East Asian Science, Technology, and Medicine (EASTM - Universität Tübingen)

East Asian 
Science, Technology, 
and Medicine 
 
Number 28 
2008 
 
A journal dedicated to the study of traditional and modern  
East Asian science, technology, and medicine. 
 
 
 
Editor:  
Hans Ulrich Vogel 
 
Seminar für Sinologie und Koreanistik 
Eberhard Karls Universität Tübingen 
Wilhelmstr. 133 
72074 Tübingen / Germany 
FAX: 0049 - 7071 - 295733 
E-Mail: eastm@uni-tuebingen.de 
 
 
 
Managing and Production Editors: 
Vanessa Dahlmann, Seminar für Sinologie und Koreanistik, Tübingen 
Valerie Keppel, Seminar für Sinologie und Koreanistik, Tübingen 
 
 
 
English Language Editor:  
John P. C. Moffett, Needham Research Institute, Cambridge (UK) 
 
 
 
Local Advisory Board: 
Klaus J. Antoni, Seminar für Japanologie, Tübingen 
Song Moon-Ey, Seminar für Sinologie und Koreanistik, Tübingen 
Viktoria Eschbach-Szabo, Seminar für Japanologie, Tübingen 
Robert Horres, Seminar für Japanologie, Tübingen 
Achim Mittag, Seminar für Sinologie und Koreanistik, Tübingen 
EDITORIAL COMMITTEE 
Bridie Andrews-Minehan, Department of History, Bentley College 
Francesca Bray, Department of Social Anthropology, University of Edinburgh 
Christopher Cullen, Needham Research Institute and Darwin College,  
Cambridge 
Benjamin A. Elman, East Asian Studies and History, Princeton University 
Charlotte Furth, Department of History, University of Southern California,  
Los Angeles 
Hashimoto Keizō, Faculty of Sociology, Kansai University, Osaka 
Huang Yi-Long, Institute of History, National Tsing Hua University, Hsinchu 
Jeon Sang-woon, Cultural Properties Committee Korea, Seoul 
Catherine Jami, Centre National de la Recherche Scientifique, Paris 
Yung Sik Kim, College of Humanities, Seoul National University 
Dieter Kuhn, Institut für Kulturwissenschaften Ost- und Südasiens - Sinologie, 
 Universität Würzburg 
Angela Ki Che Leung, Sun Yat-Sen Institute for Social Sciences and Philosophy,  
Academia Sinica, Taipei 
Liu Bing, Institute of Science, Technology and Society, Tsinghua University, 
Beijing 
Liu Dun, Institute for the History of Natural Science, Academia Sinica, Beijing 
Morris Low, Department of the History of Science, Medicine, and Technology, 
Johns Hopkins University 
Georges Métailié, Centre Alexandre Koyré, CNRS-EHESS-MNHN, Paris 
Shi Yunli, Department of the History of Science and Scientific Archaeology, 
University of Science and Technology of China, Hefei 
Nathan Sivin, Department of the History and Sociology of Science, University of 
Pennsylvania, Philadelphia 
C. Michele Thompson, Department of History, Southern Connecticut State 
University, New Haven 
Tsukahara Togo, History and Philosophy of Science, Technology and Medicine, 
Kobe University 
Paul U. Unschuld, Horst-Götz-Stiftungsinstitut für Theorie, Geschichte und Ethik 
Chinesischer Lebenswissenschaften, Charité, Berlin 
Donald B. Wagner, Department of Asian Studies, University of Copenhagen 
Yoshida Tadashi, Center for Northeast Asian Studies, Tohoku University, Sendai 
 
 
 
THE SCOPE OF EASTM 
Copyright  2008. EASTM (formerly Chinese Science) is published by the International 
Society for the History of East Asian Science, Technology, and Medicine (ISHEASTM). 
Numbers 1-10 (1975-92) were published irregularly under the editorship of Nathan Sivin 
(University of Pennsylvania). Numbers 11-15 (1993-98) were issued annually at the 
University of California, Los Angeles, by Benjamin A. Elman. Beginning with Number 
16 (1999), the name of the journal changed to East Asian Science, Technology, and 
Medicine and is published at the University of Tübingen, Germany. From 2003 to 2008 
two issues per annum have been the norm, however, only one issue per annum will be 
published from 2009 onwards. The publication of this periodical is supported by a grant 
from the Deutsche Forschungsgemeinschaft (DFG). 
This journal includes studies on the science, technology, and medicine of traditional and 
contemporary East Asia. Any study based on original research using Chinese, Japanese, 
or Korean primary sources or artifacts, that elucidates the relationships and interactions of 
science, technology, and medicine with politics, society, economics, philosophy, culture, 
religion, historiography, as well as their disciplinary traditions, or throws light on the 
work of scientists, technologists, and physicians in East Asia will gladly be considered. 
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The publication, since the fifties, of Joseph Needham’s (1900-1995) monumental work, 
Science and Civilisation in China, has been followed by a rapid development of research 
on the history of science, technology, and medicine in China, as well as in civilisations 
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Vietnam. Since 1982, International Conferences on the History of Science in China had 
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International Society for the History of East Asian Science, Technology, and Medicine 
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The Society’s purpose is to serve, represent and speak for scholars of the field defined by 
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and also to establish and reinforce links with other scholarly communities, at an 
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• The publication of a journal, EASTM; 
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This journal is printed on acid-free paper.   
ISSN #1562-918X 


Editorial

Nakayama, Shigeru

94 EASTM 28 (2008) 
Ho Peng Yoke, Reminiscence of a Roving Scholar: Science, Humanities and 
Joseph Needham. Singapore et al.: World Scientific, 2005. xii, 240 pp. 
 
