In the late nineteenth and early twentieth centuries, Western physicians and missionaries opened several psychopathic hospitals in urban China, including the John Kerr Refuge for the Insane in Guangzhou and the Beijing Psychopathic Hospital. Although local families relied on the charitable services offered by these facilities, they generally remained ambivalent about, if not outright resistant to, neuropsychiatric theories and practices. This article examines how and why ordinary families made medical decisions when faced with the problem of mental illness. In contrast to previous research on biomedicine in the Republican period (1911–1949), which has tended to emphasize issues relating to ideology and cultural nationalism, this paper argues that support of (and resistance to) neuropsychiatry was less often framed in terms of identity politics than in terms of far more practical concerns, such as access, intelligibility, and effectiveness. Disparities in how “mental” disorders were conceptualized in Chinese and Western medicine, problems pertaining to translation and communication, and the very ineffectiveness of psychiatric treatment itself help to explain why families may have patronized psychopathic hospitals but remained unconvinced by the epistemic foundations of neuropsychiatric medicine.
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