Toward Global Histories of Pharmaceuticals in East Asia

Timothy Yang Pacific University
Abstract: This brief essay considers the history of pharmaceuticals in East Asia. It begins with a discussion of the burgeoning popularity of cultural and social histories of modern medicine in East Asia, and it describes the benefits and potential pitfalls of examining medicines as commodities. It ends by drawing attention to a growing number of scholars writing pharmaceutical histories in the region.

The history of medicine has become a burgeoning subfield in East Asian history. In recent years, a growing number of historians have analyzed medicine and public health from the perspectives of the state above, society below, as well as practitioners in between. Some have emphasized the utilitarian motives and disciplinary practices of medical professionals on subject populations; others have conversely examined how subject populations use medical knowledge and medicinal practices to assert their own subjectivity. Some of the most fruitful work concerns medicine in colonial contexts. Imbued with multiple meanings and imbricated in shifting power relations, medicine—in the hands of a social or cultural historian—serves as a crucial site to analyze the variegated, and often contradictory, dynamics between elements of state and society.1

Imbued with multiple meanings and imbricated in shifting power relations, medicine—in the hands of a social or cultural historian—serves as a crucial site to analyze the variegated, and often contradictory, dynamics between elements of state and society.

The attraction of medicine for historians of East Asia, of course, has much to do with context. The cultural turn in the humanities and social sciences exposed a generation of scholars to notions of governmentality, hegemony, and discourses of the body. The decades-long battle for health care reform in the United States, which has saturated the news, undoubtedly influenced many scholars to consider health, health care, and medicine as important historical subjects of analysis. Groundbreaking historical work in the history of medicine outside of East Asia has similarly catalyzed research.2 Historians of East Asia do not live or work in a vacuum (contrary, perhaps, to grumblings from within the field and without).

Perhaps another reason for the attraction of medicine as a historical subject is simply its importance to the grand narratives of nation-state building in modern East Asia. Medicine was never far from the minds of nationalists in the pursuit of modernity. Chinese nationalists like Lu Xun often expressed their efforts as curing the soul of China, the "sick man of Asia" (Lu, 1960). The Japanese statesman Gotō Shinpei—Japan’s supposed stand-in for Cecil Rhodes and himself a physician by training—famously expressed the importance of Western medicine for the governance of the Japanese empire by comparing the disciplinary function of medicine to the proselytizing power of religion.3 Histories of medicine in modern East Asia have almost always been—intentionally or not—histories tied to the state. That likely will not change. And despite scholars’ best efforts to locate, in the words of Ruth Rogaski, "fluctuations and moments of resistance" against coercive regimes of medicine and public health, "the resulting overall picture reveals a growing hegemony of biomedical approaches to health in the public discourse" (Rogaski, 2004, 9).

Yet, modern medicine did not simply spread, top-down, through state-supported institutions and networks of like-minded practitioners. Numerous non-state actors helped modern medicine permeate peoples’ hearts and minds in subtle, diverse, and often conflicting ways. Pharmaceuticals thus represent an important, and perhaps under-examined, site for analyzing the medicalization of societies—a site that allows scholars to analyze the triangulated relationships between state, society, and the market, not to mention the influence of science and technology.

Pharmaceuticals represent an important, and perhaps under-examined, site for analyzing the medicalization of societies—a site that allows scholars to analyze the triangulated relationships between state, society, and the market, not to mention the influence of science and technology.

The importance of studying pharmaceuticals results from their nature as commodities—they seemingly represent objectified medical practices or serve as metonyms for medical professionals (van der Geest and Whyte, 1989). Non-prescription medicines, for example, symbolize concretized care and healing, in inexpensive and ready-to-use form; they allow a sick individual to bypass a visit to a doctor, and, hence, to seemingly avoid entering into an unequal power relationship between physician and patient, predicated on knowledge and authority. Yet, as a wealth of scholarship on commodities—from Marx to Appadurai to Mintz—has shown, every commodity contains layer-upon-layers of unequal power relationships, congealed during its production, distribution, and even consumption.4 Every actor who contributes to the production and distribution of a medicine—from laboratory chemists and farm laborers to pharmacists and advertising directors—imbue it with diverse meanings, through their different aims and disparate means. Bringing a medicine to market requires massive institutional frameworks and huge investments of capital to procure and process raw materials as well as to maintain commodity chains. Deals among drug firms, governments, shippers, labor unions, and others need to be brokered. Legislation on tariffs, trademarks, or anything else concerning intellectual property and the logistics of trade needs to be enacted and protected. Research scientists need to be paid. The entire commodity chain, of course, needs to be guaranteed and protected—a function that, more often than not, only a state (or better yet, an imperial state) could provide. These unequal relationships only continue in a medicine’s consumption, a practice that appears as a subjective act of individual agency. After all, an individual knows only what medicine to take—and how to take it—based on a "doctor’s orders," on the advice of a friend or family member, or from an advertisement.

