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An historical sketch of medicine and obstetrics in China

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An historical sketch of medicine and obstetrics in China

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Content HISTORICAL SKETCH
OF
MEDICIHE AND OBST^ETRICS IN CHINA
'Sl
X-tiW
Â T h e s is
P r e s e n t e d to th e D epartm ent o f H is to r y
U n i v e r s i t y o f S o u th e rn C a l i f o r n i a
In p a r t i a l f u l f i l l m e n t
o f t h e
R eq u irem en ts f o r t h e
D egree o f M aster o f A r t s
By
C l a r a B* Whitmore
J a n u a ry , 1931
UMI Number: EP59142
All rights reserved
INFORMATION TO ALL USERS
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Oissgftatton R uW isM ng
UMI EP59142
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This thesis, having been approved by the
special Faculty Committee, is accepted by the
Council on Graduate Study and Research
of the University of Southern California,
in partial fulfillment of the requirements
for the degree of ................ ..
ecretary
Committee;
Dean
P rofessor Benjamin
P rofessor Ci 111 land.
Professor McKibben
CONTENTS
CHAPTER Page
PREFACE
INTRODUCTION
PART I
I . CLASSIFICATION OF PERIODS OF CHINESE MEDICINE 1
I I . THE LEGENDARY PPERIOD.. . .................................... 3
I I I . THE HISTORICAL OR CLASSICAL PERIOD ......... 5
The E ig h t P rim ary K w a s ...................................................... 7
The D o c trin e o f S i g n a t u r e s ..................................... 8
The D o c tr in e o f S ym pathy........................ 10
The D o c trin e o f T e m p e r a t u r e s . . . ...................................... 11
P h y s i c i a n s o f th e H i s t o r i c a l P e r i o d . . . . ................ IP
M e d ic a l P r a c t i c e s o r A chievem ents o f
th e H i s t o r i c a l P e r i o d ................................ ................. 21
M e d ic a l L i t e r a t u r e o f th e H i s t o r i c a l
o r C l a s s i c a l P e r i o d ............................................................ 38
IV. THE MEDIEVAL OR CONTROVERSIAL PERIOD............................... 40
L i t e r a t u r e o f t h e C o n t r o v e r s i a l P e r i o d ............... 40
The F o u r S c h o o ls o f th e C o n t r o v e r s i a l P e r i o d . 42
V. _THE MODERN OR TRANSITIONAL PERIOD.......................... 45
W estern M e d ic in e ....................................................................... 46
The B e g in n in g o f M e d ic a l E d u c a tio n i n
P e k i n g .............................................................................. 52
C hina M e d ica l M is s io n a r y S o c i e t y 54
11
CHAPTER Page
P o s t Mortem and D i s s e c t i o n A llo w e d . . 55
N a t i o n a l M e d ica l A s s o c i a t i o n o f
C h in a . . . . . . . ............ 56
M e d ica l S i t u a t i o n 1922 a.nd 1 9 2 6 . . . . . 60
H o s p i t a l S i t u a t i o n 1 9 2 6 - 1 9 2 7 .......................... 65
The P u b l i c H e a lth S i t u a t i o n in C h i n a . . . . . . . . 64
The O r g a n iz a t i o n o f th e M i n i s t r y o f H e a l t h . . 66
• PART I I
V I. OBSTETRICS IN' CHINA.................................... 74
V I I . OBSTETRICAL LITERATURE, PRESCRIPTIONS AND
DRUGS ......................... 77
V I I l ; SUPERSTITIONS, CUSTOMS AND PRACTICES.............................. 87
T h e i r R e l a t i o n s h i p to th e P r e s e n t S i t u a t i o n . . 87
”S t e a l i n g Luck” ............... 88
CONCLUSION......................................................................................... 98
BIBLIOGRAPHY........................................ 100
I l l
PREFACE
In 1915 t h e a u th o r s a i l e d from V ancouver f o r S hanghai
a n d th e n e x t f o u r t e e n y e a r s w ere s p e n t i n m ed ical p r a c t i c e
I n C h in a. D u rin g t h a t tim e n a t u r a l l y many p h a s e s o f
C h in e s e l i f e and th o u g h t came u n d e r o b s e r v a t i o n o f t h e
w r i t e r .
A p h y s i c i a n i n th e p r a c t i c e o f m e d ic in e i s b r o u g h t i n t o
i n t i m a t e to u c h w ith t h e th o u g h t and h e a r t o f a p e o p l e . Be
c a u s e o f t h i s I n t i m a t e an d i n t e r e s t i n g p r o f e s s i o n a l r e l a t i o n
s h i p w ith t h e p e o p le o f C hina, t h e i n t e r e s t o f t h e a u th o r
becam e a t t r a c t e d to th e many e m p i r ic a l m ethods o f home t r e a t
m ent and t h e many s u p e r s t i t i o n s p r e v a i l i n g among t h e p e o p le
r e g a r d i n g them . Many o f t h e s e grew o u t o f custo m s and p r a c
t i c e s which had t h e i r o r i g i n i n th e m ethods and r e l i g i o n o f
t h e n a t i v e d o c t o r s , and had a v i t a l r e l a t i o n to m e d ic in e i n
C h in a .
W hile p r a c t i c i n g m e d ic in e i n C hina and w h ile c o n d u c tin g
t h i s r e s e a r c h , th e a u t h o r i n a l l o f h e r i n v e s t i g a t i o n s had
a c c e s s to t h e l i b r a r y o f t h e P e k in g Union M edical C o lle g e ,
t h e sc h o o l i n c o n n e c tio n w ith work o f th e R o c k e f e l l e r Founda
t i o n f o r M edical R e se a rc h , s i t u a t e d a t P e k in g , C h in a.
Acknowledgment i s made o f th e s e r v i c e o f t h e l i b r a r i a n
a t t h a t C o lle g e , a l s o f o r th e k i n d l y h e lp o f M iss E d it h
C am pbell, o f t h e M edical L ib r a r y o f t h e U n i v e r s i t y o f
C a l i f o r n i a .
IV
P r o f e s s o r G i l b e r t G id d in g s B enjam in s u p e r v i s e d th e
work o f t h i s t h e s i s and to him i s t e n d e r e d th a n k s f o r
g u id a n c e and a d v ic e . Acknowledgment i s a ls o made t o
P r o f e s s o r 0. V. G i l l i l a n d and Dr. P . S, McKibben f o r t h e i r
k i n d l y c r i t i c i s m .
Ü. S. 0. J a n . , 1931.'
C l a r a B. W hitmore
INTRODUCTION
G re a t d e s e r t s on t h e n o r t h , m o u n ta in m asses on t h e w e st,
t h e s e a on t h e s o u th and e a s t , s h u t C hina o f f from th e c iv
i l i z a t i o n o f E g y p t, th e r e l i g i o h o f P a l e s t i n e , t h e a r t s o f
G re e c e o r t h e law s o f Home.
Q u ie tly ,, p a t i e n t l y , p e r s i s t e n t l y , China m oulded h e r own
c i v i l i z a t i o n . In many r e s p e c t s h e r c i v i l i z a t i o n was su p e r
i o r t o t h a t o f t h e West u n t i l modern s c i e n c e e n a b le d th e
W est to o u t - d i s t a n c e and s u r p a s s h e r i n t h e m e c h a n ic a l forms
o f c o n v e n ie n c e s .
In t h e a r t s t h a t stand, f o r b e a u ty China h a s g iv e n to
t h e w orld p i c t u r e s , p o t t e r y and monuments t h a t c a n n o t be s u r
p a s s e d . In b u i l d i n g an d a r c h i t e c t u r e she was a s d i s t i n c t i v e
a s G reece h e r s e l f . I n h e r e d u c a tio n t h e r e was p h ilo s o p h y
and m e d ic in e . As a g r e a t c i v i l i z e r , C h in a h a s g iv e n l a n
g u a g e, l i t e r a t u r e , r e l i g i o n , law and b o t h t h e m e c h a n ic a l and
f i n e a r t s to K orea, Ja p a n , th e Mongols and t h e Manchus,
The w o rld h a s knocked a t C h in a 's d o o r s . Some would
g i v e h e r p r e c i o u s g i f t s and some would s n a tc h from h e r th e
p r o d u c t o f h e r l a b o r and w e a lth but w h e th e r i t h a s been t h e
m i s s i o n a r y o r t h e a d v e n t u r e r , th e m erc h an t o r t h e e x p lo r e r ,
t h e calm, q u i e t o r d e r l y sway o f l i f e h a s met them and b a f
f l e d th e i n q u i r y and p u z z l e d th e mind o f th e g u e s t s o f t h a t
s t r a n g e l a n d .
To t h e f o r e i g n e r t h e C h in ese a r e a p u z z l e . The more
Vi
you know them th e l e s s you u n d e rs ta n d them. B ut h i s t o r i
c a l l y we know t h a t from a nomadic p e o p le th e C h in e se a d o p t
ed a g r i c u l t u r e and t h a t t h e i r e a r l y l e a d e r s gave them a ru de
form o f w r i t i n g and th e a r t o f m e d ic in e . T h e ir m e d ic in e i n
t h e e a r l y s t a g e o f d e v elo p m en t c o n s i s t e d l a r g e l y i n sim p le
m assa g e and i n h a rm le s s d e c o c ti o n s from th e v e g e t a b l e s and
p l a n t s a ro u n d them. The s i m p l i c i t y o f t h e p e o p le and th e
s im p le ra n g e o f l i f e im p re ss e d i t s e l f upon e a r l y m e d ic in e .
I n a l i m i t e d m easure i t we.s a s c i e n t i f i c m e d ic in e i n t h a t ; t h e
s t u d y o f d r u g s and d i s e a s e w ith i t s c u r e , was i n s i s t e d upon.
B e g in n in g w ith th e s e v e n th c e n t u r y B.C. a g a la x y o f
p h i l o s o p h i c a l and e t h i c a l w r i t e r s l e d by L a o - tz e , C o n fu c iu s,
M encius, an d o t h e r s , c o n ti n u e d to i n f l u e n c e f o r some h und red s
o f y e a r s , t h e e a r l y th o u g h t o f C h in ese l i f e . " I t w a s ," s a i d
S u z u k i, com m enting on t h i s p e r i o d , "as though one w alked i n
t h e s p r i n g t im e , a f t e r a l o n g m onotonous w i n t e r , i n t o th e
f i e l d s where f l o w e r s o f v a r i o u s hues and o d o rs g r e e t him on
a l l s i d e s .
The C h in ese mind may have d e v e lo p e d l a t e r a higher power
o f r e a s o n i n g , b u t th e ra n g e o f i n t e l l e c t u a l a c t i v i t i e s was
n e v e r s u r p a s s e d in any l a t e r p e r i o d .
T h e o r ie s a s f a n c i f u l and f a n t a s t i c a s th e t a l e s o f
A l i c e i n W onderland a r e to t h e c h i l d , were im posed upon a
s im p le t r u s t i n g p e o p le . Y et C o n fu c iu s , M encius, and Chu Hsi
and o t h e r s , h a d no th o u g h t o f t h r o t t l i n g p r o g r e s s an d grow th
^ D .T .S u z u k i, A B r i e f H is t o r y o f E a r ly C h in ese P h i l o s o p h y , 2.
v i l
i n t h e i r t e a c h i n g s , b u t so i t p ro v e d f o r m e d ic in e . T h e ir
i d e a s w ere t h a t ceremony and f i x i t y and s u b m is s iv e n e s s made
f o r r e v e r e n c e o f a u t h o r i t y i n t h e home and in t h e s t a t e .
A u t h o r i t y w ould in t u r n c a re , f o r th e i n d i v i d u a l . The p e t
r i f y i n g e f f e c t o f t h i s d o c t r i n e o f b l i n d a c c e p ta n c e w ith o u t
q u e s t i o n h a s b e e n c a r r i e d down th r o u g h th e c e n t u r i e s .
^ Many f a c t o r s have e n t e r e d i n t o t h e p rob lem . D espotism
and ty ra n n y have n o t b e en l a c k i n g . The Emperor o f t h e Oh«in
D y n a sty was annoyed by t h e o p p o s i t i o n o f th e l i t e r a t i and
ended i t by b u r y i n g a l i v e a l l c r i t i c s and b u rn in g t h e l i t e r
a t u r e i n 213 B.C.
The boo ks on m e d ic in e w ere exem pted from d e s t r u c t i o n ,
b u t he su c c e e d e d i n s u p p r e s s in g a l l in d ep e n d en c e o f th o u g h t
and re d u c e d t h e n a t i o n to a com atose c o n d i t i o n w hich la s te d ,
f o r a m ille n n iu m .
D u rin g t h i s p e r i o d t h e a lc h e m i s t , a s t r o l o g i s t , and
p r i e s t , a l l c o n t r i b u t e d i n t r a n s f o r m i n g m ed icin e i n t o a mass
o f c o n j e c t u r e s , s u p e r s t i t i o n s and i g n o r a n c e . Soon t h e s e
s u p e r s t i t i o n s so c o m p le te ly d om in ated th e mind o f th e m asses
t h a t even th e w o r t h i e s t o f men among t h e p h y s i c i a n s a t tim e s
c o u l d n o t r e s i s t p l a y i n g upon th e c r e d u l i t y o f t h e sim p le
m inded p e o p le . Li S h ih Chen, a u th o r o f th e g r e a t C hinese
p h a rm a c o p o e ia , c la im e d d i v i n e r e v e l a t i o n f o r h i s knowledge
o f how to make g o ld and to h e a l t h e s i c k . B e fo re h i s d e a t h ,
how ever, he c o n f e s s e d t h a t he had w r i t t e n h i s r e v e l a t i o n s
p u r e l y a s w orks o f f i c t i o n .
M edicine i n i t s s t r u g g l e f o r th e b e s t found t h a t
viii
C o n fu c iu s had s e t h i s s e a l o f a p p ro v a l upon th e o l d th e o r y
o f Y in and Yang and had even en co u rag ed t h e s tu d y o f th e
kwas which i n th e hands o f t h e u n s c r u p u lo u s was l i k e th e
whip i n t h e h a n d o f th e s l a v e d r i v e r . C o n fu c iu s h im s e lf
d i d n o t f a v o r s u p e r s t i t i o n , f a n a t i c i s m and i r r a t i o n a l vaga
r i e s , h u t h i s te a c h in g i n c u l c a t e d a r e s p e c t f o r a u t h o r i t y so
a b s o l u t e t h a t soon a l l c l a s s e s w ere s t a n d i n g a s a u n i t a g a i n s t
a n y i n v a s i o n o f t h a t a u t h o r i t y , even th o u g h fo u n d ed upon wrong
p r e m i s e s . No d o c to r d a re d to p e rfo rm an a u to p s y o r d i s s e c
t i o n , o r w r i t e o r p u b l i s h t h e o r i e s o r t e a c h i n g s c o n t r a r y to
t h e o l d ones s a n c t i o n e d and approved by t h e E m peror. The
B u d d h i s t s t a u g h t t r a n s m i g r a t i o n o f t h e s o u l. When an Em- •
p e r o r sp o n s o re d t h i s t e a c h i n g and o f f i c i a l d o m was rea d y to
p u n i s h any a c t t h a t m ight mar o r d e f a c e t h e dead body, i t
s p e l l e d th e doom o f o r i g i n a l work and grow th i n p h y s io lo g y ,
anatom y, h i s t o l o g y , p a th o lo g y , m e d ic in e and s u r g e r y .
D u rin g t h e C o n t r o v e r s ia l P e r io d t h e r e was a s l i g h t hope
o f b e t t e r i n g t h e c o n d itio n , o f m e d ic in e b u t owing to th e op
p o s i t i o n o f a l l c l a s s e s a g a i n s t o r i g i n a l work, i t s p e n t i t s
f o r c e upon t h e o r i e s and w r i t i n g s b a s e d upon th e o l d and d a re d
n o t in v ad e t h e rea lm o f a c t u a l i n v e s t i g a t i o n and r e s e a r c h .
A f t e r t h e i n v a s i o n o f t h e p r i n c i p l e s o f W estern m e d ic in e i n t o
C h in a , i t to o k o v e r a h u n d re d y e a r s b e f o r e th o s e i n a u t h o r i t y
d a r e d f a c e t h e o p p o s i t i o n o f th e m a sse s, and a llo w th e d i s
s e c t i o n and a u to p s y o f t h e human bo dy, w ith o u t w hich no
s c i e n t i f i c m e d ic in e can e x i s t .
The l a c k o f c o - o p e r a t i o n betw een C h in ese d o c t o r s , and
IX
t h e a b se n c e o f a n y o r g a n i z a t i o n has s e r v e d a s a f u r t h e r ob
s t a c l e to p r o g r e s s . l o n g c e n t u r i e s o f i n e f f e c t i v e e f f o r t s
to , b re a k away fro m t h e s e c o n t r o l l i n g i d e a s have a t l a s t r e
s u l t e d in a triu m p h o f c o m p le te in d ep e n d en c e o f o l d r e s t r i c
t i o n s . T h is was consummated th ro u g h t h e a c t i v i t i e s a t t e n d
i n g and f o l l o w i n g upon t h e r e c e n t R e v o lu tio n , and i t marks
t h e dawn of a new and a b e t t e r day f o r C hin ese m e d ic in e .
P a r t I
AN HISTORICAL SKETCH OF MEDICINE
IN CHINA
CHAPTER I
CLASSIFICATION OF THE PERIODS OF CHINESE MEDICINE
A cco rd in g to C h in ese c l a s s i f i c a t i o n , th e h i s t o r y o f
t h e i r m e d ic in e i s d i v i d e d i n t o f o u r d i s t i n c t p e r i o d s .
I . THE LEGENDARY- from t h e dawn o f h i s t o r y to t h e end o f
t h e 8hang D y n a sty , B.C. 1154.
I I . THE HISTORICAL OR CLASSICAL- B e g in n in g B .C . 1 1 5 4 w ith
t h e Chou D y n a sty and end
in g w ith t h e Tang D yn asty,
959 A.D.
I I I . THE MEDIEVAL OR CONTROVERSIAL- 959 - 1805 A.D.
IV. THE MODERN OR TRANSITIONAL- 1805 A.D. to t h e p r e s e n t
tim e .
The f i r s t o r L egendary P e r io d o f C h in ese m e d ic in e was
d i s t i n c t i v e l y a p e r i o d o f .beginnings b u t may be c o n s i d e r e d
one o f c o n s i s t e n t h o n e s t e f f o r t and g ro w th .
The second o r C l a s s i c a l P e r io d i s t h a t o f su c h l i t e r a r y
a n d p h i l o s o p h i c a l b r i l l i a n c y t h a t t h e p r o f e s s i o n o f m ed icin e
d i d n o t r e a l i z e th e d e a t h blow i t was r e c e i v i n g . I t was un
a b l e to cop e a g a i n s t i t . .
The t h i r d o r C o n t r o v e r s i a l P e r i o d , r e s p o n d in g t o a gen
e r a l p r o g r e s s i n o t h e r l i n e s p ro m ise d to make g e n u in e p r o g r e s s
to w a rd s c i e n t i f i c s t a n d a r d s . But when i t ra n c o u n t e r to t h e
dogma o f r e l i g i o n and t h e ty r a n n y o f p h i l o s o p h i c a l th o u g h t
2
i t was r e q u i r e d t o bow t o t h e demands o f custom , and no
p h y s i c i a n d a r e d t o go beyond w r i t i n g . The f a c t t h a t th e y
ev en d a re d to t h e o r i z e was a g r e a t g a i n .
The l a s t p e r i o d o r t h e T r a n s i t i o m l P e r i o d was marked
by t h e com ing o f W estern m ethods and m e d ic in e . So g r e a t
was t h e im p a ct o f t h i s t h a t t h e r e was a g ra d u a l r e s p o n s e to
i t and w ith more freedom i n c i v i l an d p o l i t i c a l l i f e , t h e r e
was more freedom i n m e d ic in e .
CHAPTER II
THE LEGENDARY PERIOD
t
In a c c e p t i n g any f a c t s o f t h i s p e r i o d i t m ust be remem
b e r e d t h a t w hat h a s been t r u e o f any a n c i e n t p e o p le h a s been
t r u e o f C hina. Love o f th e m a rv e llo u s and awe o f th e un
known have been s t r o n g f a c t o r s i n k e e p in g a l i v e many in c r e d
i b l e s t o r i e s w hich a r e t h e f a b r i c a t i o n s o f s u b s e q u e n t tim e s .
T hese le g e n d s a r e n o t a c c e p t e d by th e e d u c a te d C h in ese o f
t h e p r e s e n t tim e b u t a r e b e l i e v e d i n and p r a c t i c e d by th e
m a sse s o f t h e u n e d u c a te d .
Among t h e names v e n e r a t e d i n C hina i s t h a t o f Sheng
Nung, th e F a t h e r o f C h in e se M e d icin e. He i s a s c r i b e d to
t h e p e r i o d o f 2737 B.C. C r e d i t was g iv e n to him f o r t a s t
in g d a i l y s e v e n t y p o i s o n s and e s c a p in g w ith no i l l e f f e c t s .
T h is was k e p t up t i l l he had t e s t e d a l l th e known p l a n t s
an d th e n he e s t a b l i s h e d t h e p h a rm a co lo g y . He w ro te th e
P en T sao. o r C h in e se M a te r ia Medica w hich i s su p p o se d to be
t h e o l d e s t s c i e n t i f i c C h in e s e work.
P r i n c e Huang Ti i s su pp osed to have l i v e d 2697 B.C.
He, w ith t h e a s s i s t a n c e o f h i s m i n i s t e r , Chi Pok, c la im e d
t o h a v e w r i t t e n th e famous Nei C hing, t h e most im p o r ta n t
m e d ic a l c l a s s i c o f C h in e se m e d ic in e . L a t e r h i s t o r i c a l r e
s e a r c h h as p r o v e n t h a t he was n o t t h e a u t h o r .^
^K. C. Wong, "Four M illen n iu m s o f C hinese M e d ic in e ,"
L a n c e t, J u l y 1929.
4
To I Y in, t h e a b le and f a i t h f u l m i n i s t e r o f Emperor
Tang o f t h e Shang D y n a sty , i s g iv e n th e c r e d i t o f d i s c o v e r
in g t h e m ethod o f m aking d e c o c t i o n s . T his was th o u g h t to
be a g r e a t s t e p fo rw a rd .
C h in ese h i s t o r i a n s c h a r a c t e r i z e t h i s p e r i o d a s t h e tim e
when nomadic l i f e was b e in g tr a n s f o r m e d i n to t h e a g r i c u l t u r a l .
Thus i t i s r e a s o n a b l e t o lo o k f o r some c u r i o s i t y and e x p e r i
m e n t a t i o n w i t h th e p l a n t l i f e a b o u t. A s e a r c h f o r food
p r o b a b l y a c c o u n ts f o r t h e t a s t i n g o f t h e s e v e n ty supposed
p o i s o n s by Sheng lu n g . M edicine was a s t r a n g e m ix tu r e o f
h e a l i n g , a s t r o l o g y and r e l i g i o n . P r i e s t c r a f t and s o r c e r y
c o n t r o l l e d m e d ic in e u n t i l t h e Chou D y n a sty 1154 B.C.
CHAPTER III
THE HISTORICAL OR CLASSICAL PERIOD
The Chou D y n asty i n w hich C o n fu c iu s l i v e d may a s a p e r
i o d o f C h in ese h i s t o r y be compared w i t h th e A ugustan Age,
t h e Golden Age o f Rome. H is to r y , a r t , l i t e r a t u r e , p h i l o s o
p h y , r e l i g i o n , governm ent, and a l l t h a t i s in c l u d e d i n th e
te rm c i v i l i z a t i o n re a c h e d a h ig h d e g r e e o f d e v elo p m e n t. The
p h i l o s o p h e r s o f th e a g e , L a o - tz e , C o n fu c iu s , M encius, and
o t h e r s , s p e c u l a t e d on e v e ry p h a se of l i v i n g and t h e i r i n f l u
e n c e was so g r e a t t h a t no p h a s e o f l i f e e sca p ed . I t s i n
f l u e n c e was b o t h h e l p f u l and p e r n i c i o u s . I t changed medi
c i n e from p r a c t i c e i n t o t h e o r y . . M edicine b a s e d u pon o b s e r
v a t i o n and know ledge became i n s t e a d , a p r e t e n t i o u s system o f
h e a l i n g b ased upon t h e im a g in a tio n of p h i l o s o p h e r s and th e
o r i s t s . The e l a b o r a t e c o m p lic a te d d e t a i l s o f t h e o r e t i c a l
know ledge k i l l e d t h e e f f e c t i v e n e s s o f m e d ic in e i n p r a c t i c e .
In s e e k i n g f o r th e e x p la n a tio n ' o f phenomena and d i s e a s e ,
C o n fu c iu s s a i d ;
When Pao Hsi r u l e d o v e r th e Em pire he o b se rv e d t h e phenomena
o f t h e h e av e n s above and t h e form s on e a r t h below ; he n o te d
t h e manner o f b i r d s and b e a s t s and t h e p r o d u c t s o f th e s o i l ;
a n d r e c e i v i n g s u g g e s tio n s in w a rd ly from h i s own s e l f and ex
t e r n a l l y from d i s t a n t o b j e c t s he f i r s t i n v e n te d t h e e ig h t
kwas i n o r d e r t o p e n e t r a t e i n t o th e m y s t e r i e s o f n a t u r e and
d i s e a s e and to d e s c r i b e t h e r e a l i t y o f a l l t h i n g s . !
The o l d e s t t e x t s i n which a r e fo u n d r e f e r e n c e s to th e
o r i g i n o f t h e Yang and t h e Yin a r e th e S h ik in g , t h e Chou-1i
^ C o n fu c iu s , Book o f Change, ed. 1 0 , App. 1 . P a r t I I .
6
an d t h e Tso Ghuan. T hese r e f e r e n c e s i n d i c a t e t h a t i n t h e
t w e l f t h and e l e v e n t h c e n t u r i e s B.C. n o t o n ly w ere t h e words
Yang and Yin u s e d b u t th a.t th e e n t i r e t h e o r y b u i l t th e r e o n
was known i n a l l i t s d e t a i l s .
A c c o rd in g to t h i s d o c t r i n e Yang and Yin a r e th e two
p r i m o r d i a l e le m e n ts . E v e r y th in g u n d e r th e sun i s supposed
to o r i g i n a t e from th e m .! Yang and Yin a r e g e n e r a l l y re p
r e s e n t e d by a c i r c l e named t h e , g r e a t a b s o l u t e o r t h e i n f i n
i t e v o id w hich i s d i v id e d i n t o two p e a r shaped b o d i e s by a
c u rv e d l i n e . Upon t h e s e two d ia g ra m m a tic e le m e n ts a r e
e i g h t symbols each made up o f a c o m b in a tio n o f t r i p l e l i n e s
w hole and b ro k e n , a r r a n g e d i n su ch a manner a s n o t t o re p e a t
i t s e l f .
These e i g h t kwas o r e i g h t t r i g r a m s a r e su p p o sed to d a t e
b a c k from Fuh H s i, 2852 B.O . , 2 th e p l a n b e in g r e v e a l e d to him
on t h e back o f a s u p e r n a t u r a l anim al c a l l e d t h e d r a g o n - h o r s e
t h a t r o s e from th e w a te r s o f th e Y ello w R iv e r. Each o f
t h e s e e ig h t t r i g r a m s h a s a s p e c i a l name, w ith s y m b o lic a l and
f a n c i f u l m eaning, b u t no one has been a b l e to g iv e a d e f i n i t e
i n t e r p r e t a t i o n to them. C o n fu c iu s was g r e a t l y i n t e r e s t e d
i n t h e s e f i g u r e s o r kwas an d s a i d t h a t i f he c o u ld d e v o te
f i f t y y e a r s t o t h e s tu d y o f them, he m ig ht a t t a i n wisdom.
As g iv e n by Hu S h ih , P r o f e s s o r o f P h ilo s o p h y a t th e
H a.tio n al U n i v e r s i t y o f P e k in g , th e e i g h t p rim a ry kwas a r e
^ A l f r e d F o rk e , W orld C o n c ep tio n o f th e C h in e s e , 163.
^S. W ells W illia m s , The M iddle Kingdom. I I , 1 48.
a s f o l lo w s ;
I . THE EIGHT PRIMARY KWA8
6 8
1. Heaven
S. E a r th
3. Thunder 5. F i r e 7. W ater, moving
4. M ountain 6. W ater 8. Wind; wood
These l i n e s o r kwas w ere a p p l i e d a s a w orking p r i n c i p l e
to m e d ic in e . The s t u d y o f m ed icin e was soon d o m in a te d b y
t h e s c h o l a s t i c s u b tle tie s o f v i s i o n a r y p h i l o s o p h e r s . "Rever
ence f o r a u t h o r i t y , " sa y s K. 0. Wong,"became p e t r i f i e d
fo rm a lis m w ith a . p e d a n t i c e x ce ss o f d e t a i l . "
T here w ere many t h e o r i e s and d o c t r i n e s b u t among them
t h e p r i n c i p l e o f Yang and Yin, and t h a t o f th e E le m e n ts a r e
o f m a jo r im p o rta n c e .
The Yang and th e Yin r e p r e s e n t t h e m ale an d t h e fem ale
e le m e n ts . They s ta n d f o r heaven and e a r t h , th e sun and th e
moon, day and n i g h t , h e a t and c o ld , l i f e and d e a t h , s tr o n g
a n d weak, p o s i t i v e and n e g a t i v e , and a l l o p p o s i t e s . When
t h e male and th e fem ale e le m e n ts a r e u n i t e d i n t h e i r v i r t u e s
t h e r e i s harmony and h e a l t h and p e a c e .
The s e c o n d i s fo u n d ed upon t h e f i v e e le m e n ts w hich a r e ,
m e t a l , wood, w a te r , f i r e , e a r t h . The human body i s sup posed
t o b e made up o f a h arm on iou s m ix tu r e o f t h e s e p r i m o r d i a l
s u b s t a n c e s . So lo n g a s t h e r e i s a p r o p e r p r o p o r t i o n , h e a l t h
e x i s t s . I f t h e b a la n c e i s d i s t u r b e d d i s e a s e f o l l o w s . The
8
i n t e r a c t i o n o f t h e f i v e e le m e n ts i s a s f o llo w s ;
M etal g e n e r a t e s w a te r and d e s t r o y s wood.
W ater g e n e r a t e s wood and d e s t r o y s f i r e .
Wood g e n e r a t e s f i r e and d e s t r o y s e a r t h .
F i r e g e n e r a t e s e a r t h and d e s t r o y s m e ta l.
E a r t h g e n e r a t e s m e ta l and d e s t r o y s w a te r.
No. Organ B l a n e t E lem ent C o lo r T a s te C lim a te D i r e c t i o n
1 h e a r t Mars F i r e r e d b i t t e r h o t so u th
2 l i v e r J u p i t e r Wood g re e n s o u r windy e a s t
3 s p le e n S a tu r n e a r t h y e llo w sw eet m o is t c e n t r a i
4 lu n g s Venus m e ta l w h ite p u n g e n t d ry w est
