Changing Narratives and Persisting Tensions: Conflicts between Chinese and Western Medicine and Professional Profiles in Chinese Films and Literature, 1949-2009.

This paper analyses the shifting images of Chinese medicine and rural doctors in the narratives of literature and film from 1949 to 2009 in order to explore the persisting tensions within rural medicine and health issues in China. Popular anxiety about health services and the government's concern that it be seen to be meeting the medical needs of China's most vulnerable citizens - its rural dwellers - has led to the production of a continuous body of literary and film works discussing these issues, such as Medical Practice Incident, Spring Comes to the Withered Tree, Chunmiao, and Barefoot Doctor Wan Quanhe. The article moves chronologically from the early years of the Chinese Communist Party's new rural health strategies through to the twenty-first century - over these decades, both health politics and arts policy underwent dramatic transformations. It argues that despite the huge political investment on the part of the Chinese Communist Party government in promoting the virtues of Chinese medicine and barefoot doctors, film and literature narratives reveal that this rustic nationalistic vision was a problematic ideological message. The article shows that two main tensions persisted prior to and during the Cultural Revolution, the economic reform era of the 1980s, and the medical marketisation era that began in the late 1990s. First, the tension between Chinese and Western medicine and, second, the tension between formally trained medical practitioners and paraprofessional practitioners like barefoot doctors. Each carried shifting ideological valences during the decades explored, and these shifts complicated their portrayal and shaped their specific styles in the creative works discussed. These reflected the main dilemmas around the solutions to rural medicine and health care, namely the integration of Chinese and Western medicines and blurring of boundaries between the work of medical paraprofessionals and professionals.

[The publication of the Medicine News and its influence on the spread of modern-western medicines in China and its role in western medicine communication].

Medicine News, first published in 1880, was the earliest western medicine journal founded in China, playing an important role in the history of Chinese modern journals and the history of western medicine communication. Today, no original copies of this journal survive in China. Quotations, citations and comments of some newspapers and periodicals on it at the time, reveal that the publication aim of this journal was to disseminate knowledge of western medicine to the Chinese people, that its editorial policy was "showing western medicine is superior to traditional Chinese medicine" , and that its communication of western medicine knowledge was also based on this policy. Medicine News reported on an international medical academic conference held in London for the first time, and it is worth mentioning that thousands of people attended the meeting. Medicine News is known to have promoted western medicine communication in China to an advanced and more up-to-date level. At the same time, its editorial policy and strategy had a great influence on the editing and publication of western medicine journals in the late Qing Dynasty and the Republic of China.

[Study on the first translated obstetrics book Tai chan ju yao (Essentials in Obstetrics)].

In 1893, Wan Tsun-mo translated and published Tai chan ju yao (Essentials in Obstetrics), the first monograph of western obstetrics in modern China, symbolizing the independence of obstetrics from such maternal and child books as Fu ying xin shuo and Fu ke jing yun tu shuo, which occupies an important position in the history of the development of modern Chinese obstetrics. The book introduced anatomy, physiology, pathology, embryology, diagnostics, surgery, pharmacology and other knowledge of obstetrics in a catechismal form, and had a detailed discussion of such advanced obstetrical technologies as antiseptic, anesthesia, forceps and cesarean section for the first time.Judging from the content and translation of Tai chan ju yao, this book has already possessed the basic knowledge system of modern obstetrics, though the translation appeared to be somewhat jerky and not elegant and the terminology needing to be further improved, it was not only used as an important medium for the introduction of obstetrical knowledge, but also of great clinical value.However, its influence was so weak that later researchers seldom mentioned this book.

Ser profesional sanitario en el siglo XXI: algunos apuntes / Ser profissional sanitário no século XXI: alguns apontes / Being a health professional in the 21st century: some notes

Desde los años 70 del pasado siglo, los teóricos de la historia han señalado el advenimiento de una nueva época, adjetivada como postmodernidad, Modernidad tardía o Modernidad reflexiva. Este nuevo tiempo, el nuestro, vendría marcado por el fin de los grandes relatos que hicieron comprensible el mundo humano occidental desde la Antigüedad, resquebrajando las viejas certidumbres y arrojando al sujeto a la atomización social y la auto-responsabilidad exacerbada de su propia existencia. Estas transformaciones ideológicas y sociales han traído profundas consecuencias en diversas esferas de la vida humana en Occidente tales como el trabajo, las relaciones personales o la política, a las que no escapa, obviamente, la medicina y la praxis médica occidental. Partiendo de este hecho, el propósito de este artículo es intentar analizar, en primer lugar, las significaciones y problemáticas de ese cambio de época. y desde ahí, y en segundo lugar, tratar de comprender las consecuencias y variaciones que esas transformaciones están suponiendo para la medicina y sus profesionales sanitarios (AU)

