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the living. The surgical practice has consisted almost entirely of external applications. Tumours and boils are treated by scarification or incisions. Asepsis is absolutely unknown among the Chinese doctors. Most of us who have seen the application of Chinese plasters will realise how septic they are. These plasters vary greatly in composition. They are applied in cases of skin diseases, sprains, abscesses, swellings of all kinds, ulcers and so on. The on'y Chinese surgeon worthy of any note was Hua Tu (#) who lived at the time of the "Three Kingdoms." He treated fractures and performed minor operations, and as far as we know he was practically the only Chinese doctor who had often recourse to his knife. The distinctive Chinese surgical invention, as the Encyclopædia Britannica gives it, is acupuncture, or the insertion of fine needles of hardened silver or gold for an inch or more, (with a twisting motion) into the seats of pain or inflammation, and 367 points are specified where needles may be inserted without injury to great vessels or vital organs. Headaches, lethargies, convulsions, and colics are thus treated. In some cases, the needle is allowed to remain in the part for several minutes, or in some cases of neuralgia for days. Rheumatism and chronic gout are among the localised pains so treated. Sometimes while the needle is left inserted in the part, moxa is burnt at the other end, with great advantage.

Chinese medicine, as I have just related, made little progress during the last few centuries. "The Chinese physicians are supposed to be able to find out by their touch not only that the body is diseased but also from what cause or what part the sickness proceeds. To make themselves masters of this skill, they must explore men's pulses till they become as well known and as familiar to them as a violin or fiddle is to the players thereon; it not being enough for them to know that there is something amiss which spoils the tune, but that they must also know what string it is which causes that fault." The Chinese physicians claim that there is a different and distinctive pulse for every part of the body which is felt on both wrists. They divide the superficial part of the radial artery into three parts. The distal third is called ts'un, (f) the proximal third ch'ih, (R) and the part in between the two kwan, () They consider that the left ts'un has its pulse influenced by the heart, the left kwan by the liver, and the left ch'ih by the small intestine, the kidney and the bladder. The right hand, on the other hand, is different; the ts'un has its pulse influenced by the lungs, the kwan by the spleen and stomach, and the ch'ih by the kidney and large intestine. The technique for feeling the pulse, as is given in the medical books, is as follows:-The patient, if possible, should be asked to sit up. He or she should not be allowed to move or speak too much as this will disturb the pulse. The doctor then

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puts his middle finger just proximal to the styloid process of the radius to locate kwan, beginning always with the left hand in the case of males and the right hand in the case of females. He then proceeds to locate ts'un and ch'ih. First he should touch the artery but lightly to find what they call the "superficial pulse" and then somewhat harder to find the "middle pulse," and then he should press the artery hard against the bone and then release very slightly to find the "deep pulse." He will then release two of the fingers to find what is wrong with the third, and this he repeats until he has determined which part of the body or which organ is diseased. The nature of the pulse varies according to the sex, age, and condition of the patient and to the season of the year, and it is classified into 28 different kinds according to whether they are slow, rapid, weak, hidden, diffuse, tight, long, short, fine, thready, overflowing, irregular and so on. Diagnosis depends more or less on the determination of these different kinds of pulse.

It will thus be seen that a Chinese doctor has got very few things to trouble about for his information with regard to the condition of the patient. Having felt the sick man's pulse, looked at his tongue, and otherwise observed him, he has finished his diagnosis, and must prescribe accordingly. The doctor, if he is a good one, or at least, if he professes to be a good one, should ask the patient very few questions. So important is the pulse in Chinese medicine that the diagnosis, prognosis, and treatment of of every disease rest entirely on it. The man's body is said to be composed of the five viscera which partake of the nature of the Five Elements, i.e. metal, wood, water, fire and earth, and these they connect with the Five Tastes, Five Colours, and the Seven Passions: diseases are produced by a disturbance in the balancing of all these elements. The disturbance may be due to dampness, exposure to the sun's rays or wind or to too much internal heat. There are many elaborate theories as to the behaviour of the pulse and breath, mostly based on the Yin-yang doctrine, but these I do not propose to touch.

The materia medica of the Chinese embraces a vast collection of drugs belonging to the animal, mineral and vegetable kingdoms, into which they are classified. Of all drugs, ginseng (A) is the most celebrated. It is employed in cases where virile power fails as in the aged and debilitated. The Chinese attribute many virtues to this drug and its use as a tonic is known all over China. In all cases of severe disease and debility the Chinese fly to this remedy, hence its enormous consumption every year. Pan-hsia (4) is said to be antifebrile and tussic and is administered in fevers, jaundice, and bronchial

catarrh. The prepared drug, according to Dr. Stuart, has been used to substitute sulphate of potash in some mission hospitals in the preparation of Dover's powder. Huang lien() is a bitter and is often used in dysentery, gastro-intestinal disorders and in diabetes. When mixed with borax and given to newly-born infant, it is said to prevent aphthae. The tincture of the drug is of use where bitters are wanted. Rhubarb () is very much used in fever, diarrhoea, colics and constipation. In addition to its purgative properties, the Chinese regard it as a general tonic to the digestive tract. Menthol is found in Chinese markets under the name Lung-tan ( ). It is recommended in fevers, rheumatism, and general debility. Locally it is used in skin diseases, ulcers, and in affections of the throat. Aconite, of which several species are met with in China, is used in fevers, ague, rheumatism, neuralgias and all sorts of painful conditions. Chaulmoogra oil () has been used in China in the treatment of leprosy as far back as the twelfth century and Pents'ao () gives a description of the method of preparing the oil. It is also recommended for impetigo, psoriasis, syphilis, and scabies. Pents'ao, a voluminous work, has pictures and descriptions of each of the drugs which amount to 1882 in number. Generally speaking, these drugs fall under three headings:

(1) Quite a number of these drugs are standard western
drugs. These include senna, camphor, aloes, cinnamon,
cloves, rhubarb, aconite, benzoin, menthol, croton oil,
nux vomica, stramonium, cardamon, linseed, castor oil,
ginger root, myrrh, musk, mustard, and many others.
(2) This class constitutes those which have proved to be
satisfactory substitutes for western products.

