Manufacturing Tibetan Medicine. The Creation of an Industry and the Moral Economy of Tibetanness examines the (re-)manufacturing of Tibetan medicine as a system of knowledge and practice. As the author stated from the beginning, within a decade, traditional Tibetan medicine has been converted into a modern production. The place of hospital pharmacies throughout the Tibetan areas of People’s Republic of China was taken by pharmaceutical companies. The book, as Saxer stated from ‘Introduction’ has as its aim ‘to describe and to understand the industrial assemblage of the Tibetan medicine industry’ (p. 15). In doing that Saxer adopts an anthropological perspective that allows him both to describe the complexities involved in the transformation of social practices and knowledge and to invite the reader at a deeper understanding of the inherent contradictions any modernisation process entails. The choice of Tibetan medicine as ‘object of research’ is not an accident but it can be seen (and ‘read’) as linked to the general questions of globalisation (and here the rise of People’s Republic of China is only the top of the iceberg) local identity (with Tibetanness as a paradigmatic example) .
The monograph is divided into eight chapters, each of them approaching the industrial assemblage of Tibetan medicine industry from a different angle and describing specific elements. As the main concept used in analysis Saxer had choose the term ‘assemblage’. As a social fundamental concept ‘assemblage’ could cover all the social processes and formations encountered in his anthropological approach to the ‘empirical field’. Secondly, as Saxer stated from the beginning, it has a dual nature being conditioned both spatial and temporal. Finally, it is a ‘flexible’ concept that allows to anthropologist (the author) to change (from one chapter to another) the positions from where he had offered alternative understandings of the reality (e.g. from macro perspectives on Tibetan medicine as a process to the micro analysis of practices involved in collecting raw materials).
The first chapter set the general theoretical framework and historical background of the anthropological approach to the object of scientific inquiry. On the one hand, the Tibetan medicine is seen as a medicine industry which is embedded in the development agendas of People’s Republic of China. On the other hand, the same Tibetan medicine is seen as a ‘locus’ of Tibetan identity and culture. As a (medicine) industry, Tibetan medicine was born in the context of the post-socialist industrial market society managed by a communist party. The process was dependent on two layers of modernising process that took place in the People’s Republic of China: forms of neo-liberal ideas of governance (in the shape of ‘good manufacturing practices’) and high-modernist planning. While the content of neoliberal ideas of governance emphasize continuous self-assessment, management technique and quality control, the implementation of this labour philosophy relies on centralist management, top-down planning and tight deadlines. This internal contradiction that lay in the heart of Tibetan medicine as an industry was further complicated by search of preserving the cultural heritage of Tibet. From that perspective, as Saxer stressed, Tibetan medicine has a symbolic value and is seen as a part of the Tibetan culture. And here, again, another tension arises: that between the moral economy of Tibetanness and the Chinese business culture. As the author stated the core thesis of the volume (p. 15):
‘In summary, the conditions that frame the Tibetan medicine industry [...] can be described as an intersection where different figuration of modernity [...] met with a moral economy of cultural identity’.
The second chapter (‘The Creation of an Industry’) summarised the history of Tibetan medicine since the 1950s, stressing the changes and transformations recorded in that period of time. In approaching this issue Saxer showed that, in the last half of century, Tibetan medicine had lost its status as the result of different external factors that had been present in Tibet since the 1950s. Those changes were the results of, on one hand, the state’s support for the Traditional Chinese Medicine to directly compete with Tibetan medicine, and, on the other, the transition from local pharmacies (specific to Tibetan medicine) to industrial production of medicines (imposed by the so-called ‘socialist market economy’). The chapter showed that, due to those external pressures, Tibetan medicine was transformed into an industry and, as such, it is confronted with conflicting visions of morality and Tibetanness.
In ‘Manufacturing Good Practice’ (the third chapter of the monograph) Saxer abandon the general perspective on Tibetan medicine in favour of an ethnographic approach to the ways in which the practices of industrial production were implemented in the traditional ways of producing Tibetan drugs. The textual comparison between, on the one hand, the new regulations of (so-called) ‘good manufacturing practices’, official laws of People’s Republic of China regarding drugs and Chinese pharmacopoeia and, on the other, traditional texts of Tibetan medicine, showed that the pitfalls in the industrialisation of Tibetan medicine were the results of practical implementations by Chinese officials of the regulations regarding the production processes and not inherent in the legal texts. As in other parts of the world where the transition from centralised economy to the free-market took place (e.g. Eastern Europe) this lead to the apparition of a ‘legally grey area’, a space of uncertainty and opportunity in which ambiguities and strict regulations of the Tibetan medical practices co-exist.
