制度擴散與在地化：蘭安生（John B. Grant）在北京的公共衛生試驗，1921-1925

Institutional Diffusion and Localization: John B. Grant’s Public Health Experiments in Beijing, 1921-1925

1914年，美國洛克菲勒基金會進入中國，資助科學醫學的發展，但未惠及公共衛生。1921年，蘭安生故該基金會派往中國，成為美式公共衛生制度擴散與北京市政當局之間的溝通橋樑。為得到基金會支持，他提議：在醫學院開設衛生系，培養公共衛生人才；在特定區域建立預防醫學與臨床醫學相結合的衛生中心，兼具醫學實習和衛生行政的雙重職能。1924年，該計畫得到基金會的支持。蘭安生利用他建立的廣泛社會關係，促成京師警察廳同意開設試辦公共衛生事務所。蘭安生隱藏其後，實際控制著該所的財政和人事任免權，保誰該所試驗基於科學醫學原則的公共衛生業務。為得到警察廳的支持，他注意處理與各級官員之間的關係，在有些事務上持妥協態度。該所對北京公共衛生的制度變還有著重要影響，卻由於深層次的文化和經濟原因，未能普及。蘭安生的試驗實際是制度擴散和在地化的雙重壓力之下的產物：須滿足基金會的基本原則，否則會失去資金支持；須適應地方情勢，否則會失去政治支持，舉步維艱。

In 1921 John B. Grant was sent to China by the International Health Board of the Rockefeller Foundation, thus furthering the institutional diffusion of American public health policies in Beijing. To gain the support of the Foundation, Grant proposed opening a health department in the Union Medical College and setting up a health center to practice medicine and train health workers based on clinical and preventive medicine. In 1924, the Foundation agreed to give him financial support. Grant took advantage of his existing social networks to set up a public health station under the auspices of the Police Department. Grant controlled the station's finances and personnel, which ensured that the station adhered to the principles of scientific medicine. The station fundamentally influenced institutional changes to public health services across Beijing, representing both institutional diffusion and localization. It had to obey the basic principles of the Foundation lest it lose financial support, while it had to meet the requirement of the local government lest it lose political support.