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Japanese Infuence in Chinese Medical Education Author(s): E. V. Cowdry Source: The Scientific Monthly, Vol. 14, No. 3 (Mar.

, 1922), pp. 278-293 Published by: American Association for the Advancement of Science Stable URL: http://www.jstor.org/stable/6380 . Accessed: 30/09/2013 05:43
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JAPANESE INFUENCE IN CHINESE MEDICAL EDUCATION' ByDr. E. V. COWDRY


CHINESE STUDENTS IN JAPAN

HE forty-fifth annual reportof the Japanese Ministerof State for Education, published in 1920, is an imposingvolume of about four hundredpages, printedin English. It is an analysis of the activitiesof the departmentfor the fiscalyear 1917-1918,and clearly showshow Chinese studentsof all kinds come to Japan for their education. They are found from the Kindergartensto the Imperial Universities, in the technicalschools,Academy of Music, Fine Art School, in the Schools of Agriculture and Forestry,of Sericulture and Filature, even in the schools for the deaf, in fact almost everywhere. In the public and private special schools 980 are studyinglaw and politics (giving Japanese ideals a strongfooting in China) as compared with 66 in medicine. In the Imperial where it is more difficult Universities, to gain admission,there are but 18 in medicine. It is quite clear from the context that the Chinese are often listed simply as "foreigners," though a very small minority of foreigners are probablyEuropeans. A conservative estimatewould place the numberof Chinese students at well over 4,500. The report,as far as it concernsus, may be summarized as follows:
Foreigners in elementary schools 71 --. ..... Foreigners in public and private kindergartens 127 Chinese in Tokyo School for the Deaf -,,,------.,-,. 1 Chiinesein Tokyo Higher Normal School for Men,, 79 Chinese in Hiroshima Higher Normal School .,,,-,---6 - . Chinese in Tokyo Higher Normal School for Women .. 7 1 Foreigners in normal schools ----------------------------------------------------------Foreigners in public and private middle schools 11 ---------------------------Foreigners in public and private higher schools for girls--------- 1 Chinese in higher schools......................................-.. 154 Foreigners in Tokyo Imperial University ...................................... 52 Chinese in Kyoto Imperial University 29 -------------------------------Foreigners in Tohoku Imperial University 17 Chinese in Kyushu Imperial University .................................-......... 10 Chinese in Kokyo Fine Art School 13
1 Anatomical Laboratory of the Peking Union Medical College and the Laboratories of the Rockefeller Institute for Medical Research, New York.

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Foreigners in public and private special sehools............................ 1,188 11 Foreigners in Tokyo Academy of Music---------------------------------Chinese in Kagoshima Higher School of Agriculture and Forestry-it Chinese in Tokyo Higher School of Sericulture and Filature... 4 Chinese in Tokyo Higher Commercial School. 24 Chinese in Kobe Higher Commercial School.................................. 14 . Chinese in Nagasaki Higher Commercial School -. Foreigners in Tokyo Higher Technical School -20....... 2 Chinese in Osaka Higher Technical School 27 Chinese in Kyoto Higher Technical School5. Chinese in Nagoya Higher Technical School.................................. 10 Chinese in Kumamoto Higher Technical School............................ 1 29 Foreigners in public and private technical schools........................ Foreigners in public and private miscellaneous schools ..-.. 3,052 4,962

Since the elementaryschools maintained by the Chinese communitiesin Yokohama,Osaka and other large commercialcenters, and somne private schools,are apparently not always included, it is safe to estimatethat the numberof Chinese studentsreturning home each year to enter professionalor business careers is well over a hundred. During the past few years some ill-feelinghas developedbut thereare indicationsthat a few of the moreprogressive Japanese are alive to the fact that these studentsmay be converted into ambassadors of good will between the nations. It is unlikelythat therehas been any great falling offin number. Detailed reports subsequent to 1917-1918 are unavailable; but Mr. Shun Ichi Ono has very.kindly obtained data from the official records kept in the "Inspection Officefor Chinese Students in Japan," maintained in Tokyo by the Chinese Government, showing that 199 Chinese studentshave registered for courses in medicine (including dentistry) for the academic year 1921-1922 distributedas follows:
Achi Medical School............................Chiba Medical School for W omen.................................I .......1 Chiba Special Medical School....................... ................. . Fuji Pharmaceutical School..................1.......... Jikei M edical School (Tokyo) .......................................................... Keioh University Medical School...........................Kyoto Imperial University ........................... Kyoto Medical School .3 Kyoto Prefectural Medical School............................-2...... Kyoto Pharmaceutical School .4 Kyushu Imperial University -17 Mizuhara Midwifery School l Nagasaki Midwifery SchoolNagasaki Special Medical School .9 Nagoya Prefectural Medical School.............................-1...............1 14 0 1 6 6 2 1

