The Westernizing of Chinese Medical Practice Author(s): Charles W. Young Source: The Journal of Race Development, Vol. 4, No.

1 (Jul., 1913), pp. 34-57 Published by: Stable URL: http://www.jstor.org/stable/29737978 . Accessed: 30/09/2013 05:34
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THE WESTERNIZING OF CHINESE MEDICAL PRACTICE

By Charles W. Young, M.D., Professor of Bacteriology and

Pathology, Union Medical

the process considering medical practice, ing of Chinese Before medical Let easy study and

College, Peking
status of the westerniz? to be oriented as

it is well

to what it is that is being changed.

Briefly what is Chinese

It is open mind. Racial prejudice

practice? us approach with this question to ridicule what is not understood.

is not confined to the Chinese and if we take the trouble to

of interest will be the original sources, not only much some of but information value. real Often it is stated found, terms and based on bizarre in strange but the exper? theories, ience tion of centuries is behind methods at Chinese it and medicine parts deserve investiga? by modern In our glance nations of research. it is to be remembered

that Chinese
European the same iums.

civilization

is in the stage occupied by the

in the middle

condition if we Thus

It has been in much ages. of suspended animation for two millen a of it will be view Chinese medicine get

one of that practiced by them in the times of the Greeks and than that it is extremely to note Romans. More interesting run parallel of cosmogony that the theories of the Chinese to those of The each of are the Greeks, on based believed and those that that of the the theories cosmogony. was universe To of pathology illustrate:

Greeks

four elements, viz., earth, air, fire and water, was composed the human quently organism was tive substances. Health conditioned proportion disproportion or balance of these or loss of balance. constituents; These views

of composed conse? and that of these on the disease primi? proper on the

of Empedocles not only the form permeate in a modified (fifth century B.C.) of the Greeks and Romans, but of all writers up pathology 34

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WESTERNIZING to the eighteenth humoral theory,

OF CHINESE MEDICAL To the this was

PRACTICE the

35

century. i.e., that

added

so-called of blood,

and black yellow phlegm, the four elements noted and The ent the four conditions predominence

consist body fluids and that to these correspond and earth, above, fire, air, water and dry. moist of matter, warm, cold, bile; over the others sanguine, little differ? produce or bilious phlegmatic, anatomy. They

of one fluid

viz.; temperaments, and melancholic. choleric The Greeks, Their knew very

of human

feared the dead

burial. of animals,

and

their religion

enjoined

immediate

knowledge including

came from dissection of anatomy and from observations apes, during between that tendons, liga? contained arteries medical cult, in a physician. the guaranteed was of

operations. surgical did not differentiate The ancients nerves. believed and They ments, it to the various air and conveyed While Rome There capacity extremely I have in Greece anyone no were who there was wished could

organs. a well-defined declare

himself

laws, which

of the practitioner, limited. taken time

with, complied and medical responsibility these matters theories

to enumerate to Chinese

because

the striking similarity the with the Greeks,

of five elements, metal, earth, fire, Cor? in turn from the derived each succeeding. wood, water, are conditions the to five these hot, cold, windy, responding or correct pro? on the balance Health depends dry, moist. the there are added Moreover of these elements. portion or female and male, the Yin and Yang, influences, Yin dark and The and (elemental light. positive, negative or the liver, in semi-solid the solid resides viscera, moisture) rules the con? The Yang and kidney. lungs, spleen, heart, small intestine the large intestine, hollow tractile organs, great dual bladder, wood, metal, hollow to The liver corresponds and stomach. gall-bladder to to the the heart the lungs to earth, fire, spleen Each to water. solid organ has a and the kidneys or minister; as its assistant thus the liver is viscus

logy and treatment is composed the universe

As and practices. of cosmogony agreed on, patho? theory are perfectly To the Chinese rational.

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36 assisted the seat The

CHARLES W.

YOUNG the small the large and

by

spleen of the

the gall-bladder, by the stomach, soul;

the heart the lungs of

by by

intestine, intestine

and the kidneys by the urinary bladder.

the gall-bladder

The

liver is the
courage.

temperament, lungs regulate on the examination of the pulse and rests mainly Diagnosis of the face and tongue. the inspection The pulse is palpated are felt care and detail. with wrists The patients' greatest

strength and so on.

in turn by the physician with the three fingers of the opposite

each hand, of organs. of a different the condition pair revealing and differentiate respec? Light heavy palpation and their corresponding between the hollow viscera tively or governing chief types of pulse are solid organs. Fifty-one finger recognized. thirty-seven For the extensive used arsenic, alum, phor, The face appearances treatment of disease materia is minutely inspected. of the tongue. the of Chinese their There have are

in the West, copper ammonium aconite,

medica. Many as calomel and sulphate,

anise, licorice, musk, ginger, orange cinnamon, aloes, gentian, cardamons, peppermint, castor oil, and digitalis. In addition there are many peel, inert or disgusting snakes' e.g., insects, skins, substances, recent and fossil bones of animals, and faeces of men and ani? are not peculiar in this. mals. But the Chinese The London Pharmacopoea, Royal College pearls, oyster ent qualities. faeces human and and was in England, the first by the compiled of Physicians in 1618. It contained crabs' eyes, to have differ? shells, and coral, each supposed It also formulae recommended containing geese growing 1721 were dogs' skulls. and calculi, animals, blind and it, puppies made changes important on excrement, earthworms, other

chloride, cannabis indica,

drugs forms of mercury, sodium iron, sulphur, sulphate, root, cam? rhubarb, pomegranate other

are

a very also

of men, dogs, mice, skull and the moss Not from until edition

earthworms. even that moss the

retained human

contain many Chinese usually prescriptions ingredients, one nine or ten, often fifty. The same was true in the West or two hundred of the The years ago. ingredients prescrip

