Book Review: Hygienic Modernity: Meanings of Health and Disease in Treaty-Port China by Ruth Rogaski

Yaming You //

In this book, Ruth Rogaski provides a discursive analysis of the shifting connotation of one single Chinese word—weisheng 卫生  (hygiene/sanitation)—to “place meanings of health, disease at the center of Chinese experiences of modernity” in twentieth-century China (1). As hygiene was transformed from a personal and individual practice into a public and national project of modernization in the twentieth-century, the meaning of weisheng moved away from a Chinese cosmological way of guarding life (the direct translation of weisheng in traditional Chinese) to encompass “state power, scientific standards of progress, the cleanliness of bodies, and the fitness of races” (1). As this shift occurred, there was a “persistent association of weisheng with questions of China’s place in the modern world”—hence the translation of weisheng into “hygienic modernity” to underlie the changing conditions of colonization and racialization in the twentieth century. This research ultimately portrays twentieth-century China with “a growing hegemony of biomedical approaches to health in the public discourse of Chinese elites” and “a concurrent acceptance of a picture of the Chinese people as inherently lacking when compared with Western-defined standards of health,” and Chinese modern elites’ struggles to transform China into a “hygienic” country based on a European standard as part of their nation-building efforts (9).

Chapters One and Two explore the premodern meanings of weisheng in Chinese culture, with an emphasis on these “guarding-life” guidelines as individual practices like moderate sexual conduct, appropriate times and locations for certain activities, and so on. Chapter Three focuses on the first encounter between Tianjin and Britain as a Western colonial power in the 1860s, concluding that there were no major differences between Chinese and British medical practices at this time. Chapters Four and Five turn to Shanghai and Tokyo as two sites where weisheng/hygiene was attentively translated into hygienic modernity. Meiji Japan quickly embraced the Western science on hygiene and adopted the notion that the government should be responsible for public health, a theory that had already gained traction in Germany. Nagayo Sensai, a Japanese doctor who was part of the Iwakura Mission and the founder of the Meiji Japanese Medical Affairs Bureau, translated the Western notion of “public health with medical police” into “衛生” (eisei) using the kanji system. Eisei (weisheng in Chinese) was stripped of its Daoist and ethical implications and became a strictly scientific guidance. It included not only personal habits that could transform people into “healthy constituents of the national body,” but also the national goal that “the people of Japan could be tutored in civilization and enlightenment, and would willingly equate the goals of the state with their own” (164). In Chapter Six, we see Tianjin being introduced to this “hygienic modernity” through the chaos of the Boxer Movement and the resulting international occupation of the city. Under the municipal rule of fragmented foreign powers, there could not be “a shared, public health” and “a true public administration,” which rendered true hygienic modernity impossible (195). What’s more, clean water and waste disposal system were only available to wealthy people who could afford them. Dark drifters, night soil carriers, and slaughterhouse workers, along with other “filthy” people, were moved out of certain neighborhoods. 

Despite these limitations, weisheng came to be the symbol of bifurcation between the civilized and the uncivilized. Middle-class consumers and intellectuals labeled themselves as sanitary and distinguished themselves from the unsanitary, as Chapter Eight shows. The Japanese occupation of Tianjin after 1937 intensified hygienic modernity under colonial rule. Chapter Nine explores the different methods utilized by the Japanese Army to intervene in the populace’s daily lives, which in turn were met with resistance as the role of weisheng was transformed from “a marker of inherent Chinese deficiency” to “the pivot of China as a victim of violent imperialism” (284). It was in 1952, under the Communist-Party-led Patriotic Hygiene Campaign (Aiguo weisheng yundong), discussed in Chapter Ten, that the goals of weisheng reached its “culmination” with the achievement of “a system that combined government institutions and individual participation to form the basis of a national health” (298). 

The sheer scale of the chronological and geographical traversing in Rogaski’s research is impressive. More importantly, Rogaski’s work contributes significantly to the historical studies of China and Asia by situating itself not only within the realm of urban history, but also the studies of colonial and medical history. Rogaski’s translation of weisheng into “hygienic modernity” incorporates the modern Chinese history of medicine and health into ongoing discussions of Chinese nation-building and nationalism, as well as China’s twentieth-century experiences with state, power, colonization, and race. However, the project is not without its limitations. By and large, Rogaski’s work is an intellectual history of weisheng/hygiene, with only scarce reference to the subaltern experience with “hygienic modernity”—like the night soil carriers in Chapter Seven. She gestures towards the existence of classed experiences with hygienic modernity but does not dive into too much detail. Put simply, Rogaski’s “hygienic modernity” opens up windows to deeper investigations into class, race, colonization, and power in the realm of Chinese medical history but itself is a bit lacking in these explorations. In my opinion, however, it is always important to keep in mind that no book can possibly achieve everything, and the significance of Rogaski’s work is beyond doubt in terms of its refreshing arguments, its collection of primary sources, and the windows it opens for future research potential.

Work Cited

Rogaski, Ruth. Hygienic Modernity: Meanings of Health and Disease in Treaty-Port China. Berkeley and Los Angeles, California: University of California Press, 2004.

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