The Invention of Madness State, Society, and the Insane in Modern China
by Emily Baum
University of Chicago Press, 2018
Cloth: 978-0-226-58061-6 | Paper: 978-0-226-55824-0 | Electronic: 978-0-226-58075-3
DOI: 10.7208/chicago/9780226580753.001.0001
ABOUT THIS BOOKAUTHOR BIOGRAPHYREVIEWSTABLE OF CONTENTS

ABOUT THIS BOOK

Throughout most of history, in China the insane were kept within the home and treated by healers who claimed no specialized knowledge of their condition. In the first decade of the twentieth century, however, psychiatric ideas and institutions began to influence longstanding beliefs about the proper treatment for the mentally ill. In The Invention of Madness, Emily Baum traces a genealogy of insanity from the turn of the century to the onset of war with Japan in 1937, revealing the complex and convoluted ways in which “madness” was transformed in the Chinese imagination into “mental illness.”

Focusing on typically marginalized historical actors, including municipal functionaries and the urban poor, The Invention of Madness shifts our attention from the elite desire for modern medical care to the ways in which psychiatric discourses were implemented and redeployed in the midst of everyday life. New meanings and practices of madness, Baum argues, were not just imposed on the Beijing public but continuously invented by a range of people in ways that reflected their own needs and interests. Exhaustively researched and theoretically informed, The Invention of Madness is an innovative contribution to medical history, urban studies, and the social history of twentieth-century China.

AUTHOR BIOGRAPHY

Emily Baum is associate professor of modern Chinese history at the University of California, Irvine.

REVIEWS

The Invention of Madness offers refreshing new perspectives on a topic that has been surprisingly understudied—the diverging ways in which mental illness was understood, managed, and experienced in China in the first half of the twentieth century. With well-crafted arguments that are vigorously supported by a wide array of archival sources, this excellent book is anchored by a deep and comprehensive bibliography of scholarship on modern Chinese history, the history of Chinese medicine, and the comparative history of psychology and psychiatry, and should find an audience among historians of medicine, psychology, and psychiatry as well as experts in the history of modern China.”
— Carol A. Benedict, Georgetown University

“This book makes significant headway toward illuminating our understanding of mental illness and healing in a period that was central to the emergence of the modern Chinese state. Emily Baum has identified important sources and developed a fascinating narrative that presents the formation of a recognizably modern psychiatry in China. She ably guides the reader through a complex history wrought by overwhelming transformations felt at elite and popular levels alike.”
— Richard C. Keller, University of Wisconsin-Madison

"Baum's construction of 'madness' reveals the resilience of Chinese traditional medical practice. By focusing on mental health, an emerging but difficult field of modern Chinese history, Baum’s pathbreaking work demonstrates with remarkable clarity and conviction the complexity of China’s quest for 'hygienic modernity' from the late Qing to the 1930s. . . . Invite[s] us to contemplate again this rich, recent past to refresh our understanding of China’s modernity, an ongoing process of 'becoming.'"
— Cross-Currents: East Asian History and Culture Review

"A historical narrative that is dynamic and remarkably kaleidoscopic. . . . The Invention of Madness is a pathbreaking work. As the first historical monograph on madness and psychiatry in modern China, it fills many long-extant knowledge gaps in an area that has thus far remained relatively unexplored. . . . With its rich findings and innovative framework, [it] will shed light on future research on mental illness and psychiatry in other major Republican cities as well as in other historical periods in modern and contemporary China. While the subject of the book may seem narrow and esoteric at first sight, it touches upon a wide range of issues and will interest scholars in fields as diverse as medical history, medical anthropology, urban history, and the study of everyday life. Mental health professionals can also learn about their discipline’s past from this beautifully written and accessible text. . . . It will be worthwhile to follow Baum’s lead and take a view that is at once close-up and panoramic to grasp the complexities of this new, evolving landscape."
— China Review International