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WESTERNIZING tion are divided into to our

OF CHINESE MEDICAL the minister and

PRACTICE and subordinate

37

ruler,

basis, adjuvant is popular among the Chinese. Liver, lung Organotherapy are given of those for human disease and kidney of animals ban? of tigers, bears and notorious organs. Gall, especially corresponding dits is eaten to secure tonic. the supreme a son or daughter of a parent. The medicines foreign refined massacre has been of from bones are considered courage. Tigers' flesh is used occasionally, Even human a bit to cure a wasting disease sacrificing ignorant have explained that these the of strength were remedies

corrective.

by supposing victims. The Tientsin the organs of kidnapped It of 1870 grew out of the spread of such reports. common rumor that foreign doctors I have patients. who Personally felt it necessary pluck known out of the an

eyes American

their

physician

to guard

the reputa?

tion of himself and his hospital by requiring the presence of

a responsible of an eye of enucleation friend at the operation rumors. senseless to receive the organ and so guard against the Chinese have At least since the eleventh prac? century were The directions inoculation ticed smallpox. against very minute. into taken contents introduced and rubbed The of The account. season and A wad subject were with the of cotton moistened was case of smallpox a mild condition of the pustule was powdered lack of and of

a pustule from or a dried into the nostril, into but are the nares. have from never lack

Chinese

handicraft

not from been surgeons, of anatomy of knowledge

methods
procedures variously common. two figures mannikins

of stopping the flow of blood.

acupuncture or by applied, The safe spots prepared are still and

Almost

their only

by heat is very Acupuncture scraping. on are indicated 388 in number, counterirritation

These order in 1027 A.D. by imperial I Yuan in the T'ai in use (Imperial

Medical
needles

College)

in Peking.

The

locations

into which

and include the joints, abdomen, be introduced may his to rendered have is said An ancient patients surgeon eye. The name them medicine anaesthetic internally. by giving

of this drug is not given but it is supposed to have been

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38 Indian to

CHARLES W.

YOUNG Chinese to our do use coroners. the latter Their

The hemp or hyocyamus. induce sleep. has officials China corresponding on an official Europe many

is based training ?a time at which Although

it contains a few centuries the of the body

in 1248 A.D. codex published of the kind. nothing possessed in absurd tests such as abounded some of shrewd methods death. Only the

Europe of determining exterior Medical Physicians diviners with

ago, it also has cause or manner is examined.

practice are considered and school

is ranked a teachers.

in China. low among the callings but little above below priests

the medical

of successful generations physi? from the start. be greater cians, probably reputation are made visits invitation and Professional only on specific are likely to be called in rapid succession, several physicians his will and discarded The with their and the treatment cessful. careful Fees are bearing observation small and of bargaining. of this unless on cases that can immediately time require be suc? and

enced practitioner can point back to several

a familiarity After gaining an with an experi? classics, apprenticeship If the novitiate is considered necessary.

supervision cost of treatment ethics

subject are not cians

Medical

appreciated. is likely to be the it must be confessed that causes physi? on A work

very high. Probably in comparatively to be held

it is this

low esteem.

medical

ethics published during the Ming

dynasty

says:

a patient is severely ill, treat him as thou wouldest wish When to be treated thyself. If thou art called to a consultation, go at once and do not delay. If he ask thee for medicine, give it to him at once and do not ask if he be rich or poor. Use thy heart always to save life and to please all; so will thine own happiness be exalted. In the midst of the darkness of the world be sure there is someone who is protecting thee. When thou art called to an acute illness and thinkest with all thy might of nothing but making money out if thy heart be nor filled with love of thy neighbor, of the patient, be sure that in the world there is someone who will punish thee.

This is good, but with

it contrast the Hippocratic

oath:

I swear by Apollo the physician, and iEsculapius and Hygiea and Panacea and all the gods and goddesses, that according to my I will keep this oath and this stipulation ability and judgment,

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WESTERNIZING

OF CHINESE MEDICAL

PRACTICE

39

. I will follow the system of regimen which, accord? I consider for the benefit of my ing to my ability and judgment, and abstain from whatever is deleterious and mischievous. patients, I will give no deadly medicine to anyone if asked, nor suggest any I will not give to any woman a such counsel; and in like manner I to produce abortion. With pessary purity and with holiness what? will pass my life and practice my art.Into ever houses I enter, I will go into them for the benefit of the sick, and corruption; and will abstain from every act of mischief and, of freemen and of females or males, further, from the seduction in connection with my professional slaves. Whatever, practice or not, in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge as reckoning I keep this oath un vio? that all such should be kept secret. While lated, may it be granted to me to enjoy life and the practice of the But if I should trespass and art, respected by all men in all times! violate this oath, may the reverse be my lot !

We must remember that it is the spirit of Hippocrates

has animated

that

in the West from the earliest the profession To it from becoming times and has preserved mercenary. us it with to the plane in China elevate medicine occupies is one of the great tasks before us. While in China tioner

a medical become anyone may practi? are some restrictions. out his there shingle, by hanging that code orders 297 of the criminal Section medicine an unskillful in administering Whenever practitioner to the estab? or using the puncturing contrary needle, proceeds lished forms, and thereby causes the death of a patient, the magis? or to examine the medicine trate shall call in other practitioners and if it appears that the injury done was uninten? the wound, shall then be treated according to the statute tional the practitioner and shall not be any longer allowed to for accidental homicides, if he depart from the estab? But medicine. designedly practise in to cure the malady in his attempt lished forms, and deceives to its amount, he shall then according order to obtain property, be treated as a thief; and if death ensure from his malpractice, then, for thus having used medicine with intent to kill, he shall be Middle Kingdom). inWilliams' beheaded (translation A and has few years examination ago a law was enacted requiring but western medicine of all practicing

registration not been enforced.

it

It is said that during the T'ang Dynasty (618-907 A.D.) medical schools flourished throughout the empire but they
have disappeared, the only trace being the T'ai I Yuan or

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40

CHARLES W.

