TABLE OF CONTENTS

PART I.

REPORTS OF CANTON HOSPITAL NO. 1 to 11
from Nov. 4th. 1835 to June 17 1840.
copied from the Chinese Repository.

PART II.

1. EXTRACTS FROM THE "MEDICAL MISSIONARY IN CHINA"
by William Lockhart.

2. MEDICAL MISSIONARY SOCIETY REGULATIONS AND RESOLUTIONS, 1838

3. FIRST REPORT OF THE MEDICAL MISSIONARY SOCIETY'S HOSPITAL AT MACAO.

4. FIRST ANNUAL REPORT OF THE MEDICAL MISSIONARY SOCIETY IN CHINA, 1838.

5. INQUEST ON A DEAD PATIENT.

6. REPORT OF MEDICAL MISSIONARY SOCIETY, 1839.

7. SECOND ANNUAL REPORT OF THE MEDICAL MISSIONARY SOCIETY IN CHINA, 1841.

8. REPORT OF MEDICAL MISSIONARY SOCIETY 1843
Report of Dr. Hobson.

Ophthalmic Hospital at Canton; first quarterly report, from the 4th of November 1835 to the 4th of February 1836. Conducted by the Rev. Peter Parker, M.D. The Chinese Repository. Vol. IV. Page 461.

(We have been asked repeatedly, how the hospital is supported? In reply we stated, its pecunia ry responsibilities have been assumed by Dr. Parker, in behalf of the A. B. C. F.M. the benevolent society, under the auspices he came to the East. Dr. P. receives no sa lary, or any aid except so much as is unnecessary to defray his own expenses and those of the hospital: the latter, for the quarter, were $454,84. Several generous donations for the support of the institution have been received from benevolent person in Canton. It is known that many others are also desirous of aiding in the same way. We are requested therefore, to state that such donations will be thankfully received by Dr. Park er andthe Editor of the Chinese Repository in Canton, and by Dr. Colledge in Macao; and that all the sums received shall be duly ac knowledged, and carefully appropriated to the support of the hospital.

It is designed to make the institution permanent, and hoped that it may increase in usefulness as it advances in age. The number of blind among the Chinese is very great. Not long ago we ascertained from official records that there were in and about this city 4750 blind persons. This number could not, we suppose, have included one half of those who have diseased eyes.- By a letter which has just reached Canton, we have formed that a Dispensary for the benefit of the sick and afflicted has recently been opened at Bankok in Siam by D.B.Bradley, M.D. It is stated in the letter that the number of patients often exceeded one hundred a day. However, this <u>tum boon</u> doing good every day, being "contrary to the laws of the Siamese empire", has been interdicted, but was likely soon to be resumed.)

Encouraged by the success of a dispensary at Singapore for the benefit of the Chinese, where, from the 1st of January 1835 to the following August, more than one thousand were received, it was resolved on my return to Canton, to open a similar institution here. The successful experiments made byxMr. doctors Pearson, Colledge; and others, both atx Canton and Macao, left no doubt of the feelings with which the Chinese would welcome such an attempt. After some delay, the factory No.7 in Fungtae hong was rented of Howqua, the senior member of the cohong, at $500 per annum. Its retired situation, and direct communication with a street, so that patients could come and go without annoying foreigners by passing through their hongs, or excite the observation of natives by being seen to resort to a foreigner's house, rendered it a most suitable place for the purpose. Besides a large room in the second story, where two hundred may be comfortably seated and prescribed for, the house can afford temporary lodgings for at least forty patients. The dense population of Canton rendered it probable that a single class of diseases of <u>prandial interest</u>, <u>membranous</u> would furnish as many applicants as could be treated and accommodated, however it was designed to admit exceptions in cases of peculiar interest, and promise. Diseases of the eye were selected as those the most common in China; and being a class in which the native practitioners are most impotent, the cures, it was supposed, would be as muchappreciated as any other. the antici pation that a single class of diseases would furnish full employment for one physician was soon realized, and patients in great numbers have been sent away because no more could be received at that time. As will appear from the report, a case of peculiar interest directed my atten tion to the ear, and this fact was construed by many into a treit con sent to treat them for maladies of that organ. The dumb also have applied for aid

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<table><tbody><tr><td>Adipose or fleshy thickening of Cornea</td><td>14</td><td>Cancer of the Breast</td><td>1</td></tr><tr><td>Staphyloma.</td><td>39</td><td>Cancer of the face</td><td>1</td></tr><tr><td>" sclerotica</td><td>3</td><td>Necrosis of the lower jaw.</td><td>2</td></tr><tr><td>Onyx</td><td>6</td><td>Juxation of the lower jaw.</td><td>1</td></tr><tr><td>Iritis</td><td>29</td><td>Disease of the lower jaw with great tumefaction.</td><td>2</td></tr><tr><td>Synechia Anterior</td><td>8</td><td>Benign polypus of the nose</td><td>1</td></tr><tr><td>Synechia posterior</td><td>9</td><td>Malignant polypus of the nose.</td><td>1</td></tr><tr><td>Myosis</td><td>6</td><td>Curvature of the spine with paralysis</td><td>4</td></tr><tr><td>Mydiasis</td><td>8</td><td>Phymosis</td><td>1</td></tr><tr><td>Closed pupil with deposition of lymph.</td><td>12</td><td>Fistula in ano</td><td>4</td></tr><tr><td>Procedentia iridis</td><td>2</td><td>Cauliflower exrecescence of uterus</td><td>1</td></tr><tr><td>Glaucoma</td><td>5</td><td>Sarcomatous Tumor</td><td>4</td></tr><tr><td>Night Blindness</td><td>5</td><td>Incisted Tumor</td><td>1</td></tr><tr><td>Day Blindness</td><td>8</td><td>Imperforate auditory foramen.</td><td>2</td></tr><tr><td>False Vision</td><td>2</td><td></td><td></td></tr><tr><td>Exophthamia</td><td>2</td><td></td><td></td></tr><tr><td>Sclerotitis</td><td>2</td><td></td><td></td></tr><tr><td>Chloriditis</td><td>2</td><td></td><td></td></tr><tr><td>Hydrops oculi</td><td>3</td><td></td><td></td></tr><tr><td>Atrophy.</td><td>10</td><td></td><td></td></tr></tbody></table>

Table showing the number of patients, 1st, under 20 years of age; 2 between twenty and thirty; 3rd, between thirty and forty; 4th, between forty and fifty; 5th, those over fifty years of age; 6th, the Youngest; 7th the oldest. 8th the males, 9th the females.

<table><thead><tr><th>Diseases.</th><th>Under 20 years</th><th>20-30</th><th>30-40</th><th>40-50</th><th>Over 50 years</th><th>Youngest</th><th>Oldest.</th><th>males.</th><th>Females.</th></tr></thead><tbody><tr><td>Amaurosis</td><td>3</td><td>9</td><td>16</td><td>14</td><td>8</td><td>9</td><td>60</td><td>36</td><td>14</td></tr><tr><td>Acute Ophthalmia</td><td>6</td><td>16</td><td>22</td><td>11</td><td>13</td><td>10</td><td>65</td><td>-</td><td>-</td></tr><tr><td>Chronic ophthalmia</td><td>3</td><td>1</td><td>16</td><td>8</td><td>11</td><td>4</td><td>68</td><td>-</td><td>-</td></tr><tr><td>Ophthalmia</td><td>1</td><td>4</td><td>4</td><td>2</td><td>1</td><td>13</td><td>52</td><td>-</td><td>-</td></tr><tr><td>Purulent ophthalmia</td><td>10</td><td>4</td><td>2</td><td>1</td><td>4</td><td>*</td><td>66</td><td>-</td><td>-</td></tr><tr><td>Conjunctivitis</td><td>2</td><td>2</td><td>5</td><td>2</td><td>2</td><td>6</td><td>63</td><td>-</td><td>-</td></tr><tr><td>Ophthalmia tarsi</td><td>7</td><td>2</td><td>6</td><td>3</td><td></td><td>7</td><td>44</td><td></td><td></td></tr><tr><td>Cataract</td><td>2</td><td>2</td><td>2</td><td>6</td><td>46</td><td>49</td><td>78</td><td>32</td><td>24</td></tr><tr><td>Entropia</td><td>3</td><td>7</td><td>10</td><td>20</td><td>47</td><td>14</td><td>67</td><td>58</td><td>19</td></tr></tbody></table>

A few of the more important cases may be given in details. The num- bers refer to the order in which they were presented and enrolled at the Hospital. Previous to opening the hospital one case of imperforated ears came to my knowledge, which I here introduce.

* 3 months.