Nakayama Shigeru 
 
[Nakayama Shigeru 中 山 茂  is teaching at UCLA as Paul I. Terasaki Endowed 
Chair in U.S.-Japan Relations. He received his Ph.D. from Harvard University 
in the History of Science and Learning (1960). Although most of his writings are 
in Japanese, he has published many works in English, such as his History of 
Japanese Astronomy: Chinese Background and Western Influence (Cambridge, 
Mass., Harvard University Press, 1969). His recent efforts have been devoted to 
the editing of A Social History of Science and Technology in Contemporary 
Japan (four volumes so far; Melbourne: Trans Pacific Press, 2001-). His col-
lected articles will appear soon as The Orientation of Science and Technology, 
Japanese View at the University of Hawaii Press]. 
 
 
The book under review here is an almost complete autobiography of a scholar 
who worked in close collaboration with Joseph Needham for many years. 
When historians of science get together for the first time, they start by inquir-
ing of each other ‘what discipline do you come from.’ This is then followed by 
the question ‘what brought you to the history of science?’ Unlike nowadays, with 
the professionalization of the history of science being promoted through graduate 
schools in the history of science, most of them were trained in a scientific disci-
pline. Only later did they become interested in the humanities and turned to the 
history of science.  
The author, Ho Peng Yoke, was first trained in physics and employed in a 
physics department. At the beginning of his academic career, he also taught his-
tory of science within a physics department. However, as he became more and 
more involved in history, the modern classification of science proved of only 
limited help in the understanding and explanation of historical phenomena. It was 
especially his close relationship with Joseph Needham that eventually led him 
from physics to the history of Chinese science. 
Joseph Needham was an intellectual giant and thus well able to initiate and 
pursue such an extraordinarily grand project as Science and Civilisation in China 
(SCC). According to Ho Peng Yoke (p. 178), one of his collaborators in this 
great enterprise, it was Needham’s “single-minded” devotion that kept this huge 
project going. In order to communicate it to the rest of the world, a commonsen-
sical and multi-talented collaborator was essential. As made apparent by the 
book-cover and front page, on which the portrait of the author is shown, Ho Peng 
Yoke is always smiling, one might say in order to smoothen the relationship 
between Needham and the rest of the world.  
95 Reviews 
Such a talent is not only DNA-dependent, but also formed by environment. 
Born in 1926 as the bright eldest son of an educator of overseas Chinese in colo-
nial Malaysia, he was sent to an English school. During the period of Japanese 
occupation, he acquired Japanese while working with Japanese civilians. In the 
post-war period, he received tertiary education at Singapore, and soon Needham 
agreed to become advisor for his thesis. For teaching assignments, he moved 
from Singapore to Kuala Lumpur, Brisbane and Hong Kong, while for research 
he often visited Cambridge in order to work together with Needham as a lifelong 
collaborator in writing and editing the gunpowder and alchemy sections of the 
SCC project. 
In his later days, when his collaboration with Needham was drawing to a 
close, Ho developed a particular interest in fate-calculation and divinatory arts 
(pp. 179-180), subjects which most modern scholars would not touch. My teach-
ers and predecessors in Chinese studies often warned me that one should stay 
away from research on the “Book of Changes” (Yijing 易 經), as this would be 
futile and lead nowhere. Some people tend to interpret Zhu Xi like an eighteenth-
century European scientist, but in reality he was at the same time an extensive 
supporter of the notion of astrological influence on the earth as well as terrestrial 
influence on the heavens. This non-Whiggish area, much of which concerns 
genuine Chinese natural philosophy, creates some embarrassment to those histo-
rians of science who dare to step in. When I wrote a book on astrology in Japan, I 
subtitled it ‘its position in the history of science’, thus referring to my treatment 
of astrology only in its relation with science and astronomy. Thus, I was not able 
to generate heartfelt interest in the detailed rules of calculation of pure fate-
calculation, such as have been elucidated by the admirable endeavours of Ho 
Peng Yoke. Whenever I come across interpretations of numerology, he is always 
an authority for me.  
Roving is a keyword of the author’s life, in space and also in language, cul-
ture and food. Actually most parts of this book cover the international confer-
ences, meetings, advisory board sessions and dinner parties in which he partici-
pated in East and West. Especially in the 1990s, when he replaced Needham as 
director of the Needham Research Institute, he became a true global traveller, 
circling the globe twice a year for fundraising and coordinating support groups of 
the Needham project. Without the cooperation of Ho and his overseas Chinese 
friends, the Needham project would have never become such a success story. 
 


