, which we should apply to both the object of our study and to our own best thinking. We should question “all the presuppositions and preconstructions inscribed in the reality under analysis as well as in the very thoughts of the  32 Bourdieu 1994: 1. 33 Thomas Bernhard, The Old Masters, trans. Ewald Osers, Quartet Books, London, 1989: 27, quoted in Bourdieu 1994: 1.  14 analyst.”34 This is the reflexivity of the anthropologist. Such reflexivity is echoed in the work of the science and technology studies scholars, many of whom adopt the methodology of ethnography, like Bruno Latour, and whose insights have informed the following work.  This study is about the activities of a group of elite men—educators, physicians, scientists, missionaries, publishers—who standardized the Chinese terminology for medicine and modern science as the foundational task of institutionalizing anatomically-based medicine, science, and modern education generally in China. These men were all connected to each other through the Jiangsu Provincial Education Association.35 I argue that the proper frame in which to examine this work is to think of their work in the broadest terms possible—they were establishing a school system, in Bernhard’s exaggerated terms, based in the ideology of science, from primary to professional education, in order to produce a modern state which incorporates the life and energies—the bios—of all its citizens in the most efficient manner possible. There was a link between an anatomically-based view of the body that turned knowledge of death into knowledge of life, a technical language for things that could be perceived and described, and the growth of state power over life—what has been called biopower.36 I will return to this concept, but a working definition includes the following: the growth of trust in statistical data sets of  34 Bourdieu 1994: 1. 35 See chapter two. 36 David Macey offers perhaps the most concise and accurate description of biopolitics as a product of Foucault’s 1978-79 lectures: “Biopolitics is Foucault’s term for the attempts made by governments to rationalize the problems posed by the existence of a population, namely health, hygiene, birth-rates, longevity and race. Biopolitics is a matter of treating the social body, and it provides the rationale for the formulation of health policies from the eighteenth century onwards.” Macey 2000: 43. The irony is that it is now obvious that the lectures from 1977-78 titled Security, Territory, Population (Foucault 2007), were more addressed to biopolitics than the ones of the following year which have been published under the title The Birth of Biopolitics (Foucault 2008) which were more addressed to the emerging relationship between liberalism and neoliberalism. Foucault describes bio-power thus: “By this I mean a number of phenomena that seem to me quite significant, namely, the set of mechanisms through which the basic biological features of the human species became the object of a political strategy, of a general strategy of power … how … modern Western societies took on board the fundamental biological fact that human beings are a species,” (2007: 1); and biopolitics as “[t]he development in the second half of the eighteenth century of what was called medizinische Polizei, public hygiene, and social medicine … [which] aims to treat the ‘population’ as a set of coexisting living beings with particular biological and pathological features, and which as such falls under specific forms of knowledge and technique.” (2007: 367).  15 populations (whether of subjects, citizens, wildlife or microbes) and attempts to manage such statistical trends with public health, hygiene, and racial policies.37  While this study has benefitted from many focused studies on education, science, medicine, language, elites and the state in modern China, until recently many of them have judged early twentieth century China a complete failure in state-building. Let’s look at the specific case of medicine to illustrate how this account will diverge. Problem: China as “the sick man of Asia” One hundred years ago, China was subjugated to foreign powers, and considered the “Sick Man of Asia,” a condition carried over since at least the 1860 Arrow War and the Anglo-French Joint expedition to occupy Beijing and burn the Summer Palace.38 The new Republic of China was socially and morally pathological (seen in anti-opium or anti-prostitution movements), economically ailing (seen in chronic indebtedness), and politically fragile (seen in the almost immediate devolution of the Republican system to autocratic monarchy under Yuan Shikai). And for physicians trained in the new laboratory medicine coming out of Europe, America and Japan, China was also just plain sick. Disease was rampant and holding China’s population hostage. Laboratory medicine and public health vaccines and quarantines offered large-scale solutions to many of these problems, but the concerned physicians had almost no medical system to put them into effect. If only Chinese physician-scientists had more political influence as had Rudolph Virchow in Bismark’s German Confederation or Nagayo Sensai in Meiji Japan; if only physicians and their allies could mobilize people on a mass level to eliminate the conditions and vectors of epidemics; if only they had money to invest in the institutions of biopower—urban  37 On the origins of statistical thinking, see Porter 1986; 1995; Hacking 1990. 