But are medicines and medical treatments commodities like any other? Or are they necessities? Who determines what is a medical necessity? A useful, life-saving medicine can be a dangerous poison or quackish placebo, depending on usage, dosage, and circumstance; medicines have side effects, and they often affect different individuals in dissimilar ways. Medicines are substances with multiple, fundamentally unstable meanings, particularly when they are commodities to be bought and traded or advertised and sold. Compared to most other commodities, the warning "buyer beware" seemingly has a different significance in the case of medicines, primarily because of their potential to poison (all modern nation-states, after all, have regulatory organs comparable to the Food and Drug Administration in the United States).

As a commodity-centered approach to the history of medicine, the history of pharmaceuticals has all the potential benefits and drawbacks of all commodity histories.

It makes scholars ask questions about medicine’s relationship to state and society through a deeper consideration of the structures of industrial capitalism and modern consumer culture. But, in the words of Bruce Robbins, "Looking through a commodity to the human relations behind it, what exactly should one see? Capitalism? Class? Culture? The state? After all, what is the right way to describe a commodity?" (Robbins, 2005, 455). The problem with commodity histories is that they have the potential to shed light on anything and everything, and thus lose their analytical value and critical stance.

As a commodity-centered approach to the history of medicine, the history of pharmaceuticals has all the potential benefits and drawbacks of all commodity histories.

Despite these potential pitfalls, I am presently working on a forthcoming book about a transnational Japanese pharmaceutical company in the early twentieth century, Hoshi Pharmaceuticals.5 I trace the company’s involvement in commodities like opium, quinine, and consumer medicines to show how drug companies simultaneously supported and subverted the Japanese state’s regime of public health, both within Japan and in its expanding empire in places such as Taiwan and Korea. Although the context is East Asia, it engages in broader, global questions concerning the nature of medicines as commodities and the emergence of the modern pharmaceutical industry outside of the confines of the controlled research laboratory—imbricated in geopolitical, cultural, and socio-economic changes.

But I am far from the only scholar working at the intersections between medicine and capitalism. There have been a number of groundbreaking works outside of East Asia that have examined the complexities of bringing a medicine to market, including issues of intellectual property and scientific knowledge and authority.6 And in recent years, a number of scholars working on East Asia have increasingly addressed interconnections between medicine and capitalism through pharmaceuticals as a field of study. The topics and approaches are varied; many are building on their own previous scholarship in the cultural and social history of medicine and public health, while others investigate pharmaceuticals from business history perspectives.7 This convergence of methodological approaches and themes is yielding new insights on the practices of medicinal consumption, the production and circulation of medicines and medical knowledge, and the supposed divides between traditional and modern medicines.8 At the recent Annual Meeting of the Association of Asian Studies in March 2017, a number of scholars working on pharmaceuticals met and are planning future conferences and collaborations.9 Where this will go is unclear, but what is certain is that interest in pharmaceuticals as a site of historical inquiry looks promising and will only open up new avenues for research.



