China’s medical missionary work—a catalyst for research development

By Patrick Fung, International Director for Mobilization, OMF International

Edited by Tony Lambert, Director for Research, Chinese Ministries Dept., OMF International

Medical missions have always been an important ministry arm of the Protestant missionary movement. Most history of medical missions has focused on medical work; medical research usually received little attention. This paper attempts to briefly examine the history of medical missions in China with a particular focus on their influence on research development.

A small but significant beginning
Although it is generally recognized that the first medical missionary of Protestant missions to China was Dr. Peter Parker who arrived in China in 1834, we know that the Jesuits brought new medical knowledge to the Chinese people much earlier by introducing quinine, a drug used for the treatment of malaria even today. In the early phase, medical missionary work concentrated mainly in clinical work in serving the patients rather than medical training or research.

The development of the medical branch of Protestant missions in China had a humble but significant beginning. In 1874 only ten medical missionaries were reported.1 By 1881 there were nineteen.2 The work of medical missionaries was mainly related to hospitals and dispensaries in those days. However, medical missionary work continued to grow for the next ten years. One of the earliest tasks that confronted the medical missionaries was the training of Chinese assistants mainly through the apprenticeship system. However, this training expanded into formal medical education. In 1877 30 medical students, under the training of medical missionaries serving in different areas, were reported.3

A body that facilitates development of research and writing
With the growing number of medical missionaries in China, though still a small group compared to the overall number of missionary workers, there was a general feeling of a need for better cooperation. Thus, the China Medical Missionary Association was formed in 1886. The new organization began a medical journal in 1887—the first attempt to bring Western medical science to China in a systematic way.

The China Medical Missionary Association, which had its first official meeting in 1890, held subsequent gatherings in 1905, 1907, 1910, 1913 and 1915.4 This pioneer organization, apart from publishing a regular medical journal, also spent much effort in the promotion of medical education and of public health, the preparation of medical literature, the fixing of a uniform medical terminology in Chinese and the conduct of research.

Latourette summarized the area of contributions particularly in the area of research and methodology to medical science by medical missionaries in those days:

Under the auspices of the Association an English-Chinese dictionary of 15,000 medical and scientific terms was issued, and a series of medical textbooks was projected in which the new nomenclature was to be employed. A large book on the diseases of China was the work of two missionaries. The first dissection of the human body in China for purposes of medical instruction seems to have been made in the Harvard Medical School in the International Settlement in Shanghai in 1911, a year or more before the practice was officially permitted by the government.

Pioneers in Medical Research Writing
China Medical Missionary Journal first started in 1887 but in 1907 the name was changed to China Medical Journal.5 In 1932 it merged with the National Medical Journal of China and became the Chinese Medical Journal which continues to exist today. In the early stage 1887-1932, medical missionaries played a key role as editors. One key person was Dr. J. G. Kerr, a missionary of the American Presbyterian Board. He came to Canton in 1854 and became the medical director of the hospital. Apart from clinical work, Kerr also helped publish a number of books, including the pharmacy manual and the art of surgery. However, his long-term contribution was as the chief editor of the Chinese Medical Missionary Journal.

Training beyond medical skills—setting the example for research
In 1905, out of a total of 3445 missionaries in China, 301 were physicians, 207 of them men and 94 women.6 Not only were medical missionaries training Chinese in their profession, they were preparing medical literature. Dr. Francis Hobson of the London Missionary Society wrote or translated several books on medicine and surgery in Chinese. Dr. J. Porter Smith of the Wesleyan Missionary Society in Hankow and Dr. Kerr were each the author of a materia medica in Chinese.7 Dr. Wilhem Lobscheid of the Rhenish Mission prepared several medical manuals. D. W. Osgood of the American Board’s mission in Fukien put into Chinese Gray’s Anatomy. A revision and then a new translation was done later by Dr. Whitney of the same mission. These physicians were laying the foundations for a new medical literature and terminology for China. The Medical Missionary Association, at its first meeting in 1890 appointed a committee on terminology.8 One key development was that much of the medical literature produced was in Chinese.

Research development continued under local leadership
As local medical professionals obtained more experience, it became a matter of time when local bodies played a much stronger role in the publication of medical literature as well as in research. The National China Medical Association, made up of mainly Chinese who were trained in practicing Western medicine, was an outgrowth of the Medical Missionary Association. It was founded in 1915. Chinese were becoming more favorable to Western medicine and, largely as a result of missionary efforts, a new medical professional body was born.9

An important step was the formation of a national body which coordinated all medical work in China, regardless of race or creed. In 1925 the China Medical Missionary Association, at its own request, was absorbed by the China Medical Association. A division of the latter body was formed to take over the functions of the old organization.10 In 1930 the Directory of the China Medical Association listed the names of 2,950 doctors. Of these 325 were missionaries and another 530 were Chinese doctors in mission institutions.11 By 1930 over 50 per cent of the medical profession in China were Christians or had been trained in Christian institutions. In the early 1930s there were six Protestant medical schools in Canton, Jinan, Shenyang, Shanghai and Chengdu.12 Two other schools that were mission related included Yale-in-China at Changsha and Peking Union Medical College. The most important contribution by medical missionaries, apart from direct medical service, was the standardization of medical nomenclature, the translation of medical and scientific texts and the publication of medical journals in Chinese.