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23 Nippon Medical School (Tokyo) .......-...............--------------..------.Okayama Special Medical School...................................6...... . . Osaka Dental School .... ...............-I..... Osaka Prefectural Medical School............................ ......5 Tokyo Dental School............................-......................4 Tokyo Imperial University ............................2.............2 ....................................................... 17 Tokyo M edical School 15 Tokyo Medical School for Women...........................-... Tokyo Midwifery School........................... -3............ .........3 ................. 2 Tokyo Pharmaceutical School -........................... 199

The recordsshow that the expensesof 118 of these studentsare paid by the Federal or Provincial Chinesegovernments and that 54 eomeat theirown expense. The means of supportof the remaining 27 are not given. It is interesting to note that none of the government students attends the Imperial UniversityMedical Schools, perhaps on account of their insufficienit pre-medicaltraining or in view of the relativelyhigh fees. They attendfor the mostpart the special medical schoolsof which Chiba appears to be the mostpopular, with an enrollment of 50 students. The Nippon and Tokyo Medical Schools, which also attract a considerable number, are of rather inferiorgrade. The fact that 25 out of the total numberof 199 students,or a littleover 12 per cent.are women, is indicativeof the broad-minded policywhichthe Chineseare adoptingtowardmedical educationfor women. It is indeed a considerablylarger percentage of women medical studentsthan we find,even in the United States, where in the year 1920-1921, they amounted only to 5.9 per cent.2 It is significantalso that 9 of them are maintained by the Chinese government; but why they should be sent to Japan where the opportunities forwomenmedical studentsare distinctly less favorable than in China3it is verydifficult to suggest. The instructionoffered is fairly uniform,because, in Japan, governmentcontrol is far-reaching, and the private schools are usually well-organized and systematiein the enforcement of their requirements. Judged by the "Standards of the Council on Medical Education and Hospitals of theAmericanMedical Association, " with liberal allowance for difference in local conditions,very -few of the Imperial Universities and special medical schools would fall below " B I grade while quite a number would probably be granted "A " rating. From our point of view there seems to be room for improvementin at least two directions.
2

3 Cowdry (E. V.), Anat. Record, Phila., 1920, xx, 52.

Jour. Amer. Med. Assn., Chlicago, 1921, lxxvii, 531.

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The Japanese have outdone the Germans in the domination of the lecture method and have failed to compensate for so doing by giving elective courses and by making the curriculum elastic. For example, in thirteenrepresentative medical colleges, lecturesconsumeon an average of 59.67 per cent.of all the time allotted to the teaching of anatomy.4 In one case they take up as muchas 90 per cent. Since approximately the same proportionof lecturesis given in othersubjects,it is fairly obviousthat the studentshave but little opportunity to discoverthingsfor themselves and to develop originality. The rigidityof the curriculum and the absence of any elective courses worthyof the name tend in the same way to stifleindividual initiative. On the otherhand, it can not be denied that studentsdo learn the principlesof medicinein a thorough if cut-and-dried fashionand that theyprofit greatlyby theirexperiencein otherways. Only one Japanese instructor has volunteeredthe information (quite unsolicited)that Chinesestudentsare in some cases unfairly treated. The accusationusually comesfromforeigners, who know nothingfirst-hand, or fromChinese,who have also studied in the United States or in Europe. As a matterof fact, Chinesestudents are probablytreatedwith indifference, or with a shade of patronage, which they may easily resentwhen they notice how different it is in the United States, where the instructors are particularly interested in themand vie witheach otherin their efforts to bring out theirbest qualities, so that,in effect, theyreceive preferential treatment. I have received verbal confirmation of the statement made in the reportof the China Medical Commission of the Rockefeller Foundation5that entrancerequirements are reduced in the case of Chinese students. This probably does not apply to the Imperial Universities. Actually,it is an encouragement to Chinese studentsto take up the study of medicine,thoughthe motivemay have been to increase the number of students for political or financial reasons. It is perhapssafe to assumethat theseyoung Chinese,like many of theirJapanese teachers, cometo believethat Westernsupremacy depends upon n-othing more than skill in mechanical inventions. This interpretation is soothingto their feelings,which are some times ruffled by the apparent crudity of Western customs. The more thoughtfulamong them may notice how thoroughly the Chinese classics are studied throughout the Empire anid what excellentlibrariesare to be found in Tokyo,almostrivaling those in
4