‘Raw Materials, Refined’ is the fourth chapter of the monograph and here the author dealt with the impact of industrialization of Tibetan medicine on the selection and trade of ‘raw materials’ used in the production of Tibetan drugs. The amount of ingredients traditionally used had dramatically increased due to the requirements of an industrial production and, as a result, a decrease in the quality of those ‘raw materials ‘was recorded. Faced with uncertainties related to future sustainability Tibetan factories had searched new sources of ingredients, to devise new cultivation projects and adopt new principles of conservation and commercial trade. Saxer had introduced here the concept of ‘border regime’ to describe the process of products and people movements across physical borders and conceptual division (pp.131-132) and showed the impact of this new ‘social configurations’ on the Tibetan medicine relations with other complex systems (such as the environment).
In the fifth chapter (‘Knowledge, Property’) Saxer approached the question of to whom Tibetan medicine belongs. In the last years, the traditional medicine strategies of People’s Republic of China had developed policies influenced by new principles, such as biopiracy and the protection of traditional knowledge. In analysing those aspects Saxer take a different stance toward Tibetan medicine and he saw it not only as a system of knowledge but also as a form of intellectual property (p. 162). Two cases related to Tibetan medicine were examined in this respect: the Chinese administrative protection scheme for traditional medicine, which led to a legal dispute over the right to produce high-value Tibetan drugs, and the story of registering and patenting secret old lineage formulas.
In the next chapter of the volume (Chapter 6 – ‘The Aesthetic Enterprise) Saxer analysed both the use of aesthetics for social and strategic purposes and the ways the world created by such aesthetic endeavours reciprocally affects the modes in which the Tibetan medicine operates. The levels at which the author approached this issue varied from the visual, aesthetic and material side of Tibetan medicine industry are explored in relations to the rituals of ‘good manufacturing practices’ production to the visual analysis of the advertising campaigns which promoted Tibetan pharmaceuticals in contemporary China. As Saxer showed (p. 198), one could record a visible contradiction between the aesthetic versions of what ‘modern’ Tibetan medicine should look like and the aesthetic visions of what ‘magic’ Tibet look like. At a more general level, this aesthetic tension reflects the lack of balance between the ability to Tibetan medicine to be loyal to the party-state and its capacity to be a trustful shape of authentic Tibetan essence.
‘The Moral Economy of Tibetanness’ showed the ways in which Tibetan medicine, its industry and various (e.g. visual, material and aesthetic) expressions of Tibetanness produced by them are all part of a larger ‘ethnicity economy’ existing in Tibet nowadays. Due to the fact that the complex of ‘authentic’ Tibetanness is linked to the (political) Tibetan question and, as such, it influence, at its turn, the ways in which Tibetan medicine is produced, the tension at the practical level is manifest as the tendency of pharmaceutical companies to balance Tibetan expectations of morality, on the one hand, with the economic success and political role allotted to them by the Chinese party-state.
The final chapter (‘Conclusions’) revised some of the central thesis of the volume and open ways to new directions of inquiry. The entire anthropological enterprise is assessed and the fallacies of the initial assumptions and working hypothesis were stressed. The volume ends with a revision of the concept of ‘assemblage’ in the light of the empirical results.
Overall, the volume offers very rich empirical data about the transformations and changes recorded within Tibetan medicine. The various approaches used by Saxer in his anthropological project constitutes an major advantage of the volum. All chapters succeed both to describe the empirical data and to provide an in-depth analysis of the concepts used as they appear in an empirical shape ‘within anthropological field’. From a critical perspective, the last two chapters are not at the same value as the rest of the volume. The moral economy of Tibetanness (the seventh chapter) and the conclusions could be refined and the analysis could be deepened in the next editions of this monograph. Those limitations are inherent to any empirical project. At the same time, Saxer showed his ability to go forward with the empirical insights as in the case of the concept of ‘border regime’ which is a part of his new project ‘Neighbouring China – Old Connections, New Dynamics’.
Valentina Marinescu, University of Bucharest (email@example.com)