Chinese medicine as indigenous medicine has experienced tremendous change and transformation with the advent of Western medicine since the time of late imperial China. Current scholarship has analysed the clash, reconciliation and integration of these two medical conceptual systems. However, the history of madness covering psychiatry, psychology and mental health in modern China has been long understudied due to the paucity of written documents and prerequisite subject training. Emily Baum’s The Invention of Madness analyses how the state, society and medical community constantly forged and invented the meaning and practice of madness, and how the constant reinvention of madness contributed to the rise of neuropsychiatry and mental hygiene and reconciled the theories and practice of Chinese and Western madness in the changing socio-political contexts of China from the late Qing to the outbreak of the Second Sino-Japanese War in 1937.
The book is composed of seven chapters. Chapter 1 discusses how the late imperial government mandated the role of families in managing people with mad illness and how madness was conceptualised and treated before the introduction of psychiatric medicine. Chapter 2 investigates how the institutionalisation of madness became an integral part of modern statecraft and how the police were crucial in managing the asylum and controlling the insane. Chapter 3 explores how ordinary urban households utilised the public institutionalisation of madness and deployed the charge of madness for family members and friends to obtain municipal aid. Chapter 4 addresses how psychiatric entrepreneurs commodified the experience of mental illness and marketed specialised proprietary medicines and private psychopathic hospitals in the 1920s and 1930s.
Chapter 5 examines how the Nationalist government and the Peking Medical Union College (PUMC), in the mid-1930s, formed a partnership to control the insane that contributed to the rise of neuropsychiatry for their own interests. Chapter 6 discusses how the medical intelligentsia’s pursuit of mental hygiene was integrated into the Nationalist’s political control efforts and how the mental hygiene movement was intended to achieve social conformity and obedience. Chapter 7 explores how Chinese medicine assimilated the new, competing neuropsychiatry while retaining its own epistemic authority in theories and practice.
Baum’s The Invention of Madness adroitly weaves the three major themes of the evolutionary process of madness in modern China – state, society and medical community – into a meticulously designed analytical framework following chronological order. The book clearly and logically analyses the state’s commitment to the institutionalisation of madness for the sake of its practical needs following the rise of modern statecraft. Indeed, various social classes responded to, made use of, and even participated in the new management forms of madness, while the medical community consistently attempted to both facilitate the development of the newly introduced theories and practice, and defend the practical legitimacy of its own survival.
Based on the studies of madness, Baum splendidly presents a very broad and well-connected spectrum of Chinese society during the complicated and significantly transformational era of modern China. The book vividly shows the quotidian life, motivations and behaviours of the insane, the police, ordinary urban households, entrepreneurs, the intellectual class, medical intelligentsia (i.e., neuropsychiatrists and psychologists), the Nationalist Party and its affiliated elites and Chinese medical practitioners. In the book, she has demonstrated great acuity with the theoretical and empirical studies of classical themes of modern China.
Baum shows her in-depth understanding of a complex and nuanced state-society relationship from the time of late imperial China. In the case of madness, the establishment of the Beijing Municipal Asylum symbolised the initial efforts of effective governance and social control of the modern nation-state, in which the police played crucial roles in detaining and controlling the insane. However, as Baum shows, the role of the police was quite broad during the ascent of modern statecraft as they were responsible for “the preservation of social order, the maintenance of moral authority, the advancement of public hygiene, and the promotion of ‘civility’” (p. 50). So, insanity was closely entangled with social deviance, which required policing and supervision.
Ironically, large numbers of urban poor households, particularly those of the lowest socioeconomic classes, pursued the institutionalisation of madness for their relatives and friends with either real economic and practical reasons or with false accusations. This social response was increasingly difficult to be accommodated in the crowded asylums managed by the police. The conflict between society and state unintentionally created a vacuum for smart entrepreneurs, who legalised and commercialised “the anxiety and malaise of moneyed classes” (p. 88) by establishing private psychiatric hospitals and selling proprietary medicine. These efforts further stratified social classes and created social identities.
Baum also makes a significant contribution to current scholarship about medicine and politics in modern China through her study of the history of neuropsychiatry and mental hygiene in the 1930s. As her analysis shows the PUMC neuropsychiatrists made necessary compromises with the Nationalist government due to budget constraints and the imperative of research, training and treatment. In this way, the Beijing asylum was successfully converted into a psychopathic hospital. Conversely, the Nationalist government recognised the economic and political advantage of working with the PUMC. In particular, the social control that was available through the institutionalisation of madness contributed to the restoration of social order, stabilising state power, and further justifying its political legitimacy. The interaction between medicine and politics also redefined the roles of the hospital, police, local scholars and social workers in the institutionalisation of madness.
The development of the mental hygiene movement basically followed the same pattern, in which psychologists’ and psychiatrists’ pursuit of mental hygiene was integrated into the Nationalist government’s political controls with the proclaimed grand purposes of social stability and national self-strengthening. Interestingly, psychologists affiliated with the Nationalist government played indispensable roles during this process. Baum’s book discloses the unique relationship between the Chinese elite intelligentsia and political power in modern China.
In all, Baum presents readers with a comprehensive picture of the social, political, medical, intellectual, cultural and translational history of early twentieth-century China through the perspective of madness. Her research questions, analytical framework, and theoretical contributions deserve the attention of scholars in the fields abovementioned. The only pity is that Baum does not pay particular attention to the social history of asylum and insane patients themselves – a theme that is very appealing to audience likes me. The shortage of original material might be a mitigating circumstance. In this way, Baum leaves a vacuum for colleagues to undertake a microstudy of asylums in modern and contemporary China through an interdisciplinary perspective, which will greatly deepen our understanding of the history of madness in China.
