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is the foreign language of the Orient and it is fast becoming true that no man can consider himself educated unless he knows something of it. The second factor, the matter of technical terms is also difficult. There has been a desultory work on the compilation of technical terms, but it has not reached the natural sciences and may not for a long time. By the rules of the Chinese language, it is improper to create new characters, i.e., to coin new words. It would be equivalent to making new words in a modern language without going to the dead languages for the roots. What must be done is to combine existing characters so as to give the requisite meaning, where a single ideograph does not suffice to express the thought. Thus one is confined to a choice of say forty thousand characters with their meanings which originated when the world was comparatively primitive, together with combinations of the same. The difficulty

is that what would correspond to a polysyllabic word with us becomes a string of characters a definition in fact, expressed in what must be lucid Chinese. The result is sometimes weird. A short cut but worse expedient is the transliteration of the sound of the foreign word. Here the trouble is that beside having absolutely no meaning to the uninitiated the sound values of different characters vary in different parts of the country and what might be a fair imitation in one place would have little resemblance in another. In spite of what we may say about the difficulties, the modern writers on every subject under the sun go on coining new terms (not new characters) and many of them are very pat. The same will be done in medicine in time. It should be undertaken by a government commission if suitable men can be found. It is a very difficult task if well done, for it combines an extensive knowledge of Chinese characters, a thorough technical knowledge of the science whose terms are translated, e.g., medicine, and that masterly quality which uses just the right word to express each shade of meaning. Perhaps the men can be found now; perhaps we shall have to wait a few years. The Japanese met the same difficulties and solved them as far as they have been solved, as the Chinese are doing. They began by teaching technical subjects

in the language of the country which they took as their model in that particular branch. Medicine fell to German and I understand that even yet some of the most technical parts of medicine are studied in that language. The Japanese use the Chinese classical language, having derived it with much of their culture from China many centuries ago. It might be asked why the Chinese do not use the Japanese terms or even the Japanese textbooks. The answer is that the Japanese use many characters in other senses than the Chinese do, so that the meaning is not clear; they use many unusual characters; and their whole literary style is not pleasing or shall we say correct, from the Chinese standpoint. Moreover, they have used many transliterations of the sounds of foreign terms, accurate perhaps when pronounced in Japanese, but meaningless when given the Chinese sounds. And moreover, the Chinese sound values, as I have pointed out, are not the same everywhere. The China Medical Missionary Association and those who agree with their viewpoint, that a great country like China ultimately must study and write about every subject, technical or otherwise, in their own language, have taken the bull by the horns and have compiled an English-Chinese Medical Lexicon, covering the commoner medical terms and will add to it as new editions appear. It has some faults. Some terms are poor. Some rules of Chinese composition occasionally are broken, but it is a step in the right direction. It will be tried by fire and the good will remain.

And this brings us to the subject of modern medical literature in the Chinese language. It is not a large subject, more's the pity. I have noted the abortive attempt of a Jesuit father to translate an anatomy, and the more fruitful labors of Dr. Hobson in Canton. Dr. Kerr, of Canton, wrote several treatises, as did several others, but it is since 1900 that most has been done. The works now translated and published by the publication committee of the China Medical Missionary Association comprise twenty-three titles, including most but not all of the fundamental branches of medicine. Other books are in the press and still others are being translated. Within a few years when China

has men of her own thoroughly trained in medicine and in in the other sciences, the Chinese language will be employed in the government colleges. Of that there can be no doubt. At present is is a question of whether it is better to make the student do the work of getting sufficient English to grasp the technicalities of medicine, and after he has obtained the training, be unable to transmit what he has learned to his countrymen who do not understand English, because he has no technical terms; or, to make the teacher learn Chinese and create a literature in medicine with the help, of course, of Chinese teachers, who see that the style is correct. In our own college we require the students to have some knowledge of English and to continue the study of both that and classical Chinese throughout their course unless excused for special proficiency. The aim is to make English a secondary language as students in this country have German and French for collateral reading and I believe that we are anticipating the condition that will prevail in nearly all schools a few years hence, when those who wish to study in a foreign language will seek also the greater facilities of some foreign land.