5 k id n e y M ercury w a te r b la c k s a l t c o o l n o r t h
A nother c l a s s o f d o c t r i n e s i s t h a t o f more p r a c t i c a l
v a l u e b a se d u p o n m ed ica l and p s y c h o l o g i c a l o b s e r v a t i o n s r a t h e r
t h a n upon p h i l o s o p h i c a l o n e s .
THE DOCTRINE OF SIGNATURES
In t h i s , t h e th e o ry i s t h a t t h e c r e a t o r i n p r o v i d i n g
h e r b s f o r t h e s e r v i c e o f man h a s stam ped upon them i n many
I n s t a n c e s an i n d i c a t i o n o f t h e i r s p e c i a l v a l u e . !
T his d o c t r i n e h a s s e r v e d b o t h t h e O c c id e n t and th e O rie n t,
I t s vogue was g r e a t e s t i n E urope i n t h e 1 6 th c e n t u r y b u t i t s
p o p u l a r i t y waned tow ard t h e end o f t h e 1 7 th c e n t u r y and
'A.O. W otton. C h r o n ic le s o f Pharm acy, 30.
9
t h e r e a f t e r i t was t r e a t e d a s a p o e t i c f a n c y . Among C hinese
p h y s i c i a n s n o t t r a i n e d i n W estern m e d ic in e i t i s s t i l l wide
l y u s e d .
E uropean i l l u s t r a t i o n s o f t h i s p r a c t i c e a r e fo u n d i n
Q ueen E l i z a b e t h 's S y m p a th e tic O in tm e n ts. These su p p o s e d ly
a lw a y s c o n ta in e d a s p r i g o f moss grow n on th e s k u l l o f a
d e a d man, who h ad s u f f e r e d d e a t h from v i o l e n c e , an d whose
surnam e had n o t more th a n t h r e e l e t t e r s i n i t . The G reeks
u s e d th e aW idrake f o r s t e r i l i t y b e c a u s e t h e r o o t s and tu b e r
so o f t e n s u g g e s te d th e m ale form . I n many p a r t s o f E urope
a r i s t o l o o h i a was u s e d f o r womb d i s e a s e b e c a u s e t h e shap e o f
t h e a r i s t o l o o h i a re se m b le d t h e shape o f t h e womb. P l i n y
t e l l s t h a t when a p e rs o n was s o r r y f o r a blow he h a d g iv e n
a n o t h e r t h e p a i n would soon l e a v e th e p e r s o n who had b e e n
s t r u c k i f t h e s t r i k e r s p i t i n th e m id d le o f t h e o f f e n d i n g
h a n d .
In C hin a, l e e c h e s and b e e t - r o o t b e c a u s e o f t h e i r c o lo r
a r e u s e d i n d y sm e n o rrh e a . A lso th e ho shou wu o r polygonum
m u l t i f l o r u m b e c a u s e o f i t s r e d c o lo r e d r o o t s i s u s e d f o r
p o s t p a rtu m h em o rrhage. The C hin ese c h o se th e poppy pods
a s a b r a i n s o o t h e r b e c a u s e t h e poppy pod r e s e m b le s a head.
S t a l a g m i t e s , ! i f t h e sh ap e o f a woman's b r e a s t , a r e p r e s c r i b
ed f o r g a la o to g o g u e s . . S c o re s o f i n s t a n c e s c o u ld b e c i t e d
i n which d ru g s a r e g iv e n f o r t h i s r e a s o n and n o t b e c a u se
t h e y meet any i n d i c a t i o n i n t h e d i s e a s e .
^L i S h ih Chen, Pen T sao Kang Mu. 1596 A.D. (C h in e s e
D i s p e n s a t o r y . )
10
THE DOCTRINE OF SYMPATHY!
T his d o c t r i n e i s b a s e d upon t h e p r i n c i p l e t h a t a f e l l o w
f e e l i n g o r sym pathy t a k e s away p a i n o r i l l n e s s . D uring th e
s e a s o n o f c o ld s and p neum onias th o u s a n d s o f re d s i g n s a r e
fo u n d on d o o r s i n China a s k in g t h e p a s s e r b y to b e w i l l i n g to
t a k e on h i m s e l f th e d i s e a s e . Such a sympathy o r w i l l i n g n e s s
w i l l i n s u r e a c u re f o r th e i l l . 2
In S h angh ai th e c l i m a t i c c o n d i t i o n s a r e f a v o r a b l e to
i l l n e s s n e a r t h e s e a s o n o f th e C h in ese New Y ear. At t h i s
one f e s t i v a l , above a l l o t h e r s , t h e C h in ese h o u s e h o ld e r de
s i r e s h e a l t h f o r h im s e lf and f o r t h e members o f h i s f a m ily .
Hence t h e r e a r e many r e d s i g n s i n e v id e n c e a t t h i s tim e .
The a b r u s se ed i s much u s e d i n C hin a u n d e r t h i s d o c t r i n e
o f sym pathy. The C h in ese name f o r t h e a b ru s se e d means
l o v e s i c k . I t was, a c c o r d i n g to a c e r t a i n le g e n d , g iv e n t h i s
name b e c a u se a c e r t a i n man d i e d n e a r i t . His w i f e , f i n d i n g
him t h e r e , s t a i d n e a r t h e s p o t , w eeping t i l l s h e , to o , d i e d .
T h ese se e d s b e c a u s e o f th e sorrow and syii^athy o f r e l a t i v e s
a r e g iv e n t o t h o s e suppos ed to b e p o s s e s s e d o f a c a t - d e v i l
o r o t h e r e v i l s p i r i t s . From th e C h in e se D i s p e n s a to r y we
h a v e th e f o l l o w i n g ;
I f a c a t - d e v i l h a s been se e n u s e one s e e d each o f a b r u s , c a s
t o r -Oil, c r o t o n o i l , w ith c in n a b a r and wax, make i n t o p i l l s
a n d a d m i n i s t e r a t o n ce. S u rro u n d t h e p a t i e n t w i t h a s h e s and
p l a c e h e r b e f o r e a c i n d e r f i r e . She i s a p t to s p i t t h e med
i c i n e i n t o th e f i r e , and a s i t b u b b le s up, mark i t w ith a s i g n
on t h e s u r f a c e o f t h e f i r e and th e c a t - d e v i l w i l l d i e . ^
^A .G .W otton, C h r o n i c l e s . o f Pharm acy. 30.
2c.B .W hitm ore, O r i g i n a l O b s e r v a tio n s on C h in ese Home Rem-
.ediee and E m p iric a l M ethods. P a p e r f o r Shanghai M edical S o c i e t y .
S h ih Chen, op. c i t .
11
The p a i n o f a s c o r p i o n s t i n g i s e x o r c i s e d th r o u g h b u rn
in g th e o f f e n d i n g s c o r p i o n . ! M erely k i l l i n g t h e s c o r p io n
w i l l n o t s u f f i c e . The p a i n o f a s c o r p i o n s t i n g i s so in
t e n s e and so l i k e th e p a i n o f a burn t h a t i t c a n n o t, t o t h e
C h in e s e mind, be r e l i e v e d u n l e s s t h e s c o r p i o n a l s o f e e l s th e
p a i n s of t h e fla m e s .
THE DOCTRINE OF TEMPERATURES
The C h in e se p e o p le h ave a g r e a t f e a r o f a c o ld p e r s p i
r a t i o n . The n a t i v e p h y s i c i a n s th r o u g h t h i s d o c t r i n e o f tem
p e r a t u r e s se ek t o h a rm o n ize h o t and c o ld , humid and d r y .
They t r y to p ro d u c e a s t h e y e x p r e s s i t , "a c o n d i t i o n o f c o ld
i n t h e t h i r d d e g re e , o r d ry i n t h e f i r s t d e g re e . " W estern
m e d ic in e w ould e x p re s s i t a s an a tte m p t to lo w e r te m p e r a tu re .
The d o c t o r ' s g r e a t d i f f i c u l t y i s t o make d ru g s c o m p a tib le
w i t h t h e v a r y i n g d e g r e s s o f Yang a n d Yin found i n t h e d i f f e r
e n t o rg a n s a t t h e s u c c e s s i v e s t a g e s o f a n i l l n e s s . Augment
i n g th e a c t u a l d i f f i c u l t i e s i s t h e f a c t t h a t t h e ig n o ra n c e
an d s u p e r s t i t i o n o f th e p e o p le c a u s e them to t h i n k i t n e ce s
s a r y to c a l l i n t h e s t r o l l i n g quack, and s i x to a dozen doc
t o r s , one a f t e r a n o th e r . Thus t h e p o o r p a t i e n t h a s n o t o n ly
t h e r a t i o n a l e o f th e quack b u t th e m u l t i p l e d o s e s o f t h e many
d o c t o r s to c o n te n d a g a i n s t .
From t h e s t r i c t l y m e d ic a l s t a n d p o i n t th e H i s t o r i c a l o r
C l a s s i c a l P e r i o d may b e c o n s i d e r e d u n d e r t h r e e h e a .d ln g s:
2
Whitmore, op cit.
12
I . P h y s i c i a n s and su rg e o n s,
I I , M edical P r a c t i c e s o f t h e P e r i o d .
I I I . M ed ical L i t e r a t u r e o f t h e P e r io d ,
I . P h y s i c i a n s and S urg eo n s,
The f i r s t a u t h e n t i c r e c o r d o f a r e g u l a r C h in e se p h y s i
c i a n d e v o tin g h im s e lf t o s c i e n t i f i c m e d ic in e i s t h a t o f P ie n
C hiao , l i v i n g a b o u t 255 B.C. T here i s a r e c o r d i n L ieh Tze
o f two men who came from d i f f e r e n t s t a t e s t o c o n s u l t him.
He gave them a n a r c o t i c w ine to d r i n k which a n e s t h e t i z e d
them f o r t h r e e d a y s . D u rin g t h i s tim e h e opened t h e i r
c h e s t s , to o k o u t t h e i r h e a r t s , exam ined them and th e n ex
c h an g e d them. When th e y awoke th ey f e l t w ell a n d r e t u r n e d
home. T h is i s th e f i r s t r e c o r d o f an a n e s t h e t i c b e in g g iv e n .
The s u r g e r y c a n n o t be c r e d i t e d b e c a u se o f th e a b s u r d i t y o f
t h e c la im . R ecent C h in e se i n v e s t i g a t o r s a l s o r e j e c t th e
c l a i m o f th e a n e s t h e t i c a s p a r t o f t h e le g e n d .
However a b s u r d h i s c la im s t o s u r g e r y , P ie n C hiao d id
make e x te n s i v e u s e o f t h e p u l s e method i n d ia g n o s in g d i s e a s e
a n d was keen i n h i s o b s e r v a t i o n s and d ia g n o s e s . T here a r e
many le g e n d s a b o u t him, among them th e c la im t h a t he c o u ld
b y l o o k in g a t a p e r s o n s e e a l l th e d i s e a s e s o f t h e i n t e r n a l
o r g a n s . K.O.Wong a p t l y rem arks t h a t P i e n Chiao th u s
a n t i c i p a t e d th e X -ray.
The Han D ynasty i s memorable a s th e tim e when m ed icin e
^K. 0 . Wong, "Four M ille n n iu m s o f C h in ese M e d ic in e ,"
L a n c e t. J u l y 1929, I I , 256.
13
a s m ed icin e b e g an . The s c i e n t i f i c advancem ent o f m ed icine
c e n t e r e d in t h r e e f i g u r e s , .Tsang Kung, Ohang G hung-king, and
Hua To. Chang G hung-king i s th e g r e a t e s t o f t h e t h r e e and
i s o f t e n sp oken o f a s t h e C h in ese H ip p o c ra te s . He i s ven
e r a t e d a s a s a g e . Hua To i s r e p r e s e n t e d a s t h e g r e a t e s t
C h in ese su rg e o n .
T8ANG KUNG
Tsang Kung l i v e d a b o u t 170 B.C. and i s remembered from
t h e f a c t t h a t he was t h e f i r s t p e r s o n to keep c l i n i c a l c a s e
r e c o r d s . T w e n ty -fiv e o f t h e s e c a s e h i s t o r i e s a r e s t i l l ex
t a n t . I n 8 .d d itio n to t h e c a r e i n l i s t i n g th e symptoms ob
s e r v e d he was h o n e s t i n r e c o r d i n g t h e f a c t t h a t t e n of t h e
t w e n t y - f i v e d i e d . H is p u r p o s e was to have a m o r t a l i t y r e c
o r d a s w e ll a s a g u id e f o r b e t t e r t r e a t m e n t and f u t u r e p ro g
n o s i s . A f t e r h i s d e a t h , h i s t o r y t a k i n g was d ro p p e d , and f o r
t h e n e x t f i f t e e n h u n d re d y e a r s t h e r e i s no r e c o r d o f anyone
k e e p in g c a s e h i s t o r i e s . !
OHANG CHUNC-KING
Chang C hung-king was a d o c to r o f l i t e r a t u r e a s w e ll a s
a d-octor o f m e d ic in e . Not much o f h i s c i v i l l i f e i s known
e x c e p t t h a t o f h i s p u b l i c s e r v i c e a s mayor o f Chang Cha A.D.
1 9 5 .
His p r o f e s s i o n a l fame r e s t s upon h i s work on ty p h o id f e
v e r . T his i s one o f th e m ed ical c l a s s i c s r a n k in g in im por
t a n c e w ith Huang T i ' s Canon o f M e d ic in e . The t r e a t i s e
^K.O.Wong, op.cit.
14
i n c l u d e d t h e f e v e r s o f C hina, n o t a lo n e t h a t o f t y p h o id , a s
t h e name m ig h t s u g g e s t . I n t h i s book a r e found 113 p r e
s c r i p t i o n s , v e r y s c i e n t i f i c a l l y w r i t t e n and a v o id i n g th e
f a u l t s o f th e p r e s c r i p t i o n s do m in ated by th e d o c t r i n e o f
sym pathy.
H is m ethod o f a n t i p y r e t i c t r e a t m e n t a n t e d a t e s t h a t , o f
Jam es C u r r i e ’s method by 1700 y e a r s . H is m ethods i n a u g u r a t
ed a new e r a i n m e d ic in e . D is e a s e was s t u d i e d from a c l i n
i c a l s t a n d p o i n t w ith em phasis on p h y s i c a l s i g n s . The t r e a t
ment was th e n a d a p te d ^ to th e d i s e a s e w ith a t t e n t i o n to th e
symptoms and th e a c t i o n o f d ru g s . Vague p h i l o s o p h i c a l t h e
o r i e s b a se d upon th e c o m b in a tio n s o f co m p lete and b ro k e n l i n e s
c a l l e d kwas w ith th e a b s u r d p r e s c r i p t i o n s t h a t had t o be
a d a p t e d to them w ere d i s c a r d e d . H is p r a c t i c e was a s re a s o n
a b l e and s e n s i b l e a s h i s p r e s c r i p t i o n s . When t h e bow els were
i n a c t i v e h e g ave a n enema and e n p t i e d them. T h is i s th e
f i r s t tim e i n th e h i s t o r y o f C hinese m e d ic in e t h a t enemas w ere
u s e d . When a p a t i e n t was b u rn in g w ith a h ig h f e v e r he gave
a c o ld b a t h and red u c ed i t ,
Chang G hung-king was g r e a t i n p r o f e s s i o n a l a c h iev e m e n t
a n d he was g r e a t i n i d e a l s . The p r o f e s s i o n o f m e d ic in e was
made b e t t e r by h i s h ig h c o n c e p ti o n o f i t s d i g n i t y and m is s io n .
A f t e r h i s d e a t h m e d ic in e d e g e n e r a te d a g a in i n t o fo rm a lis m f o r
a th o u s a n d y e a r s .
HUA TO
Hua To l i v e d n e a r t h e end o f t h e Han D y n asty a b o u t 205
Â.D. The f o l l o w i n g i s t h e s u b s ta n c e o f a s t o r y of h i s y o u th
15
t o l d by K. K. Chen and Amy L in g. Hua To m s w e l l s k i l l e d
i n t h e c l a s s i c s an d f i l i a l p i e t y . One day w h ile r e s t i n g
i n fr o n t o f a m o u n ta in c a v e he h e a rd two h e rm its d i s c u s s i n g
m eth o d s o f c u r e . While Hua To was l i s t e n i n g one o f th e men
c a u g h t s i g h t o f him. "Here i s Hua.To. We can g i v e him o u r
s e c r e t , " s a i d t h e o l d man. But th e o t h e r man r e p l i e d , "Tha.t
boy i s m e r c i l e s s . How can we g iv e i t t o him?"
G r e a tly s u r p r i s e d t o f i n d h i m s e l f spoken of t h u s , Hua
To w alk ed i n t o th e c a v e . S a l u t i n g them r e s p e c t f u l l y he s a i d ,
" I hav e j u s t h e a r d you d i s c u s s m ethods o f c u r e and I c o u ld
n o t r e s i s t s t a y i n g and h e a r i n g . I h a v e alw ays l i k e d to save
l i v e s but I r e g r e t t h a t I have n o t l e a r n e d any s a t i s f a c t o r y
m ethod o f p r a c t i c e . I f you can e n l i g h t e n me I s h a l l be
g r a t e f u l f o r l i f e . "
The s e n i o r o f th e o ld men re s p o n d e d , "We a r e n o t s t i n g y
a b o u t t h e s e c r e t but i t may g iv e you t r o u b l e h e r e a f t e r . I f
you do n o t d i s t i n g u i s h b etw een th e s u p e r i o r and t h e i n f e r i o r ,
t h e r i c h and t h e p o o r, t h e n o b le and t h e common, and r e f u s e
b r i b e r y , you w i l l g e t i n t o t r o u b l e . "
H ia To a c c e p te d th e a d m o n itio n , to o k t h e i r m e d ic a l o a th ,
and r e c e i v e d a book from w hich he l e a r n e d s e v e r a l m ethods u s e
f u l to h i s f u t u r e p r e o t i c e . He c o n ti n u e d h i s s c h o o l work
and a t th e tim e Chen Kuei was Prim e M i n i s t e r he r e c e i v e d t h e
d e g r e e o f M a ste r o f A r t s . He r e f u s e d a l l l i t e r a r y o f f e r s
a n d d e v o te d h i m s e l f to m e d ic in e . He was s a i d to b e a most
c a r e f u l d i a g n o s t i c i a n ! and c o u ld p r e d i c t th e r e s u l t o f any
!K.O.Wong, "Hua T o ," C hina M edical J o u r n a l . XLI,
A u g u st 1927, 1.
16
d i s e a s e w ith m a th e m a tic a l p r e c i s i o n . In a c u p u n c tu r e he
p u n c t u r e d o n ly a few s p o t s . ! In h i s p r e s c r i p t i o n s he u se d
o n ly a few d r u g s . 2 So a c c u r a t e was he in d i s p e n s i n g t h a t
he n e v e r w eig h ed h i s i n g r e d i e n t s . In h y d r o th e r a p y he u s e d
d r a s t i c t r e a t m e n t . In one i n s t a n c e o f h ig h f e v e r he o r
d e r e d th e p a t i e n t i n t o a b a th tu b and a hundred b u c k e ts o f
c o l d w ater p o u re d o v e r h e r . The r e s u l t was a c h i l l a t th e
e i g h t h b u c k e t f u l l b u t he c o m p e lle d t h e a t t e n d a n t s to con
t i n u e t i l l t h e h un dred w ere g iv e n . The woman p r o m p tly r e
c o v e r e d . A n o th e r c i t a t i o n d s g iv e n in . w hich he dia.gnosed
p r e g n a n c y from th e p u l s e . The f a m ily t o l d him t h e woman had
j u s t b een d e l i v e r e d . He i n s i s t e d t h a t t h e r e was a n o th e r
c h i l d and o r d e r e d t h e m id w ife to remove i t . The f a m i l y ob
j e c t e d b u t a month l a t e r t h e woman was d e l i v e r e d o f a b a d ly
d e c a y e d f e t u s .
In l e c t u r i n g t o a c l a s s on th e b e n e f i t s o f s y s te m a t i c
e x e r c i s e s i n r e l a t i o n to h e a l t h , Hua To s a i d : ^
The body h e e d s e x e r c i s e o n l y i t must n o t be to th e p o i n t o f
e x h a u s t i o n . E x e r c is e e x p e ls bad a i r i n t h e system , pro m o tes
f r e e c i r c u l a t i o n o f th e b lo o d and p r e v e n t s s i c k n e s s . ’The
u s e d d o o r s te p n e v e r r o t s . ' So i t i s w ith th e body. That i s
why t h e a n c i e n t s p r a c t i c e d t h e b e a r ’s n e ck , th e f o w l ’s t w i s t ,
sw aying t h e body, moving t h e j o i n t s to p r e v e n t o ld a g e . I
have a system o f e x e r c i s e s c a l l e d 'The F r o l i c o f t h e F iv e
A n i m a l s .’ The a n im a ls a r e t h e t i g e r , t h e d e e r , t h e b e a r,
t h e monkey and t h e b i r d . I t removes d i s e a s e , s t r e n g t h e n s
t h e l e g s , and i n s u r e s h e a l t h . I f one f e e l s o u t o f s o r t s ,
j u s t p r a c t i c e any one o f t h e s e f r o l i c s . I t w i l l p ro d u c e
a s w e a tin g , g i v e a f e e l i n g o f l i g h t n e s s to t h e body and
i n c r e a s e th e a p p e t i t e .
^K.C.Wong, op. c i t .
^ I b i d .
^K.K.Ohen and Amy L in g , "Fragm ents from C h in e se H i s t o r y ,"
A n n a ls o f M edical H i s t o r y . V I I I , 185.
17
U n f o r t u n a t e l y t h e s e e x e r c i s e s o f Hua To ha.ve been l o s t .
The o n ly o ld m a t e r i a l handed down on t h e s u b j e c t o f e x e r c i s e
i s t h a t o f t h e two b o o k s. Canon o f C hanging th e S in ew s, a t
t r i b u t e d to Ta Mo, a famous b o x e r o f t h e Wei D y n a sty , and
d e v o te d m a in ly to keep b r e a t h i n g e x e r c i s e s . The o t h e r book
e n t i t l e d Eig:ht P r e c io u s C h a p te r s , i s d e v o te d to t e n s i n g move
m e n ts . T h ere a r e tw e lv e l e s s o n s i n i t . The a u t h o r i s un
known.
A side from h i s s k i l l a s a p h y s i c i a n Hua To a t t a i n e d
g r e a t s k i l l i n s u r g e r y . He i n tr o d u c e d a n e s t h e s i a i n t o h i s
w ork. T h is i s th e f i r s t a u t h e n t i c u s e o f a n e s t h e s i a in
C h in a . From t h e a n n a ls o f th e l a t e r Han D ynasty t h e r e i s
a r e c o r d t h a t Hua To c a u se d th e p a t i e n t to d rin k an e f f e r
v e s c i n g pow der i n wine w hich p ro d u ce d numbness and i n s e n s i
b i l i t y . From a stu d y o f what r e c o r d s he f i n d s on t h e sub
j e c t , K. K. Chen c o n c lu d e s t h a t t h e a n e s t h e t i c h ad In d ia n
Hemp a s an i n g r e d i e n t . "B e fo re i n c i s i o n , " w r i t e s Chen,
Hua To w o u ld 'g iv e an a n e s t h e t i c m ix tu r e c a l l e d Ma Fu Shuan.
I n th e C h in ese la n g u a g e ^ means hemp o r n a r c o t i c . Fu means
a r o m a t i c . Shuan means pow der. The a c t u a l c o n s t i t u e n t s a r e
n o t known to d a y . I t i s u n f o r t u n a t e t o have th e two m eanings
f o r th e word ma b e c a u se t h e u s e o f hemp c a n n o t b e d e f i n i t e l y
e s t a b l i s h e d . A cco rd in g to a l i t e r a r y mode o f i n t e r p r e t a t i o n
i t seem s more n a t u r a l to have th e word t r a n s l a t e d a s n a r c o t i c
a r o m a ti c p o w d e r. !
T h is a n e s t h e t i c i s o b v io u s ly r e f e r r e d to by J . B lo m f ie ld and
o t h e r w r i t e r s on a n e s t h e s i a a s p r e p a r a t i o n o f hemp.2 , 3 , 4 , 5 , 6
!o h e n , o p . c i t .
^ J . B l o m f i e l d . A n e s t h e t i c s i n P r a c t i c e a n d T h e o ry , 1.
^ J.T .G ath m ey , A n e s t h e s i a and A n e s t h e t i c s . 13.
^ J .M .P a t t e n . A n e s th e s ia , Ed. 2, 3.
^Burrough Welcome and C o . . A n e s t h e t i c s A n c ie n t and M odern, 23.
% .H .H e w i t t , A n e s t h e t i c s and T h e ir A d m i n is tr a t io n , 2.
18
Upon so im p o r ta n t a s u b j e c t i t i s j u s t to h a v e d i f f e r
e n t C h in ese o p i n i o n s . " I t i s n o t known, " s a id K. G. Wong
i n h i s monograph on Hua To,
w hat was t h e e x a c t c o m p o s itio n o f t h e n a r c o t i c w in e of P i en
C h iao o r t h e e f f e r v e s c i n g powder o f Hua To. L atter p h y s i c i a n s
how ever, employed d a t u r a a l b a , rh o d e n d ro n s i n e n s e . jasm ine
s a m b a c .-and v a r i o u s s p e c i e s o f a c o n i t e f o r t h i s p u rp o s e . P r e
s c r i p t i o n s o f t h i s k in d a r e r a r e . In f a c t , none can be
fo u n d i n t h e o rd in a r]; t e x t - b o o k s . !
In th e A nnals o f t h e S t a t e o f Wei and Han, an d i n th e
T h r e e Kingdoms and i n o t h e r h i s t o r i c a l works o f t h e p e r i o d ,
t h e r e a r e fo u n d r e c o r d s o f Hua To. I n them a r e l o n g l i s t s
o f m a r v e llo u s c u r e s o f v e r y s t r a n g e d i s e a s e s , i n c l u d i n g a ls o
o p e r a t i o n s r a n g i n g from s im p le a c u p u n c tu r e t o t h e m ost com
p l i c a t e d o n e s upon th e l i v e r , s p le e n , i n t e s t i n e , b o n e s and
b r a i n . T hese a c c o u n ts a r e found i n t h e p u b l i c docum ents
b e c a u s e Hua To s e r v e d a s c o u r t p h y s i c i a n to Tso T so, th e k in g
o f Wei. C o n se q u e n tly h i s work was among th e n o b i l i t y and
t h e renowned , o f C hina an d much more a p t to be r e c o r d e d th a n
i f i t had b e e n among th e p o o r and t h e lo w ly .
When o ld and w e a r ie d , Hua To a s k e d f o r p e r m i s s io n to r e
t u r n t o h i s home to v i s i t . When t h e k in g s e n t f o r him to
r e t u r n to t h e c o u r t , Hua To s e n t word t h a t h i s w if e was i l l
a n d t h a t he c o u ld n o t r e t u r n . E n rag ed , th e k i n g s e n t o f f i
c e r s a f t e r him and th re w him i n t o p r i s o n . L a t e r he was ex
e c u t e d . A n o th e r v e r s i o n i s t h a t h i s d e a th r e s u l t e d from t h e
k i n g ' s ra g e when Hua To o f f e r e d t o open th e s k u l l o f th e k in g
u n d e r h a s h i s h i n o r d e r t o r e l i e v e him of t h e h e a d a c h e from
! k. 0. Wong, on. c i t .
19
w h ic h he was s u f f e r i n g . T h is i s p r o b a b l y th e f a c t of th e
c a s e s i n c e i t i s g iv e n i n t h e S t a t e A n n a l s .!
J u s t b e f o r e h i s d e a t h Hua To o f f e r e d h i s m a n u s c r ip ts
t o t h e j a i l e r t e l l i n g him t h a t i n them w ere many v a lu a b le
s e c r e t s . The j a i l e r d a re d n o t t a k e them , c o n s e q u e n tly Hua
To b urned them . I t i s s a i d t h a t a few l e a v e s e sc a p e d th e
f la m e s and t h a t i n them was a d e s c r i p t i o n o f t h e method o f
c a s t r a t i o n , t h e o n ly o p e r a t i o n t h a t t h e C hinese p r a c t i c e d
u n t i l w i t h in t h e p r e s e n t c e n t u r y . 2
T here h a v e grown up a g r e a t number o f l e g e n d s a b o u t h i s
work and name. T here a r e two books e x t a n t b e a r i n g h i s name.
One o f them i s e n t i t l e d E e l Chao Tu. o r "In n e r R e f l e c t i o n
D ia g ra m s ," arid t h e o t h e r i s e n t i t l e d Chung Tsang Qhing. o r
" I n t e r n a l O rg a n s ." T h is l a t t e r c o n t a i n s i n i t t h e e a r l i e r
a c c o u n t o f t h e i n t e r n a l u s e o f c alo m el i n t h e r a p e u t i c s . The
c o n s e n s u s o f C h in ese o p i n io n i s t h a t t h e s e a r e f o r g e r i e s , a l
th o u g h th e y d a t e from an e a r l y p e r i o d .
Such i s t h e r e v e r e n c e t h a t i s now g iv e n t o .Hua To, t h a t
i n t h e te m p le s a l l o v e r C h in a a r e f i g u r e s r e p r e s e n t i n g him
a s t h e god o f h e a l i n g . W ith good b u s i n e s s i n s i g h t th e
p r i e s t s o f t h e tem p les manage t o t u r n t h i s i n t o a s o u rc e o f
incom e f o r t h e te m p le . They p l a c e n e a r t h e s t a t u e o f th e
god o f h e a l i n g a l a r g e v e s s e l o r u r n , u s u a l l y o f b e a u t i f u l
sh a p e and d e s i g n , and i n t h i s u r n t h e r e a r e bamboo s l i p s o r
b o a r d s . On th e bamboo b o a rd s a r e w r i t t e n num bers i n d i c a t i n g
!%.%:.Chen and Amy L in g , on. c i t . . 185.
2k , C. W ong, op. c i t . , XLI, 1.
so
a p r e s c r i p t i o n c o r r e s p o n d in g to th e number. T hese a r e l a
b e l l e d " S u p e r i o r ," "Medium," " I n f e r i o r , " a c c o r d i n g t o th e
g r a v i t y o f t h e d i s e a s e . In a n o th e r u r n a r e th e p r e s c r i p t i o n s
The v a r i e t y o f t h e s e p r e s c r i p t i o n s a r e i n f i n i t e . Sometimes
t h e p a t i e n t i s s e n t t o a m ed ica l d o c t o r . The w r i t e r o f t h i s
p a p e r r e c a l l s a p a t i e n t who had a sk e d f o r D r. W hitmore and
w ould n o t be p u t o f f oh any o f t h e o t h e r d o c t o r s o f th e s t a f f .
"?/hy w ould you n o t t a k e t h e s e r v i c e s o f one o f t h e o t h e r F o r
e ig n o r C h in e s e d o c to r s ? " was a sk e d o f h e r . "Hua To gave me
t h i s , " was h e r answ er and she p ro d u c e d th e p r e s c r i p t i o n on
w h ich was w r i t t e n , "Saung. l i a n g Wei E-Sung, " " C o n s u lt Dr.
W hitm o re." F o llo w in g a r e t h r e e p r e s c r i p t i o n s q u o te d by Dr.
Chen:
1 . Ho. 168. S u p e r i o r - S u p e r i o r .
The n e a rb y f r a g r a n c e o f in c e n s e .
The g le a m in g l a n t e r n s n e a r by
Are a l l p a r t o f God’s good w i l l .
Then why s h o u l d n ’t you go a f a r
Up th e m o u n ta in s to f a i r y la n d s ?
As soon a s you b e g in to f e e l i n harmony
A ll w i l l be w e ll w ith you.
So c l o s e y o u r d o o rs and b e i n p e a c e .
D i l u t e g i n g e r j u i c e , t h r e e f e n .
Take i n b o i l i n g w a te r .
2. Ho. 2. Medium-Medium.
A c r a n e i s f l y i n g i n t h e sky