From 1970's theorists in History have noted the arrival of a new era known as Postmodernity, late-Modernity or reflexive Modernity. This new era, our current time, comes marked by the end of the ‘great stories’ that made western world comprehensible since ancient times, and cracking old certainties and putting the Subject in terms of social atomization and an accused self-responsibility. These ideological and social changes have brought profound consequences in many spheres (fields, scopes) in western human life, such as work, social (personal) relationships or politics, from where medicine and western practices don’t (seem to) escape. On this basis, this article tries to analyze, firstly, the meanings and difficulties of this new era; from there, and secondly, it tries to understand the consequences that these changes and variations are assuming for professionals in the fields of medicine and health (AU)

Desde os anos 70 do passado século, os teóricos da história têm assinalado a chegada de uma nova época, adjetivada como postmodernidad, Modernidad tardia ou Modernidad reflexiva. Este novo tempo, o nosso, viria marcado pelo fim dos grandes relatos que fizeram compreensível o mundo humano ocidental desde a Antiguidade, resquebrajando as velhas certezas e arrojando ao sujeito à atomización social e a auto responsabilidade exacerbada de sua própria existência. Estas transformações ideológicas e sociais têm trazido profundas consequências em diversas esferas da vida humana em Occidente tais como o trabalho, as relações pessoais ou a política, às que não escapa, obviamente, a medicina e a praxis médica ocidental. Partindo deste facto, o propósito deste artigo é tentar analisar, em primeiro lugar, as significações e problemáticas dessa mudança de época. e desde aí, e em segundo lugar, tratar de compreender as consequências e variações que essas transformações estão a supor para a medicina e seus profissionais sanitários (AU)

Hybridising Medicine: Illness, Healing and the Dynamics of Reciprocal Exchange on the Upper Guinea Coast (West Africa).

The present article seeks to fill a number of lacunae with regard to the study of the circulation and assimilation of different bodies of medical knowledge in an important cultural contact zone, that is the Upper Guinea Coast. Building upon ongoing research on trade and cultural brokerage in the area, it focuses upon shifting attitudes and practices with regard to health and healing as a result of cultural interaction and hybridisation against the background of growing intra-African and Afro-Atlantic interaction from the fifteenth to the late seventeenth century. Largely based upon travel accounts, missionary reports and documents produced by the Portuguese Inquisition, it shows how forms of medical knowledge shifted and circulated between littoral areas and their hinterland, as well as between the coast, the Atlantic and beyond. It shows that the changing patterns of trade, migration and settlement associated with Mandé influence and Afro-Atlantic exchange had a decisive impact on changing notions of illness and therapeutic trajectories. Over the centuries, cross-cultural, reciprocal borrowing contributed to the development of healing kits employed by Africans and non-African outsiders alike, which were used and brokered by local communities in different locations in the region.

Proles sine matre creata: el anhelo prometeico en la historia del cuerpo humano en Occidente / Proles sine matre creata: The promethean urge in the history of the human body in the west

Since the beginning of modernity there has been an observable tendency in Western thought to consider the human body as susceptible of technical manipulation, to the extreme of conceiving the possibility of manufacturing it. The figures of the homunculus and the automaton, the heirs of the Golem, represent the clearest embodiment of this aspiration. This paper explores the psychology underlying this plan, based on the psychological theory of C.G. Jung, and developed more recently by J. Hillman, on the hypothesis that the plan involves the denial of the feminine and, therefore, of the more truly psychological aspects of humanity, in the name of a unilaterally rationalistic and materialistic worldview. From the viewpoint of the authors mentioned, the mythical psychological reference capable of providing the fundamental key to this project would be Prometheus (AU)

Desde los inicios de la modernidad puede detectarse en el pensamiento occidental una tendencia a pensar el cuerpo humano como susceptible de manipulación técnica, hasta el extremo de concebir la posibilidad de fabricarlo. Las figuras del homúnculo y el autómata, herederas de la del gólem, representan las cristalizaciones más evidentes de esta pretensión. El presente trabajo pretende explorar la psicología que está en la base de este designio a partir de la teoría psicológica de C.G. Jung desarrollada más recientemente por J. Hillman, sobre la hipótesis de que dicho proyecto implica la negación de lo femenino y, con ello, de los aspectos más propiamente psíquicos de lo humano, al servicio de una cosmovisión unilateralmente racionalista y materialista. El referente mítico –psicológico, en la perspectiva de los autores mencionados- capaz de suministrar las claves profundas de ese proyecto sería Prometeo (AU)

Countercurrents from the West: "blue-eyed" Zen masters, Vipassana meditation, and Buddhist psychotherapy in contemporary Korea.

