The Practical Application of the Röntgen Rays in Therapeutics and Diagnosis. By William Allen Pusey, A. M., M. D., Professor of Dermatology in the University of Illinois; and Eugene W. Caldwell, B. S., Director of the Edward N. Gibbs Memorial x-ray Laboratory of the University and Bellevue Hospital Medical College, New York. Second edition, thoroughly revised and enlarged. Handsome 8vo volume of 690 pages, with 195 illustrations, including four colored plates. Philadelphia, New York, London: W. B. Saunders & Co. 1904. (Cloth, $5.00 net; sheep or half morocco, $6.00 net.)

LITERARY NOTE.

THE Medical Book News, published by P. Blakiston's Son & Company, Philadelphia, with the issue for July, 1904, makes the change from a bi-monthly to a monthly periodical. New departments have been added, illustrations introduced and other improvements made that will tend to increase the general worth and utility of this magazine. The subscription price has been raised from 25 cents to 50 cents a year.

ITEMS.

CIVIL SERVICE EXAMINATIONS FOR THE STATE AND COUNTY SERVICE. The state civil service commission announces general examinations to be held September 10, 1904, including the following positions: apothecary in state hospitals and institutions; architectural draughtsman; assistant steam engineer, Erie county service; bridge draughtsman; clerk; junior clerk; fireman; librarian, court of appeals library, Syracuse; physicians in state hospitals and institutions of both regular and homeopathic schools: trained nurse in state hospitals and institutions; women officer in houses of refuge and reformatories for women.

Applications for these examinations must be made on or before September 3. Full particulars of the examinations and application blanks may be obtained by addressing the Chief Examiner of the Commission at Albany.

THE Wabash railroad offers exceptional facilities for visitors to the World's Fair. The rate from Buffalo, for a fifteen-day limited return ticket is $19.75. The Wabash lands the traveler at the fair grounds or at the Union station at Saint Louis, as may be preferred, and furnishes en route first-class Pullman car service, chair cars and a la carte restaurant service on splendid dining cars. Physicians of Buffalo contemplating a visit to the fair, should interview the Wabash representatives before purchasing tickets.

BUFFALO MEDICAL JOURNAL.

VOL. XLIV.-Lx.

OCTOBER, 1904.

ORIGINAL COMMUNICATIONS.

No. 3

T

Chinese Doctors and Medical Treatment.

BY MRS. J. F. BISHOP, F. R. G. S.

HERE are many horrors and barbarities, coupled with much gross ignorance and superstition, to be found in Chinese medicine. Its theories have an extravagant and fantastic basis. Nothing sound can be built upon them, and at the back of all lies. a belief in malignant demons as the source of disease tending, as is usual in the East, to exorcisms and incantations as a last

resort.

But while sketching a system which on the whole merits to be supplanted, as much on the ground of chicanery and fraud with which it is interwoven as for more obvious reasons, I must not be understood as condemning the whole practice of Chinese medicine, for as men are often better than their creeds, so, often, is the practice of the Chinese doctor better than his theory. For instance, he knows the virtues of many of the valuable native herbs, especially in fevers; he realises the worth of counter irritants, and in some cases even uses the cautery successfully. He knows to some extent Chinese constitutions and what they wil bear, and it may at least be said of him that, however bad his system is, it has not arrested the increase of his race. drop lies and humbug, parts of his treatment are not reprehensive. China claims to have a science of medicine dating from the haziest antiquity and medical works dating from a time long antecedent to the Christian era. A book in twenty-four volumes on "Internal Diseases and the Practice of Amputations," was written before the dawn of authentic history, and a work on eighty "Difficult or Doubtful Medical Questions," was completed in the third century, A. D., on which eleven commentaries were

1.

If he would

At the present time Chinese doctors rarely, 1 ever, amputate, an unless they have had

foreign instruction do not know how to tie an artery.

written before the fourteenth. A noted court physician published a work on the "Pulse" in A. D. 290, which has gone through many subsequent editions, and is greatly valued. A work on the "Eye and Its Diseases," appeared in the tenth century. A six volume work on fevers followed, which was succeeded in the thirteenth century by one on the "Diseases of Women," in twentyfour volumes, which appears at intervals even now in abridged editions. In the same century a twelve-volume treatise on fevers “came out." In 1340 a work in twenty volumes appeared, taking the wide range of the "Diseases of the Large and Small Bloodvessels, Nervous Diseases, Midwifery and Women's Diseases, Diseases of the Mouth, Teeth, and Throat, and the Treatment of Fractures and Arrow-wounds." About 1360, works were written by two doctors of renown on fevers and skin diseases, and apoplexy followed a little later.

The opus magnum of Chinese medical literature is, however, a highly esteemed work written by Chu Su, an Imperial Prince of the Ming dynasty, in one hundred and sixty volumes, containing two thousand lectures on about the same number of subjects, two hundred and forty diagrams, and about twenty-two thousand prescriptions. A famous "Materia Medica," in fifty-two books was compiled in the sixteenth century, from the works of eight hundred authors, but it only gives eighteen hundred and ninety prescriptions. In 1602 a work in one hundred and twenty volumes on "Fevers, Ulcers, and the Diseases of Women and Children," was published, succeeding an important one on hygiene in 1591. The latter treats of diet, drink, regimen, amusements, rest, study, proper clothing and how to prevent disease and live virtuously.