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Akew, age 17. This Youth was born with no external ears, if we except a slight perpendicular cartilaginous ridge, which merely marked the place of the year. No indentation whatever indicated the situation of the auditory foramen, which was concealed by the common integuments. Though not totally deaf, it was but very indistinctly that he could hear a loud voice. The fact that he could hear at all, by opening his mouth wide, was presumptive evidence that the internal organs was perfect, and that to render the hearing so, it was necessary to perforate the integuments so as to admit the air to the tympanum. At his own request and that of his parents, I resolved on preforating one ear. The trochar would have been 9/16-inch least painful and most expeditious means, but I preferred the caustic potassa for its safety and its accordance with the Chinese prejudice in favor of the cautery. As soon as the slough from the first application of the caustic was removed, I have the satisfaction to find that the hearing was surprisingly improved. The same operation has been often repeated; their obstructions being found much deeper than were anticipated. The perforation has extended through two layers of cartilage, which appear to be the proper cartilage of the external ear convoluted upon itself. The artificial orifice has been made to the depth of an inch, but no cavity has been reached. Coniderable difficulty has existed in keeping it from filling again with granulations. By means of a silver tube of the size of the natural foramen, I hope to preserve the aperture. Since the operation, the youth is able to hear even a mixter whisper, and both himself and his relatives have exhibited their gratitude for the benefit. also his parents, grand-parents, and other conexions have applied for medical aid.

No. 31, N ovember 9th. Chronic iritis with deposition of coagulable lymph. Chang she, a female aged 50. Her disease supervened upon the disappearing of an affection of the breast one year ago. She was just sensible of the clear light of the sun, when she entered the infirmary: little encouragement was held out to her, but the same time she was offered the only chance of recovering sight. Treatment. She commenced immediately with alternate doses of blue pill, with daily applications of belladonna to the eyes, and subsequently calomel conjoined with opium, till full ptyalism was produced. After the lapse of some time without any perceptible benefit, she inquired why others who came after her had been restored to sight while she remained the same. Being answered that her disease was very bad and required at time to cure, she was content to be cured. Upon the 19th of November, the patient told me that a similar sensible improvement in her vision had taken place. The mercurial action was still kept up, and on the 28th, an issue opend in her arm, and vision improved so as to distinguish colors; and on the 2d of January, she could tell the number of fingers held before her face, and her countenance had no longer the vacant and downcast look of the blind, but the lively expression of one conversant with external objects. The dence coagulable lymph in the pupil, before nearly closed, and now dilated nearly to its natural size. Several other cases of similar character have been materially benefited by the same course of treatment. No 59, Nov 11th. Ulcer of the crystallinous lens, through 30, dehiscence of the epithelium, on the surface of the lens. It resembled the small deep-seated ulcer of the cornea, with its edges well defined. Four or five similar cases have occured, and in one instance the speak varied its apparent position at every motion of the eye, indicating that the lens and its capsule were not fixed in the vitreous humour, but performed partly -alrevolutions. The vision in each case was affected, but not destroyed, an affection of which I have neither read nor seen before. Probably it will terminate in capsular cataract.

No. 75, Nov. 12th. Staphyloma sclerotica. Asuy, aged 17. One year since, after spending the whole night at a singsong, in the morning he was suddenly seized with violent pain in the left eye, which continued through the day, when he came to the hospital, it appeared at first sight like a tumor of the lid, but on examination, I found it to be staphyloma of the sclerotica. By repeated punctures, in about six weeks

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the staphyloma was completely cured. Adhesive inflammation was excited, and the sclerotica and choroid again firmly united, - By the same process of repeated puncturing, essential benefit has been gained in cases of common staphyloma, and in one marked case of hydrops oculi.

No.198, Nov. 17th. Akeen, a merchant aged 31. He had an effusion of blood in his right eye, with yellow discoloration of the aqueous humor, leaving the pupil just discernible. There was also a turgid appearance of the left eye. The patient, as he stated, took cold several months before at the feast of the tombs, when his eye became affected: he was otherwise very badly diseased. The following extract from my journal contains the sequel of his case. " Dec. 29th. Today Akeen has been discharged from the institution as incurable. He came perfectly blind: I gave him but little encouragement that he would ever see again, but expressed an opinion that the effusion of blood might be absorbed, and the humors cleared. This has been affected by mercury, blisters, on the back of his neck, and his forehead, and an issue in his temple, and discloses that the iris is quite disorganized. The patient manifested much gratitude for what had been done in the improvement of his health, and for the attempt to restore sight. - It was a remark of one my respected medical preceptors to his students that when the materia medica of earth failed, they might yet point his their patients to that of heaven. I have experienced this satisfaction today, in the case of this young man. His eyes suffused with tears as I took him by the hand, and with several Chinese listening, told him through my interpreter of the world in which he may see, though never again on earth: that in heaven none are blind, none deaf, none sick, I also endeavoured to point out the way for him to find admittance there".

No.210. Nov, 20th. Cataract of both eyes. Also, aged 48, a rich merchant. This patient was a stout and corpulent man: the cataract of both eyes commenced about one year ago, and three months since, he lost nearly all sight. Treat, R. Cal. and jal. a a grs.x. at night; sulph.mag.oz.j. in morning. Meat, wine, tobacco and opium forbidden. On the 24th, the patient complained of dizziness, when he was ordered, R. Pill, hydrarg.grs.v, at night and sulph.mag.oz. j. in the morning. Next day, no vertigo, applied belladonna to his lids. R. Tart. ant.gr.j. given in one-fourth grain powders every two hours. November the 26th. The belladonna was reapplied in the morning, and I couched his left eye in the afternoon. On removing the cataract, he exclaimed" red faces, red faces" referring to the Europeans in the room. The pupil appeared beautifully clear and black. Tow hours after the operation, I took away sixteen ozs. of blood. At 11 p.m. bilious vomiting commenced. Gave R. Laudanum dr. ss.spts. camphor 20 drops, with sweetened water. He drank one half and the vomiting was allayed, but recurred the next morning, when he took at once, R. Castor gr.v. opii,gr.j. and wine ozs.j. A sinipism was also applied to the breast, the vomiting was immediately arrested, and did not return. The third after couching, I had the satisfaction to find but slight inflammation had attended the operation, and that the patient to his great joy could distinctly see objects both near and at distance. The change in his appearance and feelings was very marked. He countenance on which the shades of sadness and gloom had sat, now rekindled with its natural vivacity. A few days ago unable to walk except he was led or groped by the side of the wall but now never he could go where he pleased, he rejoicing to behold the faces of his friends and the light of the day.

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I am particular in the detail of this case, because it may serve to illus-
-trate many others that are similar. Though upwards of fifty cataract pat-
-ients have presented themselves, yet the age, ill-health, or other circums-
tances of several have prevented operating on more than about thirty. On
one occasion I couched eight patients in the same afternoon, to five
of whom vision was immediately restored, and the others, after the absorpt-
ion of the lens took place. At the request of several patients both their
eyes have been operated upon at one sitting, and with one little apparent
little inconvenience. Bleeding has been arther the exception than a gener
al rule in my treatment, the symptoms ordinary not requiring it billious
vomitting has been by no means of consequence of couching. In several inst
ances it has been occasioned to the patients the loss of one hours sleep;
and often the inflammation has been so slight, that after three or four days
the puncture of the needle has been so slight scarcely preceptible:-
A striking argument in favor of a simple mode of living. There have been
also two painful exceptions to the success of these operations, arising fr
om inflammation, which it was impossibel to fore see or to arrest. In each
case, however, the other eye was so much improved that the patients on a
whole were no losers.

No.446, Dec 27th. Sarcomatous tumor. Akae a little girl aged 13. As I was closing the business of the day, I observed a Chinese advance timidly to the hospital leading his little daughter, who at first sight appeared to have two heads. A sarcomatous tumor projecting from her right temple, and extending down to the cheek as low as her mouth, sadly disfigured her face. Over hung the right eyes and so depressed the lid as to exclude the light. The paratoid and also its accessory gland was very much enlarged. This large tumor was surrounded by several samller and well defined ones, the principle of which lay over the buccinator muscle. Slight prominences on other parts of the body indicated a predisposition to tumors, which I have since learned it was hereditary. The mother presents a most singular appearance, from birth being covered with small tumors, some in size of large warts, and others hanging pendant in shape and size like the finger. Akae is the only of her four children thus afflicted. The general health was some what deranged, the tongue foul, the pulse being frequent and feeble, and the heat of the tumor have the heat of the natural temperature of the system. The blood vessell passing over it were much enlarged. The weight accelerated its growth, and occasioned pain at night in the integuments around its base. The child complained of vertigo, and habitually inclined her head to the left side. According to the statemnet of her parents the tumor was excited into action by small pox which the child had four years since, but within the last four months that attained three fourths of its present magnitude. The child was put under medical treatment for a month, during which her health decidedly improved. From the first it appeared to me possible to remove it, yet possibility of an unfortunate result, or even of the child's "dying under the knife" the operations of the hospital hthereby interrupted or broken up, did not escape my thoughts. On the other hand, however, it was in case it was presented in devine providence, and it was evident that left it to itself the tumor might terminate the life of the child, and from the accompanying symptoms, before a great length of time. The surgical gentleman whose council I was so happy as to enjoy were all agreed to the expedency of its removal, yet with all its circumstance they reguired it a formidable case. Though in a Christian and enlightened land the surgeon might have undertaken it withoutembarrassment, it was not so here. Having often it in secret as well as in concert with other commented to the child to the great Physician, I resolved upon the undertaking, with precaution of procuring a written instrument and signed by both parents stating the case, that the operation was undertaken at their own desire, and that they would exculpate me from censure, if the child should die in consequence in the attempt. Even the burial of the corpse was a subject of forethought and agreement with the father.

