The process of understanding of Chinese medicine by modern Western medical missionaries

Since the importation of Western science in modern times, it has replaced almost all disciplines in the Chinese intellectual tradition in a disciplinary manner, with the sole exception of Chinese medicine, but it has also given rise to heated debates about the nature of Chinese medicine.

The missionary P. Joannes Terrenz, who came to China in 1621, was the first Jesuit physician to arrive in China. He pointed out to the Chinese around him that his native Switzerland also used herbs to treat illnesses, but unlike the Chinese, “the herbs are not chewed with their quality, but steamed to obtain their dew”. The Jesuits were most impressed with Chinese medicine because of the fine Chinese method of pulse diagnosis, and in 1671 the first Chinese book on pulse diagnosis was translated and published in Europe. The greatest introduction to Chinese medicine in Europe was made by the Polish Jesuit Michel Boym, who served as the royal physician. He also translated the work on Chinese pulse diagnosis. In his book “An Introduction to Chinese Medicine”, published under his name, he introduced some varieties of Chinese herbal medicine and Chinese prescriptions. A German physician, Andreas Cleyer, who was in the service of the East India Company, published in 1682 a translation of Chinese Clinics with excerpts from the classics of Chinese medicine, such as Wang Shuhe’s Pulse, the Pulse Classic, the Book of Difficulties and the Yellow Emperor’s Classic of Internal Medicine. This book inspired John Floyer, an English physician, to develop a new method of diagnosis that combined Western and Chinese experience in pulse diagnosis. By and large, the missionaries and the Westerners under their influence were still happy to learn from Chinese medicine during this period.

As their understanding deepened, the Jesuits became interested in the Chinese medicine they encountered. The missionaries noted that “the Chinese method of vaccinating children was gentler and less dangerous than the English method,” but they were more enthusiastic about their own medical successes. For example, when Kangxi suffered from malaria, he “took cinchona cream, a medicine previously unknown in China”. They observed that the Chinese were aware of the circulation of blood, but “did not know clearly in what way the blood was distributed throughout the body after flowing out of the lungs, nor how it returned to the lungs”. de Tournon, the papal envoy to Beijing in 1705, became ill and was treated by the eunuch on the orders of Kangxi, who felt after a while that there was “a lack of good doctors” in the Qing court. In general, during this period, there was cooperation between Chinese and Western doctors at the Qing court at the request of the emperor in pharmaceutical and clinical diagnosis, but there was no communication in medical theory.

After the two Opium Wars, the signing of unequal treaties between China and foreign countries allowed missionaries to expand their activities to the whole of China, and medical missionary activities advanced from the periphery of China to the center using clinics and hospitals as platforms, starting a new process of medical missionaries’ contact with and knowledge of Chinese medicine. The 19th century, however, was a time of profound changes in the knowledge structure of Western medicine, as the development of cytopathology and bacteriology provided more accurate explanations of the causes of disease, and chemical research led to the invention of anesthetics and antiseptic chemicals, making surgery the forte of Western medicine. Developments in pharmacology drove advances in the pharmaceutical industry. The use of stethoscopes, sphygmomanometers, thermometers, and a host of optical devices advanced clinical medicine. The Lancet, the leading medical journal still in print today, also appeared in 1823, which allowed overseas missionaries to learn about the latest medical achievements and publish their research through the journal. Missionaries, especially those who came from university medical education courses in medicine, would obviously now compare Chinese medicine with Western medical standards. The former is seen as modern and scientific, while the latter becomes traditional and non-scientific or even superstitious. In such a perspective, criticisms of Chinese medicine emerged like a tidal wave.

They criticized Chinese medicine for lacking anatomically based knowledge of human organs and physiology. Benjamin Hobson, a British London Missionary Doctor, was the first to criticize Chinese medicine for its lack of anatomically based knowledge of the human body in the preface to “A New Treatise on the Whole Body”. He said, “I have been in Guangdong for a number of years, and when I had the time to practice Chinese, I always sighed when I saw that the Chinese medical books contained bones, flesh, organs, and meridians, but I did not know their physical use. The work of medicine is huge, and the relationship is not light. Do not know the part, that is, do not know the source of the disease; do not know the source of the disease, that is, do not know the cure; do not know the cure and use the usual medicine, it is not to cause great harm. If you catch the wind to test the disease with medicine, there will be unbearable to say.”

From the pathology and pharmacology of Western medicine, they also had sharp questions about the philosophical basis of the theory of Chinese medicine. In the preface to the “Internal Medicine New Sayings”, Hop Sing says: “Chinese medical books, the prescriptions are voluminous …… every discussion of a disease, will float the yin and yang five elements, winding endlessly, every use of a drug, will be color, fragrance, shape and taste, the distribution of the internal organs, or high talk about pulse theory, delusional things God witch, the function of the internal organs, bewildered, even the decline of medicine. ” Dugald Christie, a Scottish Presbyterian missionary who had practiced medicine in the northeast for many years, understood the theory of Chinese medicine and knew that Chinese medicine linked the human body to the five elements, and that disease was the result of the loss of balance of the five elements, and that to restore health, the theory of using medicines classified according to the five elements to restore the balance of the five organs. He exclaimed, “The saying of Chinese medicine is really too complicated.”