on Medicine in China. University of Chicago Press, 113 pp.

5 Rockefeller Foundation, 1914, Report of the China Medical Commiission

Cowdry (E. V.), Anat Record, Phila., 1920, xviii, 84.

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Peking, as compared with the easy way in which the classics are dismissedfromconsiderationin the occident. As they follow the successivesteps in Japan 's renaissance,they cannot help observing that it is quite possible to take advantage of Western discoveries without jeopardizing the fundamentalideals of oriental civilization. Far from being injured by the new teaching Shinto and Buddhist shrinesreceive financialsupport fromthe Imperial Departmentof Education and are g-raduallyincreasing in number. withthe increasein populaWhetherthis increaseis commensurate tion,I am unable to say, but even a casual visitorwill notice how carefullythetemplesare tendedin comparisonwiththe dilapidated and neglectedappearance of national monuments in China. They note also that the Japanese have overcometheirscruples and have organize!da systemfor obtaining bodies for dissection,which is unique in its efficiency. During theyear 1914-15over one thousand bodieswere available at the TokyoImperial University alone; about ten timesthe yearlysupply for the whole of China.
BODIES
YEAR

DISSECTED

IN THE JAPANESE
TOKYO KYOTO

IMPERIAL

UNIVERSITIES
KYUSHU

1917-18 1916-17 1915-16 1914-15 1913-14 -

TOHOKU

781 939 724 1,328 888

370 416 435 427 433

223 173 93 94 89

378 396 438 330 329

in which the students live is charged with a The atmnosphere strange mixtureof liberalismand autocracy. Surprising innovationisare being made, some of which are almost withoutparallel, even in the United States. The real significance of the enforcementof a law, passed someyears ago, accordingto whichthe Presidents of the Imperial Universitiesof Tokyo and Kyoto are apof a nominatingcommittee pointed on the recommendation elected by the faculty,instead of by the Emperor,probablyescapes them; but they do observethat freedomof speech is increasingand that the votingfranchiseis being extended. Growingconfidence in the democraticmethodsof private schools is exemplified by the President of the Kyoto Imperial University sendinghis son to the Keioh Universityin preferenceto a government institution,an action which caused lively discussion and comment. The liberal and progressiveelement is certainlygaining strengthin all domestic but unfortunately affairs, it is still quite inconspicuousin the foreign policy pursued by the government in Korea and in China. Both at home and abroad these studentshave had a taste of the shady side of militarismso that many of them become intensely liberal in theirsympathies. With theirpride of race theyfeel,and