"Baum chronicles the transition from eclectic but largely family-centered premodern apprehensions and treatments of 'mad behaviors' to a more unified, biomedical, institutionalized view of madness that was intimately linked to questions of social control, political legitimacy, and the rubric of 'mental hygiene.' Along the way, this history of neuropsychiatry’s penetration of the administrative and social fabric of modern China examines topics including disjunctures between state and civil actors concerning new understandings and practices around mental illness, as well as the 'psychiatric entrepreneurs' who profited from—and sometimes helped to invent or define—new psychiatric conditions. Baum's careful unearthing of these tensions and innovations sheds informative light on the ways in which madness was invented not just as a top-down administrative or biomedical-neuropsychiatric project but in negotiation with a wide range of actors."
— New Books in East Asian Studies

"Employing abundant primary sources, [Baum] offers an insightful analysis of the madness problem and its ties with China’s nation building, state building, and society building. . . . Baum’s book presents a persuasive history of mental health in China that is skillfully grounded in the context of China's evolution as a nation and a society."
— CHOICE

"Baum's insightful examination of the modernization of mental health in republican China provides an important step in furthering our knowledge of the interaction between mental health practice and modernity."
— H-Disability

"The very first monograph on madness and psychiatry in Republican China. . . . The narrative provides clear guidance through a complex history during which popular understandings of madness (and the institutions designed to manage it) changed quickly and dramatically. . . . [An] instructive survey."
— Journal of Chinese History

"An erudite piece of scholarship that brings into sharp relief the role of Chinese madness for the literature on the history of medicine. . . . Her writing weaves together seemingly disparate facts into a compelling and accessible narrative. . . . Baum adroitly probes how the Chinese denoted and constructed native terms for madness. . . . An exemplary standard to judge the invention of madness in China."
— Bulletin of the History of Medicine

"In this breath-taking book, Emily Baum tells the story of how Chinese urbanites came to embrace Western psychiatric practice and biomedical conceptions of mental health. . . . Filled with fascinating insights concerning the co-evolution of society and the state, The Invention of Madness is a tour-de-force history of the ways in which madness was constantly created and reinvented by ordinary people on their own terms, medical pluralism both grounded and resulted from the transcultural negotiation of competing worldviews, and insanity served as the mirror reflection of those who sought a rational existence in the social and political turmoil of Republican China."
— Journal of the History of Medicine and Allied Sciences

“The first English-language monograph on the history of madness in modern China, this book offers far more than a compelling story with new information. With clear writing and persuasive argumentation, Emily Baum argues that the treatment of ‘mad’ people and evolving understandings of madness reflect China’s engagement with Western medicine and science, as well as with modernity itself...Well written and deeply engaging, TheInventionofMadness will find a ready audience among specialists in Chinese history and the history of medicine. It is well suited for classroom adoption in either of these fields, at undergraduate and graduate levels. I have already included it on the syllabus for my history of Chinese medicine course.“
— Nicole Elizabeth Barnes, Twentieth-Century China

"[A] smart, brisk book...The Invention of Madness deserves a wide readership."
— Social History of Medicine

TABLE OF CONTENTS


DOI: 10.7208/chicago/9780226580753.003.0001
[Chinese medicine;shamanism;faith healing;confinement;spirit possession;late imperial China]
This chapter discusses how madness was understood and treated in late imperial China. Arguing that madness was considered a simultaneously biological, social, supernatural, and moral issue, it shows how the insane were cared for by a range of healers, including literati physicians, herbalists, shamans, and faith healers. The chapter begins with a discussion of Qing dynasty legal codes, which mandated that the insane be confined within the home. The remainder of the chapter explores different modes of understanding, explaining, and treating the mad condition during the late imperial period. Practitioners of Chinese medicine traced madness to biological, environmental, gendered, and emotional causes. Supernatural healers posited a relationship between madness, demonic possession, and the displeasure of deceased ancestors or gods. Finally, many families attributed the onset of madness to social causes, such as financial insecurity, heartbreak, or the pressure of preparing for the civil service examinations.
This chapter is available at:
    https://academic.oup.com/chica...


