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，考察20世纪初美国式的“科学医学”如何在不同的文化环境中发挥作用，如20世纪初的中国。北京协和医院成立于1921年，是洛克菲勒基金会在世界各地最大的医疗慈善项目。它的使命是在中国建立第一个(原文如此)世界级的科学医学机构，沿着美国的模式。习惯于传统中医实践的患者和北京协和医院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假设。该项目位于历史人种学和医学史的交界处，将阐明在两种文化接触的背景下提供卫生保健的问题和政治。科学在不同文化之间的接触中扮演了什么角色--无论是客观上还是修辞上的？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？科学医学到底是一种社会实践，而不是一种抽象的理论？有没有“生物医学文化”？它是以什么条件与其他医学文化和世界观谈判的？这些广泛的、长期存在的问题可以通过北京协和医院与其中国患者基础之间的关系来进行实证探索。一门在社会环境中与人打交道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，研究人员希望能够现实地评估那个时代所倡导的“科学医学”的含义。这位研究人员将研究北京协和医院社会工作部门的记录，该部门留下了医院与患者之间进行的谈判的详细记录。这项研究还将利用洛克菲勒档案中心未得到充分利用的转载文章集，探索在北京邮电大学进行的基础医学研究与多元化医疗环境中的实用医学艺术的关系。位于北京的PUMC的医疗和社会工作案例记录将是这项工作的核心，而之前研究PUMC的学者无法获得这些记录。这些档案的医疗和社会工作部分结合在一起，形成了每个患者的多方面画面，提供了关于医生、社会工作者和患者视角的丰富信息。这些记录将使研究人员能够解决有关医学作为应用科学的社会关系以及科学在不同文化之间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.