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are justifiedin feeling,that what Japan has done theycan also do. As far as theyare able, theywill tryto duplicate her successesand to avoid the painfully mistakenPrussian philosophyof her military leaders. On theirreturnto China, maniy of themsecure positions of responsibility and exercise considerable influence(often political) in the federal and provincial medical schools and hospitals. It is natural for themto send theirown studentsto Japan, to buy theirmedical supplies in the Japanese marketswith which they are familiar,and, in some cases, to appoint skilled Japanese instructors to important posts in which otherforeigners would not be tolerated. Only recently, the following Shantung award, has it becomenecessaryto replace theseJapanese by Chinesein the medical schoolsoI the capital. Professor John Dewey6 sums up the situation as follows: "Although cultivatedJapanese as well as politicianslike Marquis Okuma have long proclaimedthe rightand duty of Japan to lead China, to be the mediatorin introducing westerncultureinto Asia (including India, wheretheylook upon the English7as alien interlopers), few Americans have taken seriously the dependence of China upon Japan in just these ways. I have seen books on the developmentof modern Chinese education which do not mention Japan, which attributethe renovationof the Chinese systemto Americaninfluence, and whichleave the impression thatit is molded upon the Americancommon schoolsystem. As a matterof fact, it is moldedadministratively whollyaftertheJapanesesystem, which, so far as Westerninfluence entersin, is based on the Germansystem, with factors borrowedfrom French centralization. I have visited nine provinces and seen the educational leaders in the capitals wherethe higherschoolsare concentrated. There are but two cities,Peking and Nanking,where,in the government schools, directwesterninfluence begins to approach the Japanese,eitherin methodsor personnel. To talk about returnedstudents and fail to discriminate betweeni those fromJapan and those fromEurope and America is to confuseeverything touchedby the discussion." He goes on to say that "By far the greaternumberof the revolutionary leaders who formedthe Republic were Japanese or had lived in Japan as refugeesand imnbibed its culture as they never assimilatedthat of the West."
JAPANESETEACHINGIN CHINA

In addition to trainingChinese studentsat home,the Japanese


6 The Asia Magazine, 1921, x-xi,582. 7 In this, the Japanese are deceiving themselves,because anthropologists hold that the English are Aryan and consequentlymore closely related to the Hindus (who are also Aryan) than are the Japanese.

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are actively carryingmedical education into China. In 1911 the South ManchuriaRailway Companyestablisheda good hospitaland medical school at Mukden. The arrangement of buildings is illustratedon page 290. Visitorsare usheredinto a receptionroomand, who conductsthem aftera fitting delay, are receivedby the director on a tour of inspection. On enteringthe wards, which extend out behind the main hospital building and are spotlesslyclean, dispensation is courteouslygranted so that it is not necessaryto follow the Japanese customand removeone's shoes. Any dirt that may is quietlywiped away by nurseswearingtheir have been introduced hair piled high in pompadour,preciselyas black and heavily-oiled in Tokyo. Passing frombuildingto building,along paths bordered with newly planted trees, one is impressedwith the completeness of it all. No necessary detail of equipmentor administration seemsto have been forgotten. The new laboratorybuilding,shown on page 291, would not seem out of place on the campus of one of our best universities. It is semi-fireproof and the roomsare laid out uporn the unit systemand supplied withmoveablefurniture so that theymay be easily adapted to meetthe changingdemands of medical science. is givenin the official Useful information printed announcement, in English (for the convenience of foreigners), fromwhichI quote verbatimas follows:
AIMS OF COLLEGE

The aims of the college lie in training Japanese and Chinese physicians of fine character and competent ability who assume their parts to contribute to the progress of medical science, particularly to study the natures of, and the cures for, endemics peculiar to Manchuria.
STATUS OF COLLEGE

The college stands on a plane equal to the medical colleges at home under governmentmanagement. It is organized according to the Imperial College Act. It goes without saying that the graduates of this college are entitled to every privilege and qualification accorded to the graduates of home colleges.
COMPETITIVE ENTRANcE EXAMINATION

The competitive entrance examination for the first year grade of the principal course is conducted in: Mlathematies (algebra, geometry and trigonometry), physics, chemistry, natural history (zoology, botany, physiology and hygiene), composition, foreign language (either English or German), Japanese (for Chinese applicants only), etc. The standard of the examination is put on a level similar to that of a graduate of a middle school. The entrance examination for the first grade of the preparatory course is held in mathematics (arithmetic and algebra), physics, geography, and history, Chinese classics, drawing, etc., on a level with the third year of the middle school.
CURRICULUM

The new students joining the firstyear grade of the preparatory course

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are to take up the study of ethics, Chinese classics, Japanese, mathematics, physics, chemistry,biology, gymnastic exercises, etc., in the course of two years, and then pass into the firstgrade of the principal course. The curriculum of the principal course running four years comprises: Physics, chemistry, anatomy, physiology, pathology, pharmacology, interclinique, surgery, kinderelinique, dermatology, the science and treatment of venereal diseases, rhyno-laryngo-otology, opthalmology,gynecology,psychology, hygiene, bacteriology, medical jurisprudence, dentistry and oral surgery, ethics, Chinese or Japanese (Chinese for the Japanese students and Japanese for the Chinese), German, gymnastic exercises, etc.
MONTHLY EXPENSES OF STUDENTS

