Chapter IV: The Hangchow Medical Mission Hospitals

The hospitals, and the dispensaries attached to them, are too important as a feature of Hangchow, and as an element in producing the remarkable goodwill towards foreigners which characterises it, to be dismissed at the tail of a chapter.

These beneficent institutions treat between them over 14,000 new patients annually, afflicted with all manner of torments. The services of Dr. Main and his coadjutor, Dr. Kimber, are in request among officials, from the highest to the lowest. Mandarins of high rank, attended by their servants, are treated in the paying wards, and occasionally leave donations of 100 dollars in addition to their payments. Officials of every rank in the Chekiang province send to the British doctors for advice and medicines. Among the many marks of the approval with which the Viceroy and other highly-placed officials regard the medical work is their recent donation of an acre and a half of land in an excellent position for the site of a branch hospital. It is no disparagement to the work of Bishop Moule, who was absent during my visit, and the other British and American clerical missionaries, to express the opinion that the tact, _bonhomie_, and devotion of Dr. Main during the last eighteen years, are one cause of the friendliness to foreigners, the Chinese being as accessible to the influence of personality as other people are.

The men’s and women’s hospitals, of which the illustration only shows portions, are of the latest and most approved European type. They are abreast of our best hospitals in lighting, ventilation, general sanitation, arrangement and organisation, and the facility of obtaining the celebrated Ningpo varnish, really a lacquer, which slowly sets with a very hard surface, reflecting much light and bearing a weekly rub with kerosene oil, greatly aids the sanitation. The purity of walls, floors, and bedding is so great as to make one long for a speck of comfortable dirt!

The men’s hospital buildings consist of four roomy and handsome general wards, eleven private paying wards, holding from one to three each, a range of rooms for the ward assistants, who are practically male nurses, students’ rooms, rooms for the three qualified assistants, a lecture-room with an anatomical [in lieu of the unattainable human] subject which cost a thousand dollars, a reception-room for mandarins with appropriate Chinese furniture, Dr. Main’s private room and medical library, a fine consulting-room and operating theatre, bathrooms, a room for patients’ clothing done up in numbered bundles after it has been washed, wardrobes for the clothing which is lent to them while in hospital, a cashier’s office, a large bottle-room, extensive storage, and an office for out-patients.

On the street side and connected with the hospitals is a fine lofty room where any non-patient passers-by, who are either tired or curious, can rest and smoke, amusing themselves meantime with the transactions of the other half of the hall, a large and attractive “drug store,” fitted up in conventional English style, where not only medicines, but medical requisites of all kinds can be procured both by non-patients and foreigners. It has been remarked by Consuls Carles and Clement Allen in their official reports, that missionaries unconsciously help British trade by introducing articles for their own use, which commend themselves to the Chinese; and this drug store has created a demand for such British manufactures as condensed milk, meat extracts, rubber tubing, soap, and the like, condensed milk having “caught on” so firmly that several of the Chinese shops are now keeping it on sale.

This rest room is also a street-chapel for preaching and discussion, and an office for inquiries of all kinds. There is also a large and handsome waiting-room for out-patients, decorated with scripture pictures, in which patriarchs and apostles appear in queues and Chinese dress, and an opium refuge—a mournful building full of bodily torment and mental depression. In the opinion of the doctor, “the cure” is seldom other than temporary, and could only be effected by building up the system for six months after leaving the refuge by tonics and nutritious diet. Besides these buildings there are large kitchens, storehouses, and a carpenter’s shop.

The women’s hospital, the great central ward of which, with its highly-varnished floor, flowers, pictures, tables, chairs, and harmonium, looks like a pleasant double drawing-room in a large English mansion, is specially under Mrs. Main’s charge, and has head and junior nurses and a dispenser trained by herself. It is equally efficient and admirable.

