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地点，考察20世纪初美式“科学医学”如何在不同的文化环境中发挥作用，即20世纪初的中国。北京协和医院（PUMCH）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。它的使命是按照美国的模式在中国建立第一个世界一流的科学医学机构。习惯了传统中医做法的病人和在PUMCH接受过生物医学培训的工作人员，通常对健康、疾病和治疗有不同的看法。该项目位于历史人种学和医学史的交汇处，将在两种文化接触的背景下阐明卫生保健服务的问题和政治。科学在文化碰撞中扮演了什么角色——无论是客观的还是修辞的？关于科学的修辞主张如何构建了人与人之间和知识传统之间的关系？作为一种社会实践，而不是一种抽象理论，科学医学究竟是什么？是否存在一种“生物医学文化”，它是在什么条件下与其他医学文化和世界观进行谈判的？这些广泛的、长期存在的问题可以通过北京协和医院与中国患者群体之间的关系进行实证探索。一门在社会环境中研究人类的应用科学是如何作为一门科学运作的？通过密切关注实验室研究及其与医院环境的关系，研究者希望现实地评估那个时代所倡导的“科学医学”的意义。研究人员将探索PUMCH社会工作部门的记录，这些记录留下了医院和病人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，探索在多元化的医疗环境中，在PUMC进行的基础医学研究与医学实践艺术的关系。北京协和大学的医疗和社会工作案例记录位于北京，这是以前研究北京协和大学的学者所没有的，将是这项工作的核心。档案的医疗和社会工作部分结合起来，形成了每个病人的多面图像，提供了关于医生、社会工作者和病人观点的丰富信息。这些记录将使研究人员能够解决有关医学作为一门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.