I am indebtedto Doctor Motoi Yamada, Director of the college at thetimeof myfirst and to his successor, visit,formanycourtesies Doctor Al. Hirano, for the followingdetailed information which showsa steady increase in the proportionof Chinese studentscompared with Japanese, and enables us to calculate the cost of the education provided. In 1921 the outlay for currentexpenses exceeds the incomeby 394,773 Yen, so that each of the 212 students represents a yearly expenditureof 1,862 Yen or about $931 U. S., whichcomparesfavorablywiththe tuitionfee of 17 Yen per month and other expenses). On the basis of ten (including dormitory months' instructionper year, this would amount to 170 Yen, or about $85 UJ. S. :8
ANNUAL BUDGiET oF 1921

The monthly expenses of a student inclusive of tuition fee, dormitory expenses, etc., amount about Y 17 each.

(School) 186,912 Buildings, gold yen............................................ Instruments ........- .----------------5,400 Books .......-..................-................ 8,100 Income -------------------------------------------6,472 Current Expenses: Outlay ........... ............................ .... 278,703
STUDENTS

(Hospital) 314,348 9,000 434,574 557,116

Final class---Fourth class........ Third class........ Second class........ First class--Total

(Japanese) 18 25 19 28 37

(Chinese) 13 15 17 16 14 85

(Total) 31 40 36 44 61 212

127 ..............................................................

8 The Report of the Council on Medical Education and Hospitals (Jou4. Amer. Med. Assn., Chicago, 1921, lxxvii, 534) for the year 1920-1921 shows that in 42 American medical schools listed in Class A, the fees for each student range from $175 to $350 per year, which does not include the very large -item of living expenses.

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GRADUATES

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(No.) (Year) lt--1915 .............-..................... ..... 2nd ...... 1916 3rd 1917 4th .............................. . 1918 5th .......................... . .. 1919 6th ............................ ........ .. 1920 Total ............................................
BODIES

(Japanese) 11 12 17 24 24 25 ........ 113


PURPOSES

(Chinese) 0 0 4 11 14 15 44

(Total) 11 12 21 35 38 40 157 (Total) 5 23 38 .................... 54 141 103 79 70 44 83 (Total) 37,427 55,890 96,736 118,539 136,793 155,346 190,311 190,982 209,450

FOR ANATOMICAL

(Year) (Men) (Women) 1911 ------------------------------.-.--------------------------------2 3 1912 ........................................ ........ .. 18 5 1913 -..... 31 7 1914 .................................................................. 44 10 1915 ................................................... .. 120 21 1916 ---------------------------------------------------------88 15 1917 ........................... 14 ....................................... 65 1918 .....................-............ . . ................ 56 14 1919 .................................................................. 34 10 1920 -.......................................................... 71 12
PATIENTS

(Year) 1911 1912 1913 1914 1915 1916 1917 1918 1919

(Outpatients) (Inpatients) 13,884 ..................-......... . . ............... 23,543 ................................................... 20,000 35,890 62,035 .......-........................ 34,701 .......... ......-............-......-.. 68,911 49,628 -.. ............................................ 69,536 67,257 .......................................... 84,839 70,507 ................................. .............. 114,423 75,888 .......................................................... 116,135 74,847 ................................................ 126,033 83,417

A beautifulbooklet,bound in yellowsilk, containinga splendid selection of photographs of the buildings, clinics and points of interest,has been recentlypublished and may be obtained from the director. In the pre-clinicaldivisionsthereis an adequate fullso that the college is able to distributeeveryyear a most timestaff, creditable volume of reprintsof scientific contributions. An important innovationis made with respect to travel. Entire classes of studentshave visited our college in Peking and make other expeditions in order to become familiar with local conditions. The Chinesestudentsat Mukden appear to be treatedon a basis of absolute equality with their Japanese companions; whereas,in the Japanese Government School at Seoul (Keijo Medical School), a special and more advanced course is provided for the Japanese which gives them certain privilegesnot enjoyed by the Koreans. The two courses are clearly set forthin the yearly Japanese an-