Ho Peng Yoke, Reminiscence of a Roving Scholar: Science, Humanities and Joseph Needham

Cover

Farris, William Wayne

 10 
Introduction 
 
Research into disease, epidemics, and medicine in pre-modern societies has rela-
tively recent origins. The systematic and scientific investigation of the history of 
pathogens and the body of knowledge that developed to treat infections really 
began with the work of Alfred Crosby, Jr., in his path-finding The Columbian 
Exchange: The Ecological Consequences of 1492 (1972). Notably, Crosby’s 
book was so different from the predominantly political and cultural history then 
popular that it nearly went unpublished.  
Crosby categorized his work on syphilis and the devastating impact of Euro-
pean microparasites on defenceless native Americans as an important subset of 
ecological history. Naturally, as scholars overcame their aversion to this topic 
and as the interaction between humans and their environment became more 
widely recognized as a critical issue, work on disease and medicine has grown 
apace. Now, looking back on almost forty years of research into the worldwide 
effects of infections, educators are truly blessed with a robust number of titles 
and increasing sophistication in approach and conclusion.  
Research on disease, pestilence, and medicine in Japan has a shorter history—
perhaps about thirty years. Despite these more recent origins, current study is 
growing by leaps and bounds and has reached a high level of sophistication and 
thoroughness. This EASTM special collection of fine essays on disease and 
medicine in Japan is a worthy testimony to the excellent work now being done. 
While they all deal with Japan, these articles run the gamut from work on epi-
demics and attempts to fend them off to detailed medical cases’ histories written 
by doctors versed in Chinese or Dutch medicine. They cover about three centu-
ries. They combine approaches that are artistic, social, political, demographic, 
economic, and magico-religious. The breadth of approaches exemplified by the 
essays in this special issue helps remind us that those invisible pathogens scholars 
once took for granted usually affected every corner of the human experience.  
These five articles share a second characteristic, besides their sophisticated 
approaches and fascinating insights. Each examines some aspect of this important 
topic that has not yet been thoroughly explored in English. Even the Smits expo-
sition of the measles epidemic of 1862 and the Gramlich-Oka discussion of the 
cholera infestation of 1858, both noted by Ann Jannetta in her fine Epidemics 
and Mortality in Early Modern Japan (1987), deliver far more than we have ever 
had in English previously. The articles by Andrew Goble and Susan Burns ex-
plore a completely new topic for Japan: how medicine was actually practiced 
before humans knew about the germ theory. 
In addition to sharing a resourceful approach, broad time coverage, and the 
freshness of their topics, each of these articles makes many and varied special 
contributions. Every fortunate reader will find his or her own “nuggets”, depend-
ing upon the scholar’s interests and specialties. For me, it is easiest to talk about 
these articles in three groups. The essays by Andrew Goble and Susan Burns, 
entitled respectively “Rhythms of Medicine and Community in Late Sixteenth 
11 
Century Japan: Yamashina Tokitsune (1543-1611) and his Patients” and “Nana-
yama Jundō at Work: A Village Doctor and Medical Knowledge in Nineteenth-
Century Japan”, explore brand new paths in premodern Japanese medical history. 
They are a natural outgrowth of the issues relating to social networking (or the 
collapse thereof) that is occurring in medicine today. Rich in detailed discussion 
of medical cases during the late sixteenth (Goble) and early nineteenth (Burns) 
centuries, these two authors are unequalled in their ability to help readers feel 
how “medicine was done” during these respective eras. Additionally, each author 
spends copious amounts of time identifying the various sorts of treatments and 
remedies available to their respective physicians.  
As a historical demographer, I found one aspect of these authors’ work espe-
cially suggestive. Andrew Goble notes that pregnant women and those with in-
fants composed one large and important network for his Dr. Yamashina. In other 
words, these women created self-help groups for each other. Similarly, Susan 
Burns noted that obstetrics and the care of infants was a sizable part of Dr. 
Nanayama’s practice. I can only wonder how this attention to pregnant women 
and infants affected the birth rates in each era. Both doctors practiced after syphi-
lis had come to Japan. Both carried out their medical professions when women 
were beginning to suckle their infants for up to three years, thus helping to reduce 
infant mortality. The interplay of medicine, disease, and fertility is never easy to 
ascertain for a premodern society, but both Goble and Burns have made a contri-
bution towards the day when we will understand the relationship much better than 
we do today. 
Gregory Smits’ “Warding off Calamity in Japan: A Comparison of the 1855 
Catfish Picture Prints and the 1862 Measles Prints” and Bettina Gramlich-Oka’s 
“The Body Economic: The Cholera Epidemic of 1858 in Popular Discourse” 
comprise a second group of essays. Each deals with an epidemic noted before in 
English but never really examined in all its aspects. Smits’ discussion of the vari-
ous artistic representations of deities and supposed cures reminds readers that 
even as late as the mid-nineteenth century susceptible persons sought out magico-
religious means to ward off measles. In that respect, things were no different than 
they had been a thousand years earlier. Gramlich-Oka’s piece on the cholera 
epidemic of 1858 is simply the best article scholars yet have on the causes, 
course, and effects of a cholera outbreak in Japan. The death rate of around five 
percent is typical of cholera, as shown for Great Britain in 1832. Gramlich-Oka 
stresses how merchants and others profited from the distress of others, another 
age-old theme described in detail never before available. 
As with the essays by Goble and Burns on medical practice, these articles on 
epidemics also held a special fascination for me. Each epidemic raged primarily 
in the big cities of late Edo Japan during the summer months. The measles out-
break of 1862 was most virulent during the sixth and seventh months and the 
cholera plague hit during the sixth through the eighth months of 1858. This seem-
ingly mundane fact confirms what demographers have learned with repeated 
experience: that epidemics in Japan raged primarily during the summer months. 
12 EASTM 29 (2008) 
Graphed on a chart with the y-axis being number of deaths and the x-axis repre-
senting the twelve months of the year, mortality from epidemics typically forms 
an inverted V. As with the earlier articles, these by Smits and Gramlich-Oka lead 
one to wonder about the interplay of a whole host of variables: in this case cli-
mate, disease, and water and food supply. 
William Johnston’s “Sexually Transmitted Diseases and Demographic 
Change in Early Modern Japan” is required reading for all those interested in 
Edo-period (1600-1868) population and economy. In particular, Johnston pre-
sents a new and stimulating theory about the reasons that Japan’s population 
could have remained static at around thirty million between 1720 and 1850 even 
though the agrarian and commercial economies were growing by leaps and 
bounds. Previous scholars have tried to explain this “conundrum” by referring to 
the misery of the peasantry, efforts to limit family size through family planning, 
or cultural factors such as the long period of breast-feeding or the separation of 
spouses, each of whom held jobs in different parts of the islands. Making use of 
data on the widespread distribution of syphilis among the populace, Johnston 
argues that sexually transmitted diseases—especially chlamydia and gonorrhea—
rendered many women infertile, thus accounting for the low birth rate. He further 
argues that loose and free mating customs among most of the people led to the 
taking of multiple partners, allowing for the ready spread of these STDs.  
Johnston’s thesis adds a new dimension to the debate over the “conundrum” 
of the 1700s and early 1800s in Japan. As the author notes, evidence for this 
stimulating thesis is sparse. Given what is known about the ubiquity of syphilis, 
however, such an inference has substantial indirect support and deserves serious 
consideration. Hopefully, social scientists will soon have the tools at their dis-
posal to evaluate Johnston’s thesis more critically than they can now. 
In sum, the five essays contained in this special issue of EASTM mark the 
growing maturity and diversity of studies on disease, epidemics, and medicine in 
premodern Japan. For some time to come they will undoubtedly prove useful and 
fascinating for researchers in all fields.  
 