  1. The scholarship is vast and growing. A few representative works include Ruth Rogaski, Hygienic Modernity: Meanings of Health and Disease in Treaty-Port China (Berkeley: University of California Press, 2004); Susan Burns, "Constructing the National Body: Public Health and the Nation in Nineteenth-Century Japan," in Timothy Brook and Andre Schmid, editors, Nation Work: Asian Elites and National Identities (Ann Arbor: University of Michigan Press, 2000); Ann Jannettas The Vaccinators: Smallpox, Medical Knowledge, and the "Opening" of Japan (Stanford, CA: Stanford University Press, 2007); William Johnston, The Modern Epidemic: A History of Tuberculosis in Japan (Cambridge, MA: Harvard Asia Center, 1995); Iijima Wataru, Mararia to teikoku: shokuminchi igaku to Higashi Ajia no kōiki chitsujo. Tokyo: Tokyo daigaku shuppansha, 2005); Angela Ki Che Leung and Charlotte Furth, editors, Health and Hygiene in Chinese East Asia: Policies and Publics in the Long Twentieth Century (Durham: Duke University Press, 2010); Michael Shiyung Liu, Prescribing Colonization: The Role of Medical Practices and Policies in Japan-Ruled Taiwan, 1895–1945 (Ann Arbor, MI: Association for Asian Studies, Inc., 2009); and Hoi-eun Kim, Doctors of Empire: Medical and Cultural Encounters in Germany and Meiji Japan (Toronto: University of Toronto Press, 2014).
  2. Representative works include David Arnold, Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-Century India. Berkeley: University of California Press, 1993); Mark Harrison, Public Health in British India: Anglo-Indian Preventive Medicine, 1859–1914 (Cambridge, UK: Cambridge University Press, 1994); Daniel Headrick, The Tools of Empire: Technology and European Imperialism in the Nineteenth Century (Oxford, UK: Oxford University Press, 1981); Philip Curtin, Death by Migration: Europe’s Encounter with the Tropical World in the Nineteenth Century (Cambridge, UK: Cambridge University Press, 1989); Warwick Anderson, Colonial Pathologies: American Tropical Medicine, Race, and Hygiene in the Philippines (Durham, NC: Duke University Press, 2006); and Nancy Rose Hunt, A Colonial Lexicon: Of Birth Ritual, Medicalization, and Mobility in the Congo (Durham, NC: Duke University Press, 1999).
  3. In a 1901 speech on public health, he declared, "Other imperial nations use religion to help them govern; exploiting weaknesses in humanity, they proselytize to unify peoples’ hearts and minds, ridding them of superstition," yet "in our country…because [we] do not have an absolute religion . . . we recognize that relieving humanity from the suffering of disease is a similar method for unifying" (quoted in Tsurumi, 2004–2007, 416–17).
  4. See Arjun Appadurai, ed., The Social Life of Things: Commodities in Cultural Perspective (Cambridge, UK: Cambridge University Press, 1988), and especially, Igor Kopytoff, "The Cultural Biography of Things: Commoditization as Process," chapter 2, 64-92. Also see Sidney Mintz, Sweetness and Power: The Place of Sugar in Modern History (New York: Penguin Books, 1985).
  5. The working title is Drugs and the Business of Empire in Modern Japan (Ithaca: Cornell University Press, forthcoming 2019).
  6. See, for example, Paul Gootenberg, Andean Cocaine: The Making of a Global Drug (Chapel Hill: University of North Carolina Press, 2008); Abena Dove Osseo-Asare, Bitter Roots: The Search for Healing Plants in Africa (Chicago: University of Chicago Press, 2014); Joseph M. Gabriel, Medical Monopoly: Intellectual Property Rights and the Origins of the Modern Pharmaceutical Industry (Chicago: University of Chicago Press, 2014); and Gabriela Soto Laveaga, Jungle Laboratories: Mexican Peasants, National Projects, and the Making of the Pill (Durham, NC: Duke University Press, 2009).
  7. See, for example, Soyoung Suh, Naming the Local: Medicine, Language, and Identity in Korea since the Fifteenth Century (Cambridge, MA: Harvard University Asia Center, 2017); Sean Hsiang-lin Lei, Neither Donkey nor Horse: Medicine in the Struggle over China’s Modernity (Chicago: University of Chicago Press, 2014); and Daniel Trambaiolo, "The Languages of Medical Knowledge in Tokugawa Japan," in Benjamin A. Elman, editor, Rethinking East Asian Languages, Vernaculars, and Literacies, 1000–1919 (Leiden: Brill, 2014), 147–68.
  8. See, for example, Susan Burns, "Marketing ‘Women’s Medicines’: Gender, OTC Herbal Medicines and Medical Culture in Modern Japan," in Asian Medicine 5 (1) 2009: 146–72; Hoi-eun Kim, "Cure for Empire: The ‘Conquer Russia Pill,’ Pharmaceutical Manufacturers, and the Making of Patriotic Japanese, 1904–1945," in Medical History 57 (2) 2013: 249–68; Miriam Kingsberg. Moral Nation: Modern Japan and Narcotics in Global History (Berkeley: University of California Press, 2014); Sherman Cochran, Chinese Medicine Men: Consumer Culture in China and Southeast Asia (Cambridge, MA: Harvard University Press, 2006); and Maki Umemura, The Japanese Pharmaceutical Industry: Its Evolution and Current Challenges (London: Routledge, 2011).
  9. Daniel Trambaiolo has led these efforts. Other scholars involved include Bridie Andrews, He Bian, Susan Burns, Sean Hsiang-lin Lei, Angela Ki Che Leung, Michael Shi-yung Liu, Izumi Nakayama, Lena Springer, So-young Suh, Wen-ching Sung, and myself.


Lu, Hsun. 1960. "Preface to the First Collection of Short Stories, ‘Call to Arms.’" In Selected Stories of Lu Hsun. New York: W. W. Norton and Company, 1960, 1–6.

Robbins, Bruce. 2005. "Commodity Histories." PMLA, vol. 120. no. 2 (Mar), 454–463.

Rogaski, Ruth. 2004. Hygienic Modernity: Meanings of Health and Disease in Treaty-Port China. Berkeley, CA: University of California Press.

Tsurumi, Yūsuke. 2004–2007. Kettaiban, seiden Gotō Shinpei, vol. 3 (Taiwan jidai, 1898–1906). Annotated and revised by Ikkai Tomoyoshi. Tokyo: Fujiwara shoten), 416–417.

van der Geest, Sjaak and Susan Reynolds Whyte, Susan Reynolds. 1989. "The Charm of Medicines: Metaphors and Metonyms," in Medical Anthropology Quarterly, New Series, vol. 3, no. 4 (Dec.): 345–367.


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