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The Adaption of German Psychiatric Concepts Around 1900 During the Academic Evolution of Modern Psychiatry in China

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The Adaption of German Psychiatric Concepts Around 1900 During the Academic Evolution of Modern Psychiatry in China UNIVERSITÄTSKLINIKUM HAMBURG-EPPENDORF Zentrum für Psychosoziale Medizin, Institut für Geschichte und Ethik der Medizin Prof. Dr. med. Heinz-Peter Schmiedebach International knowledge transfer: The adaption of German Psychiatric Concepts around 1900 during the Academic Evolution of Modern Psychiatry in China Internationale Wissenstransfer: Die Anpassungsfähigkeit der deutschen psychiatrischen Konzepte um 1900 während der akademischen Entwicklung der modernen Psychiatrie in China Dissertation zur Erlangung des Doktorgrades Dr. rer. biol. hum. / PhD an der Medizinischen Fakultät der Universität Hamburg. vorgelegt von: Wenjing Li He Bei, China Hamburg 2016 (wird von der Medizinischen Fakultät ausgefüllt) Angenommen von der Medizinischen Fakultät der Universität Hamburg am:_ 23.09.2016 ______ Veröffentlicht mit Genehmigung der Medizinischen Fakultät der Universität Hamburg. Prüfungsausschuss, der/die Vorsitzende:__Prof. Dr. H.-P. Schmiedebach_ Prüfungsausschuss, zweite/r Gutachter/in:_Prof. Dr. D. Naber__________ Contents Abstract ......................................................................................................... 1 Abstrakt ......................................................................................................... 3 1. Introduction ................................................................................................ 5 1.1 Background & status quo ....................................................................... 5 1.2 Issued question & purpose ..................................................................... 9 1.3 Research design & method .................................................................. 11 1.4 Academic innovation & value ............................................................... 14 2. Comparison between Germany and China before 1898 ........................... 16 2.1 Research paradigm .............................................................................. 18 2.2 Diseases classification ......................................................................... 20 2.3 Accommodation .................................................................................... 22 2.4 Cure & care .......................................................................................... 25 2.5 Portrait of alienists ................................................................................ 28 2.6 Portrait of patients ................................................................................ 31 3. Contention in German psychiatry and shift of the reference center ........... 34 3.1 Definition of ‘German psychiatry’ .......................................................... 35 3.2 Brief review of major schools and relationships .................................... 37 3.3 Shift of the pivotal center of modern psychiatry .................................... 57 4. Indirect transmission of German psychiatry in China ................................ 62 4.1 Historical background: wars, power relations and science ................... 62 4.2 The admission process of Western medical paradigm ......................... 68 4.3 A brief history of modern psychiatry in China (1898-1978) ................... 73 4.4 Transmission of German psychiatry through indirect channels ............ 80 5. Investigation through the lens of international knowledge transfer ............ 86 5.1 Importation: influential writings from different channels ........................ 87 5.2 Presentation: milestones writings and achievements in China ............. 95 5.3 Acceptation of bio-somatic psychiatry ................................................ 107 5.4 Rejection of psycho-dynamic psychiatry............................................. 110 5.5 Changes during the indirect transmission ........................................... 113 5.6 Standpoint of Chinese psychiatrists ................................................... 123 6. Comparison of psychiatric professionalization in Germany and China .... 132 6.1 Timeline of professionalization process .............................................. 132 6.2 Development path .............................................................................. 135 6.3 Social & cultural analysis .................................................................... 139 7. Idea: Renaissance from the perspective of cultural diversity .................. 148 7.1 Common origin and different routes ................................................... 148 7.2 Meeting in the East ............................................................................. 150 7.3 Re-evaluation of the psychiatric concepts in Germany ....................... 158 8. Discussion ............................................................................................. 161 8.1 Limitation of this research ................................................................... 161 8.2 A broader cultural perspective for history of psychiatry ...................... 163 9. Summary ............................................................................................... 168 References ................................................................................................ 173 Appendix .................................................................................................... 185 I Chinese psychiatrists with experience of studying aboard, 1898-1978 .. 185 II Professional journals of psychiatry in People’s Republic of China ........ 186 Acknowledgement ..................................................................................... 187 Curriculum vitae ......................................................................................... 189 Publication list during Ph. D. study ............................................................. 190 Affidavit (Eidesstattliche Versicherung) ...................................................... 191 Abstract Modern psychiatry was first introduced to mainland China along with the concept of ‘science’ and the idea of bio-medicine around 1900 by western missionaries. From the year of 1898 to 1978, the field of psychiatry in China had developed gradually as a result of contact with western psychiatry. In the light of the unparalleled contributions of German psychiatry around 1900, what kind of impact and how it had on the newly introduced discipline in China is the focus of this study. In order to pave the way for the research, the respective status between Germany and China before 1898 were first compared; the contention in German psychiatry and the shift of the pivotal centre of modern psychiatry were presented. From the perspective of international knowledge transfer, by using the qualitative analytical methods from comparative history and medical intelligence science, this study analysed the role played by key individuals and events in this process of ‘western studies east-bound’ in psychiatric field; investigated the landmark of psychiatric publications in China before 1978; and then argued that modern psychiatry was introduced to China through a process of adaptation in which the United States and three other countries served as bridges for German thoughts around 1900. Moreover, the reasons for the adherence to the somatic-biological orientation and those for the exclusion of the related philosophical explanations in Germany psychiatry were revealed. In view of the similarity of some ideas between Emil Kraepelin and the Traditional Chinese Medicine, the inspiration of re-evaluation of German psychiatric concepts was proposed, and a broader perspective for the future historical research in psychiatry with the emphasis of regression to its medical nature was raised. 1 This study responds to the paucity of research on the issues of international relationship about psychiatric concepts dissemination from the West to the East. The research result indicated that, despite the lack of direct intelligence exchange in psychiatric field between Germany and China, the original ideas for the initial creation of modern psychiatry in China were actually drawn from German psychiatry. Keywords: China, German psychiatry, history, knowledge transfer, America, Japan, Soviet Union, Great Britain, Traditional Chinese Medicine 2 Abstrakt Die moderne Psychiatrie wurde zum ersten Mal zusammen mit dem Konzept ‘der Wissenschaft’ und die Idee der Bio-Medizin um 1900 von westlichen Missionaren nach China eingeführt. Ab dem Jahr 1898 bis 1978 hatte sich das Gebiet der Psychiatrie in China allmählich als Folge der Berührung mit der westlichen Psychiatrie entwickelt. Vor dem Hintergrund der beispiellosen Beiträge der deutschen Psychiatrie um 1900 wird als Schwerpunkt untersucht, welche Art von Auswirkungen diese hatten und wie sie sich auf die neu eingeführte Disziplin in China auswirkten. Zunächst werden die Verhältnisse zwischen Deutschland und China vor 1898 verglichen. Sodann werden die konzeptionellen Auseinandersezungen in der Psychiatrie in Deutschland erörtert und die daraus resultierenden Schwerpunktverschiebungen dargestellt. Aus der Perspektive des internationalen Wissenstransfers analysiert diese Studie mit Hilfe der qualitativen analytischen Methoden aus der vergleichenden Geschichte und medizinische Informationswissenschaft die Rolle von Schlüsselpersonen und Ereignisse in diesem Prozess, in dem ‘westliches Wissen’ aus dem psychiatrischen Bereich im Osten verankert wurde. Sodann werden die Charakteristika der psychiatrischen Publikationen in China vor 1978 dargestellt. Auf dieser Grundlage wird argumentiert, dass die moderne Psychiatrie
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