About the same time several short treatises on "Children's Diseases," with rules for their treatment appeared, together with a work on "Acupuncture," with a number of diagrams, in seven volumes. In 1674 an important work in eight volumes on the "Diseases of Maternity" was published and in 1684 another on the same subject, to which was added the management of children. Six volumes on eye diseases, several works on smallpox and two on cholera were published during the period of the Ming dynasty. In the latter half of the sevententh century famous works on the properties of drugs and on saving life in cases of attempted suicide and accident, were published. The most complete of modern Chinese works on "The Practice of Medicine,” in ninety volumes, was put forward in 1740. It contains many plates and diagrams, and a praiseworthy and rigorous attempt to classify diseases.

The late Dr. Henderson, of Shanghai, and Dr. Hobson, to

whom I am largely indebted give very lengthy lists of Chinese medical works. The above are only a few of the most celebrated.

Besides these renowned works there are a number of general and special treatises which carry much weight in China, all showing that whatever the quality may be, quantity is not lacking.

As to the quality those Englishmen and Germans who have stuclied Chinese medical literature testify unanimously that on the whole it is inconceivably deplorable. They have some anatomical diagrams, it is true, but so competent an authority as the late Dr. Lockhart says of these:

They are just as if some person had seen an imperfect dissection of the interior of a human body, and then had sketched from memory a representation of the organs, filling up parts that were obscure out of his own imagination, and portraying what, according to his own opinion, the parts ought to be, rather than what in reality they are.

Dr. Henderson sums up the worthlessness of this great body of professedly scientific literature thus:

In all their writings there is no evidence of disinterested industry, or yearning after knowledge or more light-their best theories are based upon empty speculations and wild fancy-in their endeavors to support what they consider consistency and harmony in their system of physics, they sacrifice not only truth, but also intelligibility and reason. In many of their writings their aim seems to be to make every subject as mysterious as possible, professing to admire and reverence most that which is least known and understood. In none of their works is there any evidence that human dissection was ever practised, so that both human and comparative anatomy are utterly unknown.-Royal Asiatic Society's Journal, North China, 1864.

Chinese medical science makes no distinction between veins and arteries, nor, consequently between venous and arterial blood. Of the functions of the brain, heart, lungs, liver and kidneys, the doctors know literally nothing. They believe that the human soul resides in the liver, and from this organ emanate all great and noble purposes. The gallbladder plays very important part in their theories. It is the seat of courage; its size determines the boldness or timidity of any character, and its ascension in the body is the cause of anger. As the Chinese eat stag and rhinoceros horn and the dried blood of tigers to increase their courage, so they sometimes procure the gallbladders of bears, tigers, and

1. May the expression "white livered," to describe cowardice, be traced to the same belief? (This is undoubtedly true, as the Chinese belief is that a coward's liver is bloodless, hence white.

ED.)

even of notorious bandits who have been decapitated for their crimes, and eat them with the same object in view.

Chinese science regards man as a little universe, and the human body as composed of five elements-fire, water, metal, wood and earth connected in a mysterious manner with five solid viscera, five plants, five tastes, five metals, and five colors. Diseases are regarded as being due to a derangement in the balance of the five elements, and successful medical treatment consists in restoring their equipoise.

There are beside certain mysterious dual powers, sometimes called the male and female elements in nature the yin and yang, represented under a double comma-figure familiar to all travelers in China and Korea, which pervade animate and inanimate nature, as strength and weakness, earth and heaven, light and darkness, on which medicines are believed to have a corrective and ofttimes a powerful influence. These interlocked commas are used on terminal tiles, priestly vestments, temple drums and other sacred instruments, and on much besides.

Chinese doctors are ignorant of the manner of the circulation of the blood, of the function of the heart, and of the change which the blood undergoes in the lungs; and some of their diagrams represent tubes taking their rise in the fingers and toes, and runing up into the trunk, where they are either lost, or wander aimlessly about till they find their way into one of the larger organs. Though ignorant of the circulation of the blood, they believe that it is necessary for life that the whole body should be irrigated with it.

Chinese doctors state that the whole superstructure of medical science depends upon having a correct theory of the pulse, yet they know not what causes pulsation. They believe that man has twelve pulses, corresponding to twelve organs of the body, two of which have no existence. Three of these pulses are situated above, and three below each wrist; and it is necessary for ascertaining the nature and result of disease (diagnosis resting. solely on the study of the pulse) to feel both wrists; and the Chinese physician lacks words to express his astonishment at the foreign physician, who is so ignorant of the first principles of his profession as to feel only one. The rules for this important operation (translated by Dr. Hobson) are many and elaborate and the foundations on which they rest indicate their value.

Each season of the year has its proper pulse. In the first and second moons the pulse of the liver, answering to wood is "long and tremulous"; in the fourth and fifth the pulse of the heart corresponding to fire, is "overflowing;" and in the third, sixth, ninth and twelfth, the pulse of the stomach, which answers