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nouncement.9 In practical gross anatomy, for instance, the Japanese are given 144 hours and the Koreans only 36. No harmful results of the present regime are noticeable,probably for the the Severance Union Medical reason that a missionaryinstitution, College,gives excellentmedical trainingto classes chiefly composed of Koreans which compensatesso that highlytrained Koreans, as well as Japanese,entermedical practice. The Japanese Government maintains a medical school in Formosa,whichadmits Chinesestudents, and is reportedto be in good condition. The Japanese militaryauthoritieshave closed the formerGermanMedical School at Tsingtau,thoughthe hospital is said to be open. I am told'0 that ProfessorM. Miyajima, of the Kitasato Institute of InfectiousDisease, has recentlyvisited Shanghai in order to report on the advisability of opening there a branch of the Institute. Such action would meet a need which has long been felt for sera of diff erentkinds. A Japaniese society,of whichthe late Marquis Okuma was president,operatesa system of hospitalsin the larger cities,such as Peking, Nanking,Shanghai, etc.,and a new one is now under constructionat Hankow. The entranceto the Dojin Hospital of this society in Peking is shown on page 292. The style of architecture is very characteristicof Japanese buildings in China. While these hospitals are intendedprimarilyfor Japanese residents, and occasionally affordasylum to Chine'sepolitical refugees,they do take in numberof Chinese patientsand serve as active centersfor the dissemination of ideas of western medicine. The cures which are lead the people to doubt the efficacy effected of native Chinese medicinewhich is a stride in the rightdirectionfor dissatisfaction with presentconditionsis the strongestnotive for improvement. Japanese drug stores are widely scattered in many towns China. The drugs are not of the best and morphineis throughout oftensold in disguise,as has been shownin a carefulsurveyundertaken by the "Peking and TientsinTimes" in 1920. But we recall that other nations hold no monopoly of virtue with respect to either opium or patent medicines. The drugs dispensed in these stores at considerableprofitare, at least, improvements on native Chineseremedieswhichare oftenmade up on theprinciplethatthey must be as disgustingas possible in order to frightenaway the evil spirits which cause the disease. The stores will continue to be little clinics whereinformaladvice is given regardingminorailments. Good businessdemandsthatthe proprietors to give attempt
9 I am indebted to Dr. E. T. Hsieh for a translation. 10By Professor Hiroshi Ohshima of the Kyushu Imperial University.

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satisfactionto their customersand not impose upon them to the point of losing theirpatronage. "A little medicineis a dangerous thing" whereit leads to ignoringthe valuable advice of competent physicians; but, in China, where there are so few physicians, a little westernmedicineis certainlybetterthan none at all. It is, in a small way, and weakens the monopoly at least, a competitor of native medicine,which, with its large elements of fancy and exercises,in my opinion,a stronginhibitinginfluence superstition, and action. upon independenceof thouLght In timesof plague and famine,the Japanese are always among the firstto come forwardto help. Just at present there is a tenand to look for hidden motives dency to disparage their efforts which may not exist. When they contributeto famine relief, it is called propaganda; when they erect a new hospital, it is also called propaganda, leading, it is said, directlyto disarmingoppoand eventualcontrolof China sitionand to makingthe penietration easier. Every action in which a selfishmotive cannot be immediately seen is labeled in the same way, and they are not slow to by suspecting the actions of otherforeign returnthe compliment nations. There can be no doubt that many Japanese regard the expendituresof the RockefellerFoundation in China as propaganda pure and simple. An aphorismof the Chinese philosopher, Lao Tzuf"is d propos: "lie who has not faith in othersshall finid no faith in them." This mistrustis lamentablebecause it makes cooperationso very difficult.As a matterof fact, the absence of organized Japanese propaganda in China with attractive concesand maintenanceof cordial relasions aiming at the establishment tions is mostnoticeable. natural and straightforward Japanese help comesin a perfectly way. The Chinese ArmyMedical School in Peking may be in part regarded as an outcome of the repeated demonstrationby the Japanese in North China of the practical value of a really efficient army medical service. Regimentalsurgeonsin the south of China are trained at the Kwangtung Provincial Medical School at Ca-nton, which is below par in both equipmentand personnel. During fromthe headquartersof the Chinese Red Cross officers hostilities, in Peking are occasionally supplied to the southerntroops. in the treatyports and elsewhereare, as Japanese settlements one would expect,growingmuch more rapidly than those of other nations. The in-coming Japanese bring with them improved methodsof sanitationand for the care of the sick whichtheyplace
11

53 pp.