The transfer of skills in medicine and medical research was not always done sensitively in the spirit of humble service. Austin, in the chapter, “Clinical Christianity” of the book Saving China reported that “most missionary doctors in China could not bring themselves to trust their Chinese ‘assistants’ to go out with mission encouragement but without mission control.”13 When the medical missionaries began work in China, the Chinese already possessed a tremendous medical literature, and extensive pharmacopoeia, though lacking knowledge in anatomy, anaesthesia and antiseptics.14 There was little attempt by medical missionaries to understand traditional Chinese medicine. They mainly viewed “herbal remedies” as pagan superstition.15 Medical research in China before 1949 under the auspices of medical missionaries was mainly in the realm of Western medicine.

Some Reflections

While most medical missionaries, including those from the China Inland Mission, concentrated on medical service and evangelism,16 there were some key pioneers, like Dr. John Kerr, who was instrumental in the facilitation of medical research and research writing in China. The standardization of nomenclature was a foundation for future research. Looking to the future, if we are to encourage missiological research by the church in China, we will need standardization of nomenclature in the Chinese language. Tony Lambert has mentioned the important prerequisite for serious China research of the knowledge of spoken and written Chinese. It is encouraging to observe that many of the medical research publications from 1887 to 1930 in China were in Chinese facilitated by missionaries who made serious attempts to understand the Chinese language. Missiologists and Christian workers today need to do the same.

Time was needed to establish medical ministry before research could take place. It took more than 50 years from the time when the first medical missionary, Dr. Peter Parker, arrived in China in 1834, to the time when the first medical journal was published in 1887. Research has not always been given a high priority by those involved in missionary ministry. This may be due to the missionary doctors’ already tremendous workload. However, the methodology of serious research sets the pace for future development as in the case of medical science in China.

While the missionary doctors might possess the methodology for research, the whole area of medical research in traditional Chinese medicine was largely untouched by medical missionaries because of the often preconceived understanding that it was linked with pagan superstition. However, there were some exceptions including some outstanding medical missionary researchers like Dr. John Kerr from the American Presbyterian Mission Board, Dr. Francis Hobson of the London Missionary Society, Dr. Wilhem Lobscheid of the Rhenish Mission and others who saw the importance of Chinese in medical training and research. They showed considerable interest in Chinese medicine and the Chinese approach to health.17

This brief paper has not dealt with the issue of training native research workers by the missionaries. The spirit of service and humility is needed. Most of the literature I read on medical missions in China did not cover this particular area.

Footnotes:

1. Chinese Recorder, Vol. 6, p.342
2. Chinese Recorder, Vol. 13, p.308
3. Chinese Recorder, Vol. 11, pp. 96, 206
4. China Mission Year Book, 1913, p.287; China Medical Journal, Vol.24, p.110
5. Information from the website of Chinese Medical Journal: www.cmj.org/information
6. Latourette, A History of Christian Missions in China. NY: Paragon Book Gallery Ltd. 1975. p.652
7. Encyclopedia Sinica, p.346
8. China Mission Year Book, 1911, p.162
9. Latourette, p.760
10. Latourette, p.789
11. G. Thompson Brown. Earthen Vessels and Transcendent Power—American Presbyterians in China 1837-1952. Maryknoll, NY: Orbis Books 1997, p.234
12. Ibid p.235
13. Alvyn J. Austin. Saving China: Canadian Missionaries in the Middle Kingdom 1888-1959. Toronto: University of Toronto Press. 1986, p.183
14. Latourette, p.453
15. Austin, p.173. Chinese medication, according to Omar Kilborn, consisted of such things as “cast off snake skins, turtle shell, monkey and tiger bones, and deer horns.” The most powerful poultice was “thousand-feet earth,” that is “earth trampled by a thousand human feet. This precious medicine is found immediately outside or inside a doorway.”
16. This was more so for China Inland Mission which did not put too much emphasis on establishing hospitals apart from three large institutions: a sanatorium in Chefoo, the hospital in Kaifeng, and a leprosarium in Lanchow in the far west.
17. G. Thompson Brown, p.255. According to Sophie Montgomery Crane, a historian of Southern Presbyterian Medical Missions, “Experienced medical missionaries often came to appreciate the fact that in the field of psychosomatic problems the traditional healer’s success rate was sometimes equal to, if not superior to, Western approaches. The traditional healer was better able to navigate in the cultural milieu than the neophytes from an alien culture.”