One surprising and yet relatively unknown aspect of contemporary Korean Buddhism is the significant influence of American and European Buddhism. Between 1989 and 2009, South Koreans witnessed well-educated "blue-eyed" monastic residents via the Korean media, and the emergence of new bestsellers by authors like Thich Nhat Hahn and Jack Kornfield, written initially for Western audiences but since translated into Korean. The new teachings from the West have inspired a sudden growth of interest in vipassana meditation as an "alternative" to Kanhwa Son practice, and the emergence of a new academic field: Buddhist psychotherapy. This new wave of transnational influence from the West has changed not only the way Koreans practice Buddhism but also how they perceive Buddhist history and their own identities. In addition, the perceived "prestige" of Buddhism in the West has provided a new rhetorical strategy to defend Buddhism against other religions, particularly Korean evangelical Christianity.

From bloodletting to apheresis in Japan.

The ancient therapy of bloodletting that was universal in the West traveled to Japan 500 years ago on the trading vessels that carried physicians and barber-surgeons to care for the body and Christian missionaries to care for the soul. Then bloodletting was replaced by blood transfusion in the 19th century, only to return less than 50 years ago as apheresis. An understanding of those transitions can be gained from the story of the introduction of Western medicine to Japan and the events that have led to the practice of apheresis there today.

[The establishment and development of Blyth hospital in Wenzhou].

Blyth hospital was the earliest church hospital established by western missionaries in Wenzhou, since then, western medicine had been introduced into Wenzhou. The establishment and development of Blyth hospital greatly accelerated the development of Wenzhou local medical and health work so that the health level of the Wenzhou people improved. The objectives, pattern, experience and characteristics of the establishment of the hospital played a certain revelatory role in modern medical work and medical education.

[Taking a look at the characteristics of the diagnostic methods of Traditional Chinese Medicine (TCM) from the periodical literature in the republican period of China].

Compiling 198 pieces of literature related to TCM diagnostic method in 210 kinds of medical periodicals during the republican period of China, they can be divided into three categories by different characteristics: theoretical research, popular common sense, works and lectures etc. Taking a look at the contents of the articles, there were 74 pieces of comprehensive literature (37%) 20 pieces of inspection literatures (10%) 6 pieces of auscultation and olefaction literature (3%) 11 pieces of inquiry literature (6%) 87 pieces of palpation literature (44%) Pulse diagnosis is a traditional distinguishing diagnostic method which involves much research. The literature on pulse diagnosis was in the majority The articles about theoretical research mostly explained the TCM principles with western medical knowledge and advocated diagnosing the disease with western medical apparatus, which was the characteristic of that time.

How four different political systems have shaped the modernization of traditional Korean medicine between 1900 and 1960.

In this paper, I examine the modern formation of traditional Korean medicine and discuss the characteristics of the modernization, or modernity, of the medicine. I probe for answers to three questions: first, prior to the twentieth century, what were the main factors that traditional Korean medicine needed to be transformed into a new one? Second, how did four states, the Taehan Empire, colonial Korea, North Korea, and South Korea, treat traditional medicine differently, and why? Third, what are the main characteristics of the modernization of traditional Korean medicine? In examining these questions, I found the following four factors to be important in shaping the modern formation of traditional Korean medicine during the twentieth century: first, the influences of Western science and institutions; second, the rise of nationalism; third, the economics of the state; and fourth, the effectiveness of traditional medicine. Among them, the introduction of Western science and institutions was the most important factor. All the different states in modern Korea realized that Western science and institutions were indispensable for the country to be a powerful nation and to enhance people's welfare. The degree of confidentiality in scientific Western medicine determined the number of traditional medical practitioners and their professional status. The modernization also was greatly affected by modern nationalism, which clashed with Westernization. Many Koreans and the Korean governments regarded the traditional medicine as something culturally valuable to protect from Western culture. Especially, the majority of Koreans who had experienced the cruelty of the Japanese rule under colonization tended to believe that Japan, a foreign ruler, had suppressed traditional Korean medicine as a liquidation policy of Korean culture during the colonial period. This belief contributed greatly to the recovery of the traditional doctors' prestige in South Korea and North Korea after independence. The economic conditions of the country also had an enormous effect on the quantity and quality of traditional medicine in the national medical care. Under poor economic practices, the traditional medicine never was isolated from medical care in the whole country, in spite of the pushing of the ideology of Western medicine. Particularly, since colonial Korea after the 1930s and North Korea after the 1980s were in very poor economic condition, traditional medicine played a more important role than at any other times. In South Korea, since the 1980s, has been making economic success in the course of industrialization toward an affluent society, traditional medicine is being treated as an alternative and complement to the weakness of Western medicine in the area of health improvement and treatment of chronic illness. The deep belief that traditional medicine had excellent effectiveness in this area resulted in this success. Like their ancestors, many Koreans in the twentieth century still had faith in traditional medicine. The traditional medical doctors in Korea succeeded in maintaining their own exclusive professional status, regardless of experiencing various state systems that had different attitudes toward traditional medicine. For the most part of the last one hundred years, Westernization dominated the modern formation of traditional Korean medicine. The modernization of traditional medicine, however, has been overcoming Westernization. Today active communication between Western medicine and traditional medicine is emerging. Western medical doctors, both in South and North Korea, have lessened their prejudiced views of traditional medicine and have more interest than before in the traditional medical treatments such as acupuncture.