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On the 19th January, with the signal blessing of God, the operation was preformed. Theserenity of the sky after several days of continued rain, the presence and assistance of several surgical gentlemen, and the fortitude of a heroine with which the child endured the operation, call for my most heart-felt gratitude to the giver of all mercies. A few days previous to the extirpation, an evaporation lotion of nit. pottassa was applied to the tumor. An opiate awl given fifteen minutes before, and wine and water in the operation. The patient cherfully submitted to be blind folded and to have hands and feet confined. The extirpation in eight minutes. Another small tumore of the size of the filbert was also removed from under the eye-brow. The loss of blood was estimated to be about 10 or 12 ounces., Not an artey required to be taken up. She vomited but did not faint. The tumor weighed one pound and a quarter. The circumference at its base was sixteen inches and three quarter, and the length of the incision from the top of the head to the cheek, ten inches. On opening it I saw portions of it becoming blak, and two or three drachms of sardous blood, of a dark chocklate color, indicating that it had already taken on diseased action. After a nap, the chil awoke cheerful as usual; in the evening her pulse was accelerated and she complained of nausea, but ever afterwards uniformly said that she had no pain. No inflammation supervised, and the wound healed by the first intention. Three days after the operation, in several inches or more in length, it had completed healed; and in fourteen days the whole except the fourth of an inch was entirely healed. In eighteen days the patient was discharged.

No 639, Jan. 5th. Cataract of both eyes. Matszeah aged 54. He is a native of the province of Chekeang, now resident in this city, and for a long time employed in Kwongchowfoo's office, he was attented by his son twelve years old, and two servants. His bed, dress, and comfortable arrangements were very unlike those of the poorer classess. He had been perfectly blind on the left eyes for five years, and his right eye, three. Both cataracts were white, giving the pupil the appearance of being set in beautiful set pearl. The operation in both eyes were successful, and ocassioned but little inconvenience to the patient. When he left the hospital his sight was clear, and it scarcely perceptible that his eyes had been effected. The contrast in the expression of his countenance from the dullness of the statue to the animated glow of intelligence and friendship was very striking. On removing the compress some days after the operation, he involuntarily exclaimed "keen e sang, I see the doctor, and he unformily mainfested much gratitude. He would have knocked head before me when he left the hospital, had he not been prevented.

No 564, Jan. 4th. Fleshy tumor of the left eye. Ayu, a lad 17 years of age. The tumor commenced fourteen months ago with a slight enlargement of the caruncula lachrymalis, and gradulaay extented along the globe of the eye both above and below, till its branches met the external angle of the eye so that the patient was finally unable to close the lids of the eye. When I first saw him, it extenede out one quarter of an inch, and a little inflammed at the apex from external irritation. Slightly lobulated it closed like the unexpawed petals of a rose, concealed the cornea, and excluded all the light. A similar disease had commenced from the right eye. The patient was immediately treated constit utionally, and on the 14th of Jan. the tumor removed. With a sharp pointed bis- toury I severed the tarsi at the external union, divided the tumor down the globe, first dissected it from the lower side, and then from the lower half side and then from the upper lid, and the inner angle. The eye-ball was un effected and the sight restored, the hemorrhage was not great. The upper lid was much swollen, and the granulations was prominent. Having cleansed the eye from blood, I injected some camphor and water. In the evening bleed him twelve ounces, and he had a comfortable night. He was treated antiphlogistically and the prob

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daily passed around to prevent adhesion of the lids to the ball. Evaporation
lotions were applied to the lids, and pleasing hopes were excited that the
disease would not return.

*I would here acknowledge the kindness of Dr.R.H.Cox, W.Jardine Esq., Dr.J.Cullen, surgeon to the Lord Lowther, DR.A.A.Adee and his assita-
nee Dr.J.W.Palmer of the United States Slopp Vincenes, to whom I am
indebted for their previous council assistance on the ocassion. Dr
Adee was under the necessity to leaving town before the operation.
I cannot refrain from expressing my peculiar obligations to Dr Cox
who has unifromly aided me on my each day for surgical operations
since the opening of the hosptial, in which he has a kind and lively
interest.

But when the patient left the hosptial about four weeks after to spend the
New Year Festival at home the tumor had again attained a considerable size
notwithstanding the frequent application of Lunar caustic in substance to
and solution to prevent it.

No 911,Feb.2nd.Injury of the ear. Changshan,a soldier aged 48,a native of Pekin,afflicted with a disceses of the ear.The ear was half filled with cerumen of firm consistency.On removal of it I extracted about half a dozen small pieces of bones. The uuceration had advanced so far that I could not indentify them with the congeries of samll bones of the ear,but from their situation have no doubt of their indentity. The patient informed me of the pain and soreness commenced with the wounding of the ear,ocassioned by the barber cleaning it,.He had quite lost use of it.-- Though this is an extreme case,many similar have come under treatment which have been ocassioned by this pernicious practice,a practice that deserves to be severely reprobated.

NO.898.Febr.2nd.Asites. Peng She,an interesting young woman aged 21 when of delicate slender frame,and had been afflicted by abdominal dropsy for three years,during which she had been once gravid,butthe child did not live. At first there was edematous swelling of abdominal and lower extermities. which after a few months subsidedwhose effusion into the peritoneal cavity and the abomen became much distented. Her countenance and skin were sallow respiration hurried,pulse 120,samll and wiry; cough,distinct flucatation of the fluid;indeed all the symptoms left no doubt as to the nature of the case. As there had been no appazant increase of the fluid fro a long time I inferred that the active cause of its secretion had sudsided, and that if the absorbents were first excited,and then the fluid removed,there was the hope that the health may be restored. I commenced with the saline purgative. Upon the after third afetr I adopted the treament essentially that is re- commended by Sir Astley Cooper.R.Submuri.Hydrar.grs.jss.pulv.gamb.grs.ji. pulv.scillae.grs.jii.made into a pill and taken at night. Also a mixture of spir.nit.ether.dr.ss.cor.sub.gr.ss. and fifteen,tinct. digitals,to be taken twice a day. This treatment was continued till the tenth,when the tongue wa s affetced with the mercurial action.

On the 11 th assisted by Dr Cox in I performed paracentesis in the linea alba one and a half inches below the umbiicius.Three gallons,wanting one pint and half,of dark coffee colored fluid,with a slight deposition of lymph,were taken away. The fluid was very slowly drawn away,and with flannel bandages a uniform pressure was made. She shrieked once as the trochar entered,and during the whole time she complained of no syncope,on the contrary was an- imated and cheeurful,and lavish in her expressions of gratitude. At 9 P.M. her pulse was at 90,she had some fever,and her cough was aggravated. A mixture of paragor.elix.and tinct.scillae,each one drp.wine of antimony dr. ss,and an ounce of warm water,was given in samll doses in durning the night. On the second day,the same treatment as before was resumed,ommiting

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the calomel. On the third, the febrile symptoms had much increased, the pulse 120, and not a little solictude was entertained for the result, Oli. rici. oz. j. and pulvis Doveri grs. x were taken in the evening and operated kindly. In the morning, the pulse was 106, the usual treatment was continued, with the addition of lich. island. oz. j. in two quartsof water boiled away to one, and decanted, and one ounce of gum arabic dissolved in a quart of water, the two fluids mixed and made agreeably sweet, to be taken ad libitum. No alarming symptoms have since appeared. The wound healed without inflammation, the wound subsided, the patient has resumed her work, her countenance assumed the appearance of health; and through the operation may require to be repeated, there is everyhope of a permanent relief.

The circumstances of this case have been very interesting, the day after coming to the institution, she resumed her needle work as though she had been in health, nor did she lay it aside till the moment I went to the Chamber for the operation. When all the preparations were made, the possible consequences were stated to the husband, though no particular cause of apprehension could now be foreseen. I told him I will do my best, and he must be content with the result. He was dissatisfied with the prospect of danger and urged me that I must "secure" success; and for the resolution of the patient herself she must have gone away and abide the consequences of such an incumbrance. After some embracing delay, the husband referred to her the decision of the question, which she settled in an instant. His sentiments subsequently became quite changed, when he witnessed the result.

