5 years ago, I could've been a polygamist with syphilis when I got married, although I had to undergo the medical when renewing my spousal visa.

When I got married, my future wife bribed an official so that she and I were allowed to forego medicals. Since then, the PSB gave me the choice of renewing my L visa for 180 days without a medical, or for 360 days with a medical. I chose the former. Since renewing a zero entry for a UK citizen costs a mere 160 RMB, it would have been cheaper to do it the way I chose, given that a medical costs more than 160 RMB. The aforementioned bribe was 100 RMB, much cheaper than medicals for my wife and me. That was more than a decade ago.

Officially, my L visa is not a spousal visa, btw. In my case it's a visa for visiting a Chinese relative, namely my wife, and also for touring, with or without her. That's because I tick the relevant two boxes when applying for my L visas.

That's the procedure in Inner Mongolia. Hohhot. I've heard that in other places, foreigners with Chinese relatives can get 360 day L's without medicals being mandatory! I doubt very much that these days the Chinese authoirties will insist on medicals - that smacks of compromising one's human rights!