Giles (Lionel), The Sayings of Lao Tzu.

London, John Murray, 1917,

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at the disposal of the Chinese at a price which the Chinese are asually well able to pay. It is not at all a question of charity, which the Chinese findit so difficult to understand. Their schools and hospitals in China, like those of the Chinese Government, are absolutelyfree fromreligious teaching. Conversionto Shintoism is not even a desideratum. The Japanese have numeroustemples in China which can be recognizedby the peculiar arches, called tori, at their entrances, but there is no attempt to demonstrate, or eveni of the formof Buddhism which to suggest,the superiority safe to say that withoutthe trementhey profess. It is, I thilnk, dous force alnd inspirationof the missionarymotive the Japanese have, indirectlyand withoutany spirit of altruLism, accomplished more in the initroduction of modernmedicine than any other nation. Certainlythe results obtained by the non-missionary orgallizatioiis of any country (except perhaps the United States) do -iotbear comparisonwith those of the Japanese. Of the thirteein medical schools -under foreign control (not counting Japanese), eleveinare under missioiiaryauspices, the Medical Departmentof Hongukong is a Government UiJiversity Institutionand the Peking Uniioni Medical College is "sympatheticwith the missionaryspirit aind motive" with six of its thirteentrustees appointed by misIt is to be hoped that the Japanese will adopt the plan of offering scholarshipsor prizes to Chinese students to enable them to study in Japan. To be most effective, these scholarshipsshould come from the Imperial Japan-eseDepartmenitof Education in with the Foreign Office cooperatiorl but commercialorganizations trading in China are in a position to help. If, for instaice, some of the larce firms dealing in medical supplies, comparableto Burrows Wellcome & Co., in England, should offera scholarship to the studenit graduatingat the head of his class in each of the Chiiese provinicial medical schools enabling him to study for a year in a Japanese Imperial University,it would establish cordial relations alnd the firmwould certainlynot be the loser in the long run. This mightpave the way for the establishment of a system of exchangeprofessors-hips betweenJapanese and Chinese Universities. If the Japanese will olnlycoordinateand systematize their imUlluence in the introduction of modern medicinie into China, important results will surely followfor their opportunity is unique.
JAPAN 'S QUALIFICATIONS AS TEACHER sionary societies.

European nations can help China but the help is as nothing compared with what the Japanese are capable of giving. They
VOL. XIV.-19.

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j ,L

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PLAN OF ARRANGEMENT

OF' BUILDINGS OF TIHE SOUTH MEDICAL SCHOOL, MUKDEN

MANCHURIAN RAILWAY

have almost accomplishedthe task which China is beginniing. Seventy-fiveyears ago, the same kind of native medicine was powerful in Japan. With the aid of their stronglyceiltralized government,they have rigorously attacked it and have almost banished it fromthe Empire so that the casual visitorhas to look carefully indeed to find any traces remaining. The pictnresqnie of Old Japan, illustratedso well in a recentnumber priest-doctors of the "National Geographic Mlagazine," are seldom seeii. The with its noisomepreparationshas been old Chinese pharmacopoeia cast aside; and acupuncture,or the art of healing by relievingthe excess of male or female principles through body of the malicoiuis has been made unpopular. An intellectualrevoluneedle-sticking, tion has, in fact, been accomplished. Thanks also to the circumthat the Japanese have borrowed their writing anid their stmnce themculture from Chiiia, it is relativelyeasy for them to mnake selves at home and to uiiderstandlocal conditions. It is fashionbut in Pekiioi Canable now-a-daysto harp on racial differences, mistakeiifor Japanese; anid,when I visited tonese are sometimes