W ith i t s q u i v e r i n g s u i t o f g ra y .
Coming and g o i n g , u n c o n t r o l l e d by a n y b e in g ,
l o t even t h e s ig n s o f t h e d ra g o n i n t h e c lo u d s
Could a f f e c t i t s c o u r s e i n t h e l e a s t .
You a r e f r e e . Do n o t w o rry .
Ho m e d ic in e n e c e s s a r y .
21
3. No. 3 I n f e r i o r - î n f e r i o x .
Your coming h i t h e r i s n o t s i n c e r e
Ask y our c o n s c ie n c e i f t h i s b e n o t so.
You w i l l n o t be g r a n t e d an y m e d ic in e .
F in e d t h r e e c a t t i e s f o r i l l u m i n a t i n g o i l f o r
t h e t einple.
Each p r e s c r i p t i o n , i t sh o u ld be n o te d , c o n s i s t s of. a
num ber, a c o m b in a tio n o f q u a l i t i e s , an d a s u p e r s c r i p t i o n de
s c r i b i n g t h e c o n d i t i o n i n a p o e t i c form , and an i n s c r i p t i o n
p r e s c r i b i n g one o r more d ru g s o r g i v i n g some o t h e r a d v ic e .
P e o p l e have g r e a t f a i t h i n t h e s e p r e s c r i p t i o n s and a s soon
a s i l l n e s s e s o c c u r i n a f ’ amîly someone i s d e s p a tc h e d to th e
te m p le f o r one o f them, r e g a r d l e s s o f t h e number o f p h y s i c i a n s
who may be c a l l e d i n .
U ndoubtedly Hua To was t h e g r e a t e s t su rg eo n C hina p r o
d u c e d i n a n c i e n t tim e s . The O onfucian t e a c h i n g w hich h o ld s
t h a t th e body i s s a c r e d and n o t to b e m u t i l a t e d i n an y way
h a s h e ld s u r g e r y back s i n c e h i s day . With such t e a c h i n g
t h e r e h as been no o p p o r t u n i t y f o r p h y s i o l o g y a n d anatom y to
make any p r o g r e s s . W ithout t h i s fu n d a m e n ta l know ledge r e a l
s u r g e r y i s im p o s s i b l e . W ith th e d e a t h of t h i s g r e a t su rg e o n
ended C hin ese s u r g e r y t i l l t h e p r e s e n t c e n tu r y . Today t h e r e
a r e many W estern t r a i n e d men, who a r e d o in g b e t t e r s u r g e ry
t h a n Hua To e v e r dreamed o f .
I I . M edical P r a c t i c e s o r A chievem ents o f th e H i s t o r i c a l P e r io d ,
Many s p l e n d i d a c h ie v e m e n ts s ta n d t o th e c r e d i t of t h e
C l a s s i c a l o r H i s t o r i c a l P e r i o d o f C h in e se M ed icin e. Among
them may be m en tio n ed : A lchem y,! m assage, a c u p u n c tu r e ,
^Edward Thomas W illia m s , A S h o rt H i s t o r y o f C hina. 100.
23
anatom y and d i s s e c t i o n , c i r c u l a t i o n o f t h e b lo o d , h y g ie n e ,
c a t h e t e r i z a t i o n , c a s e h i s t o r i e s , ty p h o id and o t h e r f e v e r
t r e a t m e n t s , a n e s t h e s i a an d s u r g e r y , t h e f o u r m ethods o f
d i a g n o s i s .
ALCHEMY
Wang Ti was r e s p o n s i b l e f o r th e i n t r o d u c t i o n o f alchem y
i n t o C hina, 66 A.D. The C h in ese a r e a c o n s e r v a t i v e r a c e and
i t r e c e i v e d l i t t l e s u p p o r t i n t h e b e g in n in g . Two f a c t o r s ,
n e v e r t h e l e s s , p e r p e t u a t e d i t . At t h i s tim e Taoism was de
c l i n i n g i n C h in a and C hina was i n a f a i r way o f b e i n g r i d o f
i t . A c l e v e r T a o i s t p r i e s t , Ohang T a o - l in g , saw i n alchem y
a n o p p o r t u n i t y t o hoodwink u n s u s p e c t i n g p e o p le and g a in f a
v o r f o r h is c u l t . He i n v e n t e d charm s and i n c a n t a t i o n s which
p ro m is e d h e a l t h t o t h e p e o p le and a t t h e same tim e f i l l e d h i s
c o f f e r s . The se co n d f a c t o r was t h a t t h e B u d d h ist p r i e s t s
s e e i n g th e a d v a n ta g e i t g av e th e T a o i s t s , im m e d ia te ly i n v e n t
ed t h e i r sy ste m o f i n c a n t a t i o n s and charm s. The p e o p le have
n e v e r been a b l e to lo o s e n th e g r i p o f t h e p r i e s t h o o d and th e
r e s u l t i s t h a t to d ay th e m asses a r e s te e p e d i n a l l s o r t s o f
s u p e r s t i t i o n s . The s e a r c h f o r th e p h i l o s o p h e r ’s s to n e and
t h e e l i x i r o f l i f e , and th e f o u n t a i n o f y o u th , r e a c h e d i t s
c lim a x i n t h e Tang D y n a sty .
E verybody, d o c t o r s , m a g ic ia n s , a l c h e m i s t s , r u l e r s and
members o f t h e c o u r t and t h e common f o l k , were e x p e r im e n tin g .
Out o f tw e n ty -tw o r u l e r s o f t h i s p e r i o d , se v en l o s t t h e i r
l i v e s th ro u g h e x p e rim e n tin g w ith t h e s e e l i x i r s . ! " In t h e s e
I g h i h C M , S h ih C hi. X II, 2.
23
v a i n p u r s u i t s , " sa y s K.O.Wong, " th e tim e and th e h e a l t h and
t h e f o r t u n e s o f th o u s a n d s w ere w a s t e d ." ! I t was tw e lv e
h u n d re d y e a r s l a t e r when t h e c r a z e s t r u c k E urope. In judg
i n g t h i s p h a s e o f C h in ese e v o lu t i o n i t must be remembered
t h a t a s a s t r o l o g y was th e o r i g i n o f a stro n o m y , so alchem y
was t h e b e g in n i n g o f c h e m is tr y . Alchemy began i n China in
t h e t h ir d c e n t u r y b e f o r e C h r i s t and n o t s i x hundred yea.rs
l a t e r among t h e A le x a n d r ia n C reeks a s some would have u s b e
l i e v e . C h ie f among th e a lc h e m i s t s was Keh Hung 281-360 A.D.
He w ro te th e famous Handbook o f E m e rg en c ie s. T h is book con
t a i n e d an a u t h e n t i c d e s c r i p t i o n o f sm a llp o x , t h e f i r s t in t h e
w o rld . H h a z e 's a c c o u n t , ■which i s r eg a rd ed a s t h e e a r l i e s t
r e c o r d , was b e tw e e n 880-932 A.D.
MA88ACE
M assage had been u s e d from e a r l i e s t tim e s i n China b u t
i t was i n t h e Tang D y n asty t h a t i t was r a i s e d to t h e rank o f
a s c i e n c e and formed one o f th e seven d e p a rtm e n ts o f m e d ic in e .
At u n i v e r s i t i e s t h e r e was a s p e c i a l c h a i r o f m assage w ith a
p r o f e s s o r i n c h a r g e o f i t . A f t e r t h e Sung D ynasty t h i s
p r a c t i c e was d ro p p ed and m assage i s to d a y l a r g e l y i n th e
h a n d s o f b a r b e r s and t h e b l i n d .
ACUPUNCTURE
A cu p u n ctu re h a s been t h e g r e a t p a n a c e a f o r a l l t h e i l l s
o f t h e C h inese p e o p le . The i n v e n t i o n p ro b a b ly d a t e s from
a n t i q u i t y , f o r t h e n e e d l e s fo r m e r ly w ere made o f f l i n t . In
^K.O.Wong, op. cit. . 306.,
24
many C hinese w orks a r e good d e s c r i p t i o n s o f t h e p r a c t i c e .
In t h e 1 9 th c h a p t e r o f th e Su Wen i s t h e f o l lo w in g :
E v ery malady i s a v i s c e r a l d i s o r d e r . A v i s eus e i t h e r does
n o t s e c r e t e i t s em anation o r does n o t s e c r e t e enough o f i t ,
o r r e t a i n s i t i n s t e a d o f c i r c u l a t i n g i t . I t may th u s p ro
d u ce had work o r p a r a l y s i s o f an o r g a n . . . . What d o e s one do
t o a n ox when he draw s b a d ly ? One g i v e s him a b low w ith th e
g o a d . The a c u p u n c tu r e i s n o th in g e l s e . One p r i c k s th e re
c a l c i t r a n t o rg a n . The d a n g e rs and t h e in c o n v e n ie n c e s o f th e
m ethod sh o u ld be remembered. One s h o u ld n e v e r u s e th e n e e d le
t o o v i o l e n t l y , a n d i f i t i s u s e d e v e r so l i t t l e t o one s i d e ,
t h e r e i s t h r e a t to l i f e . The d i r e c t p r i c k s h o u ld b e r e s e r v e d
f o r d e s p e r a t e c a s e s where t h e r e i s n o t h i n g to l o s e . In o r
d i n a r y c8,8es i t i s b e t t e r to p r a c t i c e i n d i r e c t a c u p u n c tu r e .
One sh o u ld know th e p a r t s o f th e body t h a t c o r r e s p o n d to th e
v i s c u s . One p r i c k s su ch a p a r t to p u t a v i s c u s i n t o o p e ra
t i o n . I f t h e p u l s e has denounced th e h e a r t a s t h e a u th o r o f
t h e d i s o r d e r , one p r i c k s a c e r t a i n r e g i o n o f th e b a ck which
c o r r e s p o n d s t o t h e h e a r t . The h e a r t f r i s k s w ith p a i n , re c o v
e r s i t s e l f , and s e t s to work to d i s t r i b u t e th e b lo o d and t h e
v i t a l s p i r i t a,s i t o u g h t, to a l l t h e body. I f i t s f u n c t i o n
i n g l e a v e s so m e th in g to be d e s i r e d , one p r i c k s th e p l a c e
a g a i n and s t i l l a g a i n . !
In 1027 A.D. th e Emperor had two a n a to m ic a l f i g u r e s made
t o i l l u s t r a t e t h e a r t o f a c u p u n c tu r e . The c o p p e r model,
s t i l l a t t h e T ai I Yuen o r m ed ical c o l l e g e a t P e k in g , i s th e
f i g u r e o f a man s i x f e e t t a l l , on w h ich a r e g iv e n t h e names
o f t h e p u l s e a t d i f f e r e n t p a r t s o f t h e b o d y . 2 i t i s p i e r c e d
w ith v e ry s m a ll h o l e s . . I t i s c o v e re d w ith p a p e r and th e n
t h e m ed ical s t u d e n t s a r e r e q u i r e d to p r a c t i c e f i n d i n g th e
h o l e s . T h is i s t h e same p r a c t i c e t h a t was r e q u i r e d o f th e
d o c t o r s o f t h e Tang D y n a sty . The p e o p le o f t h a t tim e and
e v e r s i n c e h a v e been p r i c k e d . Many have d ie d from i t b u t
many have n o t , n a t u r e h e a l i n g t h e wounds.
Remusat s a i d t h a t t h e f i r s t n o t i o n o f a c u p u n c tu r e was
^Anonymous, Su Wen. XIX, R e v ised in th e Han D yn asty.
3 s .W e lls W illia m s, The M iddle Kingdom. I I , 1 2 3 .
25
b r o u g h t i n t o Europe from China, by a D u tch su rg e o n named
Ten-Rhyne a t t h e end o f t h e 1 7 th c e n t u r y . !
ANATOMY AND DI88E0TI0N
B ecause o f t h e t e a c h i n g s o f C o n fu c iu s t h e r e g rew up
g r e a t r e v e r e n c e f o r t h e d e a d . B ecause o f t h i s human d i s
s e c t i o n wa,s n o t common. But d i s s e c t i o n was d e s c r i b e d be
f o r e t h a t tim e , i n 2697 B.C. In th e Li She i t i s s t a t e d
t h a t a f t e r d e a t h th e body may be d i s s e c t e d and o b s e r v a t i o n s
made a s t o t h e s i z e o f t h e o rg a n s , t h e c a p a c i t y o f th e i n
t e s t i n e s , t h e l e n g t h o f th e b lo o d v e s s e l s and so o n . 2 In
t h e Han D y n a sty Emperor Wang Mang c a p t u r e d a r e v o l u t i o n a r y
and o r d e r e d t h e c o u r t p h y s i c i a n to d i s s e c t h i s body and make
m easurem ents o f th e i n t e r n a l o rg a n s . The c o u r t p h y s i c i a n
i n s e r t e d bamboo ro d s i n t o th e blood v e s s e l s to s e e where
th e y began and e n d ed .^ Many r e c o r d s o f t h i s k in d a r e in
t h e a n c i e n t l i t e r a t u r e b e f o r e th e tim e o f C o n fu c iu s . S in c e
t h a t tim e g r o s s m is ta k e s a r e in th e C h in ese c o n c e p tio n s o f
p h y s i o l o g y and anatomy.
CIRCULATION OF THE BLOOD
"About two th o u sa n d y e a r s b e f o r e Harvey made h i s d i s
c o v e ry o f t h e c i r c u l a t i o n o f th e b l o o d ," s a i d K. C. Wong,
t h e h i s t o r i a n o f a n c i e n t C hinese m e d ic in e , " th e C h in ese made
^M. Rem usat, Nouveaux Melanges A s i a t i q u e s , I , 358-389.
^Anonymous, Li She. I , 12.
^K.O.Wong, op. c i t . , 206.
26
a n e a r g u e s s . " ! He b a se d h i s a s s e r t i o n on th e f o l lo w in g
s i g n i f i c a n t p a s s a g e from th e canon o f m e d ic in e :
A l l t h e b lo o d i s u n d e r t h e j u r i s d i c t i o n o f th e h e a r t . The
tw e lv e b lo od v e s s e l s a r e d e e p ly h id d e n u n d e r th e m u sc le s and
c a n n o t be s e e n , o n ly t h o s e on th e o u t e r a n k le s a r e v i s i b l e
b e c a u s e t h e r e i s n o th in g t o c o v e r them i n t h e s e p l a c e s . A ll
o t h e r b lo o d v e s s e l s on t h e s u r f a c e o f t h e body a r e l o h v e s
s e l s ( v e i n s ) . The h a rm fu l e f f e c t s o f t h e wind and t h e r a i n
e n t e r th e body sy stem f i r s t th ro u g h t h e s k in . I t i s th e n
conveyed to t h e su n v e s s e l s ( c a p i l l a r i e s ) . When t h e s e a r e
f u l l i t goes t o th e l o h v e s s e l s ( v e i n s ) and t h e s e i n t u r n
empty i n t o t h e b ig c h in a r t e r i e s . The b lo o d c u r r e n t flo w s
c o n t i n u o u s l y and n e v e r s t o p s . 2
The Su Wen s a y s :
The h e a r t w h ich p r e s i d e s o v e r t h e f o r m a t io n o f t h e b lo o d ,
o v e r t h e c i r c u l a t i o n , an d o v e r t h e a n im a l h e a t , p a r t a k e s o f
t h e a g e n t f i r e . I t re s p o n d s t o t h e i n f l u x o f h e a t , to th e
o r i e n t a t i o n o f th e s o u th , an d to th e c o l o r re d . T h at w hich
h a s ' a b i t t e r t a s t e n o u r i s h e s i t . Too much b i t t e r i n j u r e s
t h e h e a r t and to o much a f f e c t i o n e x h a u s t s i t . The h e a r t i s
t h e s e a t o f t h e v i t a l s p i r i t and i s t h e p r i n c e o f t h e o rg an
ism . From i t comes v i t a l s p i r i t and c o n s e q u e n tly a l l
a c t i v i t y . ^
The l a t e r view i s t h a t o f t h e o ld p h i l o s o p h i c a l t e a c h i n g .
THE FOUR METHODS OF DIAGNOSIS
I n O hina, a s i n o t h e r c o u n t r i e s , m ethods o f d i a g n o s i s
h a v e v a r i e d i n d i f f e r e n t p e r i o d s o f tim e . The Nei C hing men
t i o n s f o u r m e th o d s :^ O b s e r v a tio n , A u s c u l t a t i o n , I n t e r r o g a
t i o n and P a l p a t i o n . These d i f f e r e d from th e p r a c t i c e s i n th e
same l i n e s t o d a y i n t h a t th e y were much more l i m i t e d th a n th e
^K.C. Wong, op. c i t . . 206.
2a S t a f f o r M edical Men, The Oanon o f M e d icin e, XXXVII,
p a r t 3.
^Anonymous, Su Wen, Han D y n asty R e v is io n , XIX.
% u an g T i, Nei C h in g . 3697 B.C. (N ot p a g e d .) Not i n
b o o k form t i l l Han D y n asty . Wang P in g w ro te e x p la n a t o r y
n o t e s 620 A.D.
27
m odem p r a c t i c e s . O b s e r v a tio n r e f e r r e d o n ly to th e com
p l e x i o n and e x p r e s s io n o f t h e f a c e . A u s c u l t a t i o n was lim
i t e d to th e v o i c e and so u n d . I n t e r r o g a t i o n was i n q u i r y
i n t o th e h i s t o r y , symptoms, and c a u se o f th e i l l n e s s . In
t h e hands o f a com petent p h y s i c i a n t h i s method was s i m i l a r
t o t h a t o f a W estern t r a i n e d p h y s i c i a n e x c e p t n o t so- de
t a i l e d . P a l p a t i o n was l i m i t e d to t h e p u l s e .
In th e e a r l y u s e o f t h e s e m ethods i o ^ o r t a n c e was a s
s i g n e d to t h e m ethods i n t h e o r d e r g iv e n . The D i f f i c u l t
C l a s s i c s a y s , "To know by o b s e r v a t i o n i s su b lim e , by a u s c u l
t a t i o n i s w o n d e r f u l, by i n t e r r o g a t i o n , s k i l l f u l , by p a l p a t i o n ,
a r t . " ! Ohang G hung-king, C h in a ’s m e d ic a l sa g e , i n th e
G o ld en Chamber rem arked, "The s k i l l f u l d o c t o r knows by o b s e r
v a t i o n , th e m ed io cre d o c t o r by i n t e r r o g a t i o n , w h ile th e o r d i
n a r y d o c to r knows by p a l p a t i o n . "2 i n th e t e x t . The Thousand
G old R e m e d ie s, i s fo u n d a n o t h e r view : "The s k i l l f u l d o c to r
knows what i s wrong by o b s e r v in g a l o n e , th e m id d lin g d o c to r
by l i s t e n i n g , and .the i n f e r i o r d o c to r by f e e l i n g t h e p u l s e .
'The f i r s t t h r e e g r a d u a l l y f e l l i n t o d i s u s e . At th e
p r e s e n t e n t i r e r e l i a n c e i s p la c e d upon p a l p a t i o n o f th e p u l s e
by a l l d o c t o r s n o t t r a i n e d i n W estern m e d ic in e . They have
a c c e p t e d t h e d o c t r i n e o f sym pathy w hich te a c h e s t h a t a l l
i n t e r n a l d i s e a s e s a r e u n d e r c o n t r o l o f th e p u l s e , h en ce can
be r e v e a le d by th e p u l s e .
! Anonymous, The D i f f i c u l t C l a s s i c , n o t p a g ed .
^Ohang G hung-king, The Golden Ghaai'ber. XXXVII, 43.
^Sun Su-moh, The Thousand Gold Rem edies. VI, 7.
38
HISTORICAL DATA O N THE PULSE
A lth o u g h t h e r e a r e one h u n d red and f i f t y - s i x volumes
w r i t t e n on t h e s u b j e c t o f p u l s e l o r e , y e t th e h i s t o r i c a l
d a t a i s more d i f f i c u l t to o b t a i n . K. 0. Wong h a s b r i e f l y
sum m arized th e m ain h i s t o r i c a l p o i n t s ; !
I t i s r e c o r d e d 'i n th e A n c ie n t H i s t o r y t h a t P i en C h ia o , who
l i v e d a b o u t 255 B .C ., was th e f i r s t ex p o n en t o f t h i s id e a .
But Wang Shu-ho of' th e Chin D ynasty a b o u t 280 A.D, i s g e n e r
a l l y acknow ledged as t h e g r e a t e s t a u t h o r i t y . He w ro te "The
P u l s e C l a s s i c , " a work o f t e n volum es, w hich i s c o n s i d e r e d
one o f th e s t a n d a r d works on m e d i c i n e . . . About t h e p e r i o d o f
t h e F iv e D y n a s t i e s 90 7-960 t h e r e a p p e a re d a work e n t i t l e d
"The S e c r e t o f The P u l s e , " w hich was a l s o a s c r i b e d t o Wang
S h u -h o . - R e s e a r c h e r s , how ever, p o i n t t o i t s b e in g a s p u r io u s
w ork, most p r o b a b l y w r i t t e n by Kao Y an-sheng, The form and
l i t e r a r y s t y l e i s p o o r w h ile some o f t h e t e a c h i n g a l s o d i f
f e r s from t h e c l a s s i c . T h is h a s b e e n t h e o c c a s i o n o f much
c o n t r o v e r s y among l a t e r w r i t e r s . A F re n c h m is s io n a r y , H.
H e r y ie u , t r a n s l a t e d i t i n t o F re n ch u n d e r t h e im p r e s s io n t h a t
i t was a g e n u in e work. The F re n ch copy was t r a n s l a t e d i n t o
E n g l i s h by E. B rookes i n 1736 and l a t e r p u b l i s h e d b y E. Cave,
1 7 3 8 . As f a r a s can b e a s c e r t a i n e d t h i s i s t h e f i r s t C hinese
m e d ic a l book t r a n s l a t e d i n t o a f o r e i g n la n g u a g e . R e p r in t s
o f t h e o r i g i n a l C l a s s i c s t i l l e x i s t th o u g h e x tr e m e ly r a r e .
I t may be o f i n t e r e s t t o g iv e h e r e a s h o r t h i s t o r y o f th e
v a r i o u s e d i t i o n s o f t h i s v a l u a b l e work th ro u g h t h e s u c c e s s iv e
d y n a s t i e s . The Sui and th e Tang A n n a ls , The Thousand Gold
R em edies, K an ’s M edical B io g rao h y , a l l m ention t h i s work. I t
was n o t t i l l t h e F iv e D y n a s t i e s , a s a l r e a d y s t a t e d a b o v e , t h a t
g r e a t c o n f u s io n a r o s e by t h e a p p e a ra n c e o f th e s p u r i o u s work.
The S e c r e t o f The P u l s e , w hich became so p o p u l a r t h a t th e
r e a l c l a s s i c was f o r c e d i n t o o b l i v i o n . D u rin g t h e Sung D y n asty
L in I and o t h e r s i n 106 8-1078 A.D* e d i t e d o ld m e d ic a l books
o f t h e p a l a c e , u n d e r I m p e r ia l o r d e r s , and th e P u l s e C l a s s i c
was in c lu d e d i n th e c o l l e c t i o n . In C h i a ’s tim e when Chen
K’ u n g -sh ih , h a v in g o b t a i n e d a C hien Yang copy, r e p r i n t e d i t
a t Tsao Szu, Kwangsi. In t h e Yuan D y n a sty , 1327 A .D ., Hsia.
C hin-w ang o f L iu P in r e p r i n t e d C hen’s e d i t i o n a t Tung L ien
Academy, K i a n g s i . ' In t h e Ming P e r i o d Wu Mi e n -h su eh i n c lu d e d
i t i n h i s c o l l e c t i o n o f m e d ic a l r e p r i n t s . U n f o r t u n a t e l y th e
t y p o g r a p h i c a l e r r o r s a r e such t h a t i t i s u n r e a d a b l e . In th e
t h i r d y e a r o f Wan L i, 1576, o f t h e Ming D y n asty , 8u Ching-
s h i n g , c o u n c i l o r o f F u k ie n , o r d e r e d Yuan P ia o to r e v i s e Wu’s
e d i t i o n w ith t h e n e c e s s a r y c o r r e c t i o n s . Coming t o th e T sin g
^K.C.Wong, op. cit., 207.
29
D y n a sty , we f i n d t h a t Wang H ung-nai o f Ghia T ing r e n d e r e d a
good s e r v i c e i n p e r p e t u a t i n g th e C l a s s i c by b r i n g i n g t o g e t h
e r t h e Yuan and t h e Ming e d i t i o n s w ith an old m a n u s c r ip t o f
h i s own and a n o t h e r r e p r i n t by Chu C h in g -ta n g . He c a r e f u l l y
r e v i s e d t h e t e x t and i s s u e d a v a l u a b l e r e p r i n t o f i t . T his
a g a i n i s i n c l u d e d i n Chou H s u e h - h a i 's C o l l e c t i o n o f M edical
R e p r i n t s o f 1 8 9 1 .
PULSE TABLES
The f o l l o w i n g t a b l e shows th e f o u r system s t h a t s ta n d
o u t most p r o m in e n tly and shows th e r e l a t i o n s h i p betw een th e
p u l s e and th e o rg a n s , a s b e l i e v e d by t h e C h in ese. The
p u l s e sp a ce a t t h e w r i s t i s d i v i d e d i n t o t h r e e p a r t s c a l l e d
i n c h , b a r , and c u b i t .
Wang Shu-ho Nei C hing
30
G olden Chamber Shih Chen
L e f t W rist
In c h
B ar
Ex, H e art
I n . Small
I n t e s t i n e s
Ex. l i v e r .
H e art M e d i a s ti n a l H e a rt
v i s c e r a
M e d i a s ti n a l H e a rt
v i s c e r a
L iv e r
C u b it
Ex. Kidney
I n .U r i n a r y
b la d d e r
Kidney
B e lly
M e d ia s tin a l
v i s c e r a
D iaphragm and L iv e r
g a l l b la d d e r
I n .G a l l b l a d d e r .Diaphragm L iv e r
G a ll b l a d d e r
Sm all i n t e s t i n e s Kidney
u r i n a r y b la d d e r
Kidney Sm all
I n t e s t i n e
R ig h t W ris t
Inch
Bar
Ex. Lung
In . Large
I n t e s t i n e
Ex. S p leen
In .S to m ach
Lung
T h o ra c ic
o r g a n
Stomach
S p le e n
Ex. G ate o f L i f e Kidney
C u b it
In . San C hiao B e lly
T h o ra c ic o rg a n Lung
Lung
Stomach
T h o ra c ic
organ
Stomach
S p le e n S p le e n
L arg e i n t e s t i n e Kidney
Kidney L arg e
I n t e s t i n e
31
VARIETIES OF PULSE
T h e re a r e f o u r I p r i n c i o a l p u l s e s ;
1. Fu, a s u p e r f i c i a l , l i g h t f lo w in g p u l s e l i k e a p i e c e
o f wood f l o a t i n g on w a te r.
2. Oh’ eng, a d e e p ly im p re ss e d p u l s e l i k e a s t o n e
throw n i n t o w a te r.
3. Oh’ i h , slow , a p u l s e w ith t h r e e b e a t s to one c y c le
o f r e s p i r a t i o n .
4. Shu, q u ic k , a p u l s e w ith s i x b e a t s to one c y c le o f
r e s p i r a t i o n .
Li S h ih G hen’s l i s t o f s u b s i d i a r y p u l s e s :
1. Hua, s l i p p e r y , l i k e p e b b le s r o l l i n g i n a b a s i n .
2. Be, s m a ll, f i n e slo w and s h o r t l i k e s c r a p i n g
bamboo w ith a k n i f e .
3. Hsu, einpty, slow , l a r g e an d c o m p r e s s ib le .
4. S h ih , f u l l , l a r g e , lo n g and s l i g h t l y t e n s e .
5. Chang, lo n g , n e i t h e r l a r g e n o r sm a ll, th e s t r o k e
p r o lo n g e d .
6. Tuan, s h o r t , no volum e, s t r i k e s th e f i n g e r s h a r p ly ,
l e a v e s i t q u i c k l y .
7. Hung, o v e rf lo w in g , f u l l , b o u n d in g , f o r c e f u l , r i s i n g ,
g r a d u a l d e c l i n e .
8. Wei, th r e a d y , v e ry f i n e and s o f t , e a s i l y o b l i t e r a t e d
by p r e s s u r e .
9 . C hin, t e n s e , h a r d and f u l l l i k e a c o rd .
10. Euan, t a r d y , l i k e w illo w b ra n c h e s sw aying i n th e
w ind, equ al s t r e n g t h .
3 2
11. Kung, h o llo w , s u p e r f i c i a l s o f t and h o llo w l i k e an
o n io n s t a l k .
12. H s ia n , t a u t , l i k e a tre m u lo u s m usic s t r i n g .
13. Ke, h a r d , t e n s e and h o llo w l i k e to u c h in g th e
s u r f a c e o f a drum.
14. Lao, deep s t r o n g and s l i g h t l y t a u t .
15. J u , s o f t , s u p e r f i c i a l and f i n e , l i k e t h r e a d f l o a t
i n g on w a te r .
16. Jo , f e e b l e , v e ry s o f t and d e ep , l i g h t l y coming and
g o in g .
17. San, s c a t t e r e d , l a r g e i r r e g u l a r l i k e w illo w flo w e rs
s c a t t e r i n g w ith t h e wind.
18. H si, sm a ll and f e e b l e , alw ay s p e r c e p t i b l e l i k e a
s i l k t h r e a d .
19. Tung, tre m u lo u s , q u ic k and je r k y , p u l s a t i o n s no
l a r g e r th a n a p e a .
20. C hieh , i n t e r m i t t e n t , slow w ith o c c a s i o n a l m is s in g
b e a t .
21. T s 'u , ru n n in g , r a p i d w ith m is s in g b e a t s . !
INDICATIONS OF THE PULSE
N o thin g i n th e p r a c t i c e o f m e d ic in e i s more im p o rta n t
t o t h e n a t i v e t r a i n e d p h y s i c i a n th a n t h e i n d i c a t i o n o f th e
p u l s e . H is p r o g n o s i s d ep en d s upon t h e i n d i c a t i o n s he f i n d s
i n t h e p u l s e . He must know t h e C h in ese n o t io n o f anatomy and
be a b l e to i n t e r p r e t t h e i n d i c a t i o n s .
%Li S h ih -c h e n , P u ls e C l a s s i c . V ol. I , A r t i c l e 1.
33
The o ld t e x t books a r e y e t u s e d by th o u sa n d s o f th e
n a t i v e d o c t o r s . A c c o rd in g t o t h e s e books t h e r e i s no d i s
t i n c t i o n b e tw e e n venous and a r t e r i a l b lo o d , n o r b etw een
m u s c le s and n e r v e s . They u s e th e same word f o r te n d o n s and
n e r v e s . The b r a in i s t h e home o f t h e Yin p r i n c i p l e . At
t h e b a s e o f t h e b r a i n i s a c o l l e c t i o n o f marrow w hich com
m u n ic a te s t h r o u g h t h e s p i n e w ith t h e w hole body. The l a r y n x
g o e s d i r e c t l y th ro u g h t h e lu n g s t o g e t h e r w ith t h e h e a r t . The
p h aryn x p a s s e s o v e r them to th e stom ach. The lu n g s a r e
w h i t e and p l a c e d in th e t h o r a x . They c o n s i s t o f s i x lo b e s
o r l e a v e s su sp en d e d from t h e s p in e , f o u r lo b e s on one s i d e
a n d two on t h e o t h e r . The c e n t e r o f t h e th o r a x i s th e s e a t
o f t h e b r e a t h . Joy and d e l i g h t em anate from i t and i t can
n o t be i n j u r e d w ith o u t d a n g e r . The h e a r t i s u n d e r n e a th th e
l u n g s and i s t h e p r i n c e o f th e body. Thought p r o c e e d s from
i t . The p e r i c a r d i u m comes o u t o f t h e h e a r t and c o v e r s i t
an d e x te n d s t o t h e k id n e y s . There a r e th r e e t u b e s e x te n d in g
o u t o f th e h e a r t , one g o e s t o th e s p l e e n , one to t h e l i v e r
a n d one to t h e k id n e y s . The d iap hrag m i s c o n n e c te d w ith th e
s p i n e , r ib s an d b o w els. The l i v e r i s on th e r i g h t s i d e and