For more than fifty years Chinese have been going to the West for medical training. So far as I can find any record the first to take a degree was Dr. Wang Fen, who graduated at Edinborough in 1857. He offered his services to the London Missionary Society and was in charge of the hospital of the Medical Missionary Society in Canton for a number of years. Since then a number of Chinese have studied both in Europe and America. With the great influx of Chinese students since 1900 and especially since the migrations to America that have resulted from the return of the Boxer indemnity by the United States, the number has increased. At the present time the bureau supervising students has a record of seven now studying medicine, two sanitary engineering and one sanitary chemistry.

Finally, where does western medicine stand today in the estimate of the Chinese? That depends on the precise moment at which you speak. The change that is going on in China at present is stupendous. It is safe to say that the

officials and upper classes have come into close contact with western ideas and culture more in the last decade than in the preceding century and that the last year has meant more in progress than the preceding ten. It is needless to say that if the Chinese government had known a tithe of what it does now, the Boxer delusion would have been impossible. There are still old officials who did not learn anything from that convulsion but are wondering what all the recent fuss is about. There are others who are revising their opinions. Let me quote from the address of Hsi Liang, viceroy of Manchuria at the opening of the International Plague Conference in Mukden in April, 1911:

We Chinese have for a long time believed in an ancient system of medical practice, which the experience of centuries has found to be serviceable for many ailments, but the lessons taught by this epidemic, which until three or four months ago had been unknown in China, have been great, and have compelled several of us to revise our former ideas of this valuable branch of knowledge. We feel that the progress of medical science must go hand in hand with the advancement of learning, and that if railways, telegraphs, electric light and other modern inventions are indispensable to the material welfare of this country, we should also make use of the wonderful resources of western medicine for the benefit of the people. I trust and believe too, that modern medicine and especially sanitary science will in future receive more attention in this country than it has hitherto done, and we shall be better prepared to deal with similar epidemics when they arise. My great regret is that as many as 40,000 lives have been lost in these Provinces, especially including those of some of our foreign doctors, whose unselfish devotion to duty and the welfare of our people I shall always remember.

At the first graduation exercises of the Union Medical College in Peking in April 1911, the Privy Councillor Na T'ung gave the principal address. He said in part:

There is abundant proof that neglect of the laws of sanitation and absence of proper medical care have brought about more deaths of officers and men in the fiercest of modern warfare than the destructive power of the terrible weapons of war. What is true in times of war is no less true in the times of peace. We have just had an illustration in the pneumonic plague which raged so fiercely in Manchuria. In fighting against the plague -and the battle was a splendid one-the government found that it did not have a sufficient number of doctors available to do the

work and a call for volunteers was issued. Among others, several professors and students of your college responded and at once left for Harbin, where the plague was seen in its worst form. Leaving self and family out of consideration, they thought only of the good they could do, and as doctors they remembered that their duty and ambition was to fight disease and death: And it is this spirit, I believe, should inspire you throughout your lives, the spirit of service and sacrifice.

Within the year 1911, the Chinese government twice sought the coöperation of the Union Medical College in Peking when their own resources were insufficient. The first was in the case of the epidemic in pneumonic plague in Manchuria referred to by Na T'ung and the second was during the revolution. The imperial army medical corps was altogether inadequate for the task and desired the Medical College to coöperate. The reply was in the affirmative provided a Red Cross Society could be organized and that the imperial government would apply the rules of the Geneva Convention to the treatment of wounded rebels. It took a month of the time of the most active hostilities before they could be persuaded to do so, but in the end these civilized rules prevailed and three companies with nine teachers and about forty students went to the front. Aside from this and the efforts of other Red Cross Societies in China whereever there were medical missionaries their hospitals if required were filled with wounded. On the rebel side there was little army medical corps work but several organizations including the Red Cross Society in Shanghai sent companies to the scene of hostilities. The public service during these two visitations of pestilence and war has aided greatly in showing the officials in China what western medicine is by actual demonstration. After the plague one heard on every side among officials of the necessity of reform in medical education and in supervision of public health. There is no question but that the new government will move rapidly in this direction and that the institutions now at work and many others will be needed to coöperate with those that the government will establish to train physicians and public health officers for new China.

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