Hygienic Modernity is a theoretically sophisticated book that grabbed my attention, especially as a pre-medical and prospective medical school student and as a future doctor. Learning about the past, present and future of medicine has always stimulated my inquiring mind. Furthermore, this reading paralleled the learning about the formulation of treaty-port China. The book follows the change of the meaning of health and disease in China as well as the transformation of the term weisheng. Ruth Rogaski's book exhibits that it is not possible to understand these transformations without first accounting for other historical factors that may have affected these changes. By detailing the political events of the time and incorporating perspectives from different countries, Rogaski is able to understand and convey the messages of hygienic modernity.
The study takes place in the city of Tianjin, located in northern China. The city held a certain geographical importance in that it was located between the Yellow Sea and Beijing, the Qing capital. In becoming a treaty-port city, Tianjin joined Shanghai and Guangzhou and became a center of multi-cultural interactions. Eventually, the city was the home of German, Italian, French, British, Austria-Hungarian, Russian, and American occupying forces. Colonial administrations were established, an international process unprecedented by any foreign event in Qing history. At one corner of the Qing Empire, imperial forces had setup a committee, and in this process the Qing were forced to "regain their sovereignty" by adopting a new definition to the term weisheng.
I asked my peers that were fluent in Chinese their definition of weisheng. Their definitions converged to the modern notion of hygiene, associated with cleanliness and sanitation. As did Rogaski, they also went on to talk about personal and public hygiene, known as geren weisheng and gonggong weisheng, respectively. Weisheng did not always have the meaning it holds today. Before the time of the hygienic modernity study, the term had a very different meaning. In the nineteenth century, weisheng referred to a way of taking care of oneself - according to age, sex and the interactions with the environment. Weisheng was not considered cleanliness, but alternatively was a personal approach to living. The definition changed in the twentieth century and no longer meant nourishing and sustaining life, but incorporated a new notion of hygienic modernity that included governmental sanitation control as well as disease prevention along with the detection and elimination of germs. A combination of medical diversity and the political conditions of the Qing treaty ports allowed the Chinese to adopt and alter the content of the newly translated weisheng. [Metascience, (2006) 15: 371-374]
Rogaski goes on to talk about how the Boxer Rebellion was a cause of much disaster for the Chinese elite. Therefore, the elite used weisheng as a means of distancing themselves from the violence. Furthermore, she mentions that the occupation of the treaty-port by foreign powers may have violently ruptured the past, but also worsened the gap between the treaty-port elites and the urban underclass of the community. The denizens and the Chinese peasants carried around the label of hygienic deficiency while the Chinese elites focused on raising their status to the "senior members" of the global hygienic order. Rogaski goes on to discuss the importance of hygienic modernity to the Chinese elite, who considered it absolutely beneficial to the well-being of the city - although it was clearly evident that this modernity was only established at gunpoint and brought devastating violence. In essence, the experience of this violence was viewed differently by the different societies in the treaty-ports. Thus, Rogaski illuminates China's paradoxical experience with imperialism.
Rogaksi implies that the idea of superior Western medicine was simply another method used by imperialists. She asserts that "Britain used medicine to further its interests and secure its goals." The real difference between Chinese and European practice of medicine lay in the social and political context, there was simply an "unprecedented philosophy that linked the health of a population directly to the economic and military success of the nation-state." Rogaski brings forth the idea that Western medicine and hygiene was not as "modern" as it may have seemed. In actuality, European medicine did not provide any significant health advantages for China. More specifically, Rogaski attacks and challenges the idea that British physicians had "inherently superior, more complex, or more scientific approaches" to medical diseases in the nineteenth century. Furthermore, the book brings forth an argument that the early establishment of public health administrations and hospitals at Tianjin was a vital part of the European organization of health. However, Rogaski shows that the development of these establishments relied heavily on scientific reports from colonial outposts and therefore could not be considered solely European projects.
As the study continues, we reach the 1900s, by which time foreign influences were growing as was the territory they inhabited. Tianjin reformers formed a number of internal divisions within the city borders. Prior to the twentieth century, Tianjin neighborhoods actually displayed a level of intermingling of the classes. However, humans and water, foul and fragrant, public and private, and rich and poor were all separated. After the Boxer Uprising, zoning laws and health bureaus began separating residents from industries and this was further dictated by hygienic modernity - which helped to shape the use of urban space and even made some functions of daily life invisible, dictating what was to be seen and unseen.
Another main part of the study is when Rogaski discusses Japanese interactions and their importance in Tianjin. The Japanese made huge efforts to control germs in the treaty-ports. These efforts proved to be fruitless as eventually, there began rumors that "injections given by white-coated doctors cause, rather than [prevent]" disease. The existence of other germ warfare programs in China helped to justify these fears. And so, during the Japanese occupation, weisheng was used as a marker of deficient China and became a pivot for China as a victim of violent imperialism. Once the treaty-ports no longer existed, it helped to establish weisheng as a basis for resistance against imperialism.
The main idea throughout the book is that weisheng had become an instrumental discourse that would create a vision of a transformed state, society, and individual for the Chinese elite. Similar to the Meiji bureaucrats and late Qing reformers, elites were concerned about sovereignty, discipline, and government administration - and they hoped to use weisheng as a medium towards success. Their view on hygienic modernity and desire to transform the nation was the driving force behind all this.
During my reading, I was fascinated by the acceptance of China as the "sick man of Asia" by the Chinese elites. As Rogaski implies, I agree that the appeal of science and its applications played a role in this. However Japan's mediating role further played a big part in influencing the elites. Initially, I was awestruck by the idea that the Chinese actually embraced this idea. Nevertheless, as the book continues, it becomes very clear that Chinese standards of hygiene were simply used as a medium in which the Chinese elite hoped to alleviate their concerns of the new imperialistic powers and the condition of the state.
In analyzing Hygienic Modernity, I think it is vital to understand the sources utilized by Ruth Rogaski. By doing so, it makes it easier for us to understand and grasp the concepts and ideas presented in the book. As I looked through the 30 pages of the bibliography, I was dazzled by the assortment of materials. She included not only Chinese sources, but also British local archives as well. They ranged from the early 1800's all the way to contemporary times. Fundamentally, by looking at the number and quality of the sources I think it is safe to say that Rogaski is able to justify her findings and support her ideas about how weisheng was altered from its traditional meaning to the conceptions of health in the West.
Overall, I believe that Hygienic Modernity does an extraordinary job in deeply separating the history of Tianjin through the evaluation of multiple case studies. Ruth Rogaski incorporates vivid imagery and fascinating details of how citizens of Tianjin experienced life and death. She exhibits an astounding understanding of the colonization, public health, and history of China. Not only does Rogaski track down the transformation of the term weisheng, she also tracks down the evolution of public health systems in Tianjin. I am convinced of the ironies of modernity, modern medicine and personal hygiene and how these ironies were used to transform an entire nation.