h a s sev en l o b e s . The s o u l r e s i d e s i n th e l i v e r and schemes
o f a l l k in d s a r e .h a tc h e d i n th e l i v e r . The g a l l b la d d e r i s
b e lo w and p r o j e c t s up i n t o t h e l i v e r . When a p e r s o n becomes
a.ngry th e g a l l - b l a d d e r a s c e n d s . C ourage d w e lls i n i t . T h is
i s t h e re a s o n t h a t t h e i g n o r a n t o r u n e d u c a te d C h in e se a r e
a lw a y s t r y i n g to p r o c u r e t h e g a l l b l a d d e r o f a n im a ls such a s
t i g e r s , b e a r s , and even t h o s e o f f i e r c e b a n d it s , h o p in g t h a t
i t w i l l make them b r a v e . The s p l e e n l i e s b etw een t h e stom ach
34
an d t h e d iap h ra g m and a l l fo o d goes f i r s t i n t o t h e s p le e n and
p a s s e s from t h e s p le e n i n t o t h e stom ach and from i t i n t o t h e
l a r g e i n t e s t i n e . The omentum o v e r l i e s th e stom ach b u t h as
no known u s e . No- m en tio n i s made i n t h e s e t e x t books o f
e i t h e r th e p a n c r e a s or th e m e s s e n te ry .
The s m a ll i n t e s t i n e s a r e c o n n e c te d w ith t h e h e a r t , and
t h e u r i n e p a s s e s th ro u g h them i n t o th e b la d d e r , s e p a r a t i n g
fro m t h e fo o d o r f e c e s a t th e c a p u t c o l i w here th e y d i v i d e
fro m th e l a r g e i n t e s t i n e s . The l a r g e i n t e s t i n e s a r e con
n e c t e d w ith t h e lu n g s and l i e i n th e l o i n s , . h a v i n g s i x t e e n
c o n v o l u t i o n s . The k id n e y s a r e egg sh a p ed and a t t a c h e d t o
t h e s p i n a l marrow. The s u b t l e g e n e r a t i v e f l u i d i s e l i m i
n a t e d by them, go ing above to th e b r a i n and below to th e
s p e r m a t ic c o r d . The t e s t e s wai sh en o r " o u t s i d e k id n e y s "
com m unicate w i t h th e k id n e y s . The p a s s a g e from t h e r i g h t
k id n e y i s c a l l e d th e g a t e o f l i f e and se n d s th e s u b t l e
f l u i d t o t h e s p e r m a tic v e s s e l s . The b la d d e r l i e s upon th e
k id n e y s and r e c e i v e s th e u r i n e from th e sm all i n t e s t i r e s a t
t h e i l l i a c v a lv e .
The c i r c u l a t i o n o f t h e b lo o d i s n o t c l e a r and t h e t e x t
books d i f f e r g r e a t l y i n t h e m a t t e r . Some of t h e p i c t u r e s
h a v e th e v e s s e l s , from t h e f i n g e r s and t o e s l e a d i n g to t h e
t r u n k and t h e r e e n d in g , w h ile o t h e r s p i c t u r e them r e a c h in g
t h e lu n g s , l i v e r and o t h e r o rg a n s , b u t t h e r e i s no u n i f o r m i t y .
The p e l v i s i s made up o f one bo ne, a s i s a l s o th e s k u l l ,
t h e fo re a rm and t h e l e g . The m u sc le s u s e th e fram ew ork a s
a c o n v e n ie n c e .
35
The o rg a n s a r e c l a s s e d a s s o l i d o r h o llo w . There a r e
f i v e t sang s o r s o l i d o r g a n s , th e l u n g s , h e a r t , l i v e r , sp le e n
and k id n e y s . T here a r e s i x fus- o r h o llo w v i s c e r a w hich
a r e th e stom ach, th e g a l l b l a d d e r , t h e l a r g e i n t e s t i n e , th e
s m a ll i n t e s t i n e , th e u r i n a r y b l a d d e r , and th e san c h ia o ,. an
im a g in a ry o rg a n .
These two c l a s s e s o f o rg a n s have d i f f e r e n t f u n c t i o n s .
The f u n c t i o n of t h e t s a n g i s to s t o r e up w h ile t h e f u n c t i o n
o f t h e f u i s t o e l i m i n a t e b u t n o t t o s t o r e up.
N a tiv e d o c t o r s make e x c e s s iv e c la im s a s to a b i l i t y to
p ro g n o s e th r o u g h t h e i r know ledge o f t h e p u l s e , and t h e i r
s u c c e s s i n t h i s l i n e i s re m a rk a b le . The o l d e r w r i t e r s have
c h a r a c t e r i z e d seven d e a th p u l s e s b e c a u s e o f t h e i r f a n c ie d
re s e m b la n c e s to c e r t a i n sou n d s. The e x t i n c t i o n o f th e
s p l e e n p u l s e means d e a t h w i t h i n fo u r da y s when t h e p u l s e r e
se m b le s th e p e c k in g o f a b i r d o r w a te r d ro p p in g from a r o o f
c r a c k . In s e r i o u s d i s e a s e o f th e lu n g s th e end w i l l come
i n t h r e e days i f th e p u l s e re s e m b le s f e a t h e r s blow n b y th e
w ind, o r f e a t h e r s b r u sh in g a g a i n s t th e s k i n . I n s e r io u s ,
k id n e y t r o u b l e d e a t h may come w i t h in f o u r days i f th e p u l s e
i s l i k e th e sn a p p in g o f a cord o r l i k e th e f l i p p i n g o f th e
f i n g e r a g a i n s t a s to n e . When th e l i v e r c e a s e s t o p e rfo rm
i t s f u n c t i o n t h e p u l s e i s l i k e th e s t r i n g of a new bow or
l i k e t h e b l u n t edge o f a sw ord. The pa,t i e n t w i l l d i e w ith
i n e i g h t d a y s . I f th e p u l s e re s e m b le s t h e r a p i d r o l l i n g o f
p e a s , d e a th may be e x p e c te d i n a d ay. A p u l s e a c t i n g l i k e
a shrim p o r f i s h d a r t i n g a b o u t i n t h e w a te r , or a p u l s e
l i k e w a te r o o z in g from a s p r i n g i s a f a t a l sympton and d e a t h
36
comes w i t h i n t h r e e d a y s.
MEDIOAL EXAMINATIONS
S t a t e m e d ic a l e x a m in a tio n s w ere h e ld :'in -O h in a a s e a r l y
a s t h e t e n t h c e n t u r y B.C. In th e Chou rituals i t i s s t a t e d
t h a t a t th e end o f each y e a r th e d o c t o r s were exam ined and
t h e 'Salary o f e ac h f i x e d a c c o rd in g t o t h e r e s u l t s shown.
T h is e x a m in a tio n f e l l i n t o d i s u s e i n l a . t e r d y n a s t i e s ,
CATHETERIZATION
W hile N e la to n i n P a r i s in v e n te d t h e c a t h e t e r i n 1850,
i n C hina th e p r i n c i p l e was knoivn i n t h e s e v e n th c e n t u r y A.D.
In t h e Thousand Gold Remedies th e h o llo w l e a v e s o f A llium
F is tu lo s u m a r e recommended to ' be i n s e r t e d i n t o t h e u r e t h r a
f o r a d e p th o f t h r e e in c h e s when a i r i s th e n blow n i n t o
t h e m ,! One d o c t o r m e n tio n s a n o th e r t r e a t i s e , t h e work o f
Sun, C h i, P r e c i o u s M irro r o f H y g i e n e , 2 i n which i t i s r e c o r d
ed t h a t th e empty b l a d d e r o f a p i g was u s e d . The b la d d e r
h a d a q u i l l t i e d to i t and i t s e r v e d a s a c a t h e t e r and u r i
n a l . Such c r u d e te c iin iq u e w ith no know ledge o f a s e p s i s
was a t t e n d e d w ith r i s k and i t soon f e l l i n to d i s u s e . How
e v e r , th e f a c t rem ains t h a t t h e p r i n c i p l e o f t h e c a t h e t e r
was r e c o r d e d i n m ed ical l i t e r a t u r e .
CASE HISTORIES, SURGERY AND ANESTHESIA, HYTROTHERAPY
AND TYPHOID
Tsang Kung, w ith h i s method an d c a r e i n h i s t o r y ta k i n g ,
! s u n Su-moh, The Thousand Gold R em edies, V o l . L X I ,F i r s t
P a r t .
Shen C hi, The P r e c i o u s M irro r o f H y g ie n e , V ol. X I1,1 - 3 .
37
Hua To w ith h i s many s k i l l e d o p e r a t i o n s and a n e s t h e s i a ,
Ohang G hung-king w ith h i s n o v e l t r e a t m e n t o f ty p h o id and
o t h e r f e v e r s w i t h c o ld b a t h s , make t h i s e a r l y p e r i o d o f
m e d ic a l h i s t o r y one o f t h e g r e a t e s t t h a t th e w o rld had e v er
seen* To t h e s e o u t s t a n d i n g a c h ie v e m e n ts must be added th e
f a c t t h a t , ■ '
V a cc in e t h e r a p y seems to have been p ro m u lg a te d , and an i n
s t a n c e i s r e c o r d e d i n w hich t h e p a t i e n t s own p u s was ta k e n
a n d i n j e c t e d u n d e r t h e s k i n a ro u n d t h e o r i g i n a l s o r e . Or
g a n o th e r a p y , f o r m e r ly much r i d i c u l e d b u t now h a i l e d a s a
v a l u a b l e modern d is c o v e r y , was known to. every C h in e se house
w i f e . The u s e o f sheep t h y r o i d f o r c r e t i n i s m , g o i t r e , i s
m e n tio n e d i n t h e s i x t h c e n t u r y . Even charm s and i n c a n t a
t i o n s s e rv e d a s p s y c h o t h e r a p e u t i c s , a s e a r l y a s t h e second
c e n t u r y B .C .! .
HYGIENE
C h in ese H ygiene i s t h e p ro d u c t o f an e v o l u t i o n e x ten d
i n g back f o r a p e r i o d o f more th a n twro th o u sa n d y e a r s b e f o r e
t h e C h r i s t i a n e r a . T h ere w ere no O hinese s a n i t a r y law s
l i k e th e M osaic code b u t th e T a o is t r e l i g i o n i s b a se d l a r g e
l y on h e a l t h maxims. Through th e m a c h in a tio n s o f t h e
p r i e s t h o o d t h e s e have been l o s t i n a mass o f s u p e r s t i t i o n s ,
a b s u r d i t i e s , and s p i r i t u a l l o r e . 2
In th e Su Wen a book a s c r i b e d to Huang Ti o r an unknown
a u t h o r o f t h a t d a t e t h e p h ilo s o p h y o f h e a l t h i s f u l l y éevelV-
o p ed .-in th e C h in e se way. The Su Wen d e f i n e s s a n i t a t i o n ,
" h e a l t h p r e s e r v a t i o n so a s to l i v e t o an o ld a g e . "3 I t
^K.O.Wong, op. c i t . . 307.
^Edward Thomas W illia m s , op. c i t . . 100.
^Anonymous, Su Wen, Oh. XIX, l a t t e r p a r t .
38
h o l d s t h a t t r u e s a n i t a t i o n i s i n c o n fo rm ity w ith n a t u r e ' s
la w . From i t t h e C h in e se have l e a r n e d t h a t t o l i v e lo n g
t h e y must l i v e m o d e ra te ly . They have, two main la w s o f
h e a l t h and h y g ie n e , nam ely: r e s t r a i n t o f a l l a p p e t i t e s , and
c l e a n l i n e s s i n h o u se and o e r s o n .
. Owing to t h e i r t e a c h i n g t h a t c o ld i s a c a u s e o f d i s e a s e
t h e C h in ese have n e v e r e a t e n much f r u i t o r c o ld fo o d . T h e ir
w a t e r must be b o i l e d a n d ta k e n h o t. T h e ir t e a h a s always
b e e n made w ith b o i l i n g w a t e r . Raw o y s t e r s t h e C h in e s e have
n e v e r e a te n c o n s i d e r i n g them too c o ld f o r t h e stom ach. They
h a v e u s e d no m ilk . The c l e a n lim b e d m u sc u la r C h in ese of
t h e f i e l d s have alw ays b e e n h e a l t h y . I n th e c i t i e s where
o v e rc ro w d in g was n e c e s s a r y i t h a s b e e n a d i f f e r e n t m a tte r .
The w o rs t h y g i e n i c f a u l t o f th e C h in e se from e a r l i e s t tim e s
h a s b e e n t h a t t h e y have c o u n te n a n c e d o v e rc ro w d in g co u p le d
w i t h th e d re a d o f f r e s h a i r i n s l e e p i n g room s. The p o o r i n
t h e c i t i e s and th e s o l d i e r s i n t h e i r q u a r t e r s were crowded
l i k e s a r d i n e s in a can . T h e ir m eals w ere s e r v e d tw ic e a
day and th e w o rk in g c l a s s e s a t e meat once a week. T here,
w ere many who a t e meat b u t once a y e a r , w hich was a t t h e i r
New Year f e s t i v a l . D r in k in g among th e w o rk in g c l a s s e s was
p r a c t i c a l l y n o n - e x i s t e n t . From t h e e a r l i e s t . tim e s a C hinese
h e a l t h c o n s c ie n c e a d a p te d to h i s A s i a t i c e n v iro n m en t has ex
i s t e d .
MEDICAL LITERATURE OF THE HISTORICAL OR CLASSICAL PERIOD.
In th e Tang D y n a sty a monumental m e d ic a l work a p p e a re d ,
e n t i t l e d The Thousand Gold. R em edies. T h is was w r i t t e n by
39
Sun Su-moîi and p u b l is h e d 652 A.D. I t c o n ta in e d s i x t y v o l
umes and i t s a u th o r . Dr. Sun Su-moh h a s s i n c e b e e n immor
t a l i z e d a s one o f th e g e n i i , by t h e C h in e s e . He was a
d o c t o r o f l i t e r a t u r e and t h e r e was ad d ed to h i s work l a t e r
a su p p le m e n t o f t h i r t y volum es c o n t a i n i n g a f u l l c o l l e c t i o n
o f i n c a n t a t io n s ,
The work e n t i t l e d M edical S e c r e t s o f an O f f i c i a l was
c o m p ile d by Wang Chu who was n o t a m e d ic a l man by p r o f e s s i o n ,
The book c o n t a i n s f o r t y volum es o f w r i t i n g s m ain ly fo rm u la e
f o r d e m o n iacal d i s e a s e s .
In th e L ia n g D y n asty , Tao H u n g -c h ien i s s u e d Form ulae
o f Famous P h y s i c i a n s w hich i s a work on p l a n t s . He took
t h e p l a n t s of t h e Pen Tsao and a f t e r s t u d y r e v i s e d and pub
l i s h e d a book w ith a b o u t d o u b le t h e number o f d r u g s in it*
The number o f d ru g s p r e v i o u s l y m en tio n ed had b e e n t h r e e
h u n d r e d s i x t y - f i v e b u t now th e work was d i v id e d i n t o e i g h t
c h a p t e r s , and th e m a t e r i a l b ro u g h t up to d a t e and when f i n
i s h e d th e w hole number in c l u d e d was se v e n h u n d red t h i r t y
d r u g s .
The J a p a n e s e i n 609 A.D. s e n t D r. F u y iw a iy i to C hina
t o s t u d y m e d ic in e . So p l e a s e d were t h e Ja p a n e se w ith what
t h e y found t h a t o t h e r J a p a n e s e s t u d e n t s fo llo w e d and th e
fam e o f C h in e se m e d ic in e d u r i n g th e D y n a s tie s o f Han and
Tang was s p re a d a b ro a d . T h is was a b r i l l i a n t p e r i o d in
C h in e s e m e d ic in e and one o f w hich th e C h in ese may j u s t l y
be p ro u d .
40
CHAPTER IV
THE MEDIEVAL OR CONTROVERSIAL PERIOD
D uring t h e f i r s t two p e r i o d s o f C h in ese M ed ical H i s t o r y
t h e r e was a l a c k o f o r i g i n a l i t y . W hatever was a s s e r t e d by
a u t h o r i t y was a c c e p te d w i t h o u t q u e s t i o n . ' T h is v e n e r a t i o n
f o r a u t h o r i t y a c c o u n te d f o r b o th t h e p e t r i f i e d f i x e d n e s s of
m e d ic in e i t s e l f and t h e l a c k o f o r i g i n a l i t y i n t h e m ed ica l
l i t e r a t u r e .
The Sung D y nasty i s famous f o r b r e a k in g away from t h i s
o l d p r e c e d e n t . Monographs on a l l k i n d s o f d i s e a s e s beg an
t o a p p e a r , a n d t h i s p e r i o d was marked by a g r e a t e r number
a n d v a r i e t y o f m ed ica l p u b lic a p tio n s th a n h ad a p p e a re d i n a l l
t h e p r e v i o u s d y n a s t i e s com bined. Many o f t h e s e w ere o r i g i
n a l and v e ry v a l u a b l e . A l i s t o f t h e m ost i m p o r ta n t m ed ica l
w orks a p p e a r i n g i n t h e Sung D ynasty h a s been made b y K. C.
Wong, a s f o l l o w s :
1 . Tung Keh: T rea tm en t of B e r i - B e r i , 2 v o l s . The f i r s t
and o n ly .monograph on th e s u b j e c t o f B e r i - B e r i .
2 . Shen C h i: Care o f t h e Aged, th e e a r l i e s t t r e a t i s e on
h y g ie n e w ith s p e c i a l r e f e r e n c e to t h e c a r e and f e e d in g
o f o l d p e o p l e .
3 . Chen C hi^m ing: T extbook on Women's D is e a s e s , 24 volum es.
A s p e c i a l work on d i s e a s e s p e c u l i a r t o women, th e f i r s t
o f th e k in d t o a p p e a r .
4. O b s t e t r i c s , 2 v o l s . A u th o r unknown. T his i s th e e a r l i
e s t m onograph on t h i s im p o r ta n t s u b j e c t .
41
5. Ghen Yin: T h ree C auses o f D i s e a s e s , 18 v o l s . A
S ta n d a r d P a th o lo g y .
6. Anonymous : The F o n ta n e l, 2 v o l s . T h is i s th e e a r l i e s t
s p e c i a l t r e a t i s e on d i s e a s e s o f i n f a n t s and c h i l d r e n .
I t i s s a i d t h a t th e s u c c e s s o f C h ien Yueh t h e g r e a t e s t
C h in ese p e d i a t r i s t was due to h i s th o ro u g h know ledge o f
t h i s bo ok.
7. Anonymous: The Copper Model, 7 v o l s . The f i r s t p r a c t i
c a l handbook on t h e s u b j e c t o f a c u p u n c tu r e .
8. L i Shun: On C a r b u n c le s , 1 v o l . An i n t e r e s t i n g m onograph.
9 . ■ Anonymous: Royal I n f i r m a r y Model E s s a y s , 9 v o l s . A
c o l l e c t i o n o f e x a m in a tio n p a p e r s .
1 0 . Chang Kuo: M edical. M is c e lla n y , 10 v o l s . C o n t a i n i n g much
u s e f u l and i n t e r e s t i n g m edical m a t e r i a l .
1 1 . Im p e ria l C y c lo p e d ia o f M ed icine, 200 v o l s . Com piled un
d e r I m p e r ia l o r d e r s by a s t a f f o f m ed ica l men. A rem ark
a b l e work, b u t u n f o r t u n a t e l y m ost o f t h e volum es have
been l o s t .
A nother d i s t i n c t f e a t u r e o f t h i s D yn asty was t h e in o c u
l a t i o n a g a i n s t sm a llp o x . T his was d i s c o v e r e d i n 1062 A.D.
The e s t a b l i s h m e n t o f m e d ic a l s c h o o ls and th e h o l d in g o f s t a t e
e x a m in a tio n s w ere a r r a n g e d f o r i n 1068 A.D. G r a d u a lly t h e
s c h o o l s d e c l i n e d and th e n c e a s e d to e x i s t . In 1280 A.D.
t h e y w ere r e v i v e d by I m p e r i a l d e c r e e . The s t a t e exam ina
t i o n s w ere ad so d i s c o n tin u e d b u t r e i n s t a t e d i n 1317 A.D.
W ith t h e com ing o f t h e Ming D y n a sty 1368-1644, t h e e l e
m ent o f c r i t i c i s m e n te r e d m ed icin e and e v e r y t h in g f o r th e
48
f i r s t tim e was q u e s t io n e d . The a n c i e n t l i t e r a t u r e and th e
co n te m p o ra ry w r i t i n g s a s w e ll a s m ed ica l p r a c t i c e s had to
s t a n d th e f i r e o f c r i t i c i s m . Four d i s t i n c t s c h o o ls a p p e a r
ed d u r i n g t h i s p e r i o d :
1 . L iu Shou -cheng expounded t h e t h e o r y t h a t a l l d i s e a s e s
were due to e x c e s s i v e h e a t and r e q u i r e d c o o l i n g m e d ic in e s .
2. Ohang T su-ho m a in ta in e d t h a t d i s e a s e was l i k e a f o r e i g n
s u b s ta n c e i n th e body, and sh o u ld be d r i v e n o u t by d r a s
t i c d ru g s su c h a s e m e tic s , c a t h a r t i c s , and d i a p h o r e t i c s .
3. Li Tung-yuan c la im e d t h a t d e ra n g e m e n ts o f t h e d i g e s t i v e
t r a c t w ere t h e s o u rc e o f d i s e a s e .
4* Chu T a n -c h i i n s i s t e d t h a t m a l n u t r i t i o n was t h e r o o t o f
a l l t r o u b l e s and t h a t t o n i c s were i n v a l u a b l e i n r e g u l a t
in g d i s e a s e .
T h is s p i r i t o f i n q u i r y was i n v a l u a b l e . T hese f o u r men
so o n w ere c a l l e d th e "Four G re a t D o c to rs o f th e Kin Yuan
P e r i o d . " L a t e r w r i t e r s in c l u d e d S h ih L ih -c h a , Ghen H siu-
y u a n , Chang O hing-yo, and many o t h e r a b l e m ed ica l men who
g ro u p e d th e m s e lv e s aro u n d t h e s e s c h o o l s .
An im p o r ta n t c o n t r i b u t i o n to m e d ic a l s c i e n c e i n th e Ming
D y n a sty was t h e r e v i s i o n and p u b l i c a t i o n o f t h e Pen Tsao o r
C h in e se D i s p e n s a to r y . A f t e r i t s r e v i s i o n i t was named th e
P en Tsao Kang Mu o r S y n o p s is o f A n c ie n t H e rb a ls . The h i s t o r y
o f t h i s famous an d im p o r ta n t book i n C h in e s e M edical L i t e r a
t u r e i s d e s e r v i n g o f m e n tio n . P o p u l a r l y Shen Nung, th e
F a t h e r o f C h in e se M edicine t a s t e d and t e s t e d t h r e e hundred
a n d s i x t y - f i v e d ru g s and l a b e l l e d them a s f o l lo w s : 120 were
45
GUprerior o r n o n -p o is o n o u s and p o s s e s s e d r e j u v e n a t i n g q u a l i
t i e s . 120 w ere medium an d p o s s e s s e d o n ly a s l i g h t to x ic
e le m e n t w hich made them e x c e l l e n t a s t o n i c s . 125 were i n
f e r i o r and must b e u s e d w i t h c a r e to re d u c e f e v e r o r c u re
i n d i g e s t i o n . The s t y l e and th e l i t e r a t u r e and t h e r e f e r
e n c e s p u t t h i s book i n t h e Han D ynasty which was 25-221 A.D.
I n t h e L iang D y n asty 502-556 A.D. i t was r e v i s e d by Tao Hung-
c h i e n and t h e number o f d r u g s d o u b le d and th e book w ith e i g h t
c h a p t e r s i n i t , was p u b l i s h e d . I n t h e Tang D y n a sty 618-905
A.D. th e r e v i s i o n was o r d e r e d by t h e c o u r t . Emperor Kao
Chun 650- 683 a p p o in te d a com m ittee o f tw en ty -tw o o f f i c i a l s
t o r e v i s e i t . T h is c o m m ittee e n la r g e d t h e work i n t o f i f t y -
t h r e e c h a p t e r s . S i m i l a r l y in t h e Sung D ynasty 960-1276 A.D.
E m peror T ai Ohiu i n t h e y e a r 973 A.D. a p p o in te d a co m m ittee
o f n i n e who i n s e r t e d 130 more d ru g s and by th e end o f th e
D y n a s ty t h e r e w ere 1558 d ru g s i n t h e D i s p e n s a t o r y . In t h e
Ming D y n asty th e l a s t r e v i s i o n was made. I t was n o t u n d e r
t a k e n by th e c o u r t b u t-b y a d i s t r i c t m a g i s t r a t e , Li S h ih -c h e n ,
who was b o rn a t K i-c h a n , a town i n t h e e a s t o f t h e p r o v in c e
o f Hupeh. L i was d i s s a t i s f i e d b e c a u s e o f t h e c o n f u s i o n o f
n o m e n c la tu re . He c o l l e c t e d o v e r 360 m ed ica l t r e a t i s e s , 41
m a t e r i a m ed icae and 591 o t h e r s c i e n t i f i c and h i s t o r i c a l
w o r k s .2 I t to o k him t h i r t y y e a r s to c o m p le te t h e t a s k and
h i s d e a th o c c u r r e d b e f o r e he c o u ld p r e s e n t i t to h i s Emperor^,,
f o r h i s a p p r o v a l . I t was t h e p r i v i l e g e o f h i s s o n to make
^K.K.Ohen and Amy H. L in g , op. c i t . , 188.
2%.C.Wong, OP. c i t ., 207.
44
t h e o f f e r i n g o f t h i s m a g n i f ic e n t e f f o r t to th e Emperor,
i n 1596 A.D. The Emperor r a t i f i e d i t s p u b l i c a t i o n and d i s
t r i b u t i o n i n t h e whole c o u n t r y . The book was a p o p u l a r
one an d m e r i te d p r a i s e from d o c t o r s and laym en a l i k e . L a t e r
s u p p le m e n ts have been made b u t have n o t added to i t s w o rth .
T here i s a monograph w r i t t e n i n 1631 i n w hich th e v a r i
o u s symptoms o f s y p h i l i s a r e m in u te ly d e s c r i b e d and th e
h e r e d i t a r y t r a n s m i s s i o n i s d i s c u s s e d f u l l y . 1
K u o's book On P la g u e c o n t a i n s many o r i g i n a l o b s e r v a t i o n s
a n d s u g g e s t i o n s on e p id e m ic d i s e a s e s . 2 ■ T his book h a s had
g r e a t v a lu e t o th e C h in ese M edical p r o f e s s i o n .
In t h i s C o n t r o v e r s i a l P e r io d o f C h in ese M ed icin e n o t
o n ly were m ethods and p r a c t i c e s s h a r p l y s c r u t i n i z e d b u t th e
s t a t u s o f t h e p h y s i c i a n became a m a t t e r o f g r e a t e r im p o rt
a n c e . For t h e f i r s t tim e i n 1140 A.D. th e p r o f e s s i o n was
s e p a r a t e d from t h a t o f p r i e s t . A C h in e se h i s t o r i a n c a l l s
a t t e n t i o n to t h e f a c t t h a t t h e a n c i e n t w r i t t e n c h a r a c t e r
f o r d o c to r was composed o f t h r e e p a r t s . At th e to p and
l e f t c o r n e r was a q u i v e r , a t t h e r i g h t c o r n e r was a s p e a r ,
and below was a symbol common to a s o r c e r e r o r p r i e s t .
The m eaning t o be i n f e r r e d from t h i s was t h a t t h e p r i e s t
em ployed s t r o n g weapons t o e x p e l o r k i l l t h e demons o f d i s
e a s e . L a t e r t h i s lo w e r symbol was changed to t h a t o f wine,
s i g n i f y i n g t h a t m e d ic in e was no l o n g e r i n t h e h a n d s o f th e
p r i e s t b u t had p a s s e d i n t o t h e hands o f t h e r e g u l a r d o c to r
who a d m i n i s t e r e d w ines, t h a t i s e l i x i r s , to h i s p a t i e n t s . ^
^K.C.Wong, ou). c i t .
2 l b i d .
2 I b id .
45
CHAPTER V
THE MODERN OR TRANSITIONAL PERIOD
The Modern o r . T r a n s i t i o n a l p e r i o d began u n d e r t h e Man-
ch u r u l e o r i n t h e Ching D y n a sty . T h is a l i e n r u l e o f t h e
Manchus was f a c e d by t h e n e c e s s i t y o f su b d u in g d i s t a n t p a r t s
o f t h e Empire and c o n s e q u e n tly was c h a r a c t e r i z e d by h a t r e d
a n d reveng e on th e p a r t o f th e e a r l y r u l e r s . 1 In t h e f i e l d
o f m e d ic in e t h i s meant t h a t from 1644 -1 805 A.D. t h e r e was a
g r a d u a l d e c l i n e i n s c i e n t i f i c m e d ic in e .
T h is p e r io d was c h a r a c t e r i z ed b y th e i n t r o d u c t i o n o f
W estern m e d ic in e 1805. The most p ro m in e n t f e a t u r e o f th e
p e r i o d has b e e n th e s t r u g g l e f o r suprem acy b etw een th e o ld
s y s te m and t h e new* T h is s t r u g g l e i s s t i l l g o in g on and
t h e l a t t e r i s s lo w ly b u t s t e a d i l y g a i n i n g ground.
One o f th e l a t e r E m perors, C h 'i e n Lung (1736-1796) was
more k in d ly d i s p o s e d to w a rd l e a r n i n g th a n some o f t h e e a r l i e r
r u l e r s . .His p a tr o n a g e was e x te n d e d to m ed icin e and a s an
outcom e of h i s encouragem ent a co m m ittee o f d o c t o r s com piled
The Golden M ir r o r o f M e d ic in e . I t i s i n th e form o f an en
c y c l o p e d i a o f m ed icin e and i t summarized a l l th e m ed ical work
t h a t had p r e c e d e d i t . The Golden M ir r o r i s r e c o g n iz e d as
a s t a n d a r d work on C h in e se n a t iv e m e d ic in e .
One o f t h e o u t s t a n d i n g p h y s i c i a n s o f th e tim e was Wang
H su n -sh a n . He had p r a c t i c e d m ed icin e f o r f o r t y - t w o y e a r s
^E .T . W illia m s , A S h o rt H is to r y o f China. 214.
46
and had s t u d i e d th e e x t e r n a l anatom y o f t h i r t y d e c a p i t a t e d
b o d i e s . He i n c lu d e d t h e r e s u l t s o f h i s a n a to m ic a l o b s e r
v a t i o n s and c l i n i c a l e x p e r i e n c e s i n a v e r y rem arkable work
e n t i t l e d C o r r e c t i o n s o f M edical E r r o r s . T his book won f o r
him th e t i t l e o f "Reform er o f C hinese M ed icin e, " b u t u n f o r
t u n a t e l y th e c o r r e c t i o n s a r e u n t r u s t w o r t h y . T h is , however,
d o e s n o t d e t r a c t from i t s i n t e r e s t a s an h o n e st e f f o r t to
a d v a n c e t h e s c i e n c e o f m e d ic in e .
The W e ste rn method o f w a c c im t i o n was i n tr o d u c e d i n t o
C hina May 1806. I t had b e e n b ro u g h t o v e r from t h e P h i l i p
p i n e s to Macao by th e P o r tu g u e s e and t h e C hinese b ro u g h t i t
fro m Macao to C anton a n d o t h e r p a r t s o f China. The h i s
t o r i c a l f a c t must b e rem embered, how ever, t h a t a c e n t u r y b e
f o r e J e n n e r 's tim e t h e Pen Tsao Kang Mu o r C h in ese D isp en sa
t o r y m en tioned th e u s e o f f l e a s from t h e cow f o r t h e p re v e n