 
William Wayne Farris 
University of Hawai’i 
Mānoa 


Introduction

Gao, Jie

Obituary Prof. Xi Zezong (1927-2008)

Vetrov, Vitacheslav

De la difficulté de juger: Quelques ressources du mode critique en Chine et au Viêt Nam (On the Difficulty of Judgment: Some Resources of Criticism in China and Vietnam), in the journal Extrême Orient, Extrême Occident: Papers on Comparative Research

Vogel, Hans Ulrich

Note from the Editor

Klotzbücher, Sascha

85 Reviews 
Ofra Anson and Sun Shifang, Health Care in Rural China: Lessons from HeBei 
Province. Aldershot: Ashgate Publishing, 2005. xii, 259 pp. 
 
 
Sascha Klotzbücher 
 
[Sascha Klotzbücher is a post-doc-researcher in the Department of East Asian 
Studies at the University of Vienna. He specializes in studies of social policy, 
health, and governance in modern China and is a member of the transdiscipli-
nary project “Capacity-building for pastoral hospitals in Xinjiang (China)” 
(www.univie.ac.at/healthcare-china/) conducted by the Department of East 
Asian Studies and the Department of Preventive Medicine at Shihezi University. 
His latest monograph is entitled Das Gesundheitswesen der VR China: Struktu-
ren – Akteure – Dynamik (Frankfurt am Main: Peter Lang).] 
 