DOI: 10.7208/chicago/9780226580753.003.0002
[asylum;police;institutionalization;poorhouse;criminality;poverty;vagrancy;prison]
This chapter examines the establishment of the first public asylum in China. The Beijing Municipal Asylum was erected in the Chinese capital in 1908 because the Qing dynasty recognized the symbolic and practical value of such an institution: namely, it would bolster the legitimacy of the Qing state and better control its deviant populations. The asylum was placed under the management of the municipal police, who preemptively institutionalized men and women largely for having disrupted the social order. Blurring the lines between madness, criminality, vagrancy, and poverty, the police alternately sent such individuals to the asylum, the poorhouse, or the prison. Ultimately, this chapter argues that the establishment of the Beijing Municipal Asylum signaled a changing approach to the governance of madness in the early twentieth century. Unlike in the Qing dynasty, when responsibility for the insane was decentralized to families, the new Republican government took a more active -- and preemptive -- approach to the institutionalization of the insane.
This chapter is available at:
    https://academic.oup.com/chica...


DOI: 10.7208/chicago/9780226580753.003.0003
[asylum;warlordism;poverty;family;Great Confinement;institutionalization]
This chapter shifts its attention from the role of the state to the role of the general public in the institutionalization of the insane. While many members of the upper classes continued to keep their insane relatives confined at home, the urban poor gradually came to recognize the utility of public institutionalization. Particularly against the backdrop of warlordism, political instability, and economic insecurity, institutionalization offered the possibility for free food, shelter, and medical care for the insane. In the process of fighting for limited public resources, urban publics began to conceptualize the scope of madness differently. Rather than simply invoking the charge of madness for those who were severely and demonstrably mad, poor families also began to accuse relatives and neighbors of madness simply when they disrupted the normal patterns of everyday life. The label of madness, then, was a strategy employed by ordinary people to gain a modicum of power over their uncertain existence. At the same time, though, the Beijing police curbed overcrowding within the asylum system by refusing to accept any individuals whose families were not completely destitute; this approach provided a check against a European-style "Great Confinement."
This chapter is available at:
    https://academic.oup.com/chica...


DOI: 10.7208/chicago/9780226580753.003.0004
[advertising;proprietary medicine;patent medicine;hospital;entrepreneurship;neurasthenia;commercialism;pharmaceutics]
This chapter introduces "psychiatric entrepreneurs": businessmen who advertised private psychopathic hospitals and proprietary (patent) medicines for the specific treatment of madness. Aided by the rise of advertising in the commercial press, psychiatric entrepreneurs targeted middle- and upper-class consumers who were desperate for accessible and effective remedies for their psychic suffering. Many of these advertisements were influenced by Western and Japanese pharmaceutical companies which competed with Chinese businesses for the attention of consumers. Ultimately, this chapter argues that commercialism significantly contributed to new understandings of madness in the 1920s and 1930s. By introducing new types of madness (such as neurasthenia), implicating new sufferers of madness (the middle and upper classes who labored with their minds rather than their bodies), and shifting the origin of madness from the heart to the brain, psychiatric entrepreneurs played a critical role in the production and circulation of modern psychiatric knowledge.
This chapter is available at:
    https://academic.oup.com/chica...


DOI: 10.7208/chicago/9780226580753.003.0005
[neuropsychiatry;Peking Union Medical College;Guomindang;Richard Lyman;Wei Yulin;psychopathic hospital;Rockefeller Foundation;China Medical Board;social work]
This chapter examines the growing influence of neuropsychiatry in 1930s Beijing. Focusing on the Peking Union Medical College (PUMC), an American teaching hospital funded by the Rockefeller Foundation's China Medical Board, this chapter shows how neuropsychiatry gained more influence in Beijing following the takeover of the city by the Guomindang (Nationalist Party). Working with an American psychiatrist named Richard Lyman, municipal functionaries in Beijing transformed the local asylum into a modern psychopathic hospital. The hospital was managed by an American-trained neurologist, Wei Yulin, and employed treatments such as fever therapy, work therapy, and hydrotherapy. Following the success of this venture, the PUMC continued to promote Western psychiatry through the training of psychiatric social workers. This chapter highlights the critical role of state power in the advancement of new medical paradigms; although the PUMC had been trying to spread neuropsychiatric ideologies to the public long before the Guomindang rose to power, it was only through a collaboration with the regime that neuropsychiatry attained epistemic authority within the city.
This chapter is available at:
    https://academic.oup.com/chica...