YOUNG

Imperial Medical College in Peking.

the court opportunity nine physicians, affect the pulse cold; eases; diseases While there those those physicians of study. and also In

This institution trains

other the are that from dis? eyes; of the

specialists

gives practitioners the Imperial Court there in the nine classes of diseases viz.: those and those from diseases lastly arising cutaneous of the diseases

violently from female

or feebly; diseases;

acupuncture; requiring and its parts; of the mouth

bones (Williams' Middle Kingdom).

purpose. a patient to the physician, is cured he often presents When a laudatory This bears a quotation from the classics tablet. or is couched classical It is a testi? in the flowery language. monial ;and the front, as well as the interior of the house of the This method of these boards. is hung with many physician a career successful rather than licensing is that of announcing the trained but and untried novitiate. that There is some reason in up the be not is a it is natural it should have grown or licensing of examination at may but us) there are no medical diplomas answers much is a custom which or licenses the same in China,

the practice there where

is no system of end the preliminary training. to those who has been said thus far applies What Besides called ethical Chinese these, physicians. case is from with marked them also the (as sharply of who

the army charlatans, great by vehemently affirming or of their wares, their great wisdom, excellence by psychologi? of those the in the West delude cally the same methods ignorant. medicine. or another It is this class The best that gives is painfully choose, the worst inadequate, belongs the name but third or to Chinese this, like

ours, is limited only by the gullibility of its dupes.

class, as you priests. practitioners?the for their sought with the suppliant burning temples Many cures and often

To this

of group are shrines

are hung thick reputed the scrolls above mentioned. Usually lauditory and then holding drops his fee into the receptacle, in his hands, before incense himself the prostrates a bam? then draws He object of devotion. the bundle The the presented by priest. a to of that formula printed slip corresponds

image or other boo slip from number on the

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WESTERNIZING on a rack nearby. some but cults

OF CHINESE MEDICAL This is taken

PRACTICE

41

prescription

to any druggist

who fills it. Essentially

this is not greatly different

from
today, shrines

in any of our own cities that may be met us of reminds the miracle-working it especially on Chinese some medicine has been

of Europe. This description order phere The Asia

that we may have into which western record of the

understanding is being medicine introduced. contact of China with western early imperfect still more that in the physicians and so. that The of the earliest

in given of the atmos?

is very and Europe medicine tion of western records Kahn .... in one man show

introduc? account

that I can find of western physicians

Persian Great "This which Fuh-Lin actually sequently Peking Parker's opened The certain K'ang that was had Christian

in China
attached

is that the
the century to his court.

thirteenth

place

is interesting says that Aisie

for the Mongol (perhaps

a linguist, astrologer (Frank) asserts Khan that he served Kyuk in 1263 was chief physician called the p.

history, Isaiah) was a and physician, and that sub? to Kub

and astrologer

lai; in 1273 he is once styled aMussulman

officially and Religion, China in 1272. are much fathers who Broad 181).

and his hospital at

Charity." (E. H. was This hospital the to It services the court is recorded of of

records Jesuit

clearer were from

regarding attached to 1723.

Hsi, who reigned of an attack of fever in 1692 they cured the emperor This cure of by his own doctors. after his life was despaired was was by means tried on of quinine. The new medicine several taste western it. of the The courtiers before attempt by means the to the emperor was permitted same of the "to introduce emperor of a translation P. Jesuit of the anatomy was frustrated

1662

anatomy of Pierre Dionis through

by the opposition

Perennin, of the native doctors" i, p. 63). to Peking

History

Ripa of K'ang

of Medicine, (p. 42-43) who tells

vol. went

(Neuberger's In his memoirs, Father as an artist in the court

the twen? of a lay brother who attended Hsi, son of the emperor and gave a favorable tieth prognosis, so cuffed and beaten He was but the boy died. "kicked,

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42 severely by the ill." He further

CHARLES W.

YOUNG

of the emperor that he fell seriously some medical with says, "I was acquainted one of the imperial men who and were attended family," treatment. and for unsuccessful imprisoned Taught flogged other occurrences, the Jesuits who were by these and many order as mathematicians, watch? painters, never would in other under? surgeons, makers, capacities But he records that Father take to serve him as physicians. as surgeon. to Jehol Rod the same emperor accompanied " fell from his horse and was treated by a Tar? Father Ripa in the emperor's service and descrip? I was cured tion, and some of the remedies appeared useless, Because in a very of fear of encroachment short time." to which the Roman Catho? by the countries they belonged, were from the country. lic missionaries driven next The the He says, "to confess (p. 67). surgeon" was a of treatment of barbarous mode the though tar truth, al?

contact with theWest began with the East India Company in

Canton. nation cine Robert opened In 1805 Mr. at Canton institution and Alexander before he Pearson left in 1832 years Fifteen Protestant introduced vacci? saw a large vac? later, (1820), to China, with Mr.

established. the first

Morrison, a dispensary

for Chinese to the East

missionary in connection India

Livingstone, conducted 1827, Mr.

surgeon by Chinese T. R.