Besides the hospital staff of twenty-six persons, there are three native catechists who, along with Dr. Main, give Christian instruction in the hospital to those who are willing to receive it, one of them looking after patients in their homes, who, having become interested in Christianity, have returned to their villages within a radius of one hundred and fifty miles. Recently a patient, who had been for some weeks in the hospital, recounted what he had there heard of Christianity with such effect that over forty of his fellow-villagers, after some months, gave up their heathen practices and became Christians; and this after he had been beaten for his new beliefs on first going home.

The hospital is also an efficient medical school, where the usual medical and surgical courses are given, along with clinical instruction, during a period of five years. This school has helped largely to win the favour of the mandarins, who have learned to appreciate Western surgery from the cures at the hospital. Some of these students, after graduation, have taken good positions in Shanghai and elsewhere. A few in going into practice in the province have somewhat dropped European medicine, and have resorted to Chinese drugs and the method of using them, but all adhere to Western surgery, the results of which in Chinese eyes are little short of miraculous, but possibly their mode of carrying out antiseptic treatment would hardly come up to Lord Lister’s standard! It is frequently believed by Chinese patients that the object of this treatment is to prevent devils from gaining entrance to the body by means of surgical wounds!

Dr. Lu, a refined and cultured man, Dr. Main’s senior qualified assistant, a graduate of the hospital school, would anywhere be a remarkable man in his profession, first as a brilliant operative surgeon, and then for insight and accurate diagnosis. He has won the confidence of the resident foreigners. He is a skilful medical photographer, and his microscopic and physiological drawings are very beautiful and show great technical skill.

The clock tower is a decorative feature of the building, and everything within moves with clockwork regularity. The hospital is in a high state of efficiency and spick-and-spanness, such as I have seldom seen equalled abroad, and never exceeded.[11] Such work, done with skill, love, and cheeriness, has an earthly reward, and Dr. Main is on most friendly terms with the leading mandarins, who have it in their power to help or hinder greatly. The hospital blazes with their red and gold votive tablets, and I doubt if they would refuse him anything which he thought it wise to ask. Almost the latest additions to a work which is always growing are convalescent homes in the finest position outside the city, on the breezy hill above the Si Hu [Western Lake].

I have heard some grumbling at home at the expense at which this hospital is carried on, but perfection is not to be attained without outlay, and in my opinion the Hangchow hospital is a good investment. It is most desirable that Western methods of healing should be exhibited in their best aspects in the capital of this important province, and also that the medical school should be as well-equipped as is possible. The benefit of this and similar schools is incalculable. The linked systems of superstition and torture, which enter largely into Chinese medical treatment, are undermined, and rational Western surgery is demanded by the people. European treatment also assails the degrading belief in sorcery and demonism in its last resort—the sick-bed—showing processes of cure which work marvels of healing, altogether apart from witchcraft and incantations.

Of the Medical Mission Hospital as a Christian agency I need scarcely write, as its name is significant of its work. I believe in medical missions, because they are the nearest approach now possible to the method pursued by the Founder of the Christian faith, and to the fulfilment of His command, “Heal and preach.” It is not, as some suppose, that the medical missionary takes advantage of men in their pain and distress to “poke at them” the claims of a foreign religion, though if he be an honest Christian he recognises that the soul needs enlightenment as much as the body needs healing. I have never seen a medical mission among the forty-seven that I have visited in which Christianity was “poked” at unwilling listeners, or in which, in the rare cases of men declining to hear of it in the dispensary waiting-room, it was in the very smallest degree to their disadvantage as patients.

A fee of twenty-four _cash_ is charged for admission to the dispensary to foster a spirit of independence, and the charge in the paying wards is from two to ten dollars per month. Crowds of out-patients marshalled like an army, carefully trained assistants knowing and doing their duty, catechists, ward assistants, cashiers, photographers, cooks, gardeners, artisans, make up the crowd which in all the morning hours swarms over the staircases of the hospital and round the great entrance. The dispensary patients present a sorry spectacle, owing to the prevalence of skin diseases, superficial sores, and cavernous abscesses, from which the plasters with which the Chinese doctors had hermetically sealed them have been removed. Young and old, maimed, deaf, blind, loathsomely disfigured persons, meet together, and there are often cases of gunshot wounds, elephantiasis, and leprosy in the throng.