 
This book by Ofra Anson, a public health specialist at Ben-Gurion University of 
the Negev in Israel, and Shifang Sun from the Hebei Academy of Social Sciences 
is one of the few Western monographs analyzing the rural health care situation in 
the 1990s. It is an outcome of a project cooperation funded partly by the Nether-
lands-Israel Development Research Programme. This book has a clear objective 
to explore, namely the current social distribution of health status, health behavior, 
and the processes by which these came about. Anson and Sun frame this question 
in a broad way by exploring the consequences of the introduction of the house-
hold responsibility that dismantled the collective structure in the countryside. 
They examine how patterns of health behavior and provision changed. They try 
to give empirical evidence for a single province of China, Hebei Province, after 
1979 with an impressing large database of a quantitative sample of interview 
questionnaires comprising 14,895 persons in 288 villages randomly selected in 
nine counties of Hebei Province between 1996 and 1999. Additionally, more than 
1,600 interviews of village doctors and farmers were conducted. Very uncommon 
for their discipline of public health is that Anson and Sun have worked through 
many secondary, mainly English written papers and articles in public health, 
demography and economics.  
The book is structured into five chapters. The first chapter, “Setting the 
Scene: Health, Health Services, Ideology and the Economy”, presents a historical 
sketch for those unfamiliar with modern Chinese history and politics. After a 
period of collective primary health care provision during the Cultural Revolution, 
the de-facto de-collectivization after 1979 led to transformation of rural health 
care patterns described shortly for setting the ground for the next chapters. The 
authors discuss the improvement of health in the last sixty years with indicators 
like mortality and life expectancy ratios in chapter two. The challenge of preven-
tion work, especially against infectious diseases (Schistosomiasis, Aids, etc.) and 
86 EASTM 28 (2008) 
non-communicative diseases, especially pollution, injury is exemplified for Hebei 
in the 1990s in chapter three. 
Using mainly their own generated data from the samples and interviews in 
Hebei, the next two chapters discuss the main patterns of health care provision in 
the villages (chapter four) and the patterns of lay behavior of the patients (chapter 
five). The provision is of high diversity: Private and collective institutions, as 
well as government-branch hospitals providing different forms and quality of 
medical practice. Chapter five starts by examining the health-related patterns of 
utilization of health services. In contrast to other studies, structural factors like 
accessibility in terms of distance to the available service “hardly affected access 
to care or utilization” (p. 135). The question whether in rural Hebei inequality 
and inequity have worsened is discussed in chapter six. Improvements in mater-
nal health care should be taken into account for the massive improvements of 
women’s health (chapter seven). Another, in literature often neglected group, the 
elderly, can rely on the family safety net to sustain their status and health (chapter 
eight). The authors argue in the conclusion in a perspective of global challenges 
and health policies.  
 
It should be stressed that Anson and Sun argue that the villages’ per-capita in-
come is overestimated for the equity in distribution of health facilities and access 
(p. 155). “Privatization (…) does not seem to have increased inequality in the 
accessibility and affordability of health care” (p. 235). Secondly, their data show 
that the trend to “greater equality and equity in the distribution of social re-
sources allocated to health and welfare” (p. 231) is without significant changes 
before or after the transition to a market economy after 1979. This argumentation 
is in contrast to other scientific works where cost for health care is one of the 
most powerful ‘poverty traps’ in rural China.1 Even the political leadership has 
demanded political action to break the vicious cycle of poverty and illness in 
19972 with a paradigm change after 2002.  
The authors should make several cases and go more into the details of this 
discrepancy. A more comparative study with other provinces might illustrate the 
representativeness of this province or the special characteristics of the sample. 
In this book under review here the selective usage of Chinese health statistics 
or Chinese scientific reports of Hebei Province is apparent. Relying solely on 
statistical material only “available to international organizations” (p. 5) is not 
very convincing. Of course, Chinese statistical material is sometimes of question-
able quality and hardly comparable or even incongruent to other Chinese statisti-
cal material, but these international organizations too rely on data generated or 
published in Chinese statistical yearbooks or scientific journals. An integration of 
Chinese data and the ongoing scientific discussion would have enriched the au-
                                                 