My limits forbid any further detail of particular cases, and with a few miscellaneous remarks I must close the report. The oblique curvature of the upper palpebra, which is characteristic of the Chinese physiognomy, renders the inversion of the lid a very common affliction, occasioning the loss of many eyes, the opacity and vascularity of the cornea in still a greater number. As seen in the table of diseases, treble the number of the latter affection have presented to any other. The eyelashes turning in upon the eye produce itch and irritation, and the person immediately commences rubbing the eye. This only increases inflammation till it turns into a chronic stage, and finally the cornea shoots across the eye, opacity succeeds, and ulceration and destruction of the eye is the frequent result. The mode of treatment I have adopted is exactly that of the Dorsey; viz: the removal of the edge of the lid above the roots of the eyelashes. I first make a perpendicular incision at the outer angle, where the edge of the lid is taken hold of with a tenaculum, and with one of more snipp of the scissors the tarsi is removed. The hemorrhage is usually trifling, and in cases attended with inflammation, it is decanted, beneficial. In the words of Saunders quoted by Dorsey, "nothing can be more simple than this piece of dissection." The wound soon heals, the cornea already opaque clears. Vision improved, the patient is slightly disfigured, and much gratified with the result. A dozen have been thus permanently relived in a day. No difficulty has been experienced from fungi, though the operation had been prefromed on patients over sixty years of age, in only two instances have fungus exrescences appeared from the wound, and thus required but a single application of caustic.

With the solitary exception of the drawing out of the eyelashes when turned in, I have not been able to learn any one that the Chinese practitioners perform, which is of any benefit in the effectios of the eye. On the other hand I am told by my patients that their eyes were sore, and the Chinese doctor gave them strong medicine that aggreivated the diseases. The only operation I am aware of their performing, is in case of entropia. By means of a split bamboo or a copper instrument resembling that of the tweezers, they nib up a fold of loose skin of the upper lid, and thus avert the eyelashes. The instruments is continued fro a few days till a portion taken up in sloughs, and then the wound Heals. A few lashes opposite the portion thus removed remained evert, but the principal portion still lies on the cornea. I have seen repeated instances of real disfigurement resulting from this operation, but no real good. In a case of pocidentia iridis occasioned from a fall from a house, the patient thus described the treatment he had received from a Chinese Doctor; he had

(10)

eaten one half of a chicken that had died from disease or accident, and the other half he had applied as a cataplasm to the eye and the side of the head.

A few facts will illustrate the eagerness of the people to avail themselves to the benefits of the hospital. When it was the practice to adm it patients daily, I observed some of them with lanterns with which they laft their homes at two or three O'clock in the morning, in order that they may be there in season, when the days of admission were limited, they sometimes came in the previous evening that they might secure a ticket in the morning. There have been applicants from all parts of the province, from Nanking and Peking who were now resident at Canton have called. Persons from the offices of Kwonghowfoo, and from the Hoppo have been among my patients. When obliged to close the doors against new admissions, persons from a distant would avial themselevs of the influence of some foreign gentlemen, or hong mercehant to intercede them. No opposition has been excited, but on the contrary I have been assured that the hospital was known and approved by the officers of the Government. A woman of Mohammedan faith, sixty years of age, who had cataract of both eyes, when I expressed a doubt whether she could bear to my knife put into her eyes replied "if you like you can take them both out, and put them back again. Another patient had been blind with a cataract in his left eyes for forty years, but on couching it, I found that the retian still sensible to the light. A few days after when I visited him, he seemed affected with the kindness shown to him, and stroking his long white beard, that reached to his bosom he said, I am now old, and my beard is long and hoardy, but never before have I seen or heard of such a man" He then enumerated the several favors which I had done him and, added in conclusion "you must be a divine person!"

This gave me an opportunity, in correcting his mistake, to point him to our Divine Savour, and to the works which he had performed, and the sufferings which he endured, for our sinful race. Many patients would knock their heads on the floor before me, and only prevented by the assurance that if they do so I will not prescribe for them. The injury has often arisen, as I have witnessed the eagerness of this people to avail themselves of a foreigner, and said for the relief of their bodily and temporal wants, when will they be equally lly solitious to be healed of their moral maladies, and when will they equally desire to see the prefections of their Creator and be santified by their presence? If toils, precepts, and prayers, by day and by night, shall through their intercession divine blessing avail to this end, they will not have been in vain.

["Ophthalmic Hospital at Canton; second Quarterly Report,
from the 4th. of February to the 4th. of May 1836;\nby the Rev. Peter Parker, M. D.\nThe Chinese Repository, VOL V. Page 32.", "(Some repairs of the hospital, which were much needed at the end of the second term, made it necessary to close the door for a few days, --during which, Dr. Parker is enjoying a visit at Macao. His report, which he prepared before leaving Canton, goes to press during his absence; and in a few instances we have abridged the MS., it exceeding considerably the space alloted for it. The expenses of the term were $441.92. The repairs are now nearly completed, and the doors will soon be reopened. The silk weaver, brought to the Hospital on the 12th. instant, continues to improve, and has a fair prospect of a speedy recovery. May 24.)", "The whole number of patients on the records of the hospital is now 1283. There were admitted during the term 358, of whom 282 were males and 76 females. In this number, those who remained on the list at the end of the last term, with those who, having been cured and discharged, have had a relapse or a new attack of disease, though numerous, are not included. Had the object been to swell the catalogue of patients received, and were the strength of an individual sufficient for the task of an adequate attendance, the aggregate might have been thousands. The difficulty has been in avoiding applications, rather than in obtaining patients. For nearly a month, the doors were nominally closed against new applicants, and at least one third of the new patients have gained admittance by importunity and the combined influence of their friends, when there were already as many in the hospital as could be faithfully attended. The young man (a Chinese, born at Malacca and educated at the Anglochinese college,) who rendered me essential assistance during the first quarter, having returned to Singapore, and a European subsequently employed in his place having returned to England, the double task of prescribing and compounding medicines and administering the same devolved upon me, except I have availed myself of the assistance of untaught Chinese. Thus the labors have been more arduous than during the first term, though the number of new patients admitted to the hospital has been less. It would add very much to the efficiency of the institution, if the constant services of a few well-educated native youth, anxious to become masters of the healing arts and prepared to go through a thorough course of instruction, could be secured; and the benefits, which would accrue to such young men, would by no means be inconsiderable."]

["Page 2.", "The success, too, of the second term calls equally with that of the first for gratitute of heart to Him who has given it, and equally inspires fresh courage to enter upon the future. The following details will show that the institution has attracted more and more the attention of those who might be expected to be most unfriendly to it. Officers of Government have in several instances personally countenanced it by application for medical care, and in their grateful acknowledgments of benefits received have exhibited no less warmth than their countrymen, in the humble walks of life, whom they have met in large numbers upon the same floor. Ten officers of government with more than twice number of their attendants (private secretaries, clerks in the public offices, &c.,) have visited the hospital as patients. On one occasion I recollect as many as five of these official gentlemen sitting around me at one time, with seventy-five of a hundred other patients seated about the room. An elderly man, who has filled the station of provincial judge, in one of the northern provinces, (the rank of which is indicated by a blue button,) has condenced to be enrolled among the patients of the hospital. Another gentleman resigned for a time his office as district magistrate, for the same purpose; and the magistrate of Nanhae heen, or the western district of Canton, sent in his card with a request that I would treat an afflicted child of his relative.", "The arrangement adopted in the first report will be followed in this; --first, presenting a tabular view of the diseases, and then in the second place, giving in detail a few of the more important cases which have been under my care. The table showing the ages of the patients is omitted. The diseases of the ear have been so numerous, that it seemed desirable to class them together, as have been done. A few of the patients have been afflicted with more than one disease, in which cases each is numbered in the tabular form. The cases detailed, though few, must serve as specimens of the whole.", "Diseases presented during the quarter; Ist, of the eye, 2dly, of the ear, and 3dly, miscellaneous.", "Ist:", "<table><tbody><tr><td>Amaurosis</td><td>12</td><td>Nervous affections of the ears</td><td>2</td></tr><tr><td>Acute ophthalmia</td><td>34</td><td>Malformation of the meatus auditorius</td><td>I</td></tr><tr><td>Chronic ophthalmia</td><td>11</td><td>Enlargement of meatus</td><td>I</td></tr><tr><td>Purulent "</td><td>15</td><td>Deafness with enlargement of the bones of the ear</td><td>2</td></tr><tr><td>Rheumatic "</td><td>2</td><td>Deafness</td><td>4</td></tr><tr><td>Ophthalmitis</td><td>3d</td><td>Abscess of Parotid gland</td><td>1</td></tr><tr><td>Ophthalmia variola-</td><td>1<sup>3</sup></td><td>Psoas abscess-</td><td>1</td></tr><tr><td>Conjunctivitis-</td><td>2</td><td>Anasarca-</td><td>3</td></tr><tr><td>Hordeolum-</td><td>6</td><td>Cancer of the breast-</td><td>1</td></tr><tr><td>Cataract-</td><td>24</td><td>Disease of the lower jaw with great tumefaction.</td><td>1</td></tr><tr><td>Entropia-</td><td>14</td><td></td><td></td></tr></tbody></table>"]

Page 3.