of practitioners also surgeon Colledge, and conducted

It was Company. In the old school. to the East India It

opened Company was supported by the Company than 6000 cases, diseases More especially of its existence. in the five years treated

a hospital at Macao. and by private merchants. of His the

eye were ser? greater

was his advocacy to the missionary societies vice, perhaps, as use in All of work. of the pioneers missionary physicians were British, it that have been mentioned but these men of for an American Board the American remained Society, Commissioners cal missionary who M.D., 1834. for Foreign to China. an Parker, in December, ophthalmic hospital grew the Medical Society Missionary three years and which still continues later, In 1852, Dr. Parker was appointed Missions, This was to send the Rev. the first medi? Peter

opened From his work

in China, founded in Canton. its good work

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WESTERNIZING United States minister

OF CHINESE MEDICAL to China. for cystic not limited at His

PRACTICE was

43 Dr.

successor

of J. G. Kerr, record of 1400

the American operations was

Presbyterian

whose Mission, is second calculi, only

to that of SirWilliam Thompson.

Society Missionary but was the pioneer Missionary Hongkong the first British Dr. William work and in Macao,

The work of theMedical

that time to Canton, and American with British in cooperation in in Societies, locating physicians Amoy, Ningpo In this connection, of and Shanghai. the name medical missionary who arrived should be mentioned? in 1839 and began his to Hongkong, Chusan, Shanghai over In twenty years he treated men Dr. these early Hobson,

Lockhart, later going to Peking. eventually

Among on should be noted Society, Missionary a of translation. In 1850, he prepared account of his work one on air, light, heat on anatomy and physiology; work of astronomy and the elements and electricity, and natural on as as the of others and well principles practice history; 200,000 patients. also of the London surgery, practice English abortive were into Canton printed but West, Christian Medical It of children, and on the an the last with medica, With the of the and Chinese vocabulary. exception Perennin under K'ang effort of Father these Hsi, on mid-wifery of medicine and diseases and materia the translation "Shortly of western after the science appearance of the viceroy they were with the and to the

at attempts the Chinese language. the first and

of the first

of the series, it was re-published by Later then by Chinese publishers." to intercourse in Japan, then just opened all reference to their western were ether contained that origin omitted first

religion in China). Missions to note is of interest in Canton in Boston Society and for

(Lockhart's used as an

was

anaesthetic stration sionary

form.

in 1847, the year that the report notes the

its demon? following of the Medical Mis? first use of chloro?

1848-49

After new

of medical the beginning as fast cities were opened of foreigners. The to reside missionaries

in Canton, work missionary as the treaties the permitted treaty in any of Tientsin part of China in 1858 and a

residence allowed

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44

CHARLES W.

YOUNG until every

of the work rapid expansion has its physicians, hospitals are well these hospitals places is being done under very missionaries efforts of medical number, western where, centers has The the for with men

followed and

equipped; unfavorable

dispensaries. in others conditions. because

province In some fair work The out?

are noted

they

many times, all the other qualified are and because medicine they forming, where like their clerical and the

of practitioners scattered every?

colleagues, of China with modern ideas leavening on as by no other agency. carried and is being been, in the aggregate may be judged from extent of their work from the 415 medical returns missionaries incomplete 1910. The year figures about 6700 beds, representing and their assistants and women cover 126 hospitals 175 physicians. These only

education

the

treated 51,121 inpatients in the dispen? in their hospitals and 1,548,707 outpatients The last number homes. saries, on tours, and in the patients' the number of each both first and return visits, represents From these figures it can be seen the same. being nearly must in bringing be exerting as well as the to the masses a

an influence these workers what a knowledge of western medicine classes further By to give this of China. These part in the I do not mean full medical every helpers. doctor

and dispensaries have hospitals same work, of assistants. in the training those courses. that are attempting hospitals From lack of sufficient medical

colleges, his own until to

or more in government dispensaries to western to and medi? open drug shops practice frequently, no on own accounts. is There their cine medical practice this. These men are often no credit to their law to prevent teachers them cessful off. and On efficient any moderately some the other hand, and wide reputations. contact with unlike have ago our law should of them the West contributions cut many very of suc? have

they have take up positions

to a large extent, to train is compelled a men Often these few years, stay only a smattering of knowledge, and then leave

practices

medical Unfortunately bad as well as good?not directions. Few quacks far, though several years

has brought in other

established the Chinese

thus themselves was relieved public

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WESTERNIZING of considerable to be deplored ing exploitation liams' Pink Pills

OF CHINESE MEDICAL an "electric belt"

PRACTICE fakir.1 More

45

money by than quacks of patent and Doan's

is the rapidly at present medicines. and proprietary

extend? Wil?

great offenders) together are found advertised and the

two Beans (to mention Kidney nostrums with a legion of Japanese sold Chinese Many to believe that and pay $2.50

specious reading remedies these are western

everywhere. are led testimonials, of accepted show worth

for six bottles

of the British ate in this of iron and

of Williams'
to cost about

Pink Pills which

10 cents. these We

the analyses
of carbon? a is

Medical

Association

to consist

country against now opening to that they turn to the countries and commerce to ply their trade where western publicity some for time. not them trouble laws food may pure fight no wonder The opened maintained years. Some Chinese in several two government, cities, national or or in more hospitals has provincial, cases dispen?

enemies

are beginning of health. It

saries. The

board of the interior (Men Ch?ng Pu) has

of for a number in Peking large dispensaries there daily. of patients 'are treated hundreds the old style Chinese choose between practise am three times as I told that about medicine. the with former as the latter, ailments. for medical especially fact that there The