t i o n o f s m a llp o x . They w ere to b e t a k e n by m outh. Un
f o r t u n a t e l y t h e r e was no C h in ese J e n n e r to f o l l o w up th e c lew .
WESTERN MEDICINE
An E n g li s h p h y s i c i a n , Thomas R ic h a rd s o n C o ll edge,
fo u n d e d th e f i r s t d i s p e n s a r i e s i n C hin a, th e f i r s t i n Macao
i n 1827, and t h e f o l lo w in g y e a r one i n C anton. In 1834
P e t e r P a r k e r , ^ a Yale g r a d u a t e and r e c o g n iz e d a s t h e f i r s t
m e d ic a l m is s i o n a r y to C hin a, jo in e d D r. C o lle d g e a t C anton.
T o g e th e r th e y founded t h e C anton M edical M is s io n a ry S o c ie ty
o u t o f which d e v e lo p e d t h e f i r s t W estern m ed ical t e a c h i n g
Is. Wells Williams, on cit., 124.
47
i n C hina. To t h e s e two men c r e d i t m ust a l s o be g iv e n f o r
i n t r o d u c i n g t h e f i r s t W estern H o s p i t a l s to China.
Dr. C o ll edge was an o c u l i s t o f g r e a t s k i l l and Dr.
P a r k e r a c a p a b le su rg e o n and t h e i r work r a p i d l y grew to
s u c h p r o p o r t i o n s t h a t t h e y r e a l i z e d th e need o f t r a i n e d
a s s i s t a n t s . The f i r s t i s s u e o f t h e C anto n M edical Miss
i o n a r y S o c i e t y in c lu d e d a s one o f i t s aim s and m ain p u rp o s e s
"The t r a i n i n g o f C hinese y o u th in W este rn M e d ic in e ," and to
a c h i e v e t h i s p u rp o s e t h r e e C h in ese a s s i s t a n t s w ere ta k e n on
f o r t r a i n i n g . With no te x t b o o k s i n t h e C hinese la n g u a g e ,
a n d w ith no d e f i n i t e tim e f o r i n s t r u c t i o n due to t h e p r e s s u r e
o f work, t h i s method was fou n d u n s a t i s f a c t o r y .
W illiam L o c k h a rt M.D.^and B enjam in Hobson M.D. out
fro m E ngland u n d e r th e London M is s io n a r y S o c ie ty i n 1839,
L o c k h a r t to be w e ll known i n b o th S h a n g h a i and P e k in g , and
Hobson in C a n to n . A ll t h e s e men r e a l i z e d t h a t t h e r e must
b e te x tb o o k s i n t h e fu n d a m e n ta l s c i e n c e s a s the f i r s t s t e p
i n m ed ical e d u c a ti o n . So Hobson a s soo n a s he c o u ld u s e
t h e la n g u a g e , w ith th e h e lp o f a t e a c h e r began t h e t a s k o f
p r e p a r i n g su ch books i n th e C h in ese la n g u a g e . At Canton,
1 8 5 0 , Hobson p u b l i s h e d h i s f i r s t volume on anatomy and p h y s
i o l o g y . I t c r e a t e d a s e n s a t io n and t h e V icero y o f C anton
o r d e r e d i t s p u b l i c a t i o n . Dr. Hobson c o n tin u e d t h e work o f
m aking te x tb o o k s and i n 18 5 8 he w ro te :
^S. W e lls W illia m s, op. o i t . . 1 2 3 .
^ I b i d . . 1 2 7 .
48
M ed ical s c i e n c e in China i s a t a lo w ebb. I t d o e s not
e q u a l th e s t a t e o f m ed ica l a r t in th e tim e o f H ip p o c r a te s
and C e lsu s . The know ledge o f anatomy and su rg ery in
A n c ie n t G reece and Rome was much s u p e r io r to a n y th in g in
I n d ia and C hina. I have been e n d e a v o r in g to c o n t r ib u t e
my m ite to th e o b j e c t o f i n s t r u c t i n g th e C h in ese i n medi
c i n e , and h ave j u s t co m p leted a s e r i e s o f volum es on medi
c i n e , and c o l l a t e r a l b r a n c h e s, b oth f o r th e i n s t r u c t i o n o f
n a t i v e p r a c t i t i o n e r s and t o d i f f u s e g e n e r a l in fo r m a tio n on
t h e s e s u b j e c t s w ith th e hope th a t e r e lo n g th e C h in ese Gov
ernm ent w i l l do som eth in g to enoourage th e m ed ica l a r t . At
p r e s e n t th e r e a r e no c o l l e g e s or s c h o o ls in th e c o u n tr y ex
c e p t i n g th e Im p e r ia l C o lle g e a t P ek in g f o r the u s e o f H is
M a je sty and h ig h o f f i c e r s . Anatomy i s t o t a l l y i n t e r d i c t e d
b o th by law and p u b lic o p in io n . Any man may, h ow ever, p rac
t i c e m e d ic in e . Thousands do so w ith th e s le n d e r know ledge
w h ich books a f f o r d , o r by th e p r a c t i c e o f t h e i r common s e n s e
w h ich p r o v e s a s a f e r g u id e and b r in g s p e r s o n s o c c a s i o n a l l y
i n t o n o t o r i e t y and a l s o a good incom e. . . . In t h i s c o n d it io n
o f t h in g s i t seem s very d e s i r a b l e to in tr o d u c e th e w e ll e s
t a b l i s h e d p r i n c i p l e s and f a c t s o f W estern m ed ica l s c i e n c e ,
to p r e p a r e th e way fo r ch an ges in th e p r e s e n t sy stem o f
C h in a. Under t h i s c o n v i c t i o n , a work was p re p a r ed i n Canton
e i g h t y e a r s g g o , in th e s u b j e c t s o f anatom y and p h y s io lo g y ,
a v o id in g a l l t h e o r e t i c a l o p in io n s . T h is has b een e x t e n s i v e
l y rea d and v e r y fa v o r a b ly r e c e iv e d , and had p r o v e d a good
fo u n d a tio n f o r what was to f o llo w .
The n e x t t r e a t i s e was on th e p r o p e r t i e s o f a i r , l i g h t , h ea t
and e l e c t r i c i t y and th e e le m e n ts o f astronom y and n a tu r a l
h i s t o r y phenomena. T h is h as been su c c e e d e d by a work on
su r g e r y ; by a n o th e r on m id w ifery and th e d i s e a s e s o f c h i l
d r e n ; and by a f i f t h on th e p r a c t i c e o f m ed icin e and m a teria
m ed ica , t o g e t h e r w ith a m ed ica l v o c a b u la r y in E n g lis h and
C h in e se to e x p la in and f i x th e term s u s e d . The i l l u s t r a
t i o n s show a t o n c e th e s u b j e c t s t r e a t e d o f , and I have
sp a r e d no p a i n s , by th e a i d o f an i n t e l l i g e n t a s s i s t a n t , to
make t h e s e works a c c u r a te , p e r s p ic u o u s , and u s e f u l.1
The P r e s b y t e r ia n M is sio n o f A m erica s e n t o u t Dr. J.G .
K err in 1853. He took up Dr. H obson's work and d u r in g
f o r t y - e i g h t y e a r s r e s id e n c e a t Canton he t r a in e d o v e r 200
s t u d e n t s and t r a n s l a t e d o v e r tw en ty te x t b o o k s . The work
w h ich he th u s a c c o m p lish e d r e p r e s e n te d a rem arkable
^H. Balm e, "The H is to r y o f W estern M edical E d u c a tio n
In C hina," China M edical J o u r n a l, V o l. XI, August 1 9 2 6 , 701.
49
a ch iev em en t tow ards th e e s t a b lis h m e n t o f a modern m ed ical
p r o f e s s i o n .1
The f i r s t C h in ese who s t u d ie d W estern m ed icin e was
Wang C h e u k -h in g .2 A n a t i v e o f Canton he was born i n 1832
and r e c e iv e d an E n g lish e d u c a tio n i n Macao and Hongkong.-
He o b ta in e d h i s B.A . d e g r e e in Am erica and th en w ent to
E dinburgh f o r m e d ic in e , r e c e i v i n g h i s d e g r e e in 1 8 5 5 . On
h i s r e tu r n he worked in th e h o s p i t a l s o f Canton and Hongkong
t i l l h i s d e a th in 1878. Many C h in ese s tu d e n t s had gone to
Japan to stu d y m ed icin e and w ith t h e i r r e tu r n in 1899 Japa
n e s e m ed icin e became v e ry p o p u la r . The Japanese th e m se lv e s
fo u n d e d new s c h o o l s and h o s p i t a l s and g r a d u a lly d e v e lo p e d
i n t o a str o n g f o r c e , many b e in g em ployed in im p ortan t gov
ernm ent p o s i t i o n s in C h in a.
D uring th e y e a r s from 1850 to 1900 th e e x t e n s io n o f
W estern m e d ic in e fo llo w e d m a in ly a lo n g th e l i n e s o f p io n e e r
in g e f f o r t s in th e new ly opened i n t e r i o r p r o v in c e s and th e
e s t a b l i s h i n g o f h o s p i t a l s , i n th e t r e a t y p o r t s and o t h e r im
p o r t a n t c e n t e r s . The hope o f fo u n d in g m ed ical s c h o o ls was
p r e s e n t ev ery w h ere. In Septem ber 1 8 6 3 , th e N orth China
D a i l y News o f Shanghai had th e f o l lo w in g e d i t o r i a l :
A s t a r t in m e d ic in e sh o u ld b e made b y te a c h in g th e sim p le
a ilm e n t s su ch a s f e v e r s , s k in d i s e a s e s and minor su r g e r y .
V ery soon an in c r e a s i n g d e s i r e f o r know ledge on th e p a r t o f
t h e more e d u c a ted would demand i n s t r u c t o r s in o t h e r branches
b e s i d e s th o s e e s s e n t i a l l y m ed ica l and s u r g i c a l . A c o l l e g e
w ou ld th en s p r in g up, and c h a ir s o f c h e m is tr y , n a tu r a l h i s
t o r y and n a tu r a l p h ilo s o p h y would soon group th e m s e lv e s
^H. Balm e, o o . c i t . .7 0 1 .
2 k . G.Wong, o o . c i t . , 26 0 .
50
around th e c h a i r s o f anatom y, p h y s io lo g y , m e d ic in e and su r
g e r y . But b o th a s b e in g more p r a c t i c a l l y u s e f u l , a s w e ll
a s more l i k e l y to a t t r a c t a t t e n t i o n , m ed icin e and su rg e ry
sh o u ld be th e s u b j e c t s f i r s t ta u g h t. The r e s t w ould soon
f o l l o w . No on e w i l l tteny ittoifc t h i s w ould be a more d e c id e d
s t e p tow ards r e g e n e r a t in g 'China than any a ttem p t t h a t h as
y e t b een m a d e.l
"As one e n t e r s th e main g a te o f th e B r i t i s h L e g a t io n ,"
w r o te J . C. Cormack c o n c e r n in g th e e a r l y days o f m e d ic in e
i n P ek in g ,
t h e r e i s a f i n e p l o t o f sod d ed lawn surrounded by t r e e s .
H e r e .i n th e y e a r 1 8 6 1 . . . .D r. W m . L ockh art o f th e London
M is sio n a r y S o c i e t y began, i n r e n te d p r e m is e s , th e f i r s t
M ed ica l M issio n H o s p ita l in P e k in g , and t h i s d a te we may
.r e g a r d a s th e b e g in n in g o f W estern m e d ic in e among th e
C h in e s e in P e k in g .2
Dr. L ockh art had come up from Shanghai where he had had
'c h a r g e o f th e Shantung Road H o s p ita l to s e e i f a s t a r t m ight
n o t be made in P e k in g . D u rin g th e f o u r t e e n and a h a l f
m onths a t h i s h o s p i t a l and d is p e n s a r y he t r e a t e d 3 2 ,1 4 4
C h in e s e p a t i e n t s . In 18 6 5 th e h o s p i t a l p r e m ise s i n th e
L e g a tio n grou n d s had to b e g iv e n up and th e work t r a n s f e r r e d
t o a B u d d h ist Temple on Hatamen Road now known a s th e North
Compound o f th e P ek in g U nion M edical C o lle g e . In 1865 Dr.
L ock h art r e tu r n e d home and J . Dudgeon to o k ch arge d u rin g h i s
f u r lo u g h . In h i s r e p o r t to h i s Board 18 6 5 Dr.Dudgeon w rote:
"T h is i s th e o n ly fo r e ig n h o s p i t a l i n th e c i t y . The S i s t e r s
o f C h a rity have a d is p e n s a r y where p a t i e n t s , c h i e f l y women,
a r e s e e n . "3
^ E d i t o r i a l, N orth China D a ily News, Septem ber 1 8 6 3 ,
S h a n g h a i, C hina.
-2j.C .C orm ack , "Early Days o f W estern M ed icin e in P ek in g "
C liina M edical J o u rn a l,X L , No. 6 . June 1 9 2 6 , Sh anghai, C hina, 525.
D u d g e o n ,H o sp ita l R eport to London M issio n SnniBt.r i
51
The n e x t landmark in m ed ica l work i n P ek in g was in 1875
when th e M e th o d ist E p is c o p a l Church s e n t Dr. Lucy Combs o f
t h e Women's F o r e ig n M issio n a r y S o c ie t y to P ek in g to open
work and b u i l d a h o s p i t a l . She was f o llo w e d by Dr. Leonora
Howard who to o k up th e work i n 1877 but was c a l l e d t o T ie n t s in
to o p en up a h o s p i t a l u n d er th e a u s p ic e s o f th e V ic e r o y Li
H ung-ohang. The M eth o d ist work in P e k in g was suspended
u n t i l th e a r r i v a l o f Dr. W alter B. Lamb$th in 1 8 8 5 . He was
c a l l e d to Japan and a young C h in ese m ed ica l s tu d e n t , Y. K,
T sa o , to o k c h a r g e p en d in g t h e a r r i v a l o f Dr. G eorge Lowry
who took perm anent c o n t r o l . In 1903 th e H opkins' Memorial
H o s p it a l was d e d ic a t e d by th e M e th o d ists o f P e k in g . T h is
was a s e p a r a te h o s p i t a l f o r men.
The m e d ic a l work o f th e P r e s b y t e r ia n s was begun in
P e k in g in 1888 under Dr. M arian S i n c l a i r w ith M iss J a n et
M c K illic a n a t r a in e d n u r s e . A l i t t l e l a t e r Dr. E l i z a
L eonard who l a t e r became th e f i r s t P r e s id e n t o f th e P ek in g
U n ion C o lle g e f o r Women a r r iv e d . The A n g lic a n m ed ica l work
was opened by Dr. A l i c e M arston, 1 8 8 9 . A u n io n N u rses
T r a in in g S c h o o l was e s t a b l i s h e d by th e fo u r women's h o s p i
t a l s , 1 9 0 5 .
No m ed ica l sc h o o l or h o s p i t a l work on W estern l i n e s wa.s
a tte m p te d by t h e C h in ese i n P ek in g t i l l a f t e r 1 9 0 0 . At th e
p r e s e n t tim e t h e r e a r e no l e s s than f i v e C h in ese Government
h o s p i t a l s b e s i d e s many p r i v a t e h o s p i t a l s c a r r y in g on m ed ical
work on W estern l i n e s .
52
THE BEGINNING OF MEDICAL EDUCATION IN PEKING
Dr. P r itc h a r d in 1886 began a m ed ica l sc h o o l in P ek in g .
He was h e lp e d by Dr. B u s h e ll who d id th e su rg e ry and by a
c l e r i c a l m is s io n a r y who ta u g h t c h e m is tr y . "In a d d i t i o n to
p h y s io lo g y and c h e m i s t r y ," w rote Dr. P r itc h a r d , "we now f e e l
r e s p o n s ib l e f o r im p a r tin g a f a i r know ledge o f anatom y, ma
t e r i a m edica, su r g e r y and m e d ic in e. "1
The n e x t s t e p was t h e M eth o d ist M edical S ch o o l in 1896,
b u t i t W 8.S n o t t i l l a f t e r th e Boxer U p r is in g and i t s over
th row w hich sounded th e d e a th k n e ll o f t h e M anchurian Dynas
t y t h a t very su b sta n tia l^ ad van ce was made.
A fte r th e B oxer U p r is in g , 1900, th e North C hina Educa
t i o n a l Union and th e m is s io n work was d iv id e d i n t o t h r e e
d i v i s i o n s . A r t s , T h eo lo g y , M ed icin e. The M ed ical C o lle g e
was th e e s p e c i a l c a r e o f t h e London S o c i e t y but th e Metho
d i s t s gave up t h e i r own m ed ica l sc h o o l work and e n te r e d th e
U n io n . The c o l l e g e was fou n d ed 1906 w ith Dr. James Cochrane
a s i t s f i r s t P r e s i d e n t . He o b ta in e d from th e Em press Dowa
g e r r e c o g n i t io n f o r th e new c o l l e g e w h ich d e f i n i t e l y s t a t e d
t h a t i t was g iv e n t h e r i g h t to g r a n t d e g r e e s in m e d ic in e .
I t was th e o n ly c o l l e g e t h a t o b ta in e d su ch r e c o g n i t io n though
l a t e r through t h e in f l u e n c e o f the V ic e r o y , Li H ung-chang,
t h e German M ed ica l S ch o o l a t T sin g Tao was r e c o g n i z e d . 2 But
t h e P ek in g U nion M edical C o lle g e was r e g i s t e r e d by th e Board
1
J . B. P r it c h a r d , H o s p it a l R eport t o London M is sio n .
1 8 9 6 .
o
J.G.Cormack, op. cit.. 530.
53
o f E d u ca tio n and th e Board o f Home A f f a i r s , so t h a t i t s
s t u d e n t s r e c e i v e d a governm ent d ip lom a.
In T i e n t s i n , Li Hung-chang, g r a t e f u l to Dr. K enneth
M ackenzie f o r s a v in g th e l i f e o f h i s w i f e , fu r n is h e d p r o v in
c i a l fu n d s and a l o c a t i o n f o r a m ed ica l s c h o o l. The V ic e r o y 's
M ed ica l C o lle g e was opened December 1 5 , 1881, w ith a group o f
r e tu r n e d s t u d e n t s . 1 A ll i n s t r u c t i o n was g iv e n i n E n g lish
and Dr. S-lackenzie was a s s i s t e d by Dr. A tterb u ry and th e
B r i t i s h and A m erican Naval su rg eo n s o f T ie n t s in . B e fo r e th e
d e a th o f Dr. M ackenzie t h r e e c l a s s e s in m ed icin e had been
g r a d u a te d . Dr. M ackenzie was n ev er s a t i s f i e d w ith th e work,
b u t n o t o n ly d id t h i s e f f o r t r e p r e s e n t th e f i r s t a ttem p t to
b u i l d up modern m ed ica l s c h o o l in C hina, bu t i t p aved th e
way f o r th e N aval M edical C o lle g e w hich su c c e e d e d i t . T his
l a t t e r i s a governm ent su p p o r te d m ed ica l sc h o o l and o f a v e ry
h ig h s ta n d in g .
S ix y e a r s a f t e r th e m ed ica l c o l l e g e a t T i e n t s i n was e s
t a b l i s h e d , t h e Hongkong C o lle g e o f M ed ic in e was op en ed . I t
i s s t i l l i n o p e r a tio n , b e in g in c o r p o r a te d in 1 9 0 7 , i n th e
U n i v e r s i t y o f Hongkong a s i t s m ed ica l d ep artm en t. I t i s o f
i n t e r e s t to r e c o r d t h a t t h e f i r s t dean o f t h i s s c h o o l was
D r. P a t r ic k Manson, vho d e l iv e r e d th e in a u g u ra l a d d r e s s on
t h e o c c a s io n o f i t s e s ta b lis h m e n t on O ctob er 1 s t , 1 8 8 7 .
D r. Manson b e lo n g s to th e w orld now, b e c a u se o f h i s work on
t r o p i c a l m e d ic in e .
^E. H. Hume,"M edical E d u cation i n C hina," China
M ed ic a l J o u r n a l, Vol.XXXVI, No. 1 , 2 3 .
54
O u tsta n d in g men such a s H. W . B o o n e ,o f S h a n g h ai, Dugald
C h r i s t i e , o f Moukden, Duncan Main, o f Hangchow, W illia m Park,
o f 8 0 0 chow. Van Someran T a y lo r and O sgood, o f Foochow, and
James N ea l, o f Tungchow, were e s t a b l i s h i n g m ed ica l c l a s s e s .
Perhaps th e most im p o rta n t e v en t o f t h i s d eca d e was th e
fo r m a tio n i n 1886 o f th e C hina M edical M issio n a r y S o c i e t y .
T h is has been to China what th e American M edical S o c i e t y h as
b e e n to th e p r o f e s s i o n o f m e d ic in e in A m erica. The f i r s t
c o n f e r e n c e o f th e A s s o c ia t i o n was h e ld i n Shanghai in 1890,
u n d e r th e p r e s id e n c y o f Dr. Boone. The s e s s i o n was tak en
up w ith th e problem o f m e d ic a l e d u c a tio n and m ed ica l sta n d
a r d s . A co m m ittee was a p p o in te d f o r th e p u rp o se o f u n if y
i n g C h in ese m e d ic a l te r m in o lo g y . I t h as b een t h e p o l i c y
o f th e A s s o c ia t io n t o en cou rage th e fo r m a tio n o f s tr o n g
U n ion M edical c o l l e g e s r a t h e r th an a l a r g e number o f under
manned o n e s. The t r a n s l a t i o n and p u b l i c a t i o n o f m ed ica l
l i t e r a t u r e h as b e e n a n o th e r one o f th e f u n c t io n s o f th e
C h in a M edical M issio n a r y A s s o c ia t i o n . The tim e i s coming
i n th e v ery n e a r f u t u r e when i t w i l l b e w is e r to abandon
t h i s s o c i e t y and merge a l l m is s io n a r y i n t e r e s t s in th e
N a t io n a l M edical S o c ie t y .
The d eca d e f o l lo w in g 1900 was p r e -e m in e n tly a p e r io d
o f r e v a lu a t io n w ith em phasis p u t on e d u c a tio n . M ed ical
s c h o o l s sp ran g up under m is s io n a r y a u s p ic e s in Moukden,
P e k in g , T s in in , C hentu, Changsha, Hangchow, N anking, Hankow,
S h a n g h a i, Foochow, and C anton, w ith s p e a r a te m e d ic a l s c h o o ls
f o r women in P e k in g , Soochow and C anton. At t h e same tim e
55
t h e r e were opened th e German m ed ical s c h o o ls in T s in g ta o and
C anton, th e J a p a n e s e 'm e d ic a l sc h o o l i n Moukden, th e F rench
m e d ic a l s c h o o l i n Canton, t h e Harvard s c h o o l in S h a n g h a i,
t h e P r in c e to n s c h o o l in S h a n s i,
In th e m eantim e, an i n c r e a s i n g l y l a r g e number o f C h in ese
p h y s i c i a n s who w ere g r a d u a te s o f W estern m ed icin e i n f o r e ig n
c o u n t r i e s had become i n t e r e s t e d i n th e p o s s i b i l i t y o f d e v e l
o p in g s c i e n t i f i c m ed icin e i n t h e i r own c o u n tr y . As a r e s u l t
o f t h i s th r e e im p ortan t t h in g s f o llo w e d th a t sta n d o u t a s
g r e a t landm arks in C h in ese m e d ic in e ;
1 s t . I n flu e n c e d by m em orials p r e s e n t e d by Dr. W u L ien -
Teh and o th e r s o f t h e s e W estern t r a in e d men, th e C h in ese ed
u c a t i o n a l a u t h o r i t i e s o f th e new R e p u b lica n form o f Govern
m ent i n 1913 i s s u e d i t s p e r m is s io n f o r p o s t mortem examina
t i o n s and the d i s s e c t i o n o f human b o d ie s . Dr. W h eeler, o f
P e k in g , l a t e r c o n n e c te d w ith th e Shantung C h r is t ia n C o lle g e
o f T sin a n , d id th e f i r s t d i s s e c t i o n in China on a human body
i n P e k in g . The d i s s e c t i o n was p erform ed in a l i t t l e s i d e
room o f what was th en th e lau n d ry-room o f th e P e k in g Union
M ed ic a l C o lle g e H o sp ita l and now th e Wendara H a ll. T h is
G overnm ental A ct in s u r e s f o r China a body o f p h y s i c ia n s in
t e l l i g e n t in t h e p r i n c i p l e s o f anatom y, p h y s io lo g y , and
p a t h o lo g y , and s u r g e r y .
2nd. The new R e p u b lica n Government a ls o e s t a b l i s h e d
m e d ic a l s c h o o l s in many o f th e p r o v in c e s . They w ere coed
u c a t i o n a l s c h o o ls w hich was a g r e a t s t e p forw ard i n g i v in g
woman h er p l a c e i n th e c i v i l w o rld .
56
3 rd . In 1 9 1 4 th e N a tio n a l M edical A s s o c ia t i o n o f China
was fou n d ed . I t has in i t s membership g r a d u a te s from
E uropean, A m erican, Ja p a n ese and C h in ese C o lle g e s o f medi
c i n e . T h is body e x te n d s to a l l f o r e ig n p h y s i c ia n s , p rop er
l y r e g i s t e r e d , an i n v i t a t i o n to become members. As a f a c t o r
o f p r o g r e s s i t f a r e x c e l l e d th e o ld s o c i e t y , th e China Medi
c a l M issio n a r y S o c i e t y . I t s power t o in f l u e n c e an e n l ig h t
en ed governm ent i s v a s t l y s u p e r io r to t h a t o f any f o r e ig n
group o r s o c i e t y . I t s b e t t e r know ledge o f th e la n g u a g e
m akes i t a f a r more e f f e c t i v e a g en t f o r t r a n s l a t i o n and s c i
e n t i f i c work upon te r m in o lo g y .
A te r m in o lo g y com m ittee was a p p o in te d , c o n s i s t i n g o f
r e p r e s e n t a t i v e s from t h e M in is tr y o f E d u c a tio n , t h e N a tio n a l
M ed ica l A s s o c ia t i o n , th e M edical and P h a r m a c e u tic a l S o c ie t y ,
t h e China M ed ical M issio n a r y S o c ie t y , and th e K iangsu Educa
t i o n a l A s s o c ia t i o n , to d e te r m in e th e m e d ic a l term s t o be
u s e d th ro u g h o u t China. T h is s t a n d a r d iz a t io n o f s c i e n t i f i c
m e d ic a l te r m in o lo g y and names i s in v a lu a b le to t h e p r o g r e s s
o f m ed ica l th o u g h t and e d u c a t io n in C h in a.
One o f t h e m ost f a r r e a c h in g f a c t o r s in tr o d u c e d in t o
C h in e s e m e d ic in e was the r e s e a r c h work brought in by th e
R o c k e f e l l e r F o u n d a tio n i n i t s C o lle g e a t P ek in g . The Mis
s i o n a r y Union work c a l l e d th e P ek in g U nion M edical C o lle g e ,
fo u n d e d by s i x m is s io n a r y g ro u p s o f P e k in g , was th e b e s t
e q u ip p e d and t h e b e s t s t a f f e d m ed ica l work in C hina. When
t h e R o c k e f e lle r F ou n d ation i n 1908 s e n t a com m ission to
C h in a t o i n v e s t i g a t e th e p o s s i b i l i t i e s o f e s t a b l i s h i n g
57
W estern m e d ic in e a lo n g th e m ost app roved modern l i n e s , th e
co m m issio n fou n d t h i s s c h o o l w e ll e s t a b l i s h e d i n t h e r e s p e c t
and good w i l l o f t h e Government and th e good w i l l o f th e
p e o p l e . The com m ission s o f 1 908, 1 9 1 4 , and 1 9 1 5 , a f t e r
i n v e s t i g a t i n g c o n d it io n s a l l o v e r C h in a, a d v is e d th e Founda
t i o n th a t th e P ek in g U nion M edical C o lle g e be ta k en o v e r # ,
In 19 1 5 th e China M edical Board, w h ich had been e s t a b l i s h e d
by th e % ) c k e f e lle r F ou n d ation , took o v e r th e p r o p e r ty o f
t h e P ek in g U n ion M edical C o lle g e and assum ed i t s f u l l sup
p o r t . The ter m s o f t h e t r a n s f e r p r o v id e d th a t t h e work o f
t h e c o l l e g e s h o u ld be c o n d u cte d by a Board o f T r u s te e s , con
s i s t i n g o f t h i r t e e n members, one t o be a p p o in te d by each o f
t h e s i x m is s io n a r y o r g a n iz a t io n s w hich had p r e v io u s ly main
t a i n e d th e c o l l e g e . The o th e r se v e n w ere to b e a p p o in te d
b y th e China M ed ical Board.
E a r ly i n 1916 th e t r u s t e e s o f th e P e k in g Union M edical
C o lle g e se c u r e d a p r o v i s i o n a l c h a r t e r from th e R e g en ts o f
t h e U n iv e r s it y o f New York and l e a s e d t h e p r o p e r ty o f th e
m e d ic a l sc h o o l i n P ek in g from th e China M edical Board.
The p e r io d from 1915 to 1921 was a p e r io d o f r eco n
s t r u c t i o n f o r th e c o l l e g e . The p r e -m e d ic a l s c h o o l was
op en ed in 1917 and c o n tin u e d u n t i l June 3 0 , 1 9 2 5 , when i t
was ta k en o v e r by th e YenChing U n iv e r s i t y .
Some o f t h e c o l l e g e s w ere g iv in g good c o u r s e s i n one
o r two of th e s c i e n c e s b u t n o t in a l l o f them. The China
M ed ic a l Board g a v e f i n a n c i a l a s s i s t a n c e to s e v e r a l c o l l e g e s
o f China, w h ich h a s h e lp e d them to p r o v id e b e t t e r f a c i l i t i e s
58
f o r th e t e a c h in g o f th e s c i e n c e s . There has b een a ra p id
im provem ent i n t h e te a c h in g o f p h y s i c s , c h e m is tr y , and b i o l
o g y i n r e c e n t y e a r s . There a r e a t p r e s e n t no l e s s than
t w e lv e c o l l e g e s i n China where th e p r e -m e d ic a l s c i e n c e s re
c e i v e s p e c i a l a t t e n t i o n . These i n s t i t u t i o n s a r e now a b le
t o p r e p a r e t h e i r s t u d e n ts f o r a d m issio n to th e P ek in g Union
M ed ica l C o lle g e by e x a m in a tio n . Two c o l l e g e s g r a n t th e
B .A . d e g r ee to s t u d e n t s who f i n i s h s u c c e s s f u l l y t h e i r p r e
m e d ic a l c o u r s e and on e y e a r i n th e P ek in g Union M edical
C o l l e g e . T h ese two c o l l e g e s a r e th e Canton C h r is t ia n Col
l e g e and th e Y a le U n iv e r s it y i n C hina. Soochow U n iv e r s it y
and Y enching U n iv e r s it y c o n fe r th e B .S . d e g r ee upon th e suc
c e s s f u l c o m p le tio n o f t h e t h r e e y e a r s p r e -m e d ic a l work and
on e y ea r o f work a t th e P ek in g Union M ed ical C o lle g e . T h is
r a p id d evelo p m en t o f s c i e n c e te a c h in g and th e b e t t e r prépara--