<table>
  <tbody>
    <tr>
      <td>Trichiasis</td>
      <td>- - - - 6</td>
      <td>Ranulae</td>
      <td>- - - - - - - - - 2</td>
    </tr>
    <tr>
      <td>Pterygium</td>
      <td>- - - - 11</td>
      <td>Benign polypi of the nose</td>
      <td>3</td>
    </tr>
    <tr>
      <td>Opacity and vascular</td>
      <td>-ity of the cornea</td>
      <td>Fistulea in ano</td>
      <td>- - - - 1</td>
    </tr>
    <tr>
      <td>Ulceration of the "</td>
      <td>7</td>
      <td>Amenorhoea</td>
      <td>- - - - - - 2</td>
    </tr>
    <tr>
      <td>Nebulae</td>
      <td>- - - - - 9</td>
      <td>Chronic cystitis</td>
      <td>- - - - 1</td>
    </tr>
    <tr>
      <td>Albugo</td>
      <td>- - - - - 23</td>
      <td>Abdominal tumors</td>
      <td>- - - - 3</td>
    </tr>
    <tr>
      <td>Leucoma</td>
      <td>- - - - - 4</td>
      <td>Sarcomatous "</td>
      <td>- - - - 5</td>
    </tr>
    <tr>
      <td>Staphyloma</td>
      <td>- - - - 16</td>
      <td>Encysted tumor</td>
      <td>- - - - 1</td>
    </tr>
    <tr>
      <td>Staphyloma sclerotica</td>
      <td>- - - - - 2</td>
      <td>Tinea capitis</td>
      <td>- - - - 2</td>
    </tr>
    <tr>
      <td>Onyx</td>
      <td>- - - - - - - - - 2</td>
      <td>Scrofula</td>
      <td>- - - - - - 3</td>
    </tr>
    <tr>
      <td>Iritis</td>
      <td>- - - - - - - - - 3</td>
      <td>Indolent ulcer of the</td>
      <td>foot with elephantiasis</td>
    </tr>
    <tr>
      <td>Lippitudo</td>
      <td>- - - - - 8</td>
      <td>Asthma</td>
      <td>- - - - - - - - - 2</td>
    </tr>
    <tr>
      <td>Synechia anterior</td>
      <td>- - - - - 13</td>
      <td>Bronchitis</td>
      <td>- - - - - - 1</td>
    </tr>
    <tr>
      <td>Synechia posterior</td>
      <td>- - - - - 3</td>
      <td>Bronchial flux</td>
      <td>- - - - - 1</td>
    </tr>
    <tr>
      <td>Myosis</td>
      <td>- - - - - - - - - 2</td>
      <td>Pneumonia</td>
      <td>- - - - - - 4</td>
    </tr>
    <tr>
      <td>Closed pupil with depo</td>
      <td>- - - - - - - - - 2</td>
      <td>Ichthyosis</td>
      <td>- - - - - - - - - 2</td>
    </tr>
    <tr>
      <td>sition of lymph</td>
      <td>- - - - - 3</td>
      <td>Herpes</td>
      <td>- - - - - - - - - 4</td>
    </tr>
    <tr>
      <td>Procidentia iridis</td>
      <td>- - - - 2</td>
      <td>Impetigo</td>
      <td>- - - - - - - - - 1</td>
    </tr>
    <tr>
      <td>Glaucoma</td>
      <td>- - - - - - - - - 1</td>
      <td>Psoriasis</td>
      <td>- - - - - - - - - 1</td>
    </tr>
    <tr>
      <td>Exophthalmia</td>
      <td>- - - - - 2</td>
      <td>Disease of the antrum</td>
      <td></td>
    </tr>
    <tr>
      <td>Atrophy</td>
      <td>- - - - - - - - - 13</td>
      <td>maxillare</td>
      <td>- - - - - - - - - 1</td>
    </tr>
    <tr>
      <td>Hypertrophy</td>
      <td>- - - - - 2</td>
      <td>Bronchocele</td>
      <td>- - - - - - - - - 2</td>
    </tr>
    <tr>
      <td>Complete loss of the</td>
      <td>eye</td>
      <td>Croup</td>
      <td>- - - - - - - - - 1</td>
    </tr>
    <tr>
      <td>injuries of the eye</td>
      <td>- - - - - - - - - 16</td>
      <td>Opium mania</td>
      <td>- - - - - - - - - 9</td>
    </tr>
    <tr>
      <td>Obstruction of nasal</td>
      <td>duct</td>
      <td>Inguinal Hernia</td>
      <td>- - - - - - - - - 3</td>
    </tr>
    <tr>
      <td>Weak eyes</td>
      <td>- - - - - - - - - 7</td>
      <td>Paraplegia</td>
      <td>- - - - - - - - - 1</td>
    </tr>
    <tr>
      <td>2d. Abscess of the ear</td>
      <td>- - - - - - - - - 2</td>
      <td>Paralysis of the arm</td>
      <td>- - - - - - - - - 1</td>
    </tr>
    <tr>
      <td>Otorrhoea</td>
      <td>- - - - - - - - - 12</td>
      <td>Hydrocephalus</td>
      <td>- - - - - - - - - 1</td>
    </tr>
    <tr>
      <td>Deficiency of cerumen</td>
      <td>3</td>
      <td></td>
      <td></td>
    </tr>
    <tr>
      <td>Deposition of cerumen</td>
      <td>5</td>
      <td></td>
      <td></td>
    </tr>
  </tbody>
</table>

No. 844. February 1st. Ascites with anasarca of the lower extremities. On Heong, aged thirteen. This little girl came to the hospital a few times last term, and was then absent till March. When she entered the hospital, she appeared more like a monster than a girl of thirteen. Her adomen was greatly distended, her legs three or four times their natural size, and her face very much bloated; pulse from 120 to 130, respiration difficult; severe and protracted cough at night with fever. The disease was making rapid progress, insomuch that I feared a fatal result, and told her friends they must either take her away, or be satisfied, if, after the best I could do, she should die in the hospital... They were urgent she should remain, promising to make no difficulty Calomel, jalap, and cremor tartar were first administered for a few days. Blisters were applied to the legs with manifest advantage. Afterwards a pill of calomel, gamboge, and pulvis scillae (R. cal. gr. jss. pulvis gamb. gr. j. pulvis scillae, gr. ij.) was taken every night. Of par. elixir and spts. nitr. ether, each two drachms, and of tinct. digitalis twenty drops daily. This treatment was continued till the 1st of April, when absorption commenced and advanced most rapidly. Half a gallon of fluid was evacuated daily; the adomen and lower extremities soon returned to their natural size; the

Page 4

The fulness of the cheeks disappeared: pulse 90, and the child, cheerful and light, could walk about the hospital. The same treatment was still continued, till she seemed to have nearly recovered her usual health. Thinking a change of air might be serviceable, she was permitted to go home for a week, receiving strict charge as to the diet and medical treatment in the mean time. The day after her return, she came back to the hospital dressed in fine clothes and painted like a doll, and with a box of tea and other presents were sent from her master. But my pleasure was far from being unmingled. If I had reason to think that the little child, instead of being recovered from a premature grave to be useful and and respectable in life and happy beyond the tomb, was spared to be a source of gain to her master when of a suitable age tobe sold for a concubine. And to add to this, in consequence of notadhering strictly to the directions given at her leaving, she returned in about ten days with a partial relapse, and has been put upon the same treatment.

No. 926. Gunshot wound. February 17th. Acheen, aged twenty-one. This young man unfortunately burst a matchlock in his hand. A servant in the factory came to me in agreat agitation saying that a man was shot, and that he would request me to see him. I ordered the man to be carried to the hospital, where I would dress his wound. I found both him and his friends who came with him in great alarm least the wound should prove fatal; but I soon found their alarm to be groundless, and they were pacified when assured of the patient's safety. The thumb was blown off from about the middle of the first bone, the portion that remained dislocated, the fractured end turned back to the wrist, and kept in the position by tenderness and skin, with the muscles forming the ball of the thumb torn up to the wrist. Preparation for putting the wound in proper state was commenced by removing with the knife the dislocated piece of bone, the shreds of skin, also the cartilage of the metacarpal bone, then cleansing the wound, the edges of which were supported by adhesive straps, and over these, large poultries were applied: in a few days, heathy granulations came on, and at the end of three weeks, the wound was quite healed. The patient was able to make considerable use of the preserved portion of the thumb.

No. 931. February 26th. Asthma and opium mania. Asay, aged 44, father of Akwei, the lad with imperforate meatus auditorius mentioned in the last report. This man had been afflicted with asthma from youth and had long addicted himself to the excessive use of opium. On account of his father's illness and expected death, the lad was unwilling to remain in the hospital, and after being permitted to return home became very irregular in his attendance. The father was brought in aboard opposite to the factories, where I was requested to see him. The alarm of friends was well grounded respecting him. He was very languid, breathed with great difficulty, and had general oedema throughout the system. Being unwilling to prescribe for him, without seeing him daily, and being desirous also that his son should remain longer under my care, the father was received into the hospital, his health began in a few days to improve, and strong hopes were

Page 5

entertained of his recovery. When sent for one morning to see him, as he thought to be worse, I went directly, but found, to my surprise that he had been some time dead. Probably there was effusion into the thorax. The other patients were immediately removed from the room and the door closed. Patients were received during the day, the friends were apprised of the event, and requested to come in the evening to remove the corpse.

