(2005) Volker Scheid, Chinese medicine in contemporary China: plurality and synthesis, Science and Cultural Theory series, Durham and London, Duke University Press, 2002, xx, 407, £18.50 (paperback 0-8223-2872-0).[Review]. Medical History, 49 (1) pp. 128-130. .
Scheid set out to present evidence for 'plurality as an intrinsic aspect of contemporary Chinese medicine,' 'plurality' as 'nothing else than a term denoting the way things always are forever changing and transforming origins in the whirpool of their simultaneously present pasts and futures.' In doing so, Scheid succeeds in deconstructing our western notion of a monolithic, hegemonistic Chinese medicine, and provides us with a groundbreaking analysis of Chinese medicine 'from within'.
In six distinctive, yet interrelated essays Scheid explores many factors that have come to bear on the development of contemporary medical practice in China. With detailed and intimate description of such aspects of practice as case history writing, innovative theories and techniques, practitioner training and patient choice, Scheid places himself at the vanguard of a handful of researchers engaged in remedying the over-simplified portrayals of Chinese medicine inherent in common polarities: Western scientific theory versus Chinese pragmatic knowledge, tradition versus modernity or “holism” versus reductionism.
In a series of detailed narratives highlighting the care with which individual patients weigh up their options, Scheid takes us beyond the simple idea that patients choose between clearly defined modern and traditional treatment options. The course of Mr Ke's treatment for nephritis, for instance, is as much defined by the affiliation of his unit to a particular institution, the strictures imposed by his medical insurance policy, by continued therapeutic failure, personal recommendations, and the reputation of departments and individuals as it is by belief in the efficacy of one system or another. In his discussion of teaching, Scheid demonstrates how traditional forms of learning have also adapted to the new institutions; the art of networking in China remains critical to becoming an apprentice to an acknowledged master; diagnostic tests, case histories, needling techniques are all cited as evidence for unique syntheses of a plurality of medical systems and traditions.
Chinese medicine in contemporary China: plurality and synthesis, Science and Cultural Theory series, Durham and London: Duke University Press. 2002, xx, 407, £18.50 (paperback 0-8223-2872-0).
It examines the function of standardised Chinese medicine (CM) textbooks in contemporary China. In her thesis, she investigates how standardised textbooks of acupuncture and moxibustion1 were initially written, introduced and used in the TCM universities in contemporary China. The first edition of these textbooks was compiled at the end of the 1950s; since then they have been used as course material in CM universities nationwide in the teaching of undergraduate courses on which written examinations are based. The textbooks are regularly revised and updated and the most recent sixth edition was introduced in the late 1990s. What is the role, however, that these contemporary textbooks play in learning CM?
As a medical anthropologist in China, the author paints a picture of Chinese medicine not necessarily visible from within the international training centres. He explores the changing nature of acupuncture in contemporary China and its relationship to western medical practice in that country. He then compares it with how Chinese medicine is presented in the west, often as a search for a systematic approach. His challenge to attempted integration calls for serious reflection.
This is a reprint of the final chapter (Chapter 9) from , recently published by Duke University Press. The book examines the development and transformation of Chinese medicine over recent decades based on extensive fieldwork in Beijing and Shanghai. References within the text are to other chapters in the book, which also discusses at length the key concepts such as 'infrastructure', 'plurality', and 'synthesis' employed in the present text.
I especially liked Chapter 6, 'Students, Disciples and the Art of Social Networking: Becoming a Physician of Chinese Medicine', a narrative of the lives of contemporary Chinese doctors and how history, politics, personal preference and genealogy have shaped their present practice. Equally fascinating is Chapter 5 'Shaping Chinese Medicine', in which a practitioner of integrated Chinese and western medicine (Professor Zhu) uses his knowledge of and tools from both medical traditions to create Chinese herbal prescriptions for biomedically-defined diseases such as Ménière's. Scheid's interviews of Professor Zhu provide us with valuable insights into the mind of a master, an artist skillfully and elegantly synthesising traditions and combining herbs to match clinical realities.
There is no doubt that Scheid's work has altered the face of anthropological research into Chinese medicine. He also has a serious message for those practitioners of TCM representing (Scheid's emphasis) traditional medicine in the modern world. “What, ultimately, can be gained from restraining Chinese medicine by means of a rationality blind to its own irrational constitution, and gained for whom?” What does an enhanced appreciation of the nuances of Chinese medicine teach us but the value of the art of synthesis in medical practice?—a lesson not just appropriate to Asian medicine. But will his message be heard? Mindful of the difficulties of writing for several audiences he tries to guide the reader to appropriate chapters according to their interest. Here he may well have overestimated the power of the written word. Even the most reflective practitioners of Chinese medicine may find obtuse and irrelevant the discourses of contemporary anthropology, despite their unanimous dedication to the “agency of qi”.
Volker's central premise is that the development of Chinese medicine in China is and always has been a multifactorial process which cannot be reduced to any of the simplistic assumptions commonly bandied about by modernist anthropologists and Western practitioners of Chinese medicine alike. Essentially, this is postmodernist complexity theory applied to the ethnography of Chinese medicine (with dollops of Yi Jing and the Buddhist theory of codependent origination thrown in). As such, it appears to be cutting edge social science. Volker attempts to elucidate the complex variety of factors that affect the practice and development of Chinese medicine through a series of "case histories." These case histories deal with the bi-directional relationships of Chinese medicine and its practitioners with the Chinese government, patients, Western medicine, educational institutions, the Chinese medical literature, social networks, technology, and the marketplace. While these case histories support Volker's postmodernist thesis, they are also enlightening descriptions of the state of Chinese medicine in the People's Republic of China and what life is like for a contemporary Chinese doctor. Even though I myself have lived and studied in China, I had no idea of some of the behind-the-scenes factors influencing why Chinese doctors do and say the things they do. Likewise, even though I myself read Chinese, Volker's erudition in the Chinese medical literature is extraordinary.
Volker Scheid's new book, , is a hugely significant read for anyone interested in the practice and development of Chinese medicine during the last hundred years. For those who may not know Volker, he is a German-born practitioner of Chinese medicine as well as a medical anthropologist at the University of London. While many acupuncturists might find this book is a somewhat difficult read due to its academic jargon, I believe it is well worth the effort. This book is the clearest and most complete explanation I have read of the various factors influencing the development of Chinese medicine in Republican, Maoist, Dengist, and contemporary China. If I were going to teach a class in the history of Chinese medicine, this book definitely would be assigned reading. Since its publication, there is no longer any excuse for much of the mythological thinking about Chinese medicine current in the West.