t i o n o f s t u d e n t s f o r th e stu d y o f m e d ic in e on th e p a r t o f
t h e c o l l e g e s o f C hina, c a u se d th e P e k in g Union M ed ical Col
l e g e to d is c o n t in u e i t s P re— m ed ica l S ch o o l a t th e c l o s e o f
t h e s e s s i o n o f 1 9 2 4 -3 5 . A ll l a b o r a t o r i e s o f p h y s i c s , chem
i s t r y , and b i o l o g y , t o g e t h e r w ith th e s t u d e n t s in u n com p leted
c o u r s e s in t h o s e s c i e n c e s w ere t r a n s f e r r e d to Y enching Uni
v e r s i t y .
In th e d e d ic a t o r y s e r v i c e when t h i s m a g n ific e n t p la n t ,
t h e P ek in g U nion M edical C o lle g e , was b e in g g iv e n t o th e
C h in e s e p e o p le , John D. R o c k e f e lle r , J r . , s a id :
W hatever W estern m ed ica l s c i e n c e may h ave t o o f f e r to China
w i l l be o f l i t t l e a v a i l to th e C h in ese p e o p le u n t i l i t i s
ta k e n o v e r b y them and becom es a p a r t o f th e n a t io n a l l i f e .
59
So we must lo o k forw ard t o th e day when m ost i f n o t a l l o f
t h e p o s i t i o n s on th e f a c u l t y o f th e P ek in g Union M edical
C o lle g e w i l l be h e ld by C h in e s e .. . . R e c e n tly when th e pneu
m onic p la g u e ap p eared i n S h a n s i, th e M in is te r o f th e I n t e r
i o r a s s ig n e d c e r t a i n p h y s i c i a n s , among them Dr. Yu S h u -fe n ,
t o combat i t . Dr. Yu succumbed to th e d i s e a s e and r e a l i z
in g t h a t he c o u ld n o t r e c o v e r , d i c t a t e d a f a r e w e ll m essage
in w hich t h i s rem arkable paragraph o c c u r s : 'W ith my en th u s
iasm fo r th e p la g u e p r e v e n tio n and i n my c o n s ta n t c o n ta c t
w it h th e p la g u e , I a c c i d e n t a l l y c o n t r a c t e d th e d i s e a s e . I
am d y in g f o r th e p e o p le . I have no c o m p la in t .' J u s t a few
d a y s b e fo r e h i s d e a th . Dr. Yu had w r i t t e n in th e g u e s t book
o f Dr. F . F . T ucker, o f Teh chow, ' I come to f i g h t th e p la g u e
and t o p u t i n t o p r a c t i c e G od's lo v e f o r men. ' When th e
P e k in g U n ion M ed ical C o lle g e i s manned w ith C h in ese p r o f e s
s o r s o f Dr. Y u 's ty p e , b r in g in g to b ea r upon th e s tu d e n ts
o f th e C o lle g e th e in f l u e n c e o f such l i v e s , and when men o f
t h a t c a l i b e r a r e each y e a r b e in g g r a d u a te d from t h e C o lle g e
to sp rea d abroad th rou gh ou t t h i s g r e a t la n d th e h e a lin g o f
t h e body and th e i n s p i r a t i o n o f th e s o u l o f th e C h in ese p eo
p l e , th e s p i r i t o f s e r v i c e and s a c r i f i c e i n w h ich t h i s in
s t i t u t i o n was c o n c e iv e d , w i l l have b e e n im m o r ta liz e d and
one o f th e c h i e f p u r p o se s f o r which th e c o l l e g e was founded
w i l l have b een r e a l i z e d . 1
In h i s r e p o r t on th e f i r s t f i v e y e a r s o f th e P ek in g
U nion M edical C o lle g e , Dr. W . S. C a r ter sa id :
M ed ica l r e s e a r c h o c c u p ie s an iiïp o r ta n t p la c e i n m ed ica l
s c h o o l s w hich a r e engaged c h i e f l y i n t r a i n in g u n d e rg r a d u a tes
t o become p r a c t i t i o n e r s o f m e d ic in e . I t i s o f g r e a t e r im
p o r t a n c e in t h o s e i n s t i t u t i o n s w hich p r o v id e g r a d u a te c o u r s e s
f o r i t s own g r a d u a te s who a r e c o n n e c te d w ith o th e r i n s t i t u
t i o n s . A dequate f a , c i l i t i e s must b e p r o v id e d f o r g ra d u a te
s tu d y and w ith c o n s id e r a b le em phasis on o r i g i n a l i n v e s t i g a
t i o n and r e s e a r c h w o r k . 2 , ■
In t h e y e a r s s i n c e 1925 a g r e a t number o f th e te a c h in g
p o s i t i o n s on t h e f a c u l t y o f th e P ek in g Union M ed ical C o lle g e
h ave b een f i l l e d w ith a b l e C h in ese p h y s i c ia n s , t r a in e d in
" 1
■'•John D . R o c k e f e lle r , J r . , A d d ress, D e d ic a tio n o f th e
P e k in g Union M edical C o lle g e , d e l iv e r e d a t P e k in g , Monday,
S ep t ember 1 9 , 19 2 1 .
^W. S . C a r te r , "The F i r s t F iv e Y ears o f th e P ek in g
U n io n M edical C o lle g e ," China M edical J o u r n a l, XL, August
1 9 2 6 , 726.
60
A m erica. The amount and q u a l i t y o f th e work done by t h i s
s c h o o l i s n o t e x c e l l e d anyw here in t h e w orld to d a y . The
equipm ent i s n o t su r p a ss e d i n any o t h e r s c h o o l. The p la n t
i t s e l f i s a m arvel o f b e a u ty in th e ty p e o f C h in ese a r c h i
t e c t u r e .
The China M edical A s s o c ia t io n ,t h r o u g h i t s M ed ical Edu
c a t i o n Com m ittee, fo r m u la te d and p r e s e n t e d to th e r e g u la r
A s s o c i a t i o n r eq u ire m en ts f o r th e r e g i s t r a t i o n o f Approved
M ed ic a l S c h o o ls . These r e q u ir e m e n ts w ere a c c e p te d b y th e
C hina M edical A s s o c ia t io n and p u b lis h e d i n th e C hina M edical
J o u r n a l, A ugust 192 5 . T h ese r e q u ir e m e n ts in c lu d e d e n tra n ce
s ta n d a r d s , l e n g t h o f r e q u ir e d c o u r se , c u r r ic u lu m , f a c u l t y ,
la b o r a t o r y f a c i l i t i e s , c l i n i c a l f a c i l i t i e s , and o t h e r te a c h
i n g f a c i l i t i e s .
In 1925 o n ly one m e d ic a l s c h o o l i n China had b e e n a b le
t o r e g i s t e r a s an approved m ed ica l s c h o o l by t h e sta n d a rd o f
t h e China M ed ical A s s o c ia t i o n . That n a t u r a l l y was th e
P e k in g Union M ed ical C o lle g e , under th e a u sp ic es- o f th e
R o c k e f e l l e r F o u n d a tio n .1 S ix o th e r s q u a l i f i e d w it h in two
y e a r s .
In 1922 t h e r e was in China one m e d ic a l s c h o o l f o r ev ery
f i f t e e n m i l l i o n i n h a b i t a n t s . There was one m e d ic a l s tu d e n t
f o r e v e r y 1 7 5 ,0 0 0 o f t h e p o p u la t io n . There was one modern
p r a c t i c i n g p h y s i c ia n f o r e v e r y 1 2 0 ,0 0 0 o f th e p o p u la t io n .
The t o t a l number o f m e d ic a l g r a d u a te s and th o s e h a v in g
^W. S. Carter, op. cit.
61
s t u d i e d some W estern m e d ic in e was n o t o v e r 4 ,5 0 0 ,
In 1922 th e r e w ere 24 m e d ic a l s c h o o ls i n China.
M ed ical S c h o o ls -2 4
1 . Management
a . 11 were C h in ese i n s t i t u t i o n .
b . 11 were under f o r e ig n c o n t r o l .
c . 2 were c o - o p e r a t i v e l y managed by C h in ese and
f o r e i g n e r s .
2 . M edical s tu d e n ts
a . T o ta l number o f s tu d e n ts 2 ,0 0 0 .
(a ) Of t h i s number, 9 5 w ere women.
(b ) Of t h i s number 1 ,9 0 5 w ere men.
3 . F a c u l t i e s
a . Number o f f a c u l t y members v a r ie d from:
(a ) 4 members a t Foochow.
(b) 43 members a t P ek in g U nion M ed ical C o lle g e .
4. B u dgets o f th e s c h o o ls
a . Number v a r ie d from:
(a ) $ 2 ,5 0 0 a t Hangchow.
(b ) # 8 0 0 ,0 0 0 a t th e P ek in g Union M ed ical
C o lle g e .
5. T u itio n o f th e s c h o o ls
a . Amount v a r ie d from:
(a ) N oth in g i n th e Army and Navy S c h o o l.
(b ) $300 M exican, a t Hongkong.
6. Cost o f Board and Room
a. Amount v a r ie d from:
(a ) $30 p e r y e a r -b u t t h i s r a te k ep t many away.
62
A ft e r t h e e s ta b lis h m e n t o f th e P e k in g Union M ed ical
C o l l e g e , 1 9 2 1 , w ith i t s h ig h sta n d a r d s th e China M edical
A s s o c ia t i o n b rou gh t p r e s s u r e t o b ear upon th e more p o o r ly
eq u ip p ed m is s io n c o l l e g e s to r a i s e t h e i r sta n d a r d s or c lo s e .
The r e s u l t was t h a t a number a f f i l i a t e d in d i f f e r e n t s e c
t i o n s o f th e c o u n tr y and th u s brough t t h e u n io n work up to
th e sta n d a rd .
The c i v i l war w ith i t s com m u nistic propaganda was d i s
a s t r o u s to th e work o f t h e m ed ica l c o l l e g e s . The a n t i - f o r
e ig n a t t i t u d e engendered c a u se d th e ig n o r a n t p e a s a n tr y to
a t t a c k many o f th e s c h o o l s . A summary o f th e s i t u a t i o n con
c e r n in g m ed ica l s c h o o ls i n 1 9 2 6 -2 7 f o l lo w s :
T o ta l number o f M edical S c h o o ls , 1 9 2 6 - 2 7 ......................................... 9
The number o f M edical S c h o o ls — ru n n in g more o r l e s s
n o r m a lly .......................................... 4
The number o f M ed ical S c h o o ls — ru n n in g un der a de
p l e t e d s t a f f .................................. 2
The number o f M edical S c h o o ls — c l o s e d ......................................... . . . 3
Of a l l th e M edical C o lle g e s in China th e s p le n d id ly
eq u ip p ed s c h o o l a t Changsha, th e Y a le M ed ical C o lle g e , s u f
f e r e d th e m ost s e v e r e l y in th e c o n f l i c t . The M ed ical Col
l e g e was o r i g i n a l l y a u n i o n . i n s t i t u t i o n o f th e Y ale M issio n
and th e C h in ese g e n tr y o f Hunan. B e fo r e th e r e c e n t f i g h t
i n g , how ever, th e C o lle g e had been tu r n e d ov er e n t i r e l y to
t h e C h in ese B oard o f Management. In v ie w o f t h i s , i t seemed
s t r a n g e t h a t t h e Y ale C o lle g e sh o u ld have b een so v i o l e n t l y
62
a t t a c k e d . The Communist P a r ty e v i d e n t l y had no more re
s p e c t f o r C h in ese than f o r f o r e ig n i n s t i t u t i o n s . The work
was c o m p le te ly b rok en up by th e Labor and Peasa.nt U n ion s.
The i n t e r f e r e n c e w ith m ed ical work d u rin g th e R evolu
t i o n and s i n c e , meant t h a t th e r e was a d e c r e a s e o f n e a r ly
b O /< 3 i n th e o u tp u t o f f u l l y q u a l i f i e d d o c t o r s from th e b e s t
M ed ical S c h o o ls in China. I t w i l l b e s e v e r a l y e a r s b e fo r e
t h e ‘form er f i g u r e s can a g a in b e r e a c h e d , even w ith p e a c e .
"China i s b e in g b le d w h ite and th e p r o s p e c t f o r an ad eq u ate
m e d ic a l p r o f e s s i o n f o r th e co u n try becom es more and more
d i 8 t a n t .
HOSPITAL SITUATION IN CHINA
B e fo r e t h e l a s t o u tb re a k o f th e C i v i l War in C hina, in
1 9 3 2 , th e r e w ere 300 M is s io n H o s p it a ls i n C hina. T hese
M is s io n H o s p it a ls were t h e b e s t h o s p i t a l s in China e x c e p tin g
t h e P ek in g U n io n M edical C o lle g e H o s p it a l. The h o s p i t a l s
c a r r i e d on t h e i r work a s u s u a l u n t i l th e s o l d i e r y fo r c e d
many o f them to suspend work. Some o f th e h o s p i t a l s were
d e s t r o y e d , o t h e r s were, so d e fa c e d and m u tila te d t h a t th e
c o s t o f r e p a ir would be eq u al to b u i ld in g anew. The a n t i -
f o r e i g n and a n t i - C h r i s t i a n f e e l i n g on th e p a r t o f th e red
s o l d i e r y a c c o u n te d f o r t h e d e s t r u c t io n o f b o th t h e M issio n
H o s p it a ls and th e M edical S c h o o ls . In th e Septem ber number
o f China M ed ical J o u r n a l, 1 9 2 7 , Dr. James î^axw ell. S e c r e ta r y
^James L. M axwell, " P resen t P o s i t i o n o f M edical Work
i n C hina, " C hina M edical J o u r n a l. XLI, J u ly 1927 , 669.
64
o f th e China M ed ical S o c i e t y , g i v e s a summary o f th e m ed ical
and h o s p i t a l s i t u a t i o n in China.^ He c a l l e d a t t e n t i o n to th e
f a c t th a t t h i s c r i s i s was a s e r io u s one f o r M issio n H o s p ita ls ,
T hese h o s p i t a l s w ere d ep en d en t on t h e M edical S c h o o ls f o r a
s u p p ly o f q u a l i f i e d men and women a s in t e r n e s and c o lle a g u e s
to th e f o r e ig n d o c to r s and to r e p la c e th e f o r e ig n d o c to r s as
t h e C h in ese Church s e e s i t s way to ta k e o v e r th e m ed ica l work.
Dr. M axwell e x clu d ed 51 M issio n H o s p it a ls from th e cou n t
b e c a u s e t h e i r d e s t r u c t io n seem ed d i f f i c u l t to la y to e it h e r
s i d e on a c c o u n t o f th e d e s t r u c t i v e f i g h t i n g t h a t to o k p la c e
i n th e two p r o v in c e s . B oth s i d e s were, r e s p o n s ib le a lth o u g h
p o s s i b l y o n ly th e c o n n u n is t ic elem en t o f th e S ou th ern Army
d e s i r e d th e d e s t r u c t i o n . But in th e t o t a l number d e str o y e d
t h o s e 51 h o s p i t a l s b r in g up th e l i s t to 110 h o s p i t a l s . The
h o s p i t a l s d e s tr o y e d w ere s c a t t e r e d o v e r a wide a r e a and em
b r a c e d th e h o ld in g s o f a l a r g e number o f F o r e ig n B oard s.
THE PUBLIC HEALTH SITUATION IN CHINA
Among f o r e i g n m ed ica l w orkers i n China th e r e had alw ay s
e x i s t e d a c o n v i c t i o n t h a t p u b lic h e a l t h work was n eed ed a s a
^ Summary :
T o ta l number o f h o s p i t a l s Under S ou th ern Under N orthern
Government Government
165 .......................... 84
Running n o r m a lly 35 = 31.2% 49 = 5 8 .2 ^
Running under tem porary
arrangem ent 71 = 43fo 18 - 21.4fo
S e iz e d by th e m i l i t a r y 4 = 2.4^0 17 =• 2 0 .2 ^
R uined or d e s tr o y e d 55 = 33.3^» 4 = 4.7fô
65
b a s i s f o r s u c c e s s f u l m ed ica l work. T h is c o n v i c t i o n found
i t s f i r s t e x p r e s s io n in 1 9 1 0 , a t th e B ie n n ia l C o n feren ce o f
th e China M ed ical M issio n a r y S o c i e t y . A com m ittee o f th r e e
d o c t o r s was a p p o in te d to p r e p a r e l i t e r a t u r e on t h e p r e v e n tio n
o f d i s e a s e . The P r e s id e n t o f th e M ed ical A s s o c ia t io n en
co u r a g ed th e Young Men's C h r is tia n A s s o c ia t i o n i n i t s p la n
o f a d d in g to i t s s t a f f a young d o c to r , W ,W .Peter, who was
j u s t th e n f i n i s h i n g h i s f i r s t y e a r o f la n g u a g e s tu d y . He
was a s s ig n e d t o th e work i n th e L e c tu r e Departm ent o f th e
N a tio n a l Com m ittee o f th e Young M en's C h r is t ia n A s s o c ia t i o n
i n t h e p r ^ a r a t i o n o f d em o n stra ted h e a l t h l e c t u r e s .
When th e China M ed ical M issio n a r y S o c ie t y met a g a in in
1 9 1 5 , th e C h in ese W estern t r a in e d d o c t o r s o r g a n iz e d t h e i r
own m ed ica l s o c i e t y , c a l l e d th e N a tio n a l M edical S o c i e t y .
B o th m ed ica l s o c i e t i e s , th e n a t i v e and th e f o r e i g n , a p p o in te d
s p e c i a l co m m ittee s on p r e v e n t iv e m e d ic in e .
In 1916 th e two m ed ica l s o c i e t i e s and th e Young Men's
C h r is t ia n A s s o c ia t i o n u n it e d in th e fo r m a tio n o f a J o in t
C o u n c il on P u b lic H ea lth E d u c a tio n . Each o r g a n iz a t io n
p le d g e d i t s e l f to p r o v id e a c e r t a i n p r o p o r tio n o f th e ex p e n se .
At t h e Canton C o n feren ce in 1917 a f t e r th e d e l e g a t e s had
p le d g e d # 1 ,5 0 0 M exican a y e a r fo r two y e a r s , a c t i o n was tak en
a p p e a lin g to th e M issio n Boards a t home f o r f i n a n c i a l su p p o r t.
$ 5 ,0 0 0 a y ea r was p le d g e d f o r th r e e y e a r s by th e home c h u r c h e s,
t h e B a p t i s t , P r e s b y t e r ia n , M eth o d ist, Lutheran-' and o t h e r s .
I t was c o n tin u e d fo r te n y e a r s l o n g e r . ! In 1920 th e name
P e t e r , "The F ie ld and Methods o f P u b lic H ea lth Work
i n th e M issio n a r y E n t e r p r is e , " China M edical J o u r n a l, XL, 2 3 0 ,
March, 1926.
66
was changed t o th e C o u n c il o f H e a lth E d u c a tio n , i t s name t i l l
th e C h in ese Government to o k i t o v er and e s t a b l i s h e d a M in is
t r y o f H e a lth , November 1 , 1 9 2 8 .^ O ther o r g a n iz a t io n s jo in e d
f o r c e s w ith th e w ork. T hese o r g a n iz a t io n s w e r e . The China
C h r is t ia n E d u ca tio n A s s o c i a t i o n , The Nurses* A s s o c ia t i o n o f
C h in a, and th e Young Women’ s C h r is t ia n A s s o c i a t i o n . E a c h lo f
t h e s e o r g a n iz a t io n s a p p o in te d a r e p r e s e n t a t iv e and an a l t e r
n a t e . T hese c o n s t i t u t e d th e E x e c u tiv e Com m ittee o f th e Coun
c i l . In 1924 th e r e w ere 17 w orkers in th e c e n t r a l o r g a n i z e - -
t i o n , o n ly two o f them b e in g f o r e i g n e r s . D r. W. W. P e te r o f
th e Young Men’ s C h r is t ia n A s s o c i a t i o n , and D r. I va M i l l e r ,
p r o v id e d by th e Woman’ s F o r e ig n M is sio n a r y S o c i e t y o f th e
M e th o d ist E p is c o p a l Church.
THE ORGANIZATION OF THE MINISTRY OF HEALTH
Among th e members o f th e new Government formed a t Nan
k in g , 1 9 2 8 , were many p r o g r e s s iv e young men who r e a l i z e d
t h a t th e r e c o g n it io n o f China in th e f a m ily o f n a t io n s d e
pended upon C h in a ’ s a c c e p ta n c e o f modern m eth od s. N e ith e r
w ere t h e s e young men w i l l i n g to have so im p o rta n t a need as
p u b lic h e a l t h l e f t u n r e c o g n iz e d by C h in ese a u t h o r it y and to
b e c a r r ie d on by f o r e i g n e r s . "The C h in ese G overnm ent," s a id
D r. J . H. L iu , " r e a l i z i n g th e ’n e e d s o f th e h o u r ’ a t th e
tim e o f i t s r e o r g a n iz a t io n , e s t a b l i s h e d th e M in is tr y o f
H e a lth on November 1 , 1 9 2 8 ."
! j . H. L iu , "The M in is tr y o f H e a l t h ,” China M e d ic a l
J o u r n a l. V o l. X L III, 3 1 9 , A p r i l , 1 9 2 9 .
67
The new H e a lth Departm ent found i t s e l f fa c e d w it h many
and most s e r i o u s d i f f i c u l t i e s , hut went ahead and mapped o u t
a t e n t a t i v e program f o r t h e n e x t few y e a r s .
THE ORGANIZATION OF THE MINISTRY
I . Two A d v iso ry Board.s
1 . C e n tr a l Board o f H e a lth
A. P urpose-T o c o n f e r on m a tte r s o f g e n e r a l im portance
and i n t e r e s t .
B* Member8 -Min i s t e r o f H ea lth
P o l i t i c a l , and A d m in is tr a t iv e V ic e M in is
t e r s o f H ea lth
C h ie f T e c h n ic a l E xp ert
Head o f N a tio n a l H ygien e L ab oratory
17 members a p p o in te d by th e M in is te r o f
H e a lth
C. Term o f O f f ic e - o n e y ea r
D, M e e tin g s -tw io e a year
2 . I n t e r n a t io n a l A d v iso r y C ou n cil
A. Pur p o s e - to b e n e f i t from t h e e x p e r ie n c e o f i n t e r
n a t io n a l and o t h e r f o r e ig n h e a lth o r g a n iz a t io n s
th ro u g h e x p e r ts
B. Term o f O f f i c e - i n d e f i n i t e
D. M e e tin g s -to b e c a l l e d by th e M in is te r a t con
v e n ie n t i n t e r v a l s . I n v i t a t i o n s a s hon orary
a d v i s e r s have been s e n t t o :
D r. L . Rajchrnan, League o f N a tio n s , H ea lth
S e c t i o n
68
Dr. V ic to r G. H e is e r , I n t e r n a t io n a l H ea lth
D i v i s i o n , R o c k e f e lle r F oun dation
S i r A rthur Newsholme, fo r m e r ly C h ie f M edical
O f f ic e r , L ocal Government Board, E ngland.
I I . F iv e A d m in is t r a tiv e D epartm ents in th e M in is tr y ;
1 . D epartm ent o f G en eral A d m in is tr a tio n
A. F i r s t D i v i s i o n - I n ch arge o f c o r r e sp o n d e n c e and
docum ents
B. Second D i v i s i o n - P u b l i c a t i o n s and l i b r a r y
C, T h ird D iv is io n -A c c o u n ts
D, F ourth D iv isio n -E q u ip m e n t and s u p p l i e s , super
v i s i o n o f em p loyees
2 . Departm ent o f M ed ical A d m in is tr a tio n
A. F i r s t D i v i s i o n - S u p e r v is io n o v e r l o c a l h e a lt h
a d m in is t r a t io n s
B. Second D iv is io n - G e n e r a l m e d ic a l p r a c t i c e and
d ru g s
C. T h ird D iv s io n s - H e a lt h e d u c a tio n
3 . D epartm ent o f H e a lth and S a n it a t io n
A. F i r s t D iv is io n - S c h o o l h e a l t h , m atern al and
c h i l d w e lfa r e and o th e r h e a l t h s e r v i c e s
B. Second D i v i s i o n - I n d u s t r i a l h e a lt h , h e a lt h
in s u r a n c e
C. T h ird D iv is io n - F o o d s and d r in k s , s a n it a r y
in s p e c t i o n
4. Departm ent o f E p id em io lo g y
A. F i r s t D iv isio n -C o m m u n ica b le d i s e a s e s
69
B. Second D iv is io n - a n im a l d i s e a s e s
0* T hird D iv is io n -F o o d s and d r in k s , s a n i t a r y
i n s p e c t i o n
5* D epartm ent o f V i t a l S t a t i s t i c s
A* F i r s t D i v i s i o n - V i t a l s t a t i s t i c s
B. Second D iv is io n - O t h e r h e a lt h s t a t i s t i c s
I I I . S p e c ia l C om m ittees and B oards;
A. S e c r e t a r i a t - i n ch arge o f c o r r e sp o n d e n c e , t e l
egrams and docum ents
B. C o u n s e llo r s - in ch arge o f m a tter s p e r t a i n in g
to l e g i s l a t i o n
C. T e c h n ic a l E x p e r ts-o n e c h i e f and a s s i s t a n t s , to
a s s i s t th e D epartm en ts in t e c h n i c a l m a tte r s .
D. E d it o r ia l Com m ittee
a . 0 r g a n iz a t io n s - o n e h e a d ,e d it o r and s t a f f
members a p p o in te d by th e M in is te r
b . D u t y - e d it in g and t r a n s l a t i o n o f books and
a r t i c l e s on h e a lt h
S. Comm ittee on th e Study o f Kuomintang D o c tr in e s
a . In ch a rg e o f th e d i s c u s s i o n on th e Kuomin
tan g d o c t r i n e s by s t a f f members
IV. H ea lth O r g a n iz a tio n s D i r e c t l y u n d er th e C o n tro l o f th e
M in is tr y o f H ealth;
1* H ea lth Departm ent o f P r o v i n c ia l Governments
2 . H e a lth D epartm ents o f S p e c ia l M unicipal Governments
3 . N a tio n a l H ygiene L ab oratory ( b e in g p la n n e d on l i m i t
ed s c a l e )
70
A. D i v i s i o n s :
a . D i v i s i o n s o f g e n e r a l a d m in is t r a t io n , c o r r e
sp o n d en ce, p u b l i c a t i o n s , g e n e r a l m ain ten an ce,
o th e r b u s in e s s
b . D i v i s i o n o f P a t h o lo g y - d ia g n o s t ic and r e s e a r c h
G* D i v i s i o n o f G h em istry -ch em ica l a n a l y s i s and
e x a m in a tio n o f f o o d s , b e v e r a g e s , sp ecim en ,
and r e s e a r c h work
d . D i v i s i o n o f P h a r m a c o lo g y -a n a ly s is , examina
t i o n and m an u factu re o f d ru g s, and e x p e r i
m ents w it h d r u g s '
e . D i v i s i o n o f Immunology and B a c t e r io lo g y -
Manuf a c t u r e o f serums and v a c c i n e s , b a c te r
i o l o g i c a l e x a m in a tio n s o f f o o d s , d r in k s ,
sp ecim en s and o t h e r s , and r e s e a r c h .
4. N a tio n a l Epidem ic P r e v e n tio n B u reau -m an u factu re o f
serum s and v a c c in e s
5. N a tio n a l H ea lth T r a in in g S c h o o l-u n d e r c o n te m p la tio n ■
A. P u r p o se -to t r a i n h e a lt h o f f i c e r s f o r th e H ealth
Bureaus and t h e d i f f e r e n t D epartm ents
B. S t a f f - o n e D ir e c t o r and o t h e r s h o ld in g c o n c u r r e n t
p o s t s in t h e M in is tr y
6. N a tio n a l M idw ifery B o a r d -J o in tly w ith th e M in is tr y
Of E d u c a tio n
A. P u r p o se -to prom ote m id w ife ry e d u c a tio n i n th e
c o u n tr y
B. M ember8-nine i n number
71
Two r e p r e s e n t a t i v e s each from th e M i n i s t r i e s
o f H ea lth and E d u ca tio n
F iv e o th e r members
0. Terra o f o f f i c e - t w o y e a r s
D. M e e tin g s -t w ic e a y ea r
72
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I n t e r n a t i o n a l A d v iso ry C o u n c il
N a t io n a l M id w ifery Board
N a t io n a l Board o f H e a lth
N a t io n a l H e a lth T r a in in g S c h o o l
N a t io n a l H ygien e L ab oratory
E d i t o r i a l Com m ittee
T e c h n ic a l E x p e r ts
D epartm ent o f Gen.
A d m in is tr a tio n
Departm ent of'M ed
i c a l A d m in is tr a tio n
^ .C o r r e s p o n d e n c e
2 .P u b li c a t i o n s
5 .A c c o u n ts .
^ . S u p p l i e s
1 . S u p e r v is io n o v er
l o c a l h e a l t h ad
m i n i s t r a t io n s
•^ 2 .G en er a l M ed ica l
p r a c t i c e and
drugs
5 . H e a lth E d u c a tio n
D epartm ent o f H e a lth
and S a n i t a t i o n
''1.H e a lth S e r v ic e s
2 . I n d u s t r i a l H e a lth
H e a lth In su r a n c e
S a n it a t io n
i:!
D epartm ent o f
E p id em io lo g y
D epartm ent o f
V i t a l S t a t i s t i c s
S e c r e t a r i a t
C o u n s e llo r s
1
{
1 .Communicable
D i s e a s e s .
2 . Anim al D is e a s e s
3 . Q u aran tin e
1 .V i t a l S t a t i s t i c s
2 .H e a lth S t a t i s t i c s
PART I I
OBSTETRICS IN CHINA
74
CHAPTER VI
OBSTETRICS IN'CHINA
The p e r io d s o f C h in ese o b s t e t r i c a l m ed icin e may be con
s i d e r e d th e same a s t h o s e o f C h in ese g e n e r a l m e d ic in e .!
I . L egendary— to 1154 B.C.
I I . H i s t o r i c a l or C l a s s i c a l — 1 1 5 4 B .C .-9 5 9 A .P .
I I I . M ed ieval o r C o n tr o v e r s ia l P e r io d — 959 A .D .-
1805 A.D.
IV. Modern or T r a n s it io n a l P e r io d — 1805 to p r e s e n t
tim e .
Legendary P e r io d .' The o n ly work m en tioned in th e Legend
a r y P e r io d was th e Nei C hing, B.C. 2 6 9 7 . T h is was a t t r i b u t e d
t o t h e Emperor Huang-Ti bu t was p r o b a b ly much l a t e r . 2 Ac
c o r d in g to th e C h in ese, th e N ei Ching in i t s e a r l i e s t form
w a s - w r it te n on s l i p s o f bamboo. I t i s c e r t a i n t h a t i t d id
n o t appear i n book form t i l l ab ou t th e b e g in n in g o f th e Han
D y n a sty (B .C . 202) and i t was much l a t e r th a t th e commentary
on i t was w r i t t e n by Wang P in g . T h is work h as a r e f e r e n c e
to o b s t e t r i c s .
H i s t o r i c a l o r C l a s s i c a l P e r io d . Many p h y s i c ia n s were
m en tio n e d in th e H i s t o r i c a l P e r io d b u t n o t many o f them
! k .C. Wong, "C hinese M edical L it e r a t u r e ," C h in ese
M ed ical J o u r n a l, V ol. XXXII, 154.
^K.K.Chen and Amy L in g , "Fragm ents o f C h in ese M edical
H is t o r y ," A n n als o f M ed ical H is to r y , V o l. V I II , 1 8 5 , June 1 9 2 6 .
75
d e v o te d th e m s e lv e s to o b s t e t r i c s or d id much w r i t i n g on th e
s u b j e c t . Hua To w rote upon th e s u b j e c t o f o b s t e t r i c s and
g y n e c o lo g y , but very l i t t l e . In a l l th e l i t e r a t u r e and in
a l l th e c a s e s c i t e d , Hua To d id n o t i n any i n s t a n c e d e l i v e r . !
