Revisiting Arthur Kleinman's Research on Neurasthenia

History of Psychiatry, 2022

The present study investigates the role of Taiwanese psychiatrists in turning neurasthenia into a culture-specific disease in the late twentieth century. It first delineates the shift in both explanatory models of psychoneuroses and patient population in post-World War II Taiwan. Neurasthenia became a focus of international attention in the 1970s and 1980s with the advance of cultural psychiatry, and, as China was closed to the outside world, Taiwanese psychiatrists were influential in framing the cultural meaning of neurasthenia. With the rise of post-socialist China, Taiwan lost its status as a key laboratory of Chinese studies. This paper argues that the history of neurasthenia during the period was closely associated with the professional development and national identity of Taiwanese psychiatrists.

Culture, Medicine and Psychiatry, 1989

Despite its origin in Western psychiatry, neurasthenia has become a popular concept in Chinese folk medicine, referring to a variety of somatic and psychological symptoms. Review of Chinese medicinal materials and patent medicines shows that neurasthenia is associated more often with somatic symptoms in tonic type medicine and with psychological and psychosomatic symptoms in sedative and tranquilizer type medicine. Popular Chinese books on neurasthenia suggest that causes might be attributed to lifestyle, psyebological factors, and health problems. Recommendations on treamaent emphasize self-help approaches through changing lifestyle, examining attitudes, tonic care, and relaxation. As a broad terra used loosely by professionals and the lay public in Hong Kong, neurasthenia serves the important function of destigmatizing psychiatric disorders. Psychosexual problems may also be conveyed discreetly through somatic presentation. The indigenization of neurasthenia exemplifies how an originally Western concept acquires cultural meaning. Implications of illness conceptualization and the medical paradigm are discussed.

The high prevalence of neurasthenia and its divergent social and cultural meanings in the late nineteenth and early twentieth centuries has been subjected to historical and anthropological studies. The present study explores the history of this elastic diagnosis in relation to the rise of “psy disciplines” in Republican China. Since the 1920s, emergent Chinese neuropsychiatric and mental health professionals eagerly entered the already vibrant culture of neurasthenia and provided their explanations. As China was under different spheres of influence, diverse systems of psy knowledge were practiced in the country. Differences in the conception of the nature of the disease were further intertwined with various reform projects with which these bodies of psychological knowledge were associated. Despite being the products of scientific internationalism, these discourses not only resonated with the epistemological and social concerns derived from Japan, Europe, and, gradually, the United States but generated their own ideas of personal, social, and national regeneration. By examining the history of neurasthenia in the light of the interactions among popular culture, the advent of modern psychiatric and psychological knowledge, and Republican China’s striving for modernity amid social turmoil, the article contributes to our understanding of medical culture in modern China.

Yonsei Journal of Medical History, 2020

The history of psychiatry and madness in modern China has recently become a growing field of scholarly interest. Although many researchers focused on specific institutions, cities, and medical figures, the present study provides an analysis that covers a longer time span, documenting how mental and nervous illnesses in China were conceptualized in the Western medical discourse between the 1840s and the 1930s. In particular, the present study investigates the causes that these primarily missionary medical accounts attributed to the diseases, particularly regarding specific racial or cultural characteristics of the Chinese. Furthermore, in lieu o f describing this Western involvement a s “colonial me dicine” or “imperial me dicine”, the study re-e xamines these accounts to better understand the nature of Western medical and psychiatric services in modern China.

Culture, Medicine and Psychiatry, 1996

Patient identification. Mr. A. is a 57 year-old married Chinese-American man with no previous psychiatric history who presented at the psychiatrist's office in 1989 with a three-week history of auditory hallucinations and delusions. History of present illness. The patient was in his normal state of good health until two years prior to presentation, when he stared developing intermittent acute backaches. He went to his physician and was told that he had kidney stones. Conventional medical treatment did not provide much alleviation of his symptoms, and Mr. A. gradually lost confidence in his Western-trained physician. Mr. A.'s back pain continued to flare up intermittently. After almost two years of treatment failures, Mr. A. was willing to try treatments from China. Three weeks prior to evaluation, he started practicing Qi-gong, a Chinese folk health-enhancing practice similar to Tai Chi, which consists of controlled, synchronized breathing and body movements, and is expected to have curative effects on physical illnesses. His practice of Qi-gong was intensive. Several days after starting these practices, he developed delusional and hallucinatory experiences, while he had never experienced before. These conditions persisted and intensified, interfering with his concentration, and prevented him from working as an engineer. His auditory hallucinations consisted of voices of supernatural beings communicating with him regarding how he should practice Qi-gong and delusions that he was contacting beings from another dimension. He returned to the Qi-gong masters for help, but they were unable to provide any relief. His wife, who was a registered nurse, became increasingly concerned over his inability to work. She consulted with a Caucasian psychiatrist co-worker from their health maintenance organization (HMO) who referred her husband to a Chinese-American psychiatrist in private practice. On presentation, the patient denied depressed mood,