They may and western choose many as contrasted are no wards

surgical the neces? where for inpatients they can receive for in the accounts disproportion. sary after treatment part of surgical the number In hospitals conducted by foreigners, cases is much the medical than the among inpatients. greater this brings us to an interesting fact; namely, that while

And
1 Mr.

as an expert in his address referred to whom Mr. Bland C. B. Towns, to the borderline of legitimate of the opium habit, belonged a secret to he took business. Without remedy any medical knowledge, it from to purchase the Chinese to persuade and China tried government the not be left with should this conference I mention this because him. in the treatment idea ment take that Mr. was Bland insincere meant evidently in its attempts govern? i.e., that the Chinese not it would reform because opium it should be said that Mr. Town's Further to imply, at

remedy, a drug man, general

offered. advice when expert the formula for which which himself use

as its active contains is now known, agent, this in unskilled be exceedingly yet hands, may dangerous for to scatter it abroad medical without training, proposed in the hands of the laity.

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46 the Chinese realize

CHARLES W. that western there

YOUNG

superior I believe them, the old Chinese for this are nor

to their

own it may school

that

is so infinitely surgery is no comparison, of many of them, as yet prefer be said most reasons for internal The diseases. no is no Chinese There surgery; nor nor pathology; no antisepsis nor means It is of haemostasis. seems almost miraculous surgery The of medicine it is different. not feel He the pulse cannot with the extreme the con? There? is much with what

knowledge asepsis,

fairly clear. of anatomy

anaesthetics, easy to see why western In the case to them. care physician of his Oriental does

western dition

of all the internal

fore, in the eyes inferior. Moreover, his patients which diseases the know belong hot, cold, whether

diagnose alone. organs by this means of the Chinese his skill of most he does are not use He the familiar.

confrere.

terminology does not know

to to the Yang, which even not He does moist, dry and windy. are contrary to the in nature his remedies to the Yin and which

disease abstinence

for which from

physicians and sometimes

He does not require partial they given. as the Chinese treatment under food while uses he unheard do. of, Moreover, frequently of diagnosis and treat? methods repugnant to expose the part of the body the patient and listens to what it may be; he thumps body. He uses cure cold baths in fevers

he requires ment; no matter affected and examines that

the whole his own

?whoever
believes than have westerner

heard of such a thing!

physicians doctor. Very last resort his case

And finally the Chinese

as many he frequently as or more goes to the doctors the native Chinese success habit in those

the western only

as a

after

all

pronounced of going from one doctor which when It is almost

The hopeless. to another prevents

diseases

patient

stay, perhaps The fact is out of the question. such treatment do not produce as cases. in surgical In statistics reliable systems,

and treatment. long careful watching require an in a to to become Chinese get impossible one can only promise him that after a long cure but that a perfect be improved, he may is that western cures methods in medical the two The of startling of the results comparing are almost unobtainable.

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WESTERNIZING ones available

OF CHINESE MEDICAL are those

PRACTICE and Maxwell

47

only

given

by Jeffreys

in their book Diseases of China for the Tung Wah Hospital, Hongkong for 1905. These show
General ADMISSIONS NET TOTALTREATED Western treatment Number. Per * cent. Per cent of deaths Chinese treatment Total Western treatment Chinese treatment Total diseases

1237
50.6 among

1209
49.4 admissions

2446

370
*29.91

477
*39.45 service.

847

to respective

The extremely high mortality

cover

in this hospital shows that

disease for the If this

a period of severe either the figures epidemic or that only extremely were ill patients admitted, rate is about ten times that in most death hospitals. ence main oughly patients Aside for the

less differ? is the case, the method makes much of treatment than in less critical for most will here die cases, regard? of the measures less of the care and wisdom taken. The interest lies in the fact that in as thor? the figures as as many a Hongkong foreignized practically city of treatment. choose the old as the new method of

from general hospitals, others have been established of lepers, and two for the insane. treatment Of the is that opened by Dr. Kerr in latter the first and best known in 1898. is a government in Canton The second hospital Peking western there lent treatment Great methods Chinese erly entirely trained is not under Chinese control and So Chinese physician. a single devoted institution exclusively of tuberculosis, that disease is more though than been benefits and women evolution to that in Europe the work of western out and America. of hospitals medicine, their and dispensaries part prop? art of trained in charge of a am as I far aware, to the preva?

in China

as has and men

conducted by foreigners in the diffusion of a knowledge of the

a greater

must be played by the educational institutions that will send

equipped The healing. very similar to demonstrate among the own people, science and the in China colleges At first men

of medical in America.

has been

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48

CHARLES W.

YOUNG

abroad held the field.

by what assisting be might a qualified teachers of

Then they obtained their knowledge

with were and estab? but

termed

apprenticeship?reading Later schools practitioner. of which were time to

lished, the who gave

their part Only in America have there been medical recently colleges where in subjects like physiology, and pathology, the anatomy to teaching. instructors have devoted their time exclusively are found in China of medical All these varieties instruction but come to the stage where a full have colleges commonest is offered. The of instruc? variety one or two men, more tion is where than busy with the care and dispensary, to train of a hospital take a few students as on assistants. to them lecture them They anatomy, very curriculum few

practicing physicians class instruction.

physiology

and the other fundamental subjects usually as into and Chinese go translating they colloquial probably or un? term where the Chinese is lacking the English using Men of their of the are trained teachers. fundamental Those in this way Naturally, natural who have the virtues and the first they know nothing on which modern sciences are gifted come to take fair

known. vices hand medicine

is based.

histories, but usually cians and

fair to good anaesthetists, good operators, with and are poor diagnosti? faulty technique, Their faults are that they do most prescribers.