But, wretched as the patients are, they are capable of being amused by Dr. Main’s jokes, and on one occasion when I was photographing four soldiers of the Viceroy’s guard in the hospital grounds the hilarity burst all bounds, and the distempered mass yelled with enjoyment. When I photographed the backs of the soldiers they shouted, “She pictures their backs because they ran away from the _wojen_” (dwarfs); and when Dr. Main displayed their brawny legs, they nearly danced with the fun of it, yelling, “Those are the legs they ran away on.” Not that the Viceroy’s guard had encountered the Japanese, but these people were near enough to Shanghai to have heard of the figure the Chinese troops had cut. A Chinese loves a joke, and, as I have often experienced, if he can only be made to laugh his hostility vanishes.

One of these men, picturesquely uniformed in blue and crimson, was brought back an hour later at the point of death from opium, having attempted his life, not because he had been laughed at, but because of a tiff with his superior officer.

As is well known, suicide is appallingly common in China; and in the great cities of Swatow, Mukden, and Hangchow, as a guest at medical mission houses, I have come much into contact with its various methods. In Mukden a frequent mode of taking life, specially among young wives, is biting off the heads of lucifer matches, though the death from phosphorus poisoning is known to be an agonising one. Swallowing gold leaf or chloride of magnesium, jumping down wells or into rapid rivers, taking lead, cutting the throat, and stabbing the abdomen have been popular modes of self-destruction. But these are rapidly giving place to suicide by opium owing to the facility with which it can be obtained, the easy death which results from it, and the certainty of its operation in the absence of the foreign doctor, his emetic, and his stomach-pump. Medical mission hospitals in China save the lives of hundreds of would-be suicides every year.

So far as I have been able to ascertain, the causes of suicide in China are, not as in Europe, profound melancholia, heavy losses, or disappointment in love, but chiefly revenge and the desire to inflict serious injury on another. Suicide enables a Chinese to take a truly terrible revenge, for he believes that his spirit will malignantly haunt and injure the living; and the desire to save a suicide’s life arises in most cases not from humanity, but from the hope of averting such a direful catastrophe. If a master offends his servant or makes him “lose face,” or a shopkeeper his assistant or apprentice, the surest revenge is to die on his premises, for it not only involves the power of haunting and of inflicting daily injuries, but renders it necessary that the body should lie where death occurs until an official inquiry is made, which brings into the house the scandal and turmoil of a visit from a mandarin with a body of officials and retainers. It is quite common for a man or woman to walk into the courtyard of a person against whom he or she has a grudge, and take a fatal dose of opium there to ensure these desirable results!

Among common incentives to suicide are the gusts of blind rage to which the Chinese of both sexes are subject, the cruelty of mothers-in-law, quarrels between husband and wife, failure to meet payments at the New Year, gambling losses, the desire to annoy a husband, the gambling or extravagant opium smoking of a husband, imputation of theft, having pawned the clothes of another and being unable to redeem them, being defrauded of money, childlessness, dread of divorce, being sold by a husband, abridgment of liberty, poverty, and the like. Opium, from the painless death it brings, is now resorted to on the most trivial occasions, and has largely increased the number of suicides. Though the reasons which I have given for self-destruction apply mostly to women, yet where statistics are obtainable men are largely in the majority, and revenge and the desire of inflicting injury are their great motives.

Of course, there are very many risks and difficulties in the treatment of out-patients. Chinese medicines are administered bulkily, a pint or a quart at a time, and patients do not understand our concentrated and powerful doses. Hence dangerous and grotesque mistakes are continually made, such as the following:—

_Patient_—“Doctor, when I took the medicine you gave me yesterday it made me very sick; it has given me diarrhœa and a severe pain in the stomach; my fingers and toes also feel very numb.”