1
 See Liu Yuanli et al. (2002). 
2
 See “Yin pin zhi bing, yin bing fan pin” 因 贫 致 病，因 病 返 贫 (Poverty leads to 
Illness. Due to Illness, Poverty is on the Return) in Guofa (1997-18), p. 15. 
87 Reviews 
thors’ extensive analysis of their own generated data sample and given a more 
solid basis to their conclusion drawn. For example, since 1993, the Chinese state 
has conducted a national health survey every five years including samples for 
every province. These respective survey results for Hebei, collected in a nation-
wide effort during the summer of 19983 and in the same period like the sample 
from Anson and Sun, could give more clues for a comparison with other prov-
inces.  
The exclusion of Chinese secondary sources in this volume with the argument 
that these articles “usually reported data with limited, local relevance reflecting a 
more specific, narrower interest” (p. 5) is not convincing. The questions of acces-
sibility to health care service or determinants of individual health status are also 
discussed in Chinese academic journals for different regional entities like coun-
ties or provinces. 
Despite these objections, the analysis of this Hebei sample of patients’ ques-
tionnaires is a very worthwhile reading. In fact, the authors’ approach based on 
the patients’ questionnaires—even if it is not so explicitly stated—focuses not so 
much on the general than the individual “coping resources” (p. 19) of farmers to 
sustain health and prevent illness. This very unique and interdisciplinary ap-
proach widens their analysis from the traditional scope of health condition, health 
delivery prevailing in medicine or public health disciplines to the question of 
educational level as individual knowledge and the role of families and communi-
ties as coping resources in a broader perspective.  
The aim to analyze “the role of ideology, politics, and economics processes in 
shaping the rural population’s access to health care” (p. 2) is not without its prob-
lems. Collective coping resources and state actors are falling behind, especially 
when they discuss the case of Hebei after 1979. Discussing the historical process 
of health care, the authors argue in the first chapters that several ministries and 
committees improved rural health care with different policies and resources. In 
contrast, when analyzing their own statistical sample and interview material, it 
seems that Anson and Sun leave behind the concept of a multi-level and disag-
gregated state intervention. The state and its different levels, institutions and 
policy tools are beyond the scope of their analysis and are seen as ubiquitous and 
omnipotent entity in the following chapters. State actions compensate for the 
failures of a market-oriented health care provision in Hebei. Regarding to the fact 
that in other Chinese provinces ‘the state’ failed, an analysis that takes the agents 
and modes of governance and financing into consideration would most likely 
yield to a better understanding why and how in Hebei state action has minimized 
the negative consequences that prevail in other provinces. In detail, three points 
would have needed further consideration: Firstly, the focus on the village doctors 
is too narrow. One wishes that Anson and Sun had done more to include admini-
stration and financing patterns of township and county hospitals into the scope of 
                                                 
3
 See Zhonghua renmin gongheguo weishengbu (date unclear), p. 1. See results of the 
last survey in Weishengbu tongji xinxi zhongxin (2004). 
88 EASTM 28 (2008) 
their interviews and analysis. Not only private doctors, but especially the gov-
ernment-branch hospitals are also part of the ‘three tiers of rural health care’ 
(village, township, county). Secondly, the role of the county health bureau as 
lowest representative of the health ministry and local key agency in initiating and 
implementing health projects at the county level is underestimated. Thirdly, the 
organizational split beyond the county level between hospitals of ‘Western Medi-
cine’ and of ‘Traditional Chinese Medicine’ and probably different patterns of 
health service needs deeper analysis. 
Further, the role of ideology is overestimated. In highly decentralized policy 
fields like rural health care before the year 2002, the central government and state 
institutions formulated state goals in non-binding “suggestions” (yijian 意 见) 
etc. The authors are correct to state that the ideology relating to health care did 
not change (p. 215). Access to primary health care and equity are still political 
goals, but with admitting private health providers, adopting cost containment 
measures etc. the decision-making space for local governments has widened in 
the post-collective countryside. Additionally, these goals defined at central po-
litical level were of decreasing formative power, because only the local govern-
ments formulates and implements measures according to their financial and or-
ganizational resources lacking any central funding in a highly market-oriented 
society.  
Ignoring this difference of the formulation and enforceability of central ide-
ology in local policy-making in rural China for the nineties and overestimating 
the efficiency of mass movements (p. 218) it becomes comprehensible why An-
son and Sun have not made more inroad into politics, policy and recent modes of 
health governance. There is little or no discussion of several attempts at (re-) 
introducing cooperative medical schemes. As ‘collective coping measures’ they 
are not mentioned in the policy discussion or evaluation of the situation in Hebei. 
Other state policies, propagated very extensively, but with minor effects are con-
sidered briefly, such as the problems of implementation and impact of the 
“Health for all by year 2000” program that has been evaluated as not very suc-
cessful in the preliminary phase.4  
Finally, the discussion of the historical background would have profited from 
a more Hebei-focused approach. Explorations in the local archives or oral history 
resources5 have deconstructed and scratched the myth of the barefoot doctor. In 
fact, we know very little about the real situation of that time. Western publica-
tions still refer to ‘field studies’ of Communist sympathizers or politically biased 
official statistical material of low reliability that found their way even into the 
publications of international organizations. Facing the recent reappraisal of the 
barefoot doctor by the Chinese health bureaucracy and public health specialists in 
                                                 
4
 See Huang Yongchang (1994), pp. 219-251. 
5
 See for local archives Fang Xiaoping (2003) and for oral history the interview of An 
Haiyan (2002). 
89 Reviews 
the WHO, much more research is needed for a realistic assessment of the quality 
and acceptance of these health workers in rural China during the collective era. 
One wishes that this book was better edited: The pinyin-transcription of He-
bei 河 北 as HeBei throughout the book is both strange and false, while other 
provinces like Yunnan are transcribed correctly. Further evitable examples are 
the transcription of Mao Zedong 毛 泽 东 as Mao Ze Dong (pp. 13, 118) or Deng 
Xiaoping 邓 小 平 as Deng Xiao Ping (p. 177). 
This book is strong in discussing the individual coping resources in rural He-
bei and could be read as complementary to my own recent efforts. But it falls 
behind by lack of framing it into the socioeconomic context and political struc-
ture. However despite these reservations, Anson and Sun has called upon an 
impressively extensive repertoire of quantitative analyses. The authors pack a 
high amount of new information into a single massive volume. They deserve high 
praise for this comprehensiveness and careful attention to a problem-oriented and 
risk-group presentation of their results for one province. It is a useful addition to 
the rare scholarly research in the English language on this period. 
 