(3) This class comprises those which are of no or doubtful
therapeutic properties.

I have dealt with the question of drugs and I feel that this is the most hopeful part of Chinese medicine. It is my belief that some of the remedies at least, which have been used by the Chinese for many centuries, may, when scientifically approached, be found invaluable and help to meet the world-wide needs of the sick. The subject will no doubt prove to be a big and fascinating field for research. Tang-kuei (), long used by the Chinese as a remedy in menstrua!, chlorotic and puerperal diseases of women has been found valuable in the treatment of menstrual disorders. Kaolin (), an old Chinese remedy, is still used in western medicine for diarrhoea; while chaulmoogra oil is now universally recognised as the specific for leprosy. Modern research will no doubt add many more to the list. In this connec

tion it is worth noting that medicine in Japan, according to most authorities, was first introduced from China, and as you know, the Japanese have analysed many of the drugs and tested them chemically and physiologically. It is not until we, the Chinese, begin to treat the subject in a scientific way, like the Japanese, can we ever hope to contribute something to the medical world.

It is perhaps not within the scope of this paper to describe many of the medical superstitions of China, but they are so closely connected with the healing art that it would not be out of place to mention just a few. The ignorant class, which unfortunately still form a great majority of the populace, hold that disease is caused by the anger of an offended demon or of offended dead persons. They believe that all bodily and mental disorders spring either from the air or spirits. In association with this belief is the wearing of amulets and charms as an imagined protection against disease, accidents, or other evils. When sick, the Chinese often have recourse to some deity, who is supposed to have caused the illness. Among the literary men one practice used to be very popular. The physicians said that some diseases were incurable save by a broth made from human flesh cut from the arm or thigh of a living son or daughter of the patient. In the Ching Dynasty, we find several instances of boys and girls multilating themselves in this way in their endeavour to save their parents' lives. It was believed that filial piety, in its sincerest form, as is the case of cutting one's own flesh, could move the will of God. It was essential in all such cases that the recipient should be kept in profound ignorance of the nature of the potion thus prepared, and in no case was the operation to be performed for an inferior. The doctrine of signatures also comes in very largely in Chinese medicine. Pents'ao, the only authoritative work of materia medica in the Chinese language, describes the virtues of many of the drugs as resembling the external appearance and source of the substance. Thus ginseng, owing to the peculiar shape of the root, like the body of a man, is supposed to give power and strength to the aged and sick. Examples of this are many.

I cannot allow myself to talk too much on the question of medical superstition, but it is really a shame to think that so many of the Chinese are still holding these primitive ideas as if they were still living in the dark ages. There are few sights in the world more pathetic to the intelligent on-looker than one that can be often seen in this Colony. It is that of a frenzied Chinese mother, beating, with sticks, the garment of a sick child, and repeating incantations to drive away the evil spirits from the garment. It would be easy to multiply examples of the way in

which such superstitions cause suffering. Suffice it to say, that in China, there is a great opportunity for the spread of scientific methods in medicine. China is looking towards the younger generation for her salvation, and it is our bounden duty to her to open up the minds of her ignorant, and to alleviate their suffering by bringing to them the Gospel of health.

There are two very striking facts in the Chinese medical profession: (1) There are no medical schools, the profession being hereditary, receiving very few recruits from outside. (2) There are no hospitals. The Chinese consider it would be a neglect of the duty to send any of their people when sick to such institutions. Chinese doctors are not held in high esteem in the eyes of the public. In China, too, it is perfectly free for anybody to practise medicine and there is practically nothing to check quackery. The physiological and pathological speculations are very franciful and complicated, hence it is very difficult to read the medical books. The scientific investigation is almost wholly restricted to the study of the writings of the ancient exponents of the art. Independent inquiry, the direct appeal to nature are, however, discouraged, and indeed looked upon with the utmost distrust. This spell of ancient authority is not broken even now, and people are still hunting for what they call the "ancient prescriptions."

I have endeavoured, as far as I can, to give you a rough idea of what Chinese medicine is, and I have to leave you to yourselves as to the criticism with regard to its present state. To sum up, there are several reasons why Chinese medicine has not been able to make any improvement. (1) The ignorance of the structure of the human body leads to imperfect speculations. (2) An unreasoned reverence for authority prevented any real progress. Kept back by these fixed ideas, its freedom is restricted on every side. (3) Students of western medicine who have been thoroughly trained in the sciences of anatomy and physiology never care to read over their own medical literature, and many of them are entirely ignorant of the ideas of their brother practitioners in Chinese medicine. These two classes of people will therefore never meet, and Chinese medicine has remained and will remain the same as it was five or six hundred years ago.

The fact that much of Chinese medicine at present is mere superstition cannot be denied. The most judicious remark we can make is found in the following statement made by M. Huc. He said, "Notwithstanding all this quackery, there is no doubt that the Chinese doctors possess an infinite number of valuable recipes, the result of long xperience. It is perhaps too rash to imagine that medical science has nothing to learn from the

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