Book Reviews: Accommodating the Chinese: the American Hospital in China, 1880–1920.

Michelle Renshaw's meticulously researched Accommodating the Chinese looks at an important puzzle. When Western medicine was introduced into China by Protestant missionaries, which aspects of the missionary hospitals were adopted from their Western counterparts, and which owed their character to indigenous Chinese institutions, and to what extent? The author gives us a detailed discussion with enormous historical evidence. Accommodating the Chinese addresses a topic generally ignored in the history of Western medicine in China. The book studies the physical and practical aspects of the hospital in that country, giving us an idea of how Western medicine was practised from the late nineteenth to the early twentieth century. Although much research has been done on the history of western medicine in China, there are few studies that focus on hospitals. This book, therefore, fills a gap. It is divided into three sections. In the first, Renshaw reviews organized medicine in traditional China. There were Chinese chari-table organizations in existence when the missionaries arrived and some were similar to the format of medical missionary dispensaries. Importantly, therefore, while Chinese patients in missionary hospitals may have found the medicine strange, the organization and principle of these institutions would have been familiar. The second section examines the physical aspects of the hospital. Based on painstaking research in historical records, these three chapters provide an examination of the hospital buildings—their location, orientation, architectural style, internal layout, range of facilities, building methods, materials and finishes, and so on. Renshaw also connects the development of the medical mission in China to the progress of modern medicine in the West. For example, the missionaries were aware of the on-going debate in the West linking hospital design and health. But many missionary architects and clients consciously not only translated the Chinese sentiment into bricks, but also incorporated Chinese design principles into buildings. In the end, the “Western” hospitals in China had more the appearance of other local buildings than that of their counterparts in America or Britain. Complementing the account of hospital buildings, in the third section the author also provides a vivid portrait of their day to day working and the practice of medicine within them, from the patient's experience when entering a hospital to life on the ward. The core concern is about how the missionaries appealed to the Chinese. For example, having debated whether they should require payment for drugs and treatments, in the end, in accordance with Chinese custom, most missionary hospitals charged a range of fees that varied for rich and poor, for men, women and children. This book's real aim is to portray in full historical detail the American hospital in China at the historical moment when the Chinese begin to accept Western medicine. However, Renshaw neglects the important fact that, from the moment of their arrival in China, medical missionaries and the medicine they practised were regarded with suspicion and distrust, and many outrageous rumours circulated concerning their medical practices. Because most hospitals were affiliated with a church, the simplest response of ordinary Chinese people to the hospital was: why are the doors of the church always closed? Why do so many people die after going to the hospital that is linked with the church? We are left, therefore, with some interesting questions: did the spatial arrangements for treatment in these hospitals make medical missionaries’ activities look problematic to the locals? Did the rumours influence medical missionaries to make certain accommo-dations? These questions are beyond the scope of this book. It is thus our turn to conduct further studies.