and do not understand of the rationale things by imitation, know master the proceeding. that this the They gives are apparently under what the circum? drug or that mixture stances treatment. try to learn formulas demanding They and prescriptions rather than to diagnose by careful observa? In short, they are empyrics, tion and elimination. the result of didactic instruction. Their vices are the vices of the sys? tem or lack of system under which and the they are trained, is the result of the stage of development of education system in China. It is easy fully emerged can measure definition least to condemn from them the the conditions but America few schools has not in China herself.

to up of a medical

six professors

Very Association's Medical "at college, i.e., an institution having to their time medical entire giving work, American

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WESTERNIZING

OF CHINESE MEDICAL

PRACTICE

49

a graded course of four full years of college grade in medicine not for admission less than four and requiring the usual or or school its of academic years preparation high equiva? lent None are About in addition has reached or grammar to pre-academic school studies." on Medi? of the Council the new standard Medical and more Association. or less Several

cal Education doing ten

of the American fair work schools

generous colleges. teachers.

improving rapidly. societies established by by missionary of be called the definition medical may stretching one of these has a staff of ten or more Only

com? a teacher in that one perhaps Being myself so to turn I invidious that parisons may be considered prefer to the judgment of others as to the present status of medical In Dr. R. Edwards, in of Martin China. the report colleges who in China, last year, he says, "Of and published the schools which have been established by the missionary in Peking School forces, the Union Medical gives the great? est promise. It has a good foundation in buildings, equip? ment and professorial staff. In Shanghai, the St. John's spied cal School out the land for the location of the Harvard Medi?

University

Medical

School has been established,

only college men its work. There with

but

its

admitting requirement has limited ing largely a small as school ment chow,

of two years' stand? is now in Hankow practically no equip?

along struggling or men. to buildings

have similar an The diffi? equipment." entirely inadequate working are two: First, is inade? education culties the preliminary are too and the staffs and usually quate; second, equipment of edu? condition Both are due to the undeveloped meagre. are where America in China. cational institutions They and Canton with Mis? The China Medical ago. more and of hundred four the composed sionary of medical has drawn medical missionaries up a policy to see carried out. It has recom? it hopes education which was two decades or more Association mended that be concentrated south, north, and that the education medical for the present, missionary one union college in each the in five centers, of the country, and central parts east, west that is, Mandarin, instruction be in Chinese;

Foo Soochow, Hangchow, all so-called medical schools,

THE JOURNALOF RACE DEVELOPMENT,VOL. 4, NO. 1, 1913

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50 except in Canton. Chentu

CHARLES W.

YOUNG this means, There

Nanking, in operation either cities except Canton, The have kow, copal as the

Practically, and Hankow. or under where

Peking, Canton, are such schools

three Wuhan cities a small school conducted and another across in Wuchang. the Church

in each of these organization a union is not yet consummated. Han Yang, Wuchang) (Hankow, in Han? by the two societies river under the American Epis? center This has been great

selected by the movement

headed by Lord William

Cecil

If site of the Oxford-Cambridge scheme. University an adequate medical and when this plan materializes, college from these five centers will be a part of it. Aside certainly designated by the and those mentioned Union Medical China Medical by Dr. at Chinanfu, with three Shantung and two lecturers. There is one at The only mission? five teachers. as the teaching are St. medium has now affiliated with the Har? Association Missionary in his report, there is a Edwards

permanent with Mukden, Manchuria, ary schools using English in Shanghai, John's which

College instructors

vard Medical School in China; and the University Medical School, affiliated with the Canton Christian College. Aside
from noted. has course a medical the been colleges mentioned, With chracteristic started in that may be a German school thoroughness a which Shanghai preparatory gives others and This then there are

in the German

is course, a of to and the German make Germany lan? part campaign factors in the Far East than they are at present. guage greater In Canton the French have a school with three professors. Their into Chinese?a interpreted thoroughly a method. semi? unsatisfactory Hongkong University, official institution will have a good medi? organized, recently lectures are

and in the sciences language seven years. the whole covering

cal department.
exert

Although

it is in British territory, it must

a large influence in South China. The Japanese have or are four three schools in but opened China, they purely ventures commen?ai and the less said about them the better. are for men. are two mis? All the schools mentioned There sionary medical colleges for women. One is in Canton.

The other, the Union Medical College forWomen

in Peking,

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WESTERNIZING

OF CHINESE MEDICAL The as curriculum Union

PRACTICE and some

51 of the

a six year course. gives are the same teachers (for men), Peking.

in the referred that

Medical

College notice universi? University is

Although they have been due to the marked interest ties was which have taken in education

to indirectly, several American Yale

in China. work

the first, and in 1903, opened had been selected as a site. work has been F. C. Yen, the been organized. its Young

medical and Dr. yet

in Changsha, Hunan, to the present, although Up under Dr. E. H. Hume conducted college has not

medical contemplated of The University Christian

through men

Men's

Association,

Pennsylvania, affiliated

itself with the Canton Christian College and now has three
Prince? School. Medical the University conducting mans of the Young Men's work ton University the whole in Peking, is no medical there but Christian Association in England Universities work. Oxford and Cambridge plan or one of the other Wuhan at Hankow to start a University A cooperation. sought American they have last and The scheme. of the be would part college which to enter the field is Harvard University, largest project men now seven in Shanghai. The medical has department cities. In this of St. Harvard John's and University School Medical to conduct has been in China. a medical amalgamated It plans with to teach the in

medical

a training school college, English a research labora? for for municipal officers health China, courses for foreign and post-graduate physicians? tory, men? a an ambitious institutions few of the program. Only ated St. John's University confer degrees. in the United and consequently States same is true of a few others. The foreign. tioned the is incorpor? are its degrees a This is part

of extraterritoriality

plate following tion and one that will

some new institutions contem? and while a wrong same course it is, I believe, posi? be untenable within has a few years when

varieties Only disappeared. extraterritoriality in Peking one school, Medical the Union enjoys College that is its gradu? of the Chinese the recognition government, ates receive from the board of education. certificates By a the of of the government, diplomas republican change policy

of other

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52

CHARLES W.