He d i r e c t e d a m id w ife to do th e d e l i v e r i e s . T h is i s a f a c t
to be n o ted a s c h a r a c t e r i s t i c o f C h in ese o b s t e t r i c s . Women
d e l i v e r women. The w r i t i n g s bear o u t t h i s f a c t . I t was
n o t f o r th e same r e a s o n s , th e d e s i r e f o r a s e p s i s , t h a t con
t r o l our su r g e o n s in r e f u s i n g to h a n d le o b s t e t r i c s . I t was
t h e C h in ese v ie w p o in t t h a t owing to th e s a c r e d n e s s and p r i
v a c y , t h i s work n a t u r a l l y b e lo n g e d to women.
I t was i n t h i s H i s t o r i c a l P e r io d when much c l a s s i c a l
work was b e in g produced t h a t th e f i r s t e n c y c lo p e d ia h a v in g a
d e f i n i t e s e c t i o n d e v o te d to women’ s d i s e a s e s and o b s t e t r i c s
a p p ea r e d . T h is was e n t i t l e d Ch’ao S h ih Chu P in g Yuan Hou
Tsung Lun, and app eared in th e e a r ly p a r t o f th e Sung D y n a sty
( c i r c a 589 A .D .) . P r e v io u s to th e p u b l i c a t i o n o f t h i s en
c y c lo p e d ia t h e r e had been a lo n g p e r io d o f a lm o st e ig h t hun
d r e d y e a r s , e x te n d in g from th e Han D y n a sty (B .C . 202) to
589 A.D. in t h e Sung D y n a sty when t h e r e had b een no w r it in g s
on o b s t e t r i c s . I t was s i m i la r to th e Dark Ages i n Europe
and was a p e r io d in w hich a s t r o l o g y and alchem y becam e a p a r t
o f th e s p e c u l a t i o n s g o v e r n in g g e n e r a l m e d ic in e .
The M ed ieval o r C o n t r o v e r s ia l P e r io d . In t h i s p e r io d
t h e p e d a n tic w orsh ip o f t h e a n c i e n t s g a v e way to a t t a c k s upon
!K.K.Chen, and Amy Ling, op. cit.
76
o ld w r i t i n g s . M oreover, a l l w r it in g s o f th e p e r io d were
s e v e r e l y c r i t i c i s e d . The o b s t e t r i c a l w r it in g s o f th e p e r
i o d r e f l e c t t h i s c r i t i c a l a t t i t u d e and a s a c o n se q u en ce in
d i c a t e a m easure o f im provem ent in th o u g h t a s w e ll a s p ra c
t i c e in th e l i n e o f o b s t e t r i c s . The in c r e a s e d o u tp u t o f
t h e w r it in g s was due to th e f a c t t h a t p a p er , and n o t bamboo
s l i p s , W B .8 u s e d . l With a f a i r q u a l it y o f p ap er and cheap
q u a l i t y o f p a p e r p h y s ic ia n s g la d ly tu r n e d to w r i t i n g . From
q u a n t it y grew q u a l i t y , and t h i s came ab ou t through c r i t i c i s m .
Many m onographs were p rod u ced in t h i s p e r io d in g e n e r a l medi
c i n e and a s m a lle r number on th e s u b j e c t o f o b s t e t r i c s .
A f t e r 1100 A .D . th e number o f w r i t i n g s in c r e a s e d . In 1100
A .D . and i n 1 1 2 6 A.D. t h e r e app eared s p e c i a l works c o n ta in
in g c h a p te r s on o b s t e t r i c a l s u b j e c t s b u t th e tim e o f g r e a t
e s t a c t i v i t y i n w r it in g s d u r in g t h i s p e r io d e x te n d ed from
1 5 0 0 A.D. t o 1800 A.D.
The Modern or T r a n s it io n a l P e r io d . The f o u r t h p e r io d
i n c lu d e s th e work o f f o r e i g n and m is s io n a r y d o c t o r s and th a t
o f th e W estern t r a in e d C h in e se . I t i s c h a r a c t e r iz e d by
h o s p i t a l i z a t i o n and m odem m ethods a s a p p lie d to m e d ic in e .
^J, 0 . Thompson, "M edical P u b li c a t i o n s in C h in e s e ,"
C hina M edical J o u r n a l, V o l. I, 1 1 5 , J u ly 1876.
77
CHAPTER VII
THE OBSTETRICAL LITERATURE, PRESCRIPTIONS AND DRUGS
From th e sta n d p o in t o f th e w r i t i n g s , th e o ld o b s t e t r i c a l
and g y n e c o lo g ic a l l i t e r a t u r e may be c l a s s e d u n d er th r e e h ead s;
1 . Works w r it t e n s p e c i f i c a l l y on th e s u b j e c t o f o b s t e t
r i c s o r g y n e c o lo g y .
2 . E n c y c lo p e d ia s o f m ed icin e in w hich c e r t a i n books or
s e c t i o n s a r e d e v o te d to th e e x p o s i t i o n o f th e sub
j e c t o f o b s t e t r i c s or g y n e c o lo g ic a l s u b j e c t s .
3 . Works on m ed ica l s u b j e c t s h a v in g sm a ll s e c t i o n s b ea r
in g d i r e c t l y on o b s t e t r i c o r g y n e c o lo g ic a l s u b j e c t s .
The number o f books c o l l e c t e d in t h e f i r s t c l a s s i s t h i r
t y - f o u r ; th e se co n d c l a s s , t w e n t y - f i v e ; and th e t h i r d c l a s s
t h r e e . There a r e s e v e n t y - n in e o th e r books in e x i s t e n c e , but
no c o p ie s to b e o b ta in e d . The o ld te x tb o o k s f o llo w e d th e
s t y l e o f q u e s t io n s and a n sw e rs, th e l a t e r on es o m itte d th e
q u e s t io n s and p ro ceed ed to th e d i s c u s s i o n o f th e s u b j e c t m atter,
The Nei Ohing was w r i t t e n in t h e q u e s tio n and answer
s t y l e but had l i t t l e in i t r e l a t i n g to o b s t e t r i c s . One
q u e s t io n was on th e s u b j e c t o f le u c o r r h o e a and a n o th e r on
t h e d u r a tio n o f p reg n a n cy .
The e a r l i e s t monograph, Chan Yu Pao O h'ing O h'i ( D is e a s e s
o f P regn an cy and th e P u erp eriu m ), was e d it e d by Mr. Chi Ohih-
ch u . In th e p r e f a c e he s t a t e d t h a t he found a w o r k .w r itte n
by t h r e e s c h o la r s o f th e Sung D ynasty o f su ch e x c e l l e n c e t h a t
h e se c u r e d p e r m is s io n to r e p r i n t .i t . He combined i t w ith o th e r
78
o b s t e t r i c a l works and when f i n i s h e d , th e f i r s t volum e in
c lu d e d tw e n ty -o n e d i s c u s s i o n s , t h i r t y - f o u r p r e s c r i p t i o n s , and
s i x t e e n comments. The secon d p a r t was a d i s c u s s i o n on th e
p u erp eriu m , w ith p r e s c r i p t i o n s f o r u s e in m e n str u a tio n , p reg
n an cy and th e d i s e a s e s o f p reg n a n cy . Mr. Chi s a i d in h i s
p r e f a c e :
I t i s my s i n c e r e hope t h a t h e r e a f t e r each man can a c t a s a
p h y s i c i a n , e v e r y fa m ily can p r e s c r i b e , m idw ives commit no
m is t a k e s , and b o th m other and c h i l d b e s a f e . l
T h is monograph on o b s t e t r i c s was co m p iled a b o u t 1250 A .D .
The f i r s t one on g y n e c o lo g y e n t i t l e d Fu Jen L iang Fang^ ( D is
e a s e s o f Woman) was p u b lis h e d 1566 A.D . I t may be a r e p r in t
from o ld e r w orks. The f i r s t e n c y c lo p e d ia to a p p o r tio n a d e f
i n i t e s e c t i o n to g y n e c o lo g y and o b s t e t r i c s was th e Ch'ao S h ih
Chu P in g Yuan Hou Tsung Lun, w r it t e n by Ch'ao Yuan Fang 589
A .D .3
The o r i g i n a l s o f b o th th e monograph on o b s t e t r i c s and
t h e one on g y n e c o lo g y a r e e x t a n t , and to be found i n th e Im
p e r i a l c o l l e c t i o n o f f o u r L ib r a r ie s in P ek in g . I t was re
q u ir e d by la w t h a t a l l book s w r i t t e n must f i r s t b e su b m itted
to th e Emperor to be c e n s o r e d , 4 go i t i s p r o b a b le t h a t th e
m a j o r it y o f o r i g i n a l s may be found t h e r e whenever t h e tim e
com es th a t th e y a re w anted. The v a r i e t y o f s u b j e c t s t r e a t e d
^Chi Chih-Chu, Chan Yu Pao C h 'in g C h 'i. P r e f a c e 2 .
^Hsueh L i - c h a i , Fu Jen Liang Fang, D is c u s s io n I .
^Ohai Y u an -fan g, Ch'ao Sh ih Chu P in g Yuan Hou Tsung Lun,
O b s t e t r i c a l S e c t io n .
% .C.W ong, "Four M illen n iu m s o f C h in ese M ed ic in e,"
L a n c e t. V o l. I I , (1 9 2 7 ) 2 0 6 .
79
and th e m ix tu r e o f f a c t s and f a n c i e s i n a l l th e works o f
t h e o ld l i t e r a t u r e make them e n t e r t a i n i n g s t u d i e s . The
q u e s t io n o f how to s e c u r e m ale b i r t h s was t r e a t e d by a num
b er o f w r i t e r s and a t g r e a t le n g t h . Whole s e c t i o n s were
d e v o te d to th e m ale and fe m a le . B eca u se o f t h e f a c t t h a t
f e r t i l i t y and c h i ld b e a r in g have su ch in t im a t e r e l a t i o n s ,
t h e phenomenon o f m e n str u a tio n , th e trea tm en t o f th e ir r e g u
l a r i t i e s o f t h e m en stru al f lo w r e c e iv e d g r e a t em p hasis and
o c c u p ie d many p a g e s i n th e o ld b o o k s. The d i s e a s e s n ot
common to p regn an cy bu t t h a t may happen to a p r e g n a n t woman
w ere h ere t r e a t e d . The in c id e n c e o f i n f e c t i o u s d i s e a s e s
i n p reg n a n cy and th e pu erp eriu m w ere n o te d , and th e t r e a t
ment s u i t a b l e to such c a s e s was g iv e n . Many p a g e s have
b e e n g iv e n to tre a tm en t o f v a r io u s k in d s .
M a rv e llo u s d ia g n o s e s w ere c la im e d p o s s i b l e by f e e l i n g
t h e p u l s e . In th e e a r ly s t a g e s o f la b o r n o t o n ly c o u ld
p reg n a n cy be a c c u r a t e ly p r e d ic t e d by th e p u ls e b u t th e se x
and th e d evelop m en t o f th e u t e r i n e f e t u s co u ld b e e s t a b l i s h e d . 1
IThen m e n str u a tio n sto p p e d w ith no ap p aren t d i s e a s e p r e s
e n t , i f th e t h r e e p u l s e s w ere s l i p p e r y i t i n d ic a t e d pregnan
c y . I f th e p u l s e on th e l e f t w r is t was r a p id , a son m ight
be e x p e c te d , b u t i f th e r i g h t w r is t was r a p id i t was c e r t a i n
to be a d a u g h te r . On t h e l e f t hand a s u p e r f i c i a l and o v e r
f lo w in g p u l s e i n th e ' c u b i t ' sp ace or a la r g e 'in c h ' p u ls e
d e n o te d a m ale c h i l d . On th e r ig h t hand a deep and 'c u b it '
^Yen O h 'e n g -c h a i, T ' a i Oh'an H sin Fa. D is c u s s io n V II.
80
p u l s e and a s le n d e r ' i n c h ' p u ls e i n d ic a t e d th e fe m a le c h i l d .
I f th e 'c u b it* p u ls e on b o th w r i s t s was o v e r f lo w in g i t
m eant tw in b o y s , i f th e ' c u b i t ' was deep and f u l l on both
w r i s t s i t s i g n i f i e d tw in g i r l s . T r i p l e t s m ight be lo o k e d
f o r when th e p u l s e s o f b o th w r i s t s w ere smooth and e q u a l.
A ll th r e e w ere su re to be g i r l s . I f t h e p u l s e showed th e
o p p o s i t e n a tu r e , a l l t h r e e would be b o y s .
TRANSLATIONS OF DISCUSSIONS FROM THE CHAN YU PAO
CH'ING CH'I FANG LU
D is c u s s io n I^
When th e m other h as f e v e r why d o e s th e c h i l d d i e in
u te r o ? The answ er i s t h a t f e v e r i s t h e c a u se . There a re
t h r e e danger p o i n t s in th e c o u r se o f th e d is e a s e : A l i v i d
to n g u e i n th e m other means danger to th e f e t u s ; a l i v i d
to n g u e and a red f a c e in th e m other means t h e d e a th o f th e
f e t u s , w h ile l i v i d l i p s and s a l i v a t i o n means th e d ea th o f
b o th m other and c h i l d .
D is c u s s io n I I
What i s t h e c a u se o f d i f f i c u l t la b o r ? ^ The w r ite r
e x p la in s th a t t h e r e i s a mass o f t i s s u e o f d e f i n i t e shape
c a l l e d th e f e t a l p i l l o w ( p l a c e n t a ) . When th e d e l i v e r y i s
a b o u t to o c c u r , th e r u p tu re d f e t a l p i l l o w w ith c l o t t e d and
u n h e a lth y b lo o d wraps up th e c h i l d . A b reech or t r a n s v e r s e
^Li S h ih - s h e n t , Ch'an Yu Pao O h 'in s Chi Fang Lu,
D i s c u s s i o n I .
^ I b id.3 D is c u s s io n I I .
81
p r e s e n t a t i o n a l s o o b s t r u c t s la b o r and f o llo w in g m ed icin e
sh o u ld be g iv e n fo r su ch c o n d it io n s :
R
Musk .1 o z .
Hot S a l t 1 o z .
Mix and powder.
D ose— .1 o z . w ith w ine.
In th e e d i t o r i a l comment on t h i s d i s c u s s i o n , a t t e n t i o n
i s c a l l e d to th e f a c t t h a t t h i s i s n o t th e whole t r u t h . I f
t h e m other " s i t s on th e hay"^ to o e a r l y , th a t i s , t r i e s
s t r a i n i n g to o e a r ly , th e c h i l d i s n o t g iv e n tim e to r o t a t e
i n t o p ro p er p o s i t i o n . The o ld C h in ese works a l l e x p r e ss
th e id e a t h a t th e normal p o s tu r e o f th e c h ild d u r in g p reg
n an cy i s b r e a ch and th a t t h i s ch an ges o n ly a t t h e b e g in n in g
o f la b o r . I f th e hand ap p ears f i r s t i t i s n e e d le d to make
i t draw i n , w h ile i f t h e f o o t a p p ea rs i t i s rubbed w ith s a l t .
Such a c o n d it io n c a l l s f o r th e f o l l o w i n g m ed icin e:
R
S oot
A n g e lic a aa . 5 o z .
Take .2 o z . o f t h i s powder and mix w it h eq u al
p a r t s o f good v in e g a r and t h e u r in e o f an un
m a rried boy . 5 o z .
The c a u s e o f r e t e n t i o n o f t h e p la c e n t a i s due to th e
engorgem ent w ith b lo o d . The r e s u l t i s th a t th e y cannot come
o u t owing t o t h e d i s t e n t i o n . The membranes may f i l l up th e
e n t i r e abdomen c a u sin g much p a in and d ysp oen a. The v i t a l
s p i r i t may be l o s t w ith th e b lo o d . T h is l o s s may ca u se
f a i n t n e s s . T h ir s t a f t e r la b o r and d u l l n e s s b e lo w t h e h e a r t
! c h i Chih-Chu, Ch'an Yu G h'ing O h 'i Fang Lu. Comments
on D is c u s s io n I I .
82
i s due to im proper fo o d , e s p e c i a l l y wheat f l o u r . D e p r e ssio n
o f th e m other t o g e t h e r w ith dry h o t w eath er a r e o t h e r c a u se s
f o r t h i s c o n d i t i o n .
D is c u s s io n XVI
M e n stru a tio n and S t e r i l i t y
I f t h e Yang i s more p o w e r fu l, t h e r e i s in c r e a s e d men
s t r u a t i o n due t o th e r a p id f lo w o f h o t b lo o d . I f th e Yin
o v e r b a la n c e s th e Yang, th e m en stru a l flo w w i l l come to o soon,
I f th e Yang o v e r b a la n c e s th e Yin th e m en stru al flo w w i l l be
l a t e . I f t h e s e t r o u b le s a r e a llo w e d to go on th e r e w i l l
f o l l o w anem ia, a s t h e n ia , a tr o p h y , and s t e r i l i t y . For p a in
f u l m e n str u a tio n th e M ira cu lo u s powder i s b e s t . l
R
C lo v e s
R ose r o o t
Oliabanum a . a . 1 5 o z .
A n g e lic a
Cory d a l i s
P eon y r o o t a . a . . 5 o z .
S i g . G rind i n f i n e powder
D ose— .1 o z . w ith h o t w ine j u s t b e fo r e m e a ls.
F or s t e r i l i t y ïiô m e d ic in e compares w ith th e M iracu lou s Pow
d e r and th e fam ous C o n ce p tio n p i l l s . Mr. Fan L o -c h ie n , th e
p r e f e c t o f C hin Ch* eng, p r e s e n t e d th e Emperor w ith a docu
ment i n w h ich he s a id c o n c e r n in g th e c o n c e p tio n p i l l :
As I have w e l l p roved t h i s p r e s c r i p t i o n I ta k e th e l i b e r t y
o f s t a t i n g t h a t i f c o n c e p tio n d oes n o t ta k e p l a c e w ith in
f o r t y days a f t e r a d m in is t r a t io n you may k i l l my fa m ily and
l e t th e w h o le n a t io n know my f a u l t . ^
H is m ed icin e was known a s th e C o n cep tio n F i l l s . A ft e r se v e n
^Li S h ih -s h e n g , o p . c i t . . D is c u s s io n XVI.
^Fan L o -c h ie n , A M emorial to t h e Emperor, q u o ted in
D i s c u s s i o n XVI.
83
d a y s o f a d m in is t r a t io n , b o th Yin w i l l show e v id e n c e o f
p r e g n a n c y . In t h i s c a s e th e a d m in is t r a t io n i s a llo w e d to
c o n tin u e t i l l th e t w e l f t h day and th e n sto p p e d . P r e f e c t
Fan s a id in t h i s docum ent:
My w if e , t w e n t y - s i x y e a r s o ld , was f i r s t found in s t e r i l i t y
and th e n fa v o r e d w ith p reg n a n cy , a f t e r ta k in g t h i s p rep a ra
t i o n . Mr. Yii Wen, th e form er J u n io r Guardian o f th e H e ir -
A p p aren t, a l s o found h i s w if e , Li s h ih , tw e n ty -n in e y e a rs
o l d , in s t e r i l i t y and a d m in is te r e d th e rem ainder o f my med
i c i n e to h e r . She became p reg n a n t w it h in t h i r t e e n days o f
a d m i n is t r a t i o n . I t has b e e n o c c a s i o n a l l y a d m in is te r e d by
d i f f e r e n t p e r s o n s and h a s produced th e same r e s u l t . I t i s
t h e r e f o r e c a l l e d th e C o n cep tio n P i l l . I t must b e known a s
a p u b lic p r e s c r i p t i o n . !
P reg n an t women need to be c a r e f u l o f th e in f lu e n c e , o f ■
t h e t e n t h moon. Then t h e u n iv e r s a l c i r c u l a t i o n o f Yin ta k e s
p l a c e w h ile th e c i r c u l a t i o n o f Yang has n o t b e e n ended.
Som etim es a t t h i s se a so n p l a n t s and i n s e c t s grow o u t o f se a
s o n . From tim e to tim e th ic k m is t s app ear c a u s in g human
s i c k n e s s , and human b e in g s must e x e r c i s e g r e a t c a r e . P reg
n a n t fe m a le s a r e e s p e c i a l l y l i k e l y to m isc a rr y d u rin g t h i s
s e a s o n . The p la n e t J u p it e r has an u n lu c k y i n f l u e n c e in a
Yin y e a r o r a Shen y e a r and th e t h ic k m is t s a r e s e n t to
c a u s e th e d e a th o f p r e g n a n t fe m a le s d u rin g t h e t e n t h moon.2
The f o l l o w i n g i s th e p r e s c r i p t i o n f o r th e c o n c e p tio n
p i l l : 3
R
A c o n it e , raw, p e e le d .
In d ia n bread, w ith th e
b la c k la y e r o f f .
V in ceto x icu m
P i n e l l a , washed 7 tim es
^Fan L o -s h ie n , op. c i t . , q u oted i n D is c u s s io n XVI.
^A. F o rk e, World C o n cep tio n o f th e C h in e se , 1 6 3 -1 7 0 .
^Li Shih-sheng, op. cit.. Discussion XVI.
84
Eucommia, w ith o u t th e
c o a r s e bark.
Oinnamomum, in n e r bark.
H ystu cu a.
M agn olia w ith o u t th e o u te r
b a rk . a . a . 0 .3 o z .
S i l e r
G in g er, f r e s h l y d r ie d .
,A ch ry a n th es.
Adenophora.
A sa rum,, p e e le d .
G in seng r o o t. a . a . 0 . 4 o z .
G rind to f i n e pow der. D e co c t w ith h on ey. Make
p i l l s s i z e o f a sm a ll so y b ea n . Dose— f i f t y p i l l s
e v er y d ay. I f m en stru a l change o c c u r s , do n o t
d e s p a ir but i n c r e a s e d o se .
S a f e t y P i l l s
E f f e c t : These a r e a remedy f o r t h i r t y - f i v e d i s e a s e s
o f p regn an cy and p u erp eriu m . They a r e a l s o good f o r c o ld s ,
d i s e a s e s o f m e n str u a tio n , h e m ip le g ia , lim b a c h e .!
R
In d ia n Bread, r ed and p e e le d
P eon y, th e bark o f th e r o o t , a .a . 0 .0 3 o z .
E v o d ia ,
A q u ila r ia , a .a . 0 .0 1 o z .
G in sen g , remove t h e to p s ,
A n g e lic a , w ashed, s l i c e d , d r ie d ,
Ginnamomum, w ith o u t th e o u te r
b a rk .
A oh ryan th es b id e n t a t a .
R ose r o o t .
Nothosmyriiium Japonicum ,
Ephedra, remove r o o t s .
A c o n it e ,
O on ioselin u m , Szechuan p r o d u c t,
Asarum, s e l e c t e d ,
Ocimum, th e l e a v e s .
L iq u o r ic e , pow dered.
Rook s a l t , i g n i t e d ,
S i l e r , remove th e to p ,
P la ty c o d o n , remove th e to p .
M agn olia, w ith o u t th e o u te r b a r k ,
P i n e l l a , washed c le a n ,
H ystucua,
•Li Shih-sheng, oo. cit.. Discussion XVII.
85
Eucommia, w ith o u t c o a r s e b ark ,
A c h r y a n th e se s,
Oast s k in o f O ic a d a s, l a r g e ty p e .
O ast s k in o f O ica d a s, sm a ll ty p e , a . a . 0 . 5 o z .
Hehmannia, raw and d r ie d , 1 o z .
S ig . Grind to f i n e powder, make p i l l s th e s i z e o f
b u l l e t s .
D ose— One every d ay.
In t h e p r e s c r i p t i o n s u se d i n O h in ese o b s t e t r i c a l p ra c
t i c e many d ru gs were in c lu d e d n o t a l l o f w hich a p p ly to th e
c a s e i n hand, b u t were p u t in b e c a u se o f th e g e n e r a l p r in
c i p l e o f Yang and Yin, or th e D o c tr in e o f Sympathy, or th e
D o c t r in e o f P r im o r d ia l e le m e n ts demanded them to harm onize
t h e w h o le .
G in sen g, l i c o r i c e , and cinnamon w ere th e t h r e e main
d r u g s in w h ich th e C h in ese d o c to r has had such a b s o lu t e f a i t h
t h a t he was n o t a f r a i d o f any c o n d it io n t h a t h e m ight happen
to m eet i n t h e p r a c t i c e o f o b s t e t r i c s , o r o f any d i s e a s e
t h a t m ight happen t o c o r ïp lic a t e p reg n a n cy .
G inseng a c c o r d in g to th e O h in ese w r i t i n g s had s p e c i a l
v a l u e b e c a u se o f th e i n f l u e n c e o f th e c o n s t e l l a t i o n o f O rion
upon th e p l a n t . The G in se n # p la n t grow s in M anchuria and
S h a n s i. A t one tim e t h e w ild v a r i e t y was th o u g h t t o be
b e t t e r th an th e c u l t i v a t e d f o r u s e w ith o b s t e t r i c a l p a t i e n t s ,
s o th e Government took c h a r g e o f a l l t h a t was grown a s a
governm ent m onopoly. A pound o f t h i s was a t one tim e w orth
# 6 ,0 0 0 . Y et so i m p l i c i t was th e f a i t h i n th e drug th a t a l l
c l a s s e s o f p e o p le w ould go in t o d e b t f o r i t . With th e
^Li Shih Ohen, ou. cit.
88
in c r e a s e d demand th e Government p u t up th e p r i c e , so much
so t h a t th e s a y in g , "Eat g in s e n g and hang y o u r s e l f ," o r i g i
n a t e d b e c a u se o f th e m ise ry e n t a i l e d b y burdensom e d e b ts
and s u i c i d e s .
Cinnamon was a l s o i n g r e a t fa v o r w ith th e C h in e se . The
f o l lo w in g i s an e x t r a c t from th e Pen T s'a o Kang Mu, th e
C h in ese D is p e n s a to r y :
Cinnamon h a s sto m a c h ic , s t im u la n t , c a r m in a t iv e , a s t r i n g e n t ,
s e d a t i v e and t o n i c q u a l i t i e s . The u s e i s i n d ic a t e d in c o l i c
and e x c e s s i v e s w e a tin g . I t i s p r e s c r ib e d fo r a r e t a in e d
p l a c e n t a and o th e r p ost-p artu rn t r o u b l e s . . . .The p r o lo n g e d u s e
o f t h e b e s t q u a l i t i e s w i l l im prove t h e c o m p le c tio n , g i v in g
one a y o u t h f u l rubicun d ap p ea ra n ce. Pao P u -tz u s a i d th a t
i f cinnamon were ta k en w ith t o a d 's b r a in fo r s e v e n y e a r s ,
o n e c o u ld w alk on th e s u r f a c e o f th e w a te r and n e v e r grow
o l d or d i e . Chao, th e hunchback, to o k th e drug c o n t in u o u s ly
f o r tw enty y e a r s w ith th e r e s u l t t h a t h a ir grew on t h e bottom
o f h i s f e e t . He was a b le to t a l k two hundred m ile s a day and
l i f t a w e ig h t o f t h i r t e e n hundred p o u n d s. !
The l i s t o f th e o ld w r i t i n g s in c lu d e t h e s e s p e c i a l l y
fa v o r e d rem ed ies and th e y a r e f r e q u e n t ly m en tion ed f o r a l l
k in d s o f o b s t e t r i c a l c o n d i t i o n s .
^Li Shih Chen, op. cit
87
CHAPTER V III
SUPERSTITIONS, CUSTOMS AND PRACTICES
T h eir R e la t io n s h ip To The P r e s e n t S i t u a t i o n
In th e o b s t e t r i c a l f i e l d o f m e d ic in e in C h in a, th e
C h in e se p h y s i c ia n s have done th e t h e o r i z in g and th e w r it in g ,
b u t th e a c t u a l work and p r a c t i c e o f o b s t e t r i c s has_alway_s______
b e e n i n th e hands o f t h e m id w iv es. The m id w ife u s u a l l y was
o l d , ig n o r a n t, s u p e r s t i t i o u s , and p r i e s t - d i r e c t e d . From th e
custom o f a n c e s t o r w o r sh ip ! and th e d e s i r e to h ave t h e s e fam
i l y r i t e s c a r r ie d on, e v e r y n o n - c h r i s t i a n fa m ily d e s ir e d a
so n . The h i g h l y im p r e s s io n a b le O r ie n t a l h a s a ccu m u la ted in
t h i s c o n n e c tio n a w ie rd c o l l e c t i o n o f c o n j e c t u r e s , t h e o r i e s ,
b e l i e f s and cu sto m s. What ig n o r a n c e and s u p e r s t i t i o n la c k e d ,
t h e p r ie s t h o o d o f th e c e n t u r i e s h as s u p p lie d .^
The l o t o f th e a v e r a g e c h i l d l e s s C h in ese w i f e was a v e r y
u n e n v ia b le o n e . To h e r own n a tu r a l d isa p p o in tm e n t was added
th e d is a p p r o v a l o f a l l h e r h u sb an d 's f a m ily and t h e p r o s p e c t
o f b e in g su p p la n te d by a n o th e r w i f e . For t h i s r e a so n C h in ese
women dread ed s t e r i l i t y more than th e y d id c h o le r a or sm a ll
p o x . In su ch an e v en t th e o ld m id w ife was th e f i r s t p e r so n
c o n s u lt e d , and th e p r i e s t th e n e x t .
E ith e r th e ig n o r a n t m id w ife or th e shrewd p r i e s t a d v is e d
t h e l u c k l e s s woman t o make arran gem en ts w ith th e l o c a l p r i e s t s
■ ! s . W e lls W illia m s, The M iddle Kingdom, V o l. I I , 223.
^E. T. Williams, A Short History of China. 154.
88
to chant c e r t a i n p r a y e r s f o r h er n ig h t and m orning u n t i l
r e s u l t s were o b ta in e d . The ch arge made fo r t h i s was in
p r o p o r t io n to th e means o f th e s u p p lia n t .
A g i f t to th e tem p le a l s o in v o k ed th e fa v o r o f th e
g o d s . The tem p le m ight n eed some r e p a ir s , or a new drum
m ig h t be made and s e t up , or à f e a s t g iv e n to t h e p o p u la c e ,
o r o th e r t h i n g s done a t th e b id d in g o f th e p r i e s t s , a l l o f
w h ich were e f f i c a c i o u s c u r e s and w ould in s u r e a so n .
I f th e g od s were o b s t i n a t e and s t i l l r e fu s e d t h e i r f a
v o r , i t was o f t e n n e c e s s a r y to make some lo n g jo u rn ey to
some d i s t a n t tem p le or h o ly m ountain i n o rd er to make s a c
r i f i c e and burn in c e n s e i n a more s a c r e d s i t e .
"STEALING LUCK"
A se co n d method o f c u r in g s t e r i l i t y was " s t e a l i n g lu c k ."
To in s u r e r e s u l t s th e t h e f t s were su p p osed to be made in ab
s o l u t e s e c r e c y . A lth ou gh th e p r i e s t had been c o n s u lt e d and
had arran ged f o r th e t h e f t s he must be o u t o f th e tem p le o r
grou n d s when th e t h e f t a c t u a l l y to ok p l a c e .
I f she s t o l e th e tem p le p e a c h e s , th e p r i e s t f i r s t made
them , hung them on th e t r e e s in th e tem p le gro u n d s, th en ab
s e n t e d h im s e lf to g i v e t h e o p p o r tu n ity f o r th e t h e f t . The
woman c a s u a l l y s t r o l l e d i n t o th e y a r d , sn a tch ed s e v e r a l o f
t h e h o ly p e a c h e s , c o n c e a le d them in h e r d r e s s , t h e n h u r r ie d ly
r e tu r n e d home. There sh e hung th e p e a c h e s up b e s i d e th e
h o u se h o ld god s or t a b l e t s , and each day w orsh ip ped th em .!
E liz a b e t h R e ifs n y d e r , M .D., "C hinese S u o e r s t i t i o n s
R e la t in g to C h ild b ir t h , " A Paper read a t th e China M edical
