Dissertation Research: Science and Social Negotiation; Chinese Patients and the Culture of Biomedicine at PUMCH, 1928-1952

本论文将以北京协和医院为研究对象，探讨20世纪世纪早期美国式的“科学医学”如何在与20世纪世纪早期中国不同的文化环境中发挥作用。北京协和医院成立于1921年，是洛克菲勒基金会在世界上最大的医疗慈善项目。它的使命是在中国建立第一个世界级的科学医学机构，沿着美国模式。习惯于传统中医做法的患者和接受过生物医学培训的北京和睦家医院的工作人员，通常对健康、疾病和治疗有不同的看法。这个项目位于历史人种学和医学史的交界处，将揭示在两种文化接触的背景下提供医疗保健的问题和政治。科学在不同文化间的相遇中扮演了什么样的角色--无论是客观的还是牺牲性的？关于科学的修辞主张是如何构建人与人之间以及知识传统之间的关系的？作为一种社会实践，而不是一种抽象的理论，科学医学到底是什么？是否存在一种“生物医学文化”，它与其他医学文化和世界观的谈判条件是什么？通过北京协和医学院和医院之间的关系以及中国患者基础，可以对这些广泛的、长期存在的问题进行实证研究。一门在社会环境中处理人类的应用科学如何作为一门科学运作。通过对实验室研究及其与医院环境的关系的密切关注，研究者希望能够现实地评估那个时代所提倡的“科学医学”的含义。 研究人员将研究来自WARCH社会工作部门的记录，该部门留下了医院与患者之间发生的谈判的详细文件。该研究还将利用洛克菲勒档案中心未充分利用的重印文章集，探索在CNOC进行的基础医学研究与多元化医学环境中的医学实践艺术的关系。位于北京的北京大学医学和社会工作案例记录将成为这项工作的核心，以前研究北京大学医学和社会工作的学者无法获得这些记录。结合起来，文件的医疗和社会工作部分形成了每个病人的多方面的图片，提供了医生，社会工作者和病人的观点丰富的信息。这些记录将使研究人员能够解决有关医学作为应用科学的社会关系以及科学在文化关系中的作用的问题。

This dissertation research project will use Peking Union Medical College and Hospital as a site for examining how early 20th century American style "scientific medicine" functioned in a different cultural environment, that of early 20th century China. Founded in 1921, Peking Union Medical College and Hospital (PUMCH) was the Rockefeller Foundation's single largest project in medical philanthropy anywhere in the world. Its mission was to establish the first (sic) world class institution of scientific medicine, along an American model, in China. Patients accustomed to traditional Chinese medical practices, and staff at PUMCH trained in biomedicine, generally entertained differing assumptions about health, illness and treatment. Situated at the juncture of historical ethnography and medical history, this project will shed light on the problems and politics of health care delivery in the context of contact between two cultures. What role has science played - both objectively and rhetorically - in encounters between cultures? How have rhetorical claims about science structured relations between people and between intellectual traditions? What exactly is scientific medicine, as a social practice, rather than an abstract theory? Is there a "culture of biomedicine," and on what terms does it negotiate with other medical cultures and worldviews? Such broad, perennial questions may be explored empirically through the relations between Peking Union Medical College and Hospital and its Chinese patient base. How does an applied science that deals with human beings in social settings operate as a science. By paying close attention to laboratory research and its relation to the hospital setting, the researcher hopes to realistically assess the meaning of "scientific medicine" as promoted in that era. The researcher will explore records from PUMCH's social work department, which left behind detailed documentation of the negotiations occurring at the interface between the hospital and its patients. The research will also draw on the Rockefeller Archive Center's underutilized collection of reprinted articles to explore the relation of basic medical research conducted at PUMC to the practical art of medicine in a pluralistic medical environment. PUMC's medical and social work case records, located in Beijing, which were not available to previous scholars who studied PUMC, will be central to this work. Combined, the medical and social work portions of the files form a multi-faceted picture of each patient, offering rich information on the doctors', social workers', and patients' perspectives. These records will allow the researcher to address questions regarding both the social relations of medicine as an applied science, and the role of science in relations between cultures.