YOUNG

issued by the college itself will receive the stamp of the board
of education This has in the covers future. what has been Very done little for China. What as yet. The pro? fairly China done

for herself?

gram laid down by the imperial edict of 1909 contemplated

a hospital as school and medical in every provincial capital in in well as a medical the department Imperial University of like Man? other paper reforms the many This, Peking. was never chu government, out. the carried Practically only medical education conducted by the government are

the two colleges in Tientsin?the and the Army Medical College.

or four French

Pei Yang Medical College The first is taught by three

an equal number of and about physicians of the school. of instruc? Chinese The medium graduates tion is English. instruc? The second formerly had Japanese own were lectures in their whose tors, language interpreted into Chinese. written Having in the The textbooks were those used slightly modified the Japanese to use English is about Chinese in Japan, i.e., classical language.

the Army Medical staff, as its College language. teaching for the army and navy, These schools train the surgeons of the first and older but some of their graduates, especially dismissed institutions tions. This in brings us to a consideration medicine of the in China. western language medium It is a question the China Med? favors instruc? the are now in civil and non-medical official posi?

is no unanimity. Strangely ical Missionary Association foreigners, representing Chinese for the conversational parts of the colloquial tion and the easy classical has Chinese government has been forced and the style decreed for text that books; all science,

teaching in which there

while

including

medicine
cation

shall be taught in English.

into this position lack of technical

The

board of edu?

lack of teachers

The instructors language. of the other higher branches are foreigners universities cans. go They to teach learning out under in Chinese

the by two factors, terms in the Chinese in the sciences as well as in many and colleges and Ameri? English especially so that a three-year contract, in the government is out of the question. English

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WESTERNIZING

OF CHINESE MEDICAL

PRACTICE

53

is the foreign language of the Orient and it is fast becoming

true knows work that no man can of it. consider The himself second There educated factor, has been unless he of something terms is also difficult. technical on the the matter

of technical terms, compilation not for a long time. the natural sciences and may reached to it is improper of rules the the Chinese By language, new It create new characters, to would coin words. i.e., be new words to making to the dead languages is to combine where in a modern for the roots. language What

a desultory but it has not

equivalent without going must the be done

requisite meaning, to express the suffice choice of say forty thousand which tive, together is that what originated with when

so as to give characters existing a single does not ideograph one to a is Thus confined thought. characters was of the with their meanings primi? difficulty word with the world comparatively same. The

combinations

to a polysyllabic correspond a definition us becomes a string of characters in fact, ex? in what must The result is some? be lucid Chinese. pressed would times weird. literation the sound is that beside A short of the sound is the trans? cut but worse expedient the trouble Here of the foreign word. no to the uninitiated meaning absolutely characters and what vary be a fair in different imitation

having of different values

in country might parts In one place would in another. have little resemblance the difficulties, the modern say about spite of what we may new sun on on every writers the under go coining subject of them are very pat. and many terms (not new characters) same will be done in time. It should be in medicine The of the can if suitable men commission by a government com? a if well done, for it It is very difficult task be found. a thor? of Chinese bines an extensive characters, knowledge are terms of the science whose technical knowledge ough undertaken translated, uses just Perhaps a wait and nese which and that masterly e.g., medicine, quality to express each shade of meaning. the right word can be found now; perhaps we shall have to the men met the same difficulties The few years. Japanese them as far as they They began have by been teaching solved, as the Chi? technical subjects

solved

are doing.

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54 in the in that language

CHARLES W.

YOUNG they took as their model and I fell to German technical The parts

of the country which branch. Medicine particular that are even

understand of medicine use much might terms

the Chinese of their be asked or even

yet some of the most studied in that language. classical language, having from China the Chinese

Japanese it with derived ago. It

culture

the Japanese Chinese do, so that unusual characters; or shall we pleasing

why Japanese is that textbooks. the Japanese The answer use many in other senses than the characters literary from the Chinese say correct, standpoint. of the used many have transliterations terms, accurate perhaps when pronounced when sound given the Chinese as I have China sounds. pointed Medical values, The the meaning and their is not whole clear; they use many is not style

centuries many do not use the

Moreover, they sounds of foreign in Japanese, but meaningless And moreover, out, are not Missionary that a the same

the Chinese

their view? agree with must China like great country ultimately point, or and write about technical every subject, study otherwise, in their own language, have taken the bull by the horns and an English-Chinese cover? Medical have compiled Lexicon, Association ing the editions commoner appear. Some rules medical It has of Chinese terms some and will faults. composition add Some to it as new terms are are

everywhere. and those who

poor.

occasionally

broken, but it is a step in the right direction. tried by fire and the good will remain.
And ature more's Jesuit wrote 1900 Medical

It will be

this brings us to the subject of modern medical liter? a not in the Chinese It is language. large subject, I have noted the pity. of a the abortive attempt an to translate father and the more fruit? anatomy, of Dr. Hobson several that most treatises, has been in Canton. as did several done. The Dr. of Canton, Kerr, it is since but others, now translated

ful labors

works

and published by the publication

titles, of medicine. are being Missionary including most Other translated. Association

committee of the China

comprise twenty-three but not all of the fundamental branches are in the press and still others books Within a few years when China