[Japan's Oriental medicine policy in colonial Korea].

During its colonization of Korea, the Japanese Empire used the Western medicine as a tool for advertising its advanced culture. However, the medical workforce available in Korea was insufficient. The Rule for Uisaeng (Oriental medicine practitioner) was an ordinance decreed in 1913 with a purpose of supplementing the medical workforce. As the Oriental medicine practitioners became official medical workforce, the Japanese Empire could mobilize them in a hygienic administration such as prevention of epidemics. The Uisaengs also tried to adapt themselves to the colonial environment by studying Western medicines. However, the distrust of the Japanese Empire in Oriental medicine continued until 1920s. Manchurian Incident in 1931 brought a change. As the relationship with China aggravated, the provision of medical herb became unstable and the Japanese Empire began to encourage using Oriental medical herb following the Movement for Improving Rural Region Economy. An attempt of the Japanese Empire to utilize the medical herb resulted in a plan to make the Oriental medical herb officinal. The goal was to organize and standardize the Oriental medical herb through a research by the Medical Herb Investigation Committee. However, the medical herb on the table was the one verified by the Western medicine. That is, it was not a traditional medical herb that uses the original theory of Oriental medicine. There was a minority opinion arguing that they should study the Oriental medicine itself. However, that argument was also based on the theory and principles of the Western medicine. Even though an attempt to make full use of Uisaengs expanded as the war continued, the major medical workforce that the Japanese Empire relied on was those trained in Western medicine. In other words, the Japanese Empire did not give a full credit to the Oriental medicine during the colonial era. During the colonization, Japanese Empire used Oriental medicine under the nominal reason of lack of medical workforces. In early 1930s, a policy supporting usage of Oriental medical herb was selected. However, it does not mean that the change in policy encouraged Oriental medicine since the medical herb that the Japanese Empire supported was those that were organized and categorized according to the principles in Western medicine.

[A comparative study on the ethics of Western and traditional Chinese medicine].

The ethics of Western medicine and that of traditional Chinese medicine (TCM) developed separately in their own ways. The formation and development of ancient medical ethics of China were extensively and deeply influenced by Confucianism, Taoism, Buddhism and other religious thought, while the ancient ethic basis of western society was influenced by traditional Judaism, Christianism, Catholicism and other natural philosophical thinking of ancient Greece and Rome. With the progress of medical and life sciences, the medical ethics begins to transfer into the life ethics, thus giving rise to new questions in the ethics of Western medicine and TCM.

Japan's Oriental Medicine Policy in Colonial Korea / 의사학

During its colonization of Korea, the Japanese Empire used the Western medicine as a tool for advertising its advanced culture. However, the medical orkforce available in Korea was insufficient. The Rule for Uisaeng(Oriental medicine practitioner) was an ordinance decreed in 1913 with a purpose of supplementing the medical workforce. As the Oriental medicine practitioners became official medical workforce, the Japanese Empire could mobilize them in a hygienic administration such as prevention of epidemics. The Uisaengs also tried to adapt themselves to the colonial environment by studying Western medicines. However, the distrust of the Japanese Empire in Oriental medicine continued until 1920s. Manchurian Incident in 1931 brought a change. As the relationship with China aggravated, the provision of medical herb became unstable and the Japanese Empire began to encourage using Oriental medical herb following the Movement for Improving Rural Region Economy. An attempt of the Japanese Empire to utilize the medical herb resulted in a plan to make the Oriental medical herb officinal. The goal was to organize and standardize the Oriental medical herb through a research by the Medical Herb Investigation Committee. However, the medical herb on the table was the one verified by the Western medicine. That is, it was not a traditional medical herb that uses the original theory of Oriental medicine. There was a minority opinion arguing that they should study the Oriental medicine itself. However, that argument was also based on the theory and principles of the Western medicine. Even though an attempt to make full use of Uisaengs expanded as the war continued, the major medical workforce that the Japanese Empire relied on was those trained in Western medicine. In other words, the Japanese Empire did not give a full credit to the Oriental medicine during the colonial era. During the colonization, Japanese Empire used Oriental medicine under the nominal reason of lack of medical workforces. In early 1930s, a policy supporting usage of Oriental medical herb was selected. However, it does not mean that the change in policy encouraged Oriental medicine since the medical herb that the Japanese Empire supported was those that were organized and categorized according to the principles in Western medicine.