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CHINESE

M1EJ)ICAL EDUCATION

291

politeness to me spoke English, he was at firstmistakenby his for a Chinese. Similarity of this kinid is of fellow-countrymen course exceptional, but it is nionie the less significant. Nobody would long mistake a Europeani for a Chinese. Anid,lastly, the Japaniesehave the advantage of propinqnity. With the establishmentof a inew of faststeamners linle betweein Shanghai anidNagasaki, will be greatlyexpedited. (lose estimiates show that it costs less than-onie tenth as much for C(hinesestuden-ts to obtain a good iii Japani as it does in the United States. UInder medical educiation it is niot theseeirecnmistances surprisingthat some of the provincial goverlnments senidmore studentsto Japan thanido all the rest of
reducing the time of passage to less than. thirty six lhours, travel

the Tokyo Imperial Untiversitywith a Japaniese frienidwho ouit of

NEW LABORA4TORY BUILDING OF THE SOUTH MANCHURIAN RAIL'% AY MIEDICALSCHOOL DEVOTED CHIEFLY TO INSTRUCTIONAND RESEARCH IN TIHE PRECLINICAL SCIENCES

the

w orld put together.

the low travelingexpensesand(siml)lescale of living in Japani finid very attractive. Thoug-h I agr-ee the late Mlarquis withl that it is the rioght Okuiina aindduty of Japanlto aidI Chinia,I do niotfora miomienit a(lvocate in this respect; forif the help of ailythingic approachinga moniopoly, other foreignior lp)ulrsned less vigor, powers are withidrawni, wvith it wouildbe a, very real catasti'ophie. Japan 's contribution canibe made of grreat v-alue in spite of the fact that she is niaturally uniable
12 Dr. Tsanig G. ANiof the Il a gehoj chow, Chekiang.

approxim-ately kinids in Euirope anid Amer-ica as compared with abouit onie hunidred in Japani. who have to save ill-) ani(l pay, their owni wav Stuiden-ts

Chekiani maintainis

T am

iinfoi

med1 that the Prov ince of cut thirty studenits of cliffrci

1'roviiiei1 A (lien I Shool,

1-la l-

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29'2)

THE SCIENTIFIC

MONTHLY

to competeoniaii equal footingwith Westernnationis in the introduction of westernculture and philosopihy. She giv-eswhat she has herself absorbed in the manifold applications of science to humani welfare; but China is such an immensecounitry that there is ample room for all the assistance that can be rendered. The goal is still afar off. As a matterof fact, hardly a becrinninig has made since the rural large yet been population remainis untouched. We have to guard against misplaced optimism. China's traditional inertia will probably preveintthe change from spreading withlightning-like over the nlatioii rapidityas in Japan. A stable and united government is one prerequisiteand Japan can help as none otherto this end if she so desires. The calliiig of the Arms

I~~~~

>

ENTRANCE TO THE DOJIN HOSPITAL,

PEKING

in Washinictoin is in reality a challengfe to the liberal Conifereence to and off of the burden of armain arise throw part party Japani from militaryaggression and political initrigue ments,to refrainin China anid to lead other nationis in a constructive program whichwill eventuallyplace China in a positionto help herselfand her share toward"the welfareof man-kind throughout to conitribute the world." The way is plain-all that is needed to extend Japanese inis to put in priacticea sufficiently and well fluience comprehensive is the key-word. It is, thoughtout programin which cooperationi after all, a problem in racial psychology. Duringr maniy cen-

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CHINESE

MEDICAL

EDUCAT'ION

293

turies China has been the initellectual master of Japan.13 Now a rather delicate adjustmentis required in the mlental attitude of the new teacher as well as the old master. Japan's great success in adapting herself to the outside world, and the outcome of an unequal strugglewith Russia, has bred arrogance,but I amn one of those who believe that whenshe adopts a conciliatoryalid helpful attitude, China will meet her more than half way. Certaill it is that the great masses of Chinla'svast agriculturalpopulation have not yet awakened even to a realization of theirwrongs. They toil with indifference. on in philosophiccalm and regard all foreigners Much depends upoln the spirit in which they,througheducation, slowlycometo develop coherenceand national ideals. In this,also, Japan will play a leading role.
13 Fujikawa 's Geschichte der Medzin in Japan (Tokyo, 1911) is replete with references to Chinese influence in the introduction of imedicine into Japan, particularly during the Tang and Ming dynasties. Not only was medicine introduced by travelers and priest-doctorsbut the Japanese government sent special students to China to study medicine as early as 608 A. D. Not until the coining of Europeanis did Chilneseinfluenice begin to waane.

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