38 On “Sick Man of Asia,” see Heinrich 2008; Leung 2009; on the 1860 turning point, see Hevia 2003.  16 hospitals and rural clinics, elementary and secondary schools, model prisons and quarantine wards, hygienic quarters for urban working classes and poor; if only Western medicine and its strange methods could be understood and accepted by the people so that they would adopt technologies of the self to discipline their bodies and protect themselves from disease. Leaders of the young professional association for English-speaking physicians, the National Medical Association (founded in 1915) posed the problem of instantiating power over life in the first issue of their journal. One of their number, identified by the initials E.S.T., drew an amateurish but nonetheless powerful image posing the problem of biopower as a dramatic battle between disease and the fledgling medical profession: “Medical work in China is like a Little child trying to wrestle with the giant Disease.” Little boy Medicine, although properly attired in a modern Sun Yat-sen suit (no more scholar’s robes) and short cropped hair (good-bye to the long, braided queue of subjugation to the Manchus), backed by “medical education” and armed with a policeman’s Billy club called “public interest” was nonetheless easily kept at bay by the strong arm of the giant, labeled “public indifference.” Why could the people not see the problem clearly, along with the solutions offered? The giant Disease (bing病), a fierce monster apparently inspired by a two-horned Tibetan Buddhist demon, was naked except for swaddling bands of “ignorance,” “quackery” and “superstition”—a veiled reference to the non-standardized or regulated Chinese medicine as practiced and experienced by most of China’s people. Although the arm of public indifference seemed strong enough to single-handedly neutralize the  17   Figure 1 The giant disease “Medical work in China is like a little child trying to wrestle with the giant disease.” National Medical Journal 1915 1:1, n.p. Public domain.  18 efforts of the medical profession, the giant Disease had far more powerful and deadly weapons at his disposal, including a quiver full of arrows identified as “patent medicine.”39 Far more terrifying, however, is the cat-of-nine-tails wrapped around the strong left arm of the giant Disease—“no sanitation”—and tipped with diseases almost too numerous to identify. Plague, hookworm, pneumonia, leprosy, malaria, whooping cough, meningitis, diphtheria, scarlet fever, measles, typhoid, typhus, dysentery, smallpox and tuberculosis—each with a helpless Lilliputian victim tossed hither and yon by the powerful chains of the giant Disease, and threatened by the raised right foot of “poverty.” It wasn’t that scientific medicine had no weapons against disease. What it lacked was mundane institutional power and raw political muscle.  E.S.T. certainly refers to E.S. Tyau, (1878-1958刁信德 Diao Xinde)40 who elsewhere in the journal spelled out his goals in English (only) calling for an expansive role for medicine in an editorial for the new profession. For Diao, the very recent increased “scope of modern medicine” required an increased cooperation between profession, college and government to intervene: Moreover the science of medicine is entering more and more into the various activities of modern life. The complexities of the problems constantly presented by disease and by the conditions of modern social life and the multiplicity of the means of investigating them, the laboratory facilities which are required to that end, the relation of medicine to public health matters of sanitation both for the individual and for the public, all attest to the marvelous activity of the medical mind.41   39 Many of these were produced and sold by overseas Chinese, see Sherman Cochrane 2006. 40 Common spelling of his name was E.S. Tyau, although in the NMA directory of 1932 it was written as Tiao Hsin-te, co-founder of the National Medical Association 中華醫學會 (Now known in English as the Chinese Medical Association), graduate of St. John’s University Medical School (1909) and University of Pennsylvania School of Public Health (1915), and subsequently professor and dean at St. John’s for thirty years, while also occupying leading roles at Tongren Hospital, Hongren Hospital, and the Red Cross Hospital, all in Shanghai. 41 Diao 1915: 1.  19 Yet these accomplishments were all abroad, in foreign countries, and medicine in China itself had not yet “emerged from the shadows of the dark ages.”42  The problem posed by Diao, then, may be restated: how to increase the power of little boy Medicine such that he can keep the giant Disease at bay, if not vanquish the giant completely. The image includes some hints: As of 1915 China had “No System” of medicine or public health, and “No Finance” to implement it. Most of China was untouched by little boy medicine, and the treaty ports were a hodge-podge of semi-colonial administrative systems.43 Government was too busy with wars and raising taxes and foreign loans, both in order to pay for new wars and pay off previous loans