The missionaries also saw, as Ricci did, a lack of specialized medical education in China, which they believed was the root cause of the backwardness of Chinese medicine. Hershey pointed out that “Chinese medicine is not as good today as it was in ancient times” because there was no special medical education or examination system for doctors. He said in the “Western Medicine”: “Western medical doctors, must be repeatedly examined, to take the list of famous, before being allowed to practice the world, its expensive as the name of China’s scholar, the law is slightly like China’s examination of the case of the scribe, so the practice of those who strive for excellence, the Chinese medical doctors, the scholar for their own, not by the official examination, do not add to the glory, this is not the reason for a fine.”

Probably the most influential critic of Chinese medicine was John G. Kerr of the Presbyterian Church in the U.S.A. At the first Protestant missionary conference in China, held in Shanghai in May 1877, John Kerr read a paper on medical missions and raised nine problems in the medical care of the Eastern peoples. First, the complete ignorance of anatomy and physiology and the substitution of absurd theories for true knowledge; second, the ignorance of the nature of disease, the attribution of its origin to non-existent causes, and the use of the five elements and yin and yang to explain conditions; third, the ignorance of the nature of medicine to a large extent; fourth, the fact that surgery was extremely primitive and cruel; fifth, the fact that obstetrics was not only full of fallacies, but also that once the condition was urgent and urgent In a country as populous as China, if a hundred years of statistics could be produced today, they would certainly reveal the horrendous number of people who have suffered and lost their lives”; sixth, superstitious ideas and practices dominate the medical care of all unenlightened peoples and lead Seventh, the ignorance of pediatric hygiene and pediatric diseases; eighth, the complete absence of health regulations; and ninth, the absence of charitable institutions to care for the sick. In fact, John Kahl has almost completely rejected Chinese medicine in terms of medical and pharmacological theory, clinical practice, medical system and policy administration. John Kah later served as the first president of the academic organization of missionary physicians, the Bo Medical Association, and the first editor-in-chief of the Bo Medical Association newspaper, which shows the extent to which this idea of rejecting Chinese medicine was accepted. At the Second Protestant Missionary Conference in China in 1890, A. W. Douthwaite of the Mainland Society gave a report on medical missions, saying, “What can we say about Chinese medical science? There is no such thing”. In short, to most of the missionary doctors who came to China in the 19th century, Chinese medicine was seen as a product of the ancient world that was incompatible with the modern world. In their vision, Chinese medicine had no place.

However, the problem with Chinese medicine could not be so simple. It is because Chinese medicine, which was criticized by the missionaries, has hardly changed in this era, except that its flaws were relatively highlighted in contrast to its Western contemporaries, but not in such a way that, because of the advent of Western medicine, Chinese medicine is only “ignorant” and has no rational side. As Siddhogak, a critic of Chinese medicine, had to ask in his autobiography, “Is there no merit in Chinese medicine when it has so many flaws?” Even W. A. P. Martin, who was very contemptuous of Chinese medicine, harshly admitted: “In the treatment of disease, Chinese medicine, though neither researched nor scientific, must have groped out some proven remedies like a blind cat catching a rat, from the experience accumulated over thousands of years.” Thus, when the missionaries turned to areas of experience in Chinese medicine or areas lacking in Western medicine, they could not ignore the contribution of local medicine.

The first thing they saw was the healing power of Chinese medicine. Missionary physicians often took a separate approach to Chinese medicine from “medicine. Both J. Porter Smith of the Wellesley Society in Hankow and John Garcia were early writers on Chinese medicine, and in 1858 Heshin consciously compared Chinese and Western medicines in his New Treatise on Internal Medicine. In the “East and West Materia Medica”, he argued that some Western medicines were similar to Chinese medicines, such as Poria, Plantago, etc.; some were different from Chinese medicines, but most of the medicines used by Western doctors were recorded in the Chinese Materia Medica. He also advocated that Western medicine in China “medicine to the Chinese production of the main, there must be spare, and the Chinese are not between the use of foreign medicine”. It is evident that he was more receptive to Chinese medicinal materials.

However, although some similar examples can be found, medical missionaries identified with Chinese medicine only on these limited levels. As Paul A. Cohen points out, “In a broad sense, Western superiority at the end of the nineteenth century was all-encompassing in nature, not only in material categories such as wealth and power, but also in the cultural, religious, moral, customary, and other spiritual realms.” The missionaries who came to China during this period often had a strong sense of cultural and religious superiority. In the eyes of some missionaries, the peoples of the East were in the shadow of extinction, “without hope, without God, and voluntarily slaves to sin and Satan.” A manual for young missionaries written by Arthur H. Smith in his later years put it bluntly: “To say this about the young missionary coming to China is to assume that he has an advantage – otherwise, what is he doing here?” This sense of superiority often led missionaries to despise or even lack the will to positively recognize all local cultures.

It is noteworthy that medical missionaries at that time were few in number, but great in energy. Church hospitals were also gradually spread in the cities. There were few obstacles to the acceptance of Western medicine in the Chinese imperial court, and examples abounded of medical missionaries being appreciated by Chinese officials and gentry. At the Centennial Conference of Missionaries to China held in 1907, Siddhupada, who was the chairman of the medical branch, announced that the diplomas of the medical students of the Church were recognized by the Qing government, and the outbreak of the plague in the northeast in 1910-1911, when Western medicine was officially entrusted with the task of preventing and controlling the epidemic, was seen as a landmark in the recognition of Western medicine in China.