The occurrence was regarded and treated as an event in Providence, and there was no disposition on our part to conceal the event. The corpse was removed and no difficulty ensued. A few days after, I was informed that Akwei must attend to the funeral ceremonies and could not come any more for the present. I explained to him the necessity of the case and objected to his leaving. He absented himself however, and I heard no more of him till some weeks subsequently, when being in the part of the city where he resided, I was recognized by the grandfather and invited to the residence of the deceased. The ear had been neglected and yhe orifice nearly healed up, having a depression in the situation of the foramen.

No. 962. March 5th. Disease of the Antrum maxillare. Ashun, of Kuo tong, aged 34, a carpenter. The disease commenced a little more than a year ago. Formerly it communicated both with the mouth and nose, and discharged yellowish fluid. On a former occasion, being acquainted with the use of tools, he performed an operation upon himself. With the aid of his knife and a looking-glass he evacuated its contents; but the disease returned, and, having heard of the foreigner, he preferred a three days' journey to the performance of a second operation by his own hand. When he came, the face was much swollen, and painful, and in the mouth was the appearance of a tumor from the gum. It was evident that there was a deposition of fluid. I lanced it in the mouth and evacuated two fluid ounces resembling gall. I afterwards passed a probe into the antrum, three or four inches in several directions, without pain to the patient. There was a tooth slightly defective opposite to it, which appeared to be an effect rather than a cause. I encouraged the patient to expect only temporary relief. He returned the same night with a promise to come again in three days, his business not allowing him to remain for further treatment. As I have not since heard from him, I presume that the fluid has not again collected.

No. 967. March 7th. Hypertrophy of the right eye with deep opacity of the cornea. Sze koo, aged 22, of the province of Nganhwuy, daughter of Chaou Keu, a district undermagistrate in this province, who had sent his card, a few days previously, with a representation of her case, of which a translation by Mr. Morrison is subjoined.

"I herewith present a statement respecting the affection of the eye under which she suffers, requesting instruction. My young daughter is upwards of 20 years old. In her right eye a covering (cataract) has grown up, shading the pupil, which arose from a diseased state of the bowels, when she was between five and six years old. A covering of skin has grown over the eye so that she cannot see anything with it, and al-

page 8

I then abraded a small portion of one polypus and waited to see if it healed. There was some hemorrhage. In a little time it healed kindly, and inferring from a part what might be true of the whole, I proposed to remove them. They adhered firmly around nearly the whole circumference of the anterior nares, but how far back they extended I could not determine. With a small scalpel, as the forceps were inapplicable, I dissected out both. Fortunately they were limited within the anterior nares. There was rather more than usual hemorrhage, but I have not seen a case in which the result was more satisfactory.

During the quarter, a larger proportion of cataracts have been presented than in the first term. Upon a child five years old, who had been partially blind from cataract in both eyes for three years successful operation has been performed. The difficulty of confining the little patient so as to couch it in the ordinary way rendered it necessary to introduce the needle in front, through the cornea and break up the lens. The next day I could not perceive where the puncture had been made. The wound healed and the absorption was rapid. I have since operated upon the other eye, but before the absorption will be complete, expect to introduce the needle again.

Within the last fortnight I have operated upon five children (the eldest thirteen years old,) for staphyloma. In two of these, the eye protruded so far as to render it impossible to cover it with the lids. In each case the removal of the protruding portion was attended with no unpleasant consequences. In one case the excision left the lens so that its capsule of a new deposit over it presented the appearance of a new cornea, the patient still insensible to light, but much improved in appearance, and relieved of a source of perpetual inconvenience and pain.

No. 1279. May 3rd. Injury by fall. Yeang she, aged 24. A silk-weaver. On the approach of a very severe thunder storm that occurred on the 2d instant, this woman went to take in some clothes from an upper loft, and in her haste to return fell from a ladder, a distance of twelve feet, upon a perpendicular piece of bamboo one inch in diameter and three feet high. It entered deep in the centre of the right arm-pit, came out above the shoulder beneath the clavicle which it a fractured, reentered the side of the neck, and passed apparently through the pharynx and oesophagus, rent the soft palate of the mouth from the fauces to the nose, and was arrested only by the base of the cranium. About eighteen hours had elapsed from the time of the accident, when I first saw her. The wounds had been covered over with some Chinese plaster. The patient had a high fever, hot and dry skin, pulse 125, and local inflammation about the wounds. Fluids taken into the mouth came out at the side of the neck, and the air also passed on respiration. Treatment: Dressed the wounds, applied poultices to the sore and inflamed part of the abstracted nearly fourteen ounces of blood, and gave her a calomel and rhubarb cathartic, half a drachm of Dover's powders to be taken in five grain doses hourly, and in the evening applied one dozen leeches about the clavicle along the course of the wound.

page 10

May 11th, pulse 90, and all her symptoms favorable. Proposed that the patient be removed to the hospital to-morrow. May 12th, she was able to be brought to the hospital, and all the wounds apparently healthy. Not much fatigued. Same general treatment continued.

The case of Pang, hoppo of Canton, claims a remark or two in this place. Some time in the month of March, one of the linguists came and informed me that the hoppo "had something the matter" with his eyes; but as the "great man" did not like to come to the hospital, the linguist wished to know if I would meet him at the Company's factory. As I had no right there, I preferred he should come to my own residence, the next day or at any time he chose, or if he preferred I would go to his house. With this, the linguist was pleased, and said he would bring a reply the next day. He did so, informing me that the hoppo had looked in his book, and found that the 12th of the moon was an auspicious day, and that he would the-n come. Before it arrived, however, I was informed, that as he had some extra business, it would not be convenient, but he would see me before he returned to Peking. This, however, he has not done. As he was soon to present himself at the imperial court, it might not have been unimportant if I could have been instrumental in affording him an obvious benefit; but, from all I could learn of the nature of his disease, there was little chance of rendering much assistance by merely seeing him once or twice.

I cannot close this report without adverting to the encouragement afforded by the generous donations of friends and the kind sentiments that have uniformly accompanied them. The amount of donations received now exceeds $1400, of which a particular acknowledgement will be given at the expiration of the year. In the mean time, I desire to express sincere thanks in behalf of the hundreds, recipients of their munificence. It is an encouragement, a generosity, the more sensibly appreciated as it has been unexpected. I wish also to acknowledge the unremitted kindness of Dr. Cox, who has continued to assist me weekly upon the day for operations.

In this hasty report it is impossible to convey to the mind of a stranger an adequate idea of the interesting scenes of the past three months. To do this he need imagine an assembly averaging from seventy-five to a hundred of the unfortunate in every rank. He need see the man or child lately groping in darkness now rejoicing to behold the light: here the fond mother, her countenance overcast with gloom at the apprehension that a darling child must soon die, presently wanting terms to express her joy as she sees that child prattling around her, insensible to the danger from which it has been rescued; and again he should witness the gratitude of those whose protracted afflictions they had supposed would terminate only with life, in a few days restored to health; and as he beholds considerable numbers who never again can see the light, think of a still larger company, who but for the timely relief afforded would have become alike condition of man being as it is, there unfortunate. Were it 'all of life to live,' were there no hereafter, the condition of man being as it is, there would exist no higher privilege than to be a physician,

page II

rendering advice and assistance and dispensing medicines gra-
tuitously. But the reflection perpetually recurs, it is not
all of life to live. Beyond the limits of man's earthly being,
the soul's existence is eternal, and as the duration of the latter
exceeds that of the former, so is its welfare more important and
desirable; and the perfection of earthly felicity would be to
labor directly, to labor long and successfully for it, and especially
among those whose immortal happiness has so long been neglected.
But since this is in a measure impracticable, and by the Chinese
as a nation unappreciated, it is just occasion of thankfulness
to God that those means can now be employed, which, in them-
selves most desirable, are chiefly important as preparatory to
their reception of his most valuable gift to man, the Gospel,
which is destined ultimately to bring into the fold of the
Redeemer an innumerable multitude from the inhabitants of this
unique and populous empire.

