For over 2000 years, traditional Chinese medicine was the only medical therapy consisting of various forms of herbal medicine,acupuncture,massage,exercise, and dietary therapy for treatment illnesses. With the arrival of the missionaries from the west, a new form of medical therapy which based on treatment using chemicals and surgery was introduced to China in the 19th century. This not only provided an alternative medical treatment for Chinese, it also brought in scientific, social and political upheavals to China in the 19th and 20th century.
Medical Services in 19th Century China
The first western medical service was introduced to Macau, a Portuguese’s colony at the time, by Rev Robert Morrison1 (1782-1834) in 1820. Interestingly, one of his objectives of his effort was to find out whether Chinese traditional herbal medicine would offer no additional healing for the Westerners.
In 1828, a Christian surgeon, Dr Thomas Colledge2 (1796 – 1879) opened a hospital in Guangzhou with his belief of Christians had a duty to treat the sick people of China. By 1835, Dr Colledge cooperated with Dr Peter Parker (1804 – 1888), a Protestant medical missionary and foreign Christian residents in Guangzhou formed the Medical Missionary Society of China. The new hospital appealed to the locals despite their suspicious altitude towards foreigners’ intention. By 1840, the hospital had provided over 9,000 treatments to the local patients. By 1892, over 60 hospitals and 40 dispensaries were established by the missionaries. There were over 120 male and female western medical personnel plus a corps of trained native assistants to provide services for these facilities. The hospital annual report of 1895 stated that over half a million patients were treated and over 70,000 operations were performed.
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Before the Opium War, the hospital provided access of the missionary opportunity to contact locals who otherwise were not permitted to preach in public and are restricted to reside at the “Thirteen Hong” at Guangzhou. Some patients considered allowing foreign doctors to treatment gave a favour them, some did not accept the religion of their doctors, however, many patients converted to Christianity.
The introduction of western medicine also raised the Chinese women social status. It was Chinese social custom to restrict men and women contact at the time. Hence, female patients were reluctant to be treated by male doctors. The missionaries therefore had to bring in female doctors from the west to provide treatment to female patients. Dr Mary H. Fulton (1854 – 1927), a female missionary doctor was sent by the Foreign Missions Board of the Presbyterian Church to found the first medical college foe woman, Hackett Medical College for Women in Guangzhou in 1902. By 1915, the college had 60 students; all became Christians at the influence of Dr Fulton. The college achieved its aim to spread Christianity and western medicine, as well as women social status in the Chinese society.
Medical Services in Hong Kong
In Hong Kong, a British colony at the time, Tung Wah Hospital3 was established in 1870 which was the first hospital in China providing Chinese medicine services in western hospital mode. By 1887, the first teaching institution, the Hong Kong College of Medicine for Chinese (the predecessor of the Faculty of medicine of theUniversity of Hong Kong)was established by the London Missionary Society. The new institution not only introduced breakthrough in the research and development of western medicine in China, it also brought the first graduate, Dr SUN Yat-sen4 (1866 – 1925), a Christian himself who led the Chinese Revolution and toppled the Qing Dynasty, to establish the Republic of China in 1911, profoundly changes the history of China.
The Opium War
The introduction of western medicine in China also changed the history of China. Opium5 which was found to be a good remedy for nervous disorders and its sedative and tranquilizing properties was also introduced into China by western surgeons. However, opium was also used by the British Government to balance their trade deficit with China. They grew opium in British India and sold it to China for exchange of silver. When the Emperor Daoguang of Qing Dynasty banned the smoking and trading of opium in 1838, the British began the First Opium War with the beginning of annexation of Hong Kong, opened up of ports and a series of unfair treaties with the subsequent turmoil in China for over 100 years. Recognising the additive and social destructive nature of the opium smoking, the missionaries raised against the trading of opium both in their home countries and in China6. They also set up clinic to provide medical service to opium smokers to kick off their addiction, hence providing more opportunity for them to preach Christianity.
Western medicine went hands in hand with missionaries from the west to preach and convert local into Christians. By doing so, it also changed the history of China, opened up the horizons of Chinese people, turned imperial China into a republic and profoundly affect the world, with its effect still felt today.
- Starr J Barton “The Legacy of Robert Morrison”, International Bulletin of Missionary Research, April 1998
- Fu L, “The protestant medical missions to China: Dr Thomas Richardson Colledge (1796-1879) and the founding of the Macao Ophthalmic Hospital”, Journal of Medical Biography
3Tung Wah Hospital website http://www.tungwah.org.hk/?content=314
5Allingham V. Philip, “England and China: The Opium Wars, 1839-60”, Victorian Web, Lakehead University
6Kathleen L. Lodwick, “Crusaders against Opium: Protestant Missionaries in China, 1874-1917”,Lexington: University Press of Kentucky, 1996
SECTION B Question1
There were several outbreaks of plague in the history which include the 1984 plague outbreak in Hong Kong and the pneumonic plague outbreak in Manchuria in 1910 – 1911. The 1984 plague was also known as the “black death” due to the black coloring of whole body before or after death, which is later being identified as the bubonic plague. The pneumonic plague is unique in which it was exclusively pneumonic (infection of the lungs). Patients who are infected with the pneumonic plague will present with coughing, often with hemoptysis (coughing up blood), headache, weakness etc. Although both diseases caused outbreak, different control and measures were done by the local government at that period.