DOI: 10.7208/chicago/9780226580753.003.0006
[mental hygiene;psychology;Chinese Mental Hygiene Association;Zhang Yinian;Wu Nanxuan;New Life Movement;Guomindang]
In the 1930s, the concept of "mental hygiene" penetrated Chinese intellectual discourse. Concerned with the treatment and prevention of psychological and psychiatric disorders, mental hygienists believed that national strength and political unity depended on the mental health of the Chinese people. Under the leadership of the Chinese Mental Hygiene Association, which was established by psychologists like Zhang Yinian and Wu Nanxuan, psychologists attempted to link social deviance and political transgression to mental illness, thereby justifying their intervention into the private lives of the Chinese people. This chapter shows how, through national campaigns like the New Life Movement, the discourse of mental hygiene was invoked for the twin goals of achieving ideological conformity and extending the authoritarian control of the Guomindang. To the right-wing intelligentsia, this chapter suggests, scientific psychology was not just a curative mechanism but also a technology of power.
This chapter is available at:
    https://academic.oup.com/chica...


DOI: 10.7208/chicago/9780226580753.003.0007
[Chinese medicine;psychiatry;Peking Union Medical College;translation;mind-body dualism;Dai Bingham]
This chapter confronts the assumption that "modern" and "traditional" medicine were incompatible in 1930s China. Through a series of vignettes, it suggests that "madness" (as it was conceived in Chinese medicine) and "mental illness" (as it was conceived in contemporary Western psychiatry) were ultimately reconcilable. The first vignette shows how Chinese medicine practitioners were able to systematically integrate the Chinese “heart” and the biomedical “brain” into a single conceptual system, thereby retaining the epistemic utility of both. The second vignette focuses on the translation of psychiatric terms, and describes how intellectuals invoked Chinese medical concepts to explain neuropsychiatric neologisms, blurring their respective boundaries in the process. The third vignette discusses the various ways that Chinese patients experimented with new care-seeking behaviors -- such as being treated within a hospital -- while continuing to articulate their illness narratives in a traditional vocabulary. The final vignette shows how Western-trained physicians, many of whom were working at the Peking Union Medical College, were compelled to reconsider their mechanistic vision of mind-body dualism when confronted with the alternative assumptions of Chinese medicine. The sociologist Dai Bingham was instrumental in this process.
This chapter is available at:
    https://academic.oup.com/chica...


DOI: 10.7208/chicago/9780226580753.003.0008
[Second Sino-Japanese War;Japan;Chinese Communist Party;John Kerr Refuge for the Insane;Shanghai Specialized Hospital for the Insane;psychiatry;mental illness]
The conclusion discusses the treatment of madness in China in the second half of the twentieth century. After the advent of the Second Sino-Japanese War in 1937, and for a brief period following the closure of the Peking Union Medical College in 1941, Japan administered the Beijing Municipal Asylum. When the Chinese Communist Party rose to power in 1949, it attempted to create a new method of treating mental illness that relied on the "revolutionary optimism" of the patient. Beginning in the 1980s, Western discourses yet again influenced approaches to the care of mentally ill patients in China. By examining how madness was handled in two locations outside of Beijing (the John Kerr Refuge for the Insane in Guangzhou and the Specialized Hospital for the Insane in Shanghai), and by briefly discussing approaches to and critiques of psychiatric therapies in today's China, the conclusion shows how contemporary trends in understanding, articulating, and treating mental illness mirror developments in the early twentieth century.
This chapter is available at:
    https://academic.oup.com/chica...