'Hospitalizing' traditional Chinese medicine: Identity, knowledge and reification

This dissertation is an ethnographic study of the practice of traditional medicine in contemporary China within the hospital setting, focusing upon how the identity, both of the practice itself and of its practitioners, is created and maintained. Since the late 1950's, a previously private and ambulatory traditional practice of Chinese medicine has been largely reinstalled as a parallel to Western medicine within a hospital-based institutional setting in the state healthcare system. The collective care of hospitalized patients has, as a result, become the primary site where contemporary practitioners display the traditional characteristics of Chinese medicine. Despite the increasing integration of Chinese and Western practices in this transformed traditional medicine, however, the bifurcation between the two has been recursively recreated within hospitals of Chinese medicine, and ultimately within the practice of individual practitioners. Emerging from this historical process is the central paradox that this dissertation examines. The practice of Chinese medicine has become disembodied and reified. It has become a homogenized role that practitioners assume in the professional setting. But the essence of this historically continuous autochthonous tradition is dependent upon a process of embodiment that can only be authenticated through unique, individualized experience.; Drawing upon ethnographic data collected during eighteen months of field research at a local hospital of Chinese medicine in central China, this dissertation analyzes the various activities of the narrative presentation of clinical cases, which are routinized in the hospitalized practice of Chinese medicine. I present the following conclusions: (1) Contemporary practitioners maintain the boundaries between the two kinds of eclectically applied medicine, foregrounding their practice of Chinese medicine, through discursive the activities of clinical case presentation. (2) A socially differentiated space inhabited by practitioners with varying claims to authenticity and professional seniority is indexed by the institutionalized stylistic variations to which these practitioners conform in their presentation of clinical cases. (3) These stylistic variations in the discursive performance of Chinese medicine calibrate the varying extent to which individual practitioners have embodied the knowledge and practice of traditional medicine. (4) Historical continuity with a retrospectively defined authentic practice is achieved through the use of a temporally displaced archaic literary register in the presentation of clinical cases in terms of Chinese medicine. (5) The strategies of persuasion associated with the pre-modern practice of medicine, especially those found in its scholarly textual tradition, are naturalized in the narrative core of contemporary re-enactment in today's hospitalized practice. Contemporary practitioners are using these strategies to present and legitimize a distinct perspective on clinical reality, and ultimately to define an indigenous Chinese medicine that is empirical and national.