M is sio n a r y S o c i e t y , A p r i l , 1912.
89
K idnapping a tem ple b ab y, made o f mud or wood or p ap er,
and h id d en f o r h er by th e p r i e s t was a n o th e r m ethod. Among
o t h e r t h in g s s t o l e n a s a cu re f o r s t e r i l i t y w ere t h e g o d 's
head c lo t h , or an a ilm e n t im age. A l a n t e r n , s t o l e n on th e
1 5 th o f th e f i r s t month o f th e new y e a r , was su p p osed to e f
f e c t a c u r e . A w orship b e l l , or s a c r i f i c i a l fo o d , or mar- '
r i a g e f e a s t e g g s , each m igh t in s u r e a happy i s s u e .
A fte r t r y in g t h e s e and many o th e r rem ed ies s u g g e s te d by
t h e p r i e s t s and m id w ives, th e fa m ily m ight c o n s u lt a n a t iv e
p h y s i c ia n .
B e fo r e th e R e p u b lic in 1 9 1 3 , ( s a id Dr. Marian Tang) th r e e p e r
s o n s g i v in g a recom m endation was th e o n ly c o n d it io n n e c e s s a r y
f o r s e c u r in g a m id w ifery l i c e n s e . A lth o u g h d u r ir g r e c e n t
y e a r s th e p r a c t i c e has b e e n r a is e d som ewhat, w ith th e ex cep -
t i o n - o f th r e e p e r so n s g i v i n g a recom m endation and th e a b sen ce
o f p h y s ic a l d e f e c t s , no req u irem en t i s n e c e s s a r y f o r p r a c t i c e . !
When th e hour o f la b o r a r r i v e s , a s th e Ta Sheng P ien^
I n . 1843 s a id :
Now we come to th e n e c e s s i t y o f h a v in g a m id w ife. Sometimes
we have to u s e them, b u t a s th e m a j o r ity o f them a r e f o o l s
and know l i t t l e about o b s t e t r i c s , one must ta k e th e r e s p o n s i
b i l i t y o n e s e l f and n o t f o l l o w a l l th e o r d e r s g iv e n by th e
m id w ife . When th e y come t o a hou se th e y ask th e p a t i e n t to
b e a r down in la b o r a t o n c e , and sa y t h a t th e c h i l d ’s head i s
j u s t above t h e perineum , and rub th e abdomen and b a ck , pay
in g no a t t e n t i o n t o th e s t a t e o f la b o r .
Som etim es t h e y r u p tu re th e membranes a r t i f i c i a l l y , and t h i s
m ethod may do much harm to th e p a t i e n t . In a w ord, th e y do
t h e i r b e s t t o e x h i b i t t h e i r s k i l l . The w orst c l a s s of_ mid
w iv e s som etim es ch arge an e x t r a f e e f o r th e d e l i v e r y . The
m eaning o f th e word m id w ife i s a s f o l l o w s : — a s th e y a r e o ld
and have some e x p e r ie n c e p e o p le a sk them to r e c e i v e th e c h i l d
and ta k e i t to b ed , n o t t o d e l i v e r th e c h i l d . R ich f a m i l i e s
^Marian Yang, "M idwifery T r a in in g in C h in a ," China
M ed ica l J o u r n a l. V o l. X LII, 769.
% a Sheng, Ta Sheng P i en. S e c t io n o f O b s t e t r ic s and
G y n e co lo g y , 1 9 4 2 , 62.
90
h ave t h e i r own p r i v a t e m idw ives and som etim es a f a m ily w i l l
h a v e more, th a n on e, each o f them h a s h er own m ethod, and
b e tw e en them th e y throw t h e h ou se i n t o a m arket. A l l t h e s e
t r o u b l e s a r e o n e 's own f a u l t . 1
In a c t u a l p r a c t i c e th e m idw ife has no kn ow led ge o f
c l e a n l i n e s s . The one method o f h e lp in g in a d i f f i c u l t la b o r
i s , a s th e y e x p r e s s i t , "to open th e road f o r th e baby."
T h is th ey do by t e a r in g e v e r y th in g in reach o f t h e i r lo n g
d i r t y f i n g e r n a i l s , ( s a i d Dr. Mabel C. P o u l t e r ) . The perineum ,
va g in a ,^ c e r v i x and o f t e n th e b la d d e r and i n t e s t i n e s , a r e to r n ___
op en and i*t'm eans ' t o r t u r e a t th e tim e f o r th e m other and
d e a t h from i n f e c t i o n a fte r w a r d s in many c a s e s . There i s a
l o n g t e d io u s r e c o v e r y w ith co m p lete r e c t o - v a g i n a l f i s t u l a or
a r e c t o v e s i c a l f i s t u l a , to o o f t e n i n c u r a b l e . 3
T h is s ta te m e n t i s borne o u t by D rs. R e ifs n y d e r , G arner, Wood,
W hitm ore,^ a t th e M argaret W illia m so n M a tern ity H o s p it a l,
S h a n g h a i, Dr. M argaret P o lk a t th e M eth o d ist H o s p it a l, S oo-
chow , ^ and many o th e r w orkers in M is sio n H o s p it a ls .
In F u k ien P r o v in c e , Dr. P o u lte r r e p o r ts t h a t ,
t h e f a v o r i t e m e d ic in e , o f t e n g iv e n im m ed ia tely a f t e r th e b i r t h ,
i s th e c r u s t e d sedim ent from a lo n g u s e d male u r i n a l , som etim es
g i v e n a lo n e and som etim es g iv e n w ith th e b loo d j u s t p a s s e d . I t
i s su pp osed t o have a good e f f e c t on th e u t e r u s . For f e v e r ,
a f t e r b i r t h , th e p i g ' s u r i n e , f r e s h l y p a s s e d i s o f t e n u sed .
The woman i s u s u a l l y d e l iv e r e d s i t t i n g on th e e d g e o f th e bed
o r on str a w on th e f l o o r . As soon a s th e c h i l d i s born th e
m id w ife b e g in s tu g g in g on t h e cord to a s s i s t th e p la c e n t a ,
w h i l e a t t e n d a n t s s t u f f th e woman's h a i r down h er th r o a t to en
c o u r a g e e x p u l s iv e e f f o r t s . The c h i l d i s l e f t c o n n e c te d to th e
c o r d t i l l th e p la c e n t a i-s b orn . In one c a s e o f tw in s where
t h e se c o n d one was n o t b orn t i l l t h i r t y - s i x h ou rs a f t e r , th e
f i r s t o n e 's cord was n o t t i e d fo r t h a t le n g th o f tim e . The
^Ta Sheng, o o . c i t . , 6 2.
p
f e b e l 0 . P o u lt e r , " O b s te tr ic a l E x p e r ie n c e s i n F uts in g
C i t y , F u k ien , C hina," C hina M edical J o u r n a l,J u ly 1 9 2 1 , V ol.
XXXV, 3 è l .
S c ia r a B. W hitmore, " F in d in g s from H o s p ita l R e p o r ts,"
China M edical S o c i e t y , 1 9 1 8 .
^M argaret P o lk ," O b s t e t r ic a l F in d in g s in Soochow ,"Paper
C hina M edical S o c i e t y . 1 9 1 8 .
91
c o rd i n F uk ien i s burned o f f or c u t o f f a c c o r d in g to th e s e x .
The e y e s and mouth a re n o t a tte n d e d to and th e c h i l d g e t s no
b a th u n l e s s v e r y d i r t y , and th en i t i s w iped o v er t h e f a c e
and head w ith th e n a t iv e p a p e r . The cord i s d r e s s e d w ith so d a ,
th e n powdered dung o f th e cow i s p u t around i t i n a b i t o f
d i r t y c o t t o n . A t h ic k s t i c k y p r e p a r a tio n i s p l a s t e r e d o v er
th e f o n t a n e l l e to keep i t from o p e n in g . The d e a t h r a t e from
t e t a n u s i s h ig h a s 70^ a f t e r t h i s t r e a t m e n t .!
Dr. M innie S tr y c h e r r e p o r t s t h a t from 3 0 -8 0 ^ o f c a s e s
by m idw ives i n C h ih li v i l l a g e s a r e f o llo w e d by t e t a n u s . T here,
a s e ls e w h e r e , o p th a lm ia neonatorum l e a d s n o t o n ly to much
b lin d n e s s bu t to a v a s t amount o f n e o n a ta l d e a th b e c a u se i n
any e v e n t a g i r l i s n o t w anted but a b l i n d one i s n o t worth
r e a r i n g . 2
In c e r t a i n a r e a s i n Shantung th e new born baby i s p u t
i n t o a bag f i l l e d w ith e a r th tak en from th e r o a d , w ith th e
y
r e s u l t th a t many d i e from t e t a n u s , a l s o from penum onias con
t r a c t e d from th e c o ld and c h i l l o f t h i s w et d i r t y w rapping.
In one c a s e t h a t r e p o r te d a t th e T i e n t s i n M eth o d ist H o sp ita l
t h e bag had n o t been ta k e n o f f s i n c e b i r t h and t h e c h i l d was
a month o ld . The e a r th i s su pp osed to ab so rb th e u r in e and
f e c e s , but in t h i s c a s e th e c h i l d was a l i t t l e s k e l e t o n , c a r
r y in g a pneum onia. I t d ie d a day a f t e r e n tr a n c e .^
In th e p r o v in c e s o f S h a n si, S h e n s i/ Kansu and M anchuria,
t h e r e a re a t l e a s t f o r t y thou san d c a s e s o f o s t e o m a la c ia w hich
m eans d e a th f o r th ou san d s o f m others and c h ild r e n , who a re
! Mabel C. P o u lt e r , op. c i t .
'^Minnie M . S tfy e h e r ," G le a n in g s from O b s t e t r i c a l Work,"
P a p er f o r P e k in g M edical S o c i e t y . 1 9 2 0 .
^C lara B. Whitmore, M .D., H o s p ita l Report 1 9 2 9 . M eth o d ist
H o s p it a l , T i e n t s i n , C hina.
92
away from a h o s p i t a l where a C aesarean s e c t i o n ca n b e done.
T h is w ith p r o p e r fo o d and c a r e i s a p r e v e n ta b le d i s e a s e , but
i t i s on th e in c r e a s e i n t h e s e p r o v i n c e s .!
In tow ns th e r e i s a v e r y l i m i t e d p r o v is io n f o r m atern i
t y c a r e . In th e c i t y o f P ek in g th e ann ual number o f b ir t h s
i s 3 0 ,0 0 0 a y e a r . Only 1 ,0 0 0 a re b e in g a tte n d e d by modern
t r a i n e d p h y s i c ia n s or t r a in e d m id w ives. T w o -th ir d s o f th e
1 ,0 0 0 b i r t h s o c c u r in h o s p i t a l s , and o n e - t h ir d i n th e homes.
But o v e r h a l f o f th e b i r t h s in th e homes are un der c o n d it io n s
u n f i t fo r c o n fin e m e n t; e i t h e r th e sp a c e i s to o sm a ll or th e
l i g h t and h e a t u n s a t i s f a c t o r y , so t h a t th e number o f c a s e s
r e c e i v i n g a d e q u a te c a r e i s l e s s than 1 ,0 0 0 . The a d v a n ta g es
o f th e P o rt c i t i e s and P ek in g a re f a r above th a t in th e o r d i
n a r y c i t i e s . A ccord in g to th e m a te r n ity d e a th r a t e o f f i f
t e e n w ith a b i r t h r a t e o f t h i r t y , t h e r e a r e f i v e hundred ma
t e r n a l d e a th s o c c u r r in g e v e r y day i n China am ongst a p o p u la
t i o n o f 4 0 0 ,0 0 0 ,0 0 0 . T h is i s fo u r hundred more th a n o th e r
c o u n t r i e s . T here i s a m a tern a l m o r t a l i t y o f f i f t e e n p e r one
th o u sa n d b i r t h s in China a s a g a in s t t h r e e in England and
W ales and f i v e i n th e U n ite d S t a t e s and Japan f o u r . The
i n f a n t m o r t a lit y in England, and th e U n ite d S t a t e s ' i s l e s s
th a n 80, in Japan 18 7, i n China 300. However, t h e s e f i g
u r e s a r e o n ly a p p ro x im a te b e c a u se China h a s n ev er had an ac
c u r a t e c e n s u s . The c o n d i t i o n o f th e c o u n tr y s e c t i o n s i s de
p l o r a b l e i n r e g a r d to th e m aternal c a r e .
^ P resto n J . M axw ell, M .D., "The M a te rn ity P roblem in
C h in a ," China M edical J o u r n a l. V o l. XLI, 238.
93
With th e e x c e p t io n o f a few m is s io n a r y s c h o o ls and one or
two o th e r s c h o o ls fo r m id w iv es, ( s a i d P r e s to n J . M axw ell,
o f t h e P ek in g U nion M ed ical C o lle g e ) m a te r n ity t r a i n i n g a s
su c h may he s a i d to b e n o n - e x i s t e n t i n t h e R e p u b lic . And
t h e l i t e r a t u r e o f China d e v o te d to th e s u b j e c t o f o b s t e t r i c s
i s so much a m a tte r o f s p e c u l a t i o n and s u p e r s t i t i o n t h a t th e
o ld books a r e o f v e r y l i t t l e u s e i n th e t r a i n in g o f m idwives*
Even in a c i t y a s modern a s P ek in g i t i s p o s s i b l e f o r 80^
o f th e p e o p le t o d i e w ith o u t ev er h a v in g seen o r known o f a
modern t r a in e d d o c to r . 1
W hile t h i s c o n d it io n o f a f f a i r s r e s u l t s where th e mid
w iv e s do th e work, a d i f f e r e n t s t a t e o f a f f a i r s i s met where
t h e W estern t r a i n e d C h in ese woman d o c to r h as ch a r g e o f ob
s t e t r i c a l work, b u t among a p o p u la t io n o f fo u r hundred
m i l l i o n s p e o p le , i t i s a s a drop o f w a te r in th e s e a .
Among th e p io n e e r C h in ese women p h y s ic ia n s y e t l i v i n g
a r e D rs. Ida Kahn, Mary S to n e , Ya Mei K in, Kin Yen Hsu, Amy
1/Yong, Mary T in g , and o t h e r s , a l l o f whom a r e g r a d u a te s o f
A m erican M ed ical C o lle g e s , and a l l o f whom have ren d ered in
v a lu a b le s e r v i c e t o China. A ll o f t h e s e women h a v e h o s p i t a l s
w ith enormous o b s t e t r i c a l and g y n e c o lo g i c a l p r a c t i c e . Any
one o f t h e s e C h in ese women d o c t o r s m en tion ed , w ith h e r f i n e
ap p rov ed modern s u r g ic a l te c h n iq u e and o b s t e t r i c a l t r a i n i n g ,
and w ith th e l i m i t l e s s o p p o r t u n it ie s f o r i t s p r a c t i c e , i s
w ith o u t doubt i n f i n i t e l y s u p e r io r t o t h e famous Hua To or th e
la u d e d Chang C hung-king.
. That a b e t t e r c o n d it io n o f a f f a i r s i s coming in t h e ob
s t e t r i c a l and g y n e c o lo g ic a l work i s e v id e n c e d by two f a c t e :
F i r s t , th e g r a d u a lly i n c r e a s i n g number o f W estern t r a in e d ob-
s t r e t i c i a n s i Second, th e a c t i o n o f th e Nanking Government
1
Preston J. Maxwell, op. cit.. March 1927, Vol.XLI, 238.
94
in 1928 i n e s t a b l i s h i n g th e M in istr y o f H e a lt h ,!
In t h e r e p o r t o f J . Heng L iu, V ic e M in is te r o f H ea lth
i n t h e N a t i o n a l i s t Government, N anking, o ccu r two paragrap h s
f i l l e d w ith p r o m ise s o f g r e a t th in g s i n t h e f u t u r e f o r th e
h e a l t h and w e l l - b e i n g o f C hina:
M id w ifery E d u c a tio n , The r e a l i z a t i o n o f th e paramount
im p o r ta n c e o f m id w ifery e d u c a tio n a t th e p r e s e n t moment h as
l e d t o th e fo r m a tio n on January 1 5 , 1 9 2 9 , o f a N a tio n a l Mid-
. w if.ery_B .oardjby„th e M in is t r i.e s _ o f _ H ealth .^ an d -E d u cation .-— -----
sum o f $ 3 0 ,0 0 0 p e r year was o b ta in e d from th e N a tio n a l Govern
ment f o r t h e p ro m otion o f M idw ifery e d u c a tio n . At t h e f i r s t
m e e tin g o f th e M idw ifery Board, h e ld on January 2 3 , 1929, i t
was d e c id e d t h a t th e F i r s t M idw ifery T r a in in g S c h o o l and Hos
p i t a l s h a l l b e e s t a b l i s h e d i n P e ip in g ( P e k in g ) , and th e p la n
p r o p o s e d b y th e P e ip in g M id w ifery Commission was app roved.
P u b lic H e a lth N u rsin g and S a n ita r y I n s p e c t o r s C l a s s .
T h ese s h a l l b e in tr o d u c e d a,t a s e a r ly a p e r io d a s p o s s i b l e .
In t h e m eantim e, e x i s t i n g f a c i l i t i e s w i l l be u t i l i z e d to th e
f u l l e s t e x t e n t in e n c o u r a g in g th e t r a i n i n g o f su ch p e r s o n n e l,
and th e i n i t i a t i o n o f t h e s e a c t i v i t i e s . 2
That th e M in is tr y o f H e a lth w i l l h a v e much t o do to b r in g
ab o u t th e many n e c e s s a r y refo rm s i s n o t d e n ie d i n any q u a r te r .
However, due t o m is s io n a r y s c h o o ls and h o s p i t a l s , m ed ica l gov
ernment s c h o o ls and h o s p i t a l s , and th e f a r - r e a c h in g e f f e c t s o f
th e R o c k e f e lle r r e s e a r c h work, added to t h e f i n e work o f West
ern t r a in e d p r i v a t e d o c t o r s , th e r e i s a f i n e n u c le u s from
w h ich t o w ork. Indeed t h e modern ad van ce b o th i n d ia g n o s is
and tre a tm en t o f o b s t e t r i c s by t h e s e ab ove named f a c t o r s i s
a lm o st u n b e l ie v a b l e . Among th e in p r o v e d o b s t e t r i c a l p ra c
t i c e s g e n e r a l ly a d o p ted may be s e e n :
1 . A n te n a ta l c a r e w ith i t s c o n c o m ita n t a s e p t i c m ethods.
!j.R u n g L iu , "The M in is t r y o f H e a lth " , China M edical
J o u r n a l. V o l. X L III, 32 4 , A p r il 1 9 2 9 .
2 I b i d . . 3 2 4 .
95
2 . S p in a l a n e s t h e s ia
3 . C aesarean S e c tio n i n th e tr e a tm e n t o f p l a c e n t a
p r e v ia and a c c i d e n t a l hem orrhage.
4. C aesarean S e c t io n i n th e tr e a tm e n t o f th e m ild e r
c o n t r a c t u r e s o f t h e p e l v i s , and i n c e r t a i n o th e r
s e l e c t e d c a s e s .
5 . C aesarean S e c t io n under s p in a l a n e s t h e s ia i n c a s e s
o f p regn an cy to x e m ia .
6 . The r e s t r i c t i o n o f in d u c tio n t o i t s p r o p e r f i e l d
and t h e p ro p er m ethods f o r t h e a c c o n p lish m e n t o f
t h i s p r o c e d u r e .
7. Modern d ia g n o s is and tr e a tm e n t i n p reg n an cy toxem ia
and e c l a n p s i a .
8. The u s e o f R u b in 's t e s t and l i p i o d o l i n t h e d ia g n o
s i s and tr e a tm e n t o f s t e r i l i t y , and th e grow ing
know ledge of t h e in f l u e n c e o f n u t r i t i o n .
9 . The d evelop m en t o f modern m ethods o f tr e a tm e n t in
.p u e r p e r a l s e p s i s .
1 0 . The a e t i o l o g y and tr e a tm e n t o f o s t e o m a la c ia .
1 1 . The X -ra y d i a g n o s i s o f p reg n a n cy .
M ention sh o u ld be made o f t h e e f f o r t th a t th e P ek in g
U n ion M edical C o lle g e i s making through i t s r e s e a r c h o r g a n i
z a t i o n . I t c o v e r s every l i n e o f m e d ic a l and o b s t e t r i c a l re
s e a r c h and th ro u g h i t s c o - o p e r a t io n w ith o th e r s c h o o ls and
o r g a n iz a t io n s and p h y s ic ia n s i t r e a c h e s e v e r y p a r t o f China.
R e se a r c h i s made in p a r a s i t o l o g y , and t r o p i c a l d i s e a s e s , in
f e c t i o u s and c o n t a g io u s d i s e a s e s , v e n e r e a l d i s e a s e s , c a n c e r y
s p r u e , and t u b e r c u l o s i s . No l i n e o f in q u ir y i s l e f t
96
u n to u c h e d in th e f i e l d o f d i s e a s e . The r e s u l t i s s e e n in
t h e e f f e c t upon th e members o f th e new C h in ese Government
and t h e i r a t t i t u d e tow ard m e d ic in e . As soon a s t h e r e i s a
s t a b l e governm ent and t h in g s can b e g in to f u n c t io n n orm ally
i n C hina, r e s u l t s w i l l be se e n in th e d i r e c t i o n o f h e a lt h
e f f o r t s . The M in is tr y i s an e v e n tu a l p r o v is io n f o r th e
h e a l t h o f t h e N a tio n .
Among th e C h in ese men and women p h y s ic ia n s a t work a lo n g
t h e s e l i n e s and c o n t r ib u t in g t h e i r sh a r e to th e m e d ic a l l i t e r
a t u r e o f China a r e : W m . and C h a rles New, o f S h a n g h a i, b oth
o f them s k i l l f u l su rg eo n s and a id in g th e Government t o c a r e :
f o r th e wounded i n t h e l a s t R e v o lu tio n a r y p e r io d j Dr. Y. T.
Tyau, Dean o f t h e P e n n s y lv a n ia M ed ical C o lle g e a t Sh an gh ai,
now changed i n t o a C h in ese M edical C o lle g e ; J . Hung L u i, th e
v i c e M in is te r o f H ealth a t N anking, Dr. Hu H ou -k i, i n ch arge
o f t h e M u n icip al H ea lth o f th e c i t y o f Shanghai ; Dr. W u L ien
T eh, o f i n t e r n a t i o n a l fame b e c a u se o f th e work done i n th e
p r e v e n t io n o f p la g u e i n C hina; D r.M arion Yang, i n c h a r g e o f
t h e F i r s t M id w ifery T r a in in g S ch ool i n P ek in g , Dr.M ary T ing,
i n ch a r g e o f th e Government H o s p ita l i n T i e n t s i n , China; Dr.
C .Y .H su, who h a s p u b lis h e d a modern te x t b o o k on o b s t e t r i c s
e n t i t l e d - Care o f th e M other, and p r e s e n t e d i t t o th e Nanking
Government f o r - f r e e d i s t r i b u t i o n . A n other woman p h y s ic ia n .
Dr.C.C.W ong, i s d o in g r e s e a r c h work i n C h em istry. T h is
l i s t c o u ld be le n g th e n e d enorm ou sly b u t would n e v e r b e rep
r e s e n t a t i v e w ith o u t th e name o f th e man who has d e lv e d so
f a i t h f u l l y i n t o th e o ld m e d ic in e o f C hina and who may
97
r i g h t f u l l y be c a l l e d th e H is t o r ia n o f C h in ese m e d ic in e .
Dr. K. C. Wong, in th e s e r v i c e o f th e Government, a l s o
su r g e o n o f th e Shanghai, Nanking R. R. L in e .
Among th e names o f C h in ese o b s t e t r i c a l w orkers m ight be
m en tio n e d th e name o f a lm o st e v er y C h in ese woman g ra d u a ted
i n m e d ic in e d u r in g th e l a s t f o r t y y e a r s . The demand f o r wo
men p h y s ic ia n s in t h a t f i e l d i s so g r e a t th a t i t w i l l r e q u ir e
many y e a r s to t r a i n up an a d eq u a te number.
A n o t a b le work in th e f i e l d o f o b s t e t r i c s c a r r ie d on by
a f o r e i g n m is s io n h o s p i t a l i s t h a t o f f e r g a r e t W illia m so n
H o s p it a l l o c a t e d a t S h a n g h ai. T h is h o s p i t a l was founded by
Dr. E liz a b e t h R e ifs n y d e r in 1884 and h a s b een , and s t i l l i s ,
th e l a r g e s t m a te r n ity work in China. The l i s t o f a b le phy
s i c i a n s who s e r v e d th e r e in c lu d e s th e names o f D r s. Em ily
G arn er, îsÆ ary N e w e ll, Lucy H am ilton, J u l i a Wood, B e s s i e S in
c l a i r , and i t was th e p r i v i l e g e o f th e w r i t e r t o s e r v e th e r e
a s h ead o f t h e Departm ent o f O b s t e t r ic s and G yn ecology fo r
s i x y e a r s . The h o s p i t a l was tu rn ed o v e r t o th e Women’s
C h r is t ia n U nion M edical S c h o o l in 1 9 2 0 . In s p i t e o f th e
i n t e r f e r e n c e d u r in g th e y e a r o f 1926^ 27, th e h o s p i t a l con
t i n u e d under C h in ese c o n t r o l and has s i n c e th a t tim e con
t in u e d i t s work a s a h o s p i t a l and m ed ica l c e n te r .
The w r it e r , in h er monographs on P la c e n t a P r e v ia , Ec
la m p s ia , P e l v i c M easurem ents o f th e M other, Head M easure
m en ts o f C h in ese C h ild r e n , h a s g iv e n t h e r e s u l t s o f 8 ,2 3 7
c a s e s d e l iv e r e d b y h er in C hina. T hese monographs may be
fo u n d in th e p u b l i c a t i o n s o f th e China M ed ical J o u r n a l.
98
?/h ile many h o s p i t a l s have been d e s tr o y e d or c r ip p le d
b y th e r e c e n t war i n China, y e t th e i n f l u e n c e o f th e work
b e in g c a r r ie d on by o t h e r s in d i f f e r e n t s e c t i o n s o f th e
c o u n tr y i s n o t i n c o n s id e r a b le .
A summary o f th e o b s t e t r i c a l s i t u a t i o n i n China in c lu d e s
th e f o llo w in g f a c t s :
F i r s t , th e r e h as b een i n th e p a s t and i s y e t p r e s e n t ,
t h e e le m en ts o f ig n o r a n c e , s u p e r s t i t i o n and custom to over
come.
■ S e c o n d ,. p r o s p e c t s f o r modern m ethods o f p r a c t i c e a r e
b e t t e r .
T hird, t h e r e a re th e f o llo w in g p ro b lem s a w a it in g s o lu
t i o n ;
a . The p r e v e n tio n o f p u e r p e r a l s e p s i s .
b. B e t t e r means o f t r e a t i n g p regn an cy to x a e m ia s.
c . The tr e a tm e n t o f m u lt ip le a b o r t io n .
CONCLUSION OF THE STUDY
The su rv ey o f C h in ese m ed icin e and o b s t e t r i c s r e v e a ls
a number o f f a c t s :
1 s t , C h in ese m e d ic in e , in c lu d in g o b s t e t r i c s , was o r i g
i n a l l y a normal grow ing i n s t i t u t i o n u n t i l i t f e l l under th e
i n f l u e n c e o f p h ilo s o p h e r , p r i e s t and p o l i t i c i a n .
2nd, I t s grow th in p e r io d s i s c l e a r l y • e v id e n t . Each
p e r io d has i t s own d i s t i n c t i v e c h a r a c t e r i s t i c .
3 rd , E d u c a tio n a l w orld i n f l u e n c e s h ave rea ch ed China
and have c o n t r ib u te d in t h e slo w p r o c e s s o f b e tte r m e n t in
h y g ie n e , m e d ic in e and o b s t e t r i c s .
99
4 th , The p o l i t i c a l i n f l u e n c e i n th e s t a t e h as become
e n l i s t e d in th e b e h a lf o f h e a lt h and m e d ic in e , and p r o g r e s s
i n th e l a s t two d e c a d e s-h a s b een phenom enal.
5th , There a re g r e a t o p p o r t u n i t i e s f o r h y g ie n e , p u b lic
h e a l t h work, r e s e a r c h in a l l l i n e s , g e n e r a l m e d ic in e , su r g e r y ,
and o b s t e t r i c s *
6th , The C h in ese a re th e m se lv e s ta k in g over th e le a d e r
s h i p .
K.C.Wong, i n sum m arizing th e s i t u a t i o n , s a id :
In c o n c lu s io n , th e h ig h e s t t r i b u t e must be p a id to th e Mis
s io n a r y D o c to r s who were th e e a r l i e s t to found h o s p i t a l s ,
o r g a n iz e s c h o o l s , and prom ote p u b lic h e a lth and h y g ie n e .
They have b ro u g h t a new l i g h t and a new hope to t h e teem ing
m i l l i o n s o f s u f f e r i n g hu m an ity. Though han dicapp ed by in s u f
f i c i e n t fu n d s, la c k o f p r o p e r equipm ent, and w ith o th e r ad
v e r s e c o n d i t i o n s , th e s e man la b o r e d w ith in c e s s a n t z e a l ,
g r a d u a lly g a in in g ground u n t i l W estern M ed icin e g a in e d i t s
p r e s e n t p o s i t i o n . The i n s t i t u t i o n s th e y foun ded a r e s c a t
t e r e d th rou gh ou t th e c o u n tr y . They a r e n o t o n ly c e n te r s o f
h e a l in g but a l s o f a c t o r s o f le a r n in g whence e v e r y year a
sm a ll army o f t r a in e d men a r e s e n t o u t t o jo in t h o s e in th e
f i e l d to f i g h t th e demons o f ig n o r a n c e and d i s e a s e .
The im p o rta n t f a c t now i s , n o t t h a t o f th e M issio n
D o c to r , or even W estern M ed ic in e, but t h a t th e C h in e se them
s e l v e s a r e awake to the e x t e n t o f th e o p p o r t u n it ie s ahead
o f them and i n a s p i r i t o f h e l p f u ln e s s and s e r v i c e a r e w i l l
in g and a b le t o cop e w ith th e t r y in g s i t u a t i o n ah ead o f them.
T h ere i s no r e a so n why th e C h in ese s h a l l n ot sta n d w ith th o s e
a t th e to p i n t h e p r o f e s s i o n and p r a c t i c e o f m e d ic in e , su rg e ry
and o b s t e t r i c s .
100
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Asset Metadata

Creator Whitmore, Clara Belle (author)

Core Title An historical sketch of medicine and obstetrics in China

Degree Master of Arts

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag Health and Environmental Sciences,OAI-PMH Harvest,Social Sciences

Format application/pdf (imt)

Language English

Contributor Digitized by ProQuest (provenance)

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c37-419724

Unique identifier UC11657580

Identifier EP59142.pdf (filename),usctheses-c37-419724 (legacy record id)

Legacy Identifier EP59142.pdf

Dmrecord 419724

Document Type Thesis

Format application/pdf (imt)

Rights Whitmore, C. B.

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the au...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus, Los Angeles, California 90089, USA