Chieko Nakajima’s Body, Society, and Nation is a welcome addition to the rapidly growing historical field of health management regimes, or the so-called ‘hygienic modernity’, in modern China, which studies the complicated process of translating, contesting and appropriating Western medical knowledge and public health institutions in Chinese semi-colonial treaty ports since the nineteenth century. Different from previous works limited to the development of Western-administrated public health in Shanghai’s foreign concessions, this book turns to health-and-body-related visions and experience of local Chinese residents in the Chinese sector of the city throughout the long twentieth century.
After a succinct historiographical introduction to recent studies of Western medicine, Republican China (1912–49) and colonialism in Shanghai, the first chapter of this book discusses an important yet surprisingly understudied theme in Chinese medical history: hospital. Nakajima identifies three types of non-governmental hospitals: Westerner-operated missionary hospitals, summer-disease hospitals run by local elites and Chinese medicine hospitals, in which practitioners of traditional Chinese medicine appropriated the Western-style hospital concept and institution to legitimate their medical practice. Although these hospitals served for different philanthropic, commercial or professional purposes, they all shared humanitarian ideals of providing medical care to the public, and helped to shape a syncretic medical culture of co-existing Chinese medicine and Western medicine in twentieth-century Shanghai.
Chapter Two shifts to the state-led Shanghai Municipal Public Health Bureau. Started by the Nationalist regime (1927–49) in 1927 and supported by local elites, the Bureau carried out many public health engineering programmes and disease-control measures to recreate a clean and healthy Chinese city, as well as to compete against the Western sanitation systems in Shanghai’s foreign sectors. During the wartime period (1937–45), Chinese health workers collaborated with Japanese occupiers to continue the Bureau’s pre-war public health interventions into local residents’ everyday life.
The next chapter examines hygiene campaigns in Shanghai organised subsequently by the Young Men’s Christian Association (YMCA), the Nationalists and the Japanese during the first four decades of the twentieth century. The Nationalist state in particular actively utilised mass mobilisation strategies, such as health-oriented publicities, ceremonies, street-sweeping marches and even police monitoring, in order to educate and regulate the ordinary people’s personal hygiene, and remake them responsible citizens for its modern nation-state building project.
The last chapter moves to Republican Shanghai’s light chemical industry entrepreneurs and the consumer culture of their hygiene products used daily, such as soaps, toothpastes and insecticides. It analyses how these Shanghai merchants took advantage of commercial advertisements, state-led hygiene campaigns and national product movements, and promoted their commodities as indispensable to patriotic consumers who wanted to have ‘more attractive, more hygienic, cleaner, and healthier’ bodies (p. 209). Nakajima suggests that they ‘might be more successful than the state in localising and popularizing hygienic modernity among Shanghai residents’ (p. 25).
Built upon the well-established Shanghai Studies scholarship and a wide array of local primary sources, such as archival materials from the Shanghai Municipal Archives, Chinese popular magazines, newspapers and medical journals, this book presents ‘how Shanghai Chinese understood hygienic modernity and translated it into mundane behavior and practices within the contexts of the city’s urban milieu and the culture of which they were part’ (pp. 3–4). Chieko Nakajima has made some interesting and important arguments, especially the oft-neglected roles of different-motivated local actors in shaping public health and urban culture of Chinese Shanghai. In the book’s conclusion part, she also convincingly points out that the hygienic modernity project in Shanghai has been continued under the Communist regime: including the more successful and effective state-power interventions into medical-care institutions, disciplining and surveillance of individual bodies, massive hygiene- and disease-control campaigns and the combination of Chinese and Western medicine in treatment all have pre-1949 origins.
Nevertheless, her approach of ‘Chinese Shanghai in Chinese Shanghai’ suffers from a few shortcomings. In the late nineteenth and early twentieth centuries there was not a pure-isolated ‘Chinese Shanghai’. The public health administration in the Chinese sector was greatly influenced by its counterparts in foreign concessions and international factors. For example, the League of Nations Health Organisation played an important role in its disease-control projects. Their complicated interactions have been well-studied by Yuki Fukushi in her Japanese-language monograph on the history of public health in modern Shanghai (Kindai shanhai to kōshū eisei: Bōeki no toshi shakaishi, Tōkyō: Ochanomizushobō, 2010), which is surprisingly not among Nakajima’s reference lists. The ‘Shanghai Chinese’ in this book are mainly medical, political or merchant elites. Disappointingly, there are few voices and bodily experiences of patients in hospitals, lower-class urban residents regulated and mobilised in mass campaigns, male and female consumers of hygiene-items. We do not know if the ordinary people, depicted in the book as passively disciplined subjects, Japanese collaborators or eager buyers, had any agency in their everyday life against the states, Japanese military colonialism or consumerism.
Despite these problems, this book remains a fine English-language study of health and hygiene in twentieth-century Shanghai. It would work well as a reference to students working on the history of hygienic modernity and urban culture in modern China.