Page 13

<table><tr><td>2d.</td><td>Preternatural growth<br>from the lower por-<br>tion of the orbit<br>and near the exter-<br>nal angle of the<br>right eye, resembling<br>a congeries of veins.<br>Disease of the carun-<br>cula lachrymalis.</td></tr><tr><td></td><td>Psoas abscess</td></tr><tr><td></td><td>Abscess of the thigh</td></tr><tr><td></td><td>ear</td></tr><tr><td></td><td>head</td></tr><tr><td></td><td>face</td></tr><tr><td></td><td>Otorrhoea</td></tr><tr><td></td><td>Deficiency of cerumen</td></tr><tr><td></td><td>Nervous affection of<br>the ear</td></tr><tr><td></td><td>Malformation of the<br>meatus</td></tr><tr><td></td><td>Polypus of the ear</td></tr><tr><td></td><td>Deafness</td></tr><tr><td></td><td>Disease of the lower<br>jaw</td></tr><tr><td></td><td>Dropsy</td></tr><tr><td></td><td>Ovarian dropsy</td></tr><tr><td></td><td>Rydatids</td></tr><tr><td></td><td>Cancer of the breast</td></tr></table>

<table><tr><td>Encysted tumor</td><td>- - - -1</td></tr><tr><td>Hernia</td><td>- - - -2</td></tr><tr><td>Curvature of the<br>spine</td><td>- - - - -3</td></tr><tr><td>Phymosis natural-</td><td>- -1</td></tr><tr><td>Hydrops articuli</td><td>- -3</td></tr><tr><td>Acne</td><td>- - - - -3</td></tr><tr><td>Impetigo</td><td>- - - - -2</td></tr><tr><td>Rheumatism</td><td>- - - -4</td></tr><tr><td>Intermittent fever</td><td>- -2</td></tr><tr><td>Phthisis</td><td>- - - -1</td></tr><tr><td>Dyspepsia</td><td>- - - -2</td></tr><tr><td>Death and dumb child</td><td>- -1</td></tr><tr><td>Dumbness</td><td>- - - -3</td></tr><tr><td>Urinary calculus<br>(removed)</td><td>- - - -1</td></tr><tr><td>Needle thrust into<br>the palm of a child's<br>hand, removed by a<br>magnet, after an in-<br>cision with a lancet,<br>a month subsequent to<br>the accident.</td><td>- - -1</td></tr><tr><td>Needle, thrust into<br>the breast, just be-<br>low the sternum.</td><td>- - -1</td></tr></table>

As in the former reports, only a few of the cases presented will be detailed. The first I shall mentioned occurred during my visit to Macao.

No. 1284 Lan Alin, aged 54, had been affected with an ulcerated tumor upon the crown of his head twenty-two years. Hearing that I was to visit Macao, he requested his friends here to prevail on me to see him when I arrived there. Several applications of the kind were made, and in this instance I consented. When I saw him, the tumor was in abad condition, and had the appearance of soon putting on a malignant character. At times, according to the statement of the patient, who appeared to be a sensible man, it had bled to the amount of twelve or fourteen ounces. With the concurring advice and assistance of my friend, Dr. Colledge, on the 21st. of June the tumor was extirpated. I saw it dressed while I remained, and on leaving Macao, Dr. Colledge kindly took the care of it. In about two weeks he wrote, "your patient is quite well, and in fine health has left, and I have seen no more of him." He has since sent by his son "ten thousand thanks."

On my return to Canton, on the last day of May, I had the satisfaction to find the young woman, Meang she, who was wounded by a fall in a thunder storm, quite out of danger from the injury received. The side of the neck that had been perforated by the bamboo was perfectly healed.

Page 15

Her pulse was 144; her skin was hot and dry, with a high fever, and respiration difficulty, when on the 25 of June I again performed the operation. Three gallons and two and a half pints of dark fluid, similar to the former, was abstracted, making the aggregate of about six gallons. She immediately relieved of most of her formersymptoms; herpulse the following day was 95. She rapidly recovered her health, and was discharged on the 8th of July. I am confident she could have lived two days longer without this interposition, On the 28th, she reported herself and had improved very much during twenty days' absence.

No 1500. July 8th. Chin Aying, a little girl of thirteen years of age. She had been incommoded by three sarcomatous tumors situated together, between the shoulders and above the spine. The three were in close contract, and as it was formed one, four inches in breadth and three in depth. On the 14th, they were expirpated. The largest of the cluster was firmly united to one of the spinous processes by a semi-cartilaginous or bony union. The whole tumor was a very hard and almost hony union. Judging from the rapid growth of the last year, it must soon have become a cumbersome load. No unpleasant consequences have followed the removal of it, and the wound is kindly healing up by granulations.

No. 446. The case of Akae is mentioned in the first report, under date of December 27th, 1835. About three months subsequent to the removal of the original tumor, as she was walking by the river side, a coolie carelessly passing by, thrust theend of the bamboo, with which he carried his burden, against the superciliary ridge of the right temple, from which the tumor had been removed. When she came to the hospital about a month after the accident, there was considerable tumefaction above the eye. It being the close of that term, she was directed to remained at home until the first of June; at which time the tumor had attained the magnitude of the former one, though not exactly the same shape, and others previously on the side of her face were enlarged. The new one was altogether of a different character from the former. It had the appearance of a spongy mass, and was bounded on the left by an exosysis from the superciliary process one eight of an inch deep, and one inche and a half long at its base, forming an irregular perpendicular ridge; the tumor grew rapidly and fast tending to suppuration; the general health was affected, and death seemed probable and that speedily, unless its progress could be arrested by a surgical operation, while the heat of midsummer not a little increasing the hazard of such a measure. After repeated consultations with Dr. Cox and Mr. Jardine, who had assisted in the former instance, it was resolved to embrace the first favorable day for the operation. On the 21st of July, the operation was performed. On the first incision being made, a large quantity of greenish fluid gushed out from cells of disorganized matter. Two elliptical incisions from the middle of the forehead down the cheek to the level with the ear were first made, and then a third from the middle of the first incision back upon the side of the head to a point five inches above the ear.

Page 18

Then loudly did I ask, for what cause such pain I bore, -
For transgressions in a former life unatoned for before?
But again came the reflection, how, of yore, oft, men of worth,
For slight errors had borne suff'ring great as drew my sorrow
forth.

"And shall not one," said I then? "whose worth is but as nought,
"Bear patiently, as heaven's gift, what it ordains?" The thought
Was scarce completely formed, when of a friend the footstep
fell

On my threshold, and I breathed a hope he had words of joy to
tell.

"I have heard," the friend who enter'd said, "ther is come to
us of late

"A native of the 'flower'd flag, and farffardoff and foreign state;

"O'er tens of thousand miles of sea to the inner land he's
come;

"His hope and aim to heal men's pain, he leaves his native
home."

I quick went forth, this man I sought, this gen'rous doctor
found;

He gained my heart, he's kind and good; for, high up from
the ground.

Words were but vain were I to try his kindness to recite.

With needle argentine, he pieced the cradle of the tear;

What fear I felt; SooTungpo's words rung threat'ning in
my ear:

"Glass hung in mist," the poet says, "take heed you do not
shake;"

(The words of fear rung in my ear) "how if it chance to break"

The fragile lens his needle pieced: the dread, the stinging, the
pain,

I thought on these, and that the cup of sorrow I must drain:
But then my memory faithful showed the work of fell disease,
How long the orbits of sight were dark, and I deprived of ease.

And thus I thought: if now, indeed, I were to find relief:

'Twere not too much to bear the pain, to bear the present
grief.

Then the word of kindness, which I heard, sunk deep into my
soul,

And free from fear I gave myself to the foreigner's control.

His silver needle sought the lens, and quickly from the drew

The opaque and darksome fluid, whose effects so well I know;

His golden probe soon clear'd the lens, and then my eyes he
bound,

And lav'd with water, sweet as is the dew to thirsty ground.

Page 19

Three days thus lay I, prostrate, still; no food then could
I eat,

My limbs relax'd were stretch'd as though th' approach of
death to meet;

With thoughts astray-mindill at ease- away from home and wife,
I often thought that by a thread was hung my precious life.

Three days I lays no food had I, and nothing did I feel;

Nor hunger, sorrow, pain, nor hope, nor thought of woe or weal,

My vigor fled, my life seemed gone, when, sudden, in my pain,

There came one ray, -one glimmering ray, I see-I live again.

As starts from visions of the night, he who dreams a fearful
dream,

As from the tomb, uprushing comes, one restored to day's
bright beam,

Thus, I with gladness and surprise, with joy, with keen
delight,

See friends and kindred crowd around, I hail the blessed
light:

With grateful heart, with heaving breast, with feelings
flowing o'er,

I cried, "O let me quick to him who can the sight restore"

To knee I tried, but he forbade; and, forcing me to rise,

"To mortal man bend not the knee;" then pointing to the skies; -

"I'm but," said he, "the workman's tool, another's is the hand;

"Before his might, and in his sight, men, feeble, helpless,
stand:

"Go, virtue learn to cultivate, and never thou forget

"That, for some work of future good thy life is spared thee
yet;"

The off'ring, token of my thanks, he refused; nor would he
take

Silver or gold, they seemed as dust; 'tis but for virtue's
sake

His works are done. His skill divine I ever must adore,

Nor lose remembrance of his name till life's last day is o'er.