Control and measures in Hong Kong in 1894
The plague outbreak in Hong Kong was mainly associated with the poor sanitation and dense population of Hong Kong at that period. In order to cope with the outbreak of plague the British government did several measures in order to prevent the spread of the disease and to prevent new cases from emerging. This included forced disinfection of affected houses, rapid disposal of corpses, building of the Blake Garden to reduce population density and house to house searches for infected people. The infected will then be isolated on the hospital ship – Hygeia. But due to the non-reluctant response of the Chinese population, patients were later transferred to Kennedy Town glassworks which was converted for use as a temporary hospital. The government later built a Bacteriology institute with the recruitment of a bacteriologist, Dr. William Hunter to Hong Kong for the investigation of the cause of outbreak.
Control and measures in Manchuria in 1910 – 1911
During the pneumonic plague outbreak, the cause of the disease could not be identified. So it was agreed that no cure for the pneumonic plague was available by that time1: the mortality was proved to be one hundred percent. Without antibiotic at that period, the only way to prevent the spread of the disease was quarantine and isolation. The Chinese were isolated into train cars for several days. They were not let out until no one displaying any sign or symptoms of pneumonic plague. If one plague case was identified, others in the car would be considered to have a poor prognosis. Because the location of outbreak was close to Japan and Russia, there was collaboration between countries for the control of disease2. In need of medical help from Russia and Japan, the Chinese government at that period sought help by calling for an international plague conference. While the etiology of the pneumonic plague was still being investigated, isolation was used as an effective method to prevent the spread of the disease. Autopsy was also done to investigate the cause of the disease3. In later stage, new bacteriological techniques such as culturing helped identifying the cause of the epidemic.
Similarities and differences
There are several similarities between the battle against pneumonic plague and the measures to control the plague in Hong Kong in 1894. Firstly, in both cases public health was introduced to the affected areas. In western medicine public health focuses on the surveillance and the prevention of disease. Isolation was used in both cases in order to prevent the spread and the deterioration of the disease. Different measures such as sanitation and rapid disposal of corpses in the 1894 plague in Hong Kong all refers to public health measures for the disease. This is important because by that time there was no way of treating both diseases, so public health became the only way to prevent the spread of the diseases and to control the epidemic. The treatment for plague(antibiotics) was not discovered in 1940s, about 30 years after the pneumonic plague.
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In addition, modern western medicine played a large role in coping with the outbreaks in both cases. In both cases a lot of modern western advanced sciences were used to investigate the diseases. For example, bacteriology culture and autopsy were used to investigate the cause of pneumonic plague whereas dissection of rats and bacteriology study were used in the 1894 plague. In comparison traditional Chinese medicine did not play a large role in either the prevention of the disease or the treatment of the disease.
Moreover, investigations of the diseases were both done simultaneously with the measures and controls of the outbreaks. In other words, controls and measures like isolation were done before the identification of the cause of the disease in order to prevent the spread of the disease.
One major difference of the control and measures between the two cases is the involvement of other countries in pneumonic plague. The coping of the pneumonic plague involved collaborations on the international level whereas the 1984 plague only involved isolated research without collaborations. This can be explained by the location of outbreak. As the outbreak of pneumonic plague may endanger the resident population in Russia and Japan, the two countries took part in the plague control. Whereas the 1894 plague happened in Hong Kong which will not affect other countries based on its location.
In conclusion the measures and control of the pneumonic plague and the 1894 plague outbreak in Hong Kong are similar in many ways. Both cases are very important as they show us the introduction of science and theory of western medicine such as public health into China at that period when the population knew little about western medicine. The idea of public health also helped saving a lot of people’s life at that period by preventing the spread of the disease.
- Richard Pearson Strong and the .urnal es:hat period by preventing the spread of the disease. of western medicine into China Hong Kong are similar in many wayManchurian Epidemic of Pneumonic Plague 1910 – 1911, Eli Chernin
- Oxford Journal, Mark Gamsa, The epidemic of pneumonic plague in Manchuria 1910-1911
3 Contagions – The Great Pneumonic Plague of1910-1911: https://contagions.wordpress.com/2013/03/21/the-great-pneumonic-plague-of-1910-1911/
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