 
Bibliography 
 
An Haiyan 安 海 燕 (2002). “Wo yongyou zheme fengfu jingcai de jingli, zhen 
bu wang lai renshi” 我 拥 有 这 么 丰 富 精 彩 的 经 历, 真 不 枉 来 人 世 
(With such a rich experience it was worth living), in Liu Xiaomeng 刘 小 萌 
(2004). Zhongguo zhiqing koushushi 中 国 知 青 口 述 史 (Oral histories 
from Chinese intellectual youth). Beijing: Zhongguo shehui kexue chuban-
she, pp. 268-347. 
Fang Xiaoping 方 小 平 (2003). “Chijiao yisheng yu hezuo yiliao zhidu—Zhe-
jiang sheng Fuyang xian gean yanjiu” 赤 脚 医 生 与 合 作 医 疗 制 度—
浙 江 省 富 阳 县 个 案 研 究 (The barefoot doctor and the Cooperative 
Medical System—Case study of Fuyang County in Zhejiang Province). Er-
shiyi shiji 二 十 一 世 纪 (Twenty-first Century) 79: 87-106. Also available 
online: http://www.cuhk.edu.hk/ics/21c/supplem/essay/0306048g.htm (ac-
cessed 02 August 2008). 
Guofa 1997-18 (28.5.1997). “Guanyu fazhan he wanshan nongcun hezuo yiliao 
de ruogan yijian” 关 于 发 展 和 完 善 农 村 合 作 医 疗 的 若 干 意 见 
(Some suggestions for the development and perfection of the Rural Coop-
erative Medical Schemes). Henan Zhengbao 河 南 政 报 (Henan Political 
Bulletin) 7: 15-16. 
Huang Yongchang 黄 永 昌 (1994). Zhongguo weisheng guoqing中 国 卫 生 国 
情 (Situation of health care in China). Shanghai: Yike daxue chubanshe. 
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Liu Yuanli, Rao Keqin, and Hu Shanlian (2002). People’s Republic of China. 
Toward Establishing a Rural Health Protection System. Manila: Asian De-
velopment Bank, http://www.adb.org/documents/reports/PRC_rural_health 
_protection_system/prc_rural_health.pdf (accessed 26 November 2004). 
Weishengbu tongji xinxi zhongxin 卫 生 部 统 计 信 心 中 心 (Center for Statis-
tical Information of the Ministry of Health) (eds.) (2004). Zhongguo wei-
sheng fuwu yanjiu: Di san ci guojia weisheng fuwu diaocha fenxi baogao 
中 国 卫 生 服 务 研 究: 第 三 次 国 家 卫 生 服 务 调 查 分 析 报 告 
(Research on health services in China: Third national analysis report about 
health services). Beijing: Zhongguo xiehe yiyuan daxue chubanshe. 
Zhonghua renmin gongheguo weishengbu 中 华 人 民 共 和 国 卫 生 部 (Minis-
try of Health of the People’s Republic of China) (date unclear). Di er ci guo-
jia weisheng fuwu diaocha fenxi baogao 第 二 次 国 家 卫 生 服 务 调 查 
分 析 报 告 (Analysis report of the second national health service survey). 
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2008). 


Ofra Anson and Sun Shifang, Health Care in Rural China: Lessons from HeBei Province

Suttmeier, Richard P.

106 EASTM 29 (2008) 
Henry S. Rowen, Marguerite Gong Hancock, and William F. Miller (eds.), Mak-
ing IT: The Rise of Asia in High Tech. Stanford: Stanford Univ. Press, 2007, 
xviii, 388 pp. 
 
Richard P. Suttmeier 
 
[Richard P. Suttmeier is a Professor of Political Science, Emeritus at the Uni-
versity of Oregon. He has written widely on science and technology development 
issues in China. His current research includes an NSF-supported study of the 
role of science and technology in China-US relations (http://china-
us.uoregon.edu/index.php), the role of technical standards in China’s technology 
policy, and Chinese approaches to the management of technological risks. His 
most recent publications include: “‘The Sixth Modernization?’ China, Safety, 
and the Management of Risks.” Asia Policy 6 (June, 2008); “State, Self-
Organization, and Identity in the Building of Sino-US Cooperation in Science 
and Technology.” Asian Perspective 32, 1, 2008; and Standards, Stakeholders, 
and Innovation: China’s Evolving Role in the Global Knowledge Economy, with 
Scott Kennedy and Jun Su, National Bureau of Asian Research, September 
2008.] 
 