[Traditional medicine seen from the perspective of Western medicine during the late 19th and early 20th century in Korea].

From the 18th century traditional medicine began to be criticised by some of Korean intellectuals who attained the knowledge of Western medicine through the imported books on Western science. In the early 20th century, Western medical doctors in Korea generally had critical attitude toward traditional medicine. Their critical opinions on traditional medicine are typically recognizable in the debate between two camps that occurred in 1930s. However, some exceptional doctors such as Chang Ki-moo and Bang Hap-shin had special interest in traditional medicine despite their education in Western medicine. It was their clinical experience of the limitation of Western medicine which led them to study traditional medicine. Both of them were particularly attracted by the School of Old Prescriptions, which was a school of Japanese traditional medicine. The medical theory of the school was characterized by the simplification of vague and complicated theory of traditional medicine. The school held the theory that all diseases are caused by one poison. Consequently, treatment of all diseases consists in eliminating the poison. He also put forward a theory of one prescription for one disease, and therefore the same remedy should be applied to a disease with the same cause even though it might manifest various symptoms. Given the fact that their theory of diseases is very similar to that of Western medicine, it is understandable that they were attracted to the School of Old Prescriptions. As the doctors trained in Western medicine, they were possibly more familiar with the doctrine of the School of Old Prescriptions than the traditional medicine based on Yin Yang and Five-Phase theory.

[Research on psychiatry in the integration of Chinese and Western medicine in 1950's].

In 1950's, the studies on psychiatry in the integration of Chinese and Western medicine was in its primary stage, which can be further divided into two periods, viz. the preparative stage, covering 1950 to 1954, during which doctors of traditional Chinese medicine were absorbed into the group of psychiatry research; and the preliminary development period, covering 1954 to 1958, during which there were more development of the clinical research on psychiatry in the integration of Chinese and Western medicine and in the Chinese herbal medicine, thus offering some effective new methods and drugs.

Traditional Medicine Seen from the Perspective of Western Medicine during the Late 19th and Early 20th Century in Korea / 의사학

From the 18th century traditional medicine began to be criticised by some of Korean intellectuals who attained the knowledge of Western medicine through the imported books on Western science. In the early 20th century, Western medical doctors in Korea generally had critical attitude toward traditional medicine. Their critical opinions on traditional medicine are typically recognizable in the debate between two camps that occurred in 1930s. However, some exceptional doctors such as Chang Ki-moo and Bang Hap-shin had special interest in traditional medicine despite their education in Western medicine. It was their clinical experience of the limitation of Western medicine which led them to study traditional medicine. Both of them were particularly attracted by the School of Old Prescriptions, which was a school of Japanese traditional medicine. The medical theory of the school was characterized by the simplification of vague and complicated theory of traditional medicine. The school held the theory that all diseases are caused by one poison. Consequently, treatment of all diseases consists in eliminating the poison. He also put forward a theory of one prescription for one disease, and therefore the same remedy should be applied to a disease with the same cause even though it might manifest various symptoms. Given the fact that their theory of diseases is very similar to that of Western medicine, it is understandable that they were attracted to the School of Old Prescriptions. As the doctors trained in Western medicine, they were possibly more familiar with the doctrine of the School of Old Prescriptions than the traditional medicine based on Yin Yang and Five-Phase theory.

Mental disabilities in Western civilization from Ancient Rome to the Prerogativa Regis.

A preliminary survey of formal concepts of disability from the Twelve Tables of Rome of the 5th century BCE to the Prerogativa Regis in English law of the late 13th century CE is presented. Firm conclusions are restricted by problems in translation and other limitations in available data. However, it appears that the concept of intellectual disability and its distinction from episodic mental illness first emerged in several subcultures of Western civilization during the height of ancient imperial Rome and during the early medieval period in Northern European and Arabic civilization.