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WESTERNIZING has men in the At the of her own

OF CHINESE MEDICAL trained

PRACTICE and

55 in

in the other

sciences,

thoroughly the Chinese

in medicine

colleges. government of whether is is a question present technicalities

language will be employed Of that there can be no doubt. it is better to make the

student do the work of getting sufficient English

to grasp

training, who he do not understand because countrymen English, to has no technical Chinese make the teacher learn terms; or, in medicine with and create a literature the help, of course, see that the style In is correct. who of Chinese teachers, our own college Chinese we require the students to have unless some knowl? excused for

of medicine, and after he has obtained the to his to transmit what he has learned be unable

edge of English and to continue the study of both that and

classical special proficiency. as students in this country ary language for collateral that we are antici? French reading and I believe all schools a that will prevail in nearly the condition pating to study in a foreign those who wish few years hence, when language land. West will seek than also the greater years Chinese facilities of some foreign to the record their course throughout The aim is to make a second? English and have German

For more the first London

fifty

for medical to take

training. a degree was Dr. Wang

have been going as I can find any So far Fen, who

graduated

at Edinborough

in 1857. He

offered his services to the

in charge in Canton of Chinese of the hospital for a number have studied

Society Missionary of the Medical Missionary Society Since then a number of years. and America. in Europe since 1900 and students that have

and was

both nese

to America

the great influx of Chi? since the migrations especially from the return of the Boxer resulted With the number has increased. has a students supervising two medicine, sanitary stand

States, by the United indemnity time the bureau At the present record neering Finally, estimate moment in China of seven and of one the where at which now studying

engi?

sanitary chemistry. does western medicine Chinese? That depends

The you speak. at present is stupendous.

change It is safe to say

in the today on the precise that is going on that the

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56 officials western preceding

CHARLES W.

YOUNG come in the into close contact than with in the

and upper classes have ideas and culture more

last decade

more and that the last year has meant in century than ten. It to is the needless that say progress preceding a tithe of what had known if the Chinese it does government now, the Boxer but There delusion would have been all impossible. the recent their viceroy Plague There

are still old officials who did not learn anything

convulsion about. Let me churia are are wondering what are others who of Hsi revising

from that
fuss opinions. of Man? Confer? is

quote from the address at the opening of the

Liang, International

ence inMukden

in April, 1911:

in an ancient system of We Chinese have for a long time believed medical practice, which the experience of centuries has found to be for many ailments, but the lessons taught by this epi? serviceable in ago had been unknown demic, which until three or four months China, have been great, and have compelled several of us to revise our former ideas of this valuable branch of knowledge. We feel science must go hand in hand with that the progress of medical of learning, and that if railways, the advancement telegraphs, inventions are indispensable to the electric light and other modern material welfare of this country, we should also make use of the resources of western medicine for the benefit of the wonderful trust and believe too, that modern medi? people.I science will in future receive more cine and especially sanitary in this country than it has hitherto done, and we shall be attention to deal with similar epidemics when they arise. better prepared My great regret is that as many as 40,000 lives have been lost in these Provinces, especially including those of some of our foreign to duty and the welfare of our doctors, whose unselfish devotion remember. I shall always people At the first graduation exercises address. He of the Union said in part: Medical

College
T'ung

in Peking
gave

in April

1911, the Privy Councillor Na

the principal

There is abundant proof that neglect of the laws of sanitation care have brought of proper medical and absence about more deaths of officers and men in the fiercest of modern warfare than the destructive of war. What is power of the terrible weapons true in times of war is no less true in the times of peace. We have in the pneumonic just had an illustration plague which raged so Manchuria.In fiercely in fighting against the plague ?and the battle was a splendid one?the found that government it did not have a sufficient number of doctors available to do the

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WESTERNIZING work

OF CHINESE MEDICAL

PRACTICE

57

and a call for volunteers was issued. Among others, several professors and students of your college responded and at once left for Harbin, where the plague was seen in its worst form. Leaving self and family out of consideration, they thought only of the good that their duty they remembered they could do, and as doctors And it is this and death: and ambition was to fight disease spirit, I believe, should inspire you throughout your lives, the spirit of service and sacrifice. Within the when in the the year their case referred revolution. 1911, own of the Chinese were government insufficient. twice

sought the cooperation

Peking first was

of the Union Medical

resources the epidemic to by Na T'ung The imperial

College

in

The

in Manchuria

in pneumonic plague and the second was

corps army medical during Medi? was altogether and desired the task for the inadequate in the affirmative to cooperate. The cal College reply was a and that could be organized Red Cross Society provided would the imperial government apply the rules of the Geneva Convention a month could rules about and to the treatment of the most to do three went of wounded active in the with front. rebels. end nine Aside these It before took of the time hostilities they civilized and this if re? there

be persuaded and prevailed students

so, but companies to the

teachers from

forty the efforts of other Red Cross Societies missionaries their ever there were medical were filled army with wounded. corps work Cross Society On the but medical the Red

in China

where

quired was little tions panies these

hospitals rebel side

including to the scene two visitations the

of hostilities.

several organiza? sent com? in Shanghai service during The public has western greatly is medicine on one heard aided

After the plague demonstration. in medi? of reform of the side officials among every necessity There is of public health. and in supervision cal education move new will no question but that the rapidly government now at work and and that the institutions in this direction many others will will be needed establish China. to those that the with to cooperate and public train physicians

in showing by actual

of pestilence in China officials

and war what

government health officers

for new

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