_Dr. Malcolm_ (looking at the bottle)—“Why, you have already almost finished the eight days’ medicine” (arsenic) “that I gave you yesterday. The wonder is that you are alive at all.”

_Patient No. 2_ enters—“Where is the old boss of this shop? I want some foreign devil medicine to cure malaria.”

_D._—“Allow me to tell you I am not a devil. You had better go home; and when you can come and ask respectfully for medicine we will give it you.”

_P. No. 3_ enters, holding out her hands and asking the doctor to find out her disease by “comparing her pulses.”

_D._—“Tell me what is the matter with you.”

_P._—“My bones and muscles are sore all over.”

_D._—“What was the cause of your trouble?”

_P._—“It was brought on by a fit of anger.”

_D._—“How long have you had it?”

_P._—“From the time the heavens were opened, and the earth was split” (_i.e._ a very long time).

The arms and shoulders of this woman were covered with pieces of green plaster, given her by the Chinese doctors. She proposed to throw these away and “to publish the doctor’s name abroad” if he cured her. So she received medicine with very full directions about taking it; these were not enough. She asked a string of questions such as if she must heat it before taking it, if she must keep the bottle tightly corked, if she must take it along with anything else, and lastly—

_P._—“Shall I abstain from eating anything?”

_D._—“No.”

_P._ (greatly disappointed).—“What! shall I not forbid my mouth anything at all?”

_D._ (jokingly).—“Yes. Do not talk too much; do not revile your neighbours; do not smoke opium; do not scatter lies.”

The doctor getting worried, reiterates plain directions regarding the medicine, tells her they are very busy, and that she must not ask any more questions, and shows her out.

_P._ (returning after a few minutes).—“Is the medicine to be taken inwardly, or rubbed on the outside?”

Or a man comes in and describes “chills,” and a dose of quinine is prepared for him, when he smiles serenely and says, “To tell you the truth, it is not I that take the chills; it is my mother.”

Another comes in, and describes with great minuteness and self-pity his symptoms, which are those of malarial fever. He will not take a dose of quinine in the dispensary, but wants to take it home, saying he will not “shake” till the next day. He is feigning sickness, in order to get quinine and sell it. Or an operation for cataract has been performed in one of the hospital wards, and the son of the patient comes to the doctor, begging him to go to his father, who says that his eye pains him so that he cannot stand it. The doctor finds that the bandage has been removed, and reproaches the son, who said that some friends came in to see if he could really see after being blind for so many years, and took off the bandage. The patient had rubbed the eye, the wound had burst open and was suppurating, and the man was blind for life.

Some patients come to a hospital out of impudence, some in the hope of getting drugs to sell, others out of curiosity to see how the “foreign devil doctor” works, others to steal the clothes which are lent to in-patients, and others for a lark, pretending to have various diseases, but with these the Chinese assistants occasionally indulge in a lark on their own account, and turn on them a pretty vigorous current from the electric battery.[12]

With so much vexatious expenditure of time, so much imposition and greed, and so many disappointments regarding interesting cases owing to the gross ignorance of the patients and their friends, there are many drawbacks in the life of a missionary doctor, and even in such long-established work as that at Hangchow, and with such admirable equipments and assistance, it cannot always be easy to preserve the courtesy, gentleness, patience, and forbearance which are among the essentials of success.

Of the patients treated in Hangchow last year one thousand were in-patients. “Discharged cured” might be written against the great majority of their names, and those who were incurable were greatly benefited, as in the case of the lepers, whose “grievous wounds” are closed and healed, and whose pains are subdued.

Certainly this great hospital is one of the sights of Hangchow, and no one could become acquainted with it without recognising that those who work it and support it are following closely in the footsteps of Him who came “not to destroy men’s lives, but to save them.”[13]