 
The emergence of the information technology (IT) industry in Asia symbolizes 
both the growing share of the world’s wealth coming from Asia and the diffusion 
of modern scientific and technological capabilities beyond the Atlantic region. 
The Asian IT industry also contains many of the critical nodes in the global pro-
duction and innovation networks which are such important defining characteris-
tics of the global economy. But, the rise of Asia as a major player in IT also 
raises many questions about scientific development, technological innovation, 
and political economy which this volume seeks to answer. As presented by editor 
Henry S. Rowen in his introduction to this interesting book, these include: 
 
Why has Asia emerged so strongly in this industry? What 
were the similarities and the differences in the strategies used 
among these countries? What accounts for their different 
specializations? How did their firms and government decide 
what to make and how to make it? Why have companies clus-
tered in particular localities? ... What roles have various insti-
tutions played―governments (national and local), universi-
ties, research institutes, financial institutions, legal profes-
sions, and so forth? (p. 2) 
 
To advance our understanding of these issues, the Stanford Project on Regions of 
Innovation and Entrepreneurship (SPRIE) of the Walter H. Shorenstein Asia-
Pacific Research Center at Stanford organized a series of seminars beginning in 
107 Reviews 
2002 to bring together national experts from Asia to address IT development in 
their countries. Making IT presents the reports of these specialists, along with a 
set of crosscutting thematic analyses comparing the national experiences. 
Following Rowen’s overview chapter, the book is divided into four parts. The 
first, on Japan as “Early Developer”, is then followed by three chapters on Tai-
wan, Singapore and Korea under the rubric of “Three Asian IT Tigers”. Chapters 
on China and India constitute the third part, “The Recent Arrival of Two Giants”. 
“Common Themes” are explored in the fourth part with useful chapters on the 
role of governments in shaping IT industries, the nature of venture capital in 
Asia, and a comparative assessment of university industry relations in Asia and 
the US. Missing from the study, curiously, is a discussion of Malaysia as a site 
for both foreign investment in IT and ambitious indigenous development efforts 
by the government. 
Comparisons with the US inform much of the volume, with Silicon Valley be-
ing taken as the paradigm case of regional IT development, venture capital, and 
high-tech entrepreneurship. Industrial clustering is thus an important theme in 
each of the country chapters, especially those on Taiwan, Korea and China where 
the discussion is organized around the Hsinchu Science-based Industrial Park, 
Daeduk Science Town and Tehran Road (named for Seoul’s sister city in Iran) 
and Beijing’s Zhongguancun respectively. Each of these chapters are fine case 
studies that pull together much of what is known about the evolution of these 
regional development experiences. The juxtaposition of the paradigm case and 
Asian experience is especially interesting in discussions of innovation and entre-
preneurship, clustering, and industry start ups in the chapters by Ken-ichi Imai 
and Noboru Maeda on Japan, given its efforts to reorient its national innovation 
system following its prolonged economic slump in the 1990s. 
In attempting to identify common features explaining successful IT develop-
ment, the book identifies the importance of positive economic growth policies 
and active government promotion of IT in particular, a “strategic openness” to 
the international environment, the cultivation of a critical mass of scientists and 
engineers, access to foreign technology―and especially linkages to the United 
States―and financial system changes which opened the industry to equity, as 
well as the more traditional bank finance. Interestingly, in the period covered, 
universities played little role as sources of technology. Within these common 
features, however, there was considerable national variation, and it was only 
Japan which exhibited a capacity for indigenous innovation (and was less reliant 
on foreign technology) during the years of industrial development studied. This is 
sure to change, and indeed, already has. In their concluding reflections on what 
lies ahead, the editors rightly call attention to Asia’s dynamic IT markets and the 
demands for innovation they generate, the prospects for further financial change 
and venture capital development (the current financial crisis, of course, was not 
anticipated), and the fact that the higher education and R&D systems in the re-
gion are rapidly increasing in capability. 
108 EASTM 29 (2008) 
Overall, the chapters in this book are of high quality. Changes in the Asian IT 
industry are fast-moving and it is not possible for a study such as this to include 
all the latest developments. Nevertheless, it offers stimulating, informative, and 
authoritative accounts of the enduring issues that affect IT in the region. The 
volume should therefore serve as an important standard reference in what has 
become a very large literature on the subject, and would be a very useful addition 
in advanced courses on Asian political economy and high-tech industrial devel-
opment. 
 


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Editorial

Ho Peng Yoke, Reminiscence of a Roving Scholar: Science, Humanities and Joseph Needham

Cover

Introduction

Obituary Prof. Xi Zezong (1927-2008)

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De la difficulté de juger: Quelques ressources du mode critique en Chine et au Viêt Nam (On the Difficulty of Judgment: Some Resources of Criticism in China and Vietnam), in the journal Extrême Orient, Extrême Occident: Papers on Comparative Research

Note from the Editor

Ofra Anson and Sun Shifang, Health Care in Rural China: Lessons from HeBei Province

Henry S. Rowen, Marguerite Gong Hancock, and William F. Miller (eds.), Making IT: The Rise of Asia in High Tech

370

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