Thus have I told, in these brief words, this learned doctor's
praise,

Well does his worth deserve that I should tablets to him raise.

As I remained nearly a month in the hospital, I penned also
the following lines, wherein I have stated the things which
I saw and heard while there, as illustrative of successful
practice.

( A translation of this lines here alluded to by the old
gentleman, and also of the quotation from Soo Tungpoo, may
be given in a subsequent number:- What he says, of my calling
on him to give thanks to earth, of my rich family, &c., is to
be received with due allowance as Chinese embellishment.)

Page 27

Ophthalmic Hospital in Canton: the fourth quarterly report, for the term ending on the 4th November, 1836. By the Rev. Peter Parter, M.D.

The Chinese Repository. Vol. V. Page 323.

During the year that has elapsed, since the opening of the Ophthalmic Hospital in this city, 2152 patients have been received of whom 462 entered during the last term. From the specific character of the institution, a great similarity of diseases and treatment necessarily follows; and it is superfluous to repeat the same illustrations of both, as well as the gratitude of the patients, and though cases of equal interest with any of the preceding terms have occurred in the last, they need not be narrated unless they present some peculiarity.

It has been a desideratum, to be able as is customary in the similar circumstances, to give the statistics of cases, whether the patients have gone away benefitted, knowledge of each or with palliation or entire cure of their maladies. The imperfect knowledge of each others language, the difficulty of impressing the patients with the propriety of reporting the result of the treatment, the neglect to comply with the request, or the inconvenience of doing it when they reside at a great distance, preclude such statistic.

This general statement, however, may be given, that whilst many diseases of long standing have been permanently cured, scarcely an instance is recollected in which a case that has presented in its acute stage has passed into a chronic. Seldom does a week pass in which some patients, who have received perfect cures do not return to the hospital with the expressions of lively gratitude for the favors they have enjoyed. All classes have continued to avail themselves of the benefits of the institution; and some cases subjoined show that there is no diminution of confidence on their part: cases in which they have submitted to operations after the fullest declaration that there was imminent risk, but that death was inevitable unless they accepted the possible relief.

Diseases presented both during the quarter and the year; Ist, of the eye, 2d, miscellaneous.

* = Total for quarter

○ = Total for year.

Ist, Diseases of the eye.*

<table><tbody><tr><td>Amaurosis</td><td>'15'85'</td><td>Hypertropy</td><td>'14'</td></tr><tr><td>Acute ophthalmia</td><td>'35'53'</td><td>Complete loss of one eye</td><td>'28'47'</td></tr><tr><td>Chronic o</td><td>'45'06'</td><td>Loss of both eyes</td><td>'56'148'</td></tr><tr><td>Purulent</td><td>'7'59'</td><td>Mucocele</td><td>'3'6'</td></tr><tr><td>Scrofulous</td><td>'2'</td><td>Muscae volitantes</td><td>'4'6'</td></tr><tr><td>Rheumatic</td><td>'6'</td><td>Weak eyes</td><td>'2'9'</td></tr><tr><td>Ophthalmitis</td><td>'3'19'</td><td>Malignant ulcer of the upper lid</td><td>'1'</td></tr><tr><td>" variola</td><td>'1'29'</td><td>"</td><td>'1'</td></tr><tr><td>Conjunctivitis</td><td>'2'28'</td><td>Encysted tumor of the upper lid</td><td>'1'</td></tr><tr><td>Hordeolum</td><td>'26'</td><td>"</td><td>'1'</td></tr><tr><td>Cataract</td><td>'57'60'</td><td>Tumor from the external angle of the right eye</td><td>'1'</td></tr><tr><td>Entropia</td><td>'36'71'</td><td>causing it to protrude</td><td>'1'</td></tr><tr><td>Ectropia</td><td>'1'3'</td><td>upward, out of its orbit</td><td>'1'</td></tr><tr><td>Trichiasis</td><td>'6'41'</td><td>Adhesion of the conjunctiva to the cornea</td><td>'2'2'</td></tr><tr><td>Pterygium</td><td>'28'00'</td><td>"</td><td>'1'</td></tr><tr><td>Opacity and vascularity of the cornea</td><td>'5'13'14'</td><td>Preternatural growth from the lower portion of the orbit and near the</td><td>'1'</td></tr></tbody></table>

page29

No. 1598. Obstruction of the lacrymal duct. Lew Akong, aged 25, of Shuntih, came to the hospital on the 11th July, with an obstruction of the duct of the left eye. Opened the sack, for a few days, dressed it with lint, injected it with sol. sulhp. cupri., and then introduced a stilett, which was worn for about six weeks. The discharge having ceased, it was removed. The aperture soon healed, and the passage is completely restored. Two other persons have since come to the hospital, and are now under the same treatment for the same affection.

No. 1675. Sarcomatous tumor. Leang A shing, aged 27, an artificial flower maker, came to the hospital August 5th, having an enormous tumor upon the right side of his face, extending from near a line with the zigomatic process superiorly, to two inches below the submaxillary inferiorly, and from an inch behind the ear, and standing about four or five inches from the side of the face. It was 18 inches in circumference. It had been growing for more than ten years; by the application of cautery, (the moxa is commonly used,) it had been converted into a loathsome ulcer at its apex. Though deep-seated, it appeared practicable to remove it. The patient's constitution had been not then suffered much, and there seemed no objections to delaying the operation till cool weather should return. At the expiration of more than two months, the man came back, and to my great supprize the healthy countenance had given place to the sallow and cadaverous expression of one fast verging to the grave. The tumor had become exceedingly fetid, and so decayed internally as to admit a probe three or four inches in different directions. After the system had been braced up for a short time by a course of tonic treatment, the patient was apprized of his situation, the certainty of a speedy death if left alone, the possible unfortunate termination if extirpated, and the encouraging prospect that he might live for years if he submitted to the operation. He referred it to our discretion. Himself and his brother gave a writing, certifying that they requested the removal of the tumor, and if successful should rejoice; but if otherwise, it was teen che ming. 'the will of heaven,' or fate, and no blame would be incurred by the operator. One the 3d of November, assisted by Drs. R. H. Cox and J. Cullen, and W. Jardine, esq., the tumor was extirpated successfully, in about nine minutes. Some portions of the masseter and buccinator muscles were divided, also numerous small arteries, but two of which required a ligature. It weighed twenty-five ounces avoirdupois, and was fast tending to mortification. Some days previous, his bowels had been regulated, and twenty minuted before the operation, twenty-five drops of laudanum were given. During the incisions through the integuments and the dissecting out of the tumor he did not move a muscle, change a feature of his countenance, or draw one long breath, so that apprehensions were even entertained that he was insensible; but if spoken to he answered deliberately and correctly. Subsequently he informed me he was sensible of all that was done, but putting his arms across each other, he said, "I determined not to move". In passing the sutures near the ear, he started involuntarily a few times. On paising him up to change his bloody clothes, he began to faint and was threatened with spasms, but soon recovered as he was laid down, and carb. amm. applied to his nose, and wine and water administered. After being put to bed, he complained of thirst. There was some oozing of blood from the wound. It

Page 30

At 5.P.M:pulse was 120,its average for some days before.
**Treatment.** In the evening the patient took congee and chamoline
and tea.Pill.hyd.grs.x.and lulv.Dov.grs,V.At 9 o'clockpulse
96.Patient complained of a swelling on the side of the neck,and I f
found that some blood had settled beneath the platisma myoides,
and on pressure that there was emphysema. Applied a lotion over the
part.November 4th A.M. Patient very comfortable.R.oli.riei.one
ounce.Bowels freely moved during the day. and very lilltethirst
or pain,Emphysema of the preceding night nearly disappeared--
pulse range from 90 to 96. Dovers powder repeated in the evening
November 5th dressed the wound.Its lips had united in several
places at the first intention. Nov.6th pulse 90 all the symptoms
improving and the same treatment continued. Nov.7th.on dressing
the wound found considerable fetor like tha of the tumor,and a
thin unhealthy discharge. The coagulated blood thrown off was very
black. Apparently want of vitality in the part.cleansed it with
chlorid,of lime,applied simple desssing,with a poutice gave a
glass port wine in the forepon and and noon,and htree grains
sulp,quinine in the evening. Nov.8th A.M.dressed as usual and
injected a solutionof nit.arg.and layed a plaged of lint satura
ted with laudanum over the whole. P.M.deciedly improved,more
vitality in the parts, free discharge of pus,and of a more
healthy characterless fetor,pulse 96 port wine and quinine conti
nued,and a generous diet continued. The above treatment was con
tinued daily,and the application of laudanum was decidedly
beneficial. On the tenth day after yhe operation,the discharge
had ceased.,and the whole had ceased. Theis paritial praylis
of the buccinator muscle,and of under the eyelid,and the lips
was drawn a little askew. General health was much improved.He
seems properly to appreciate the favor he has received,and was ver
ready to tell others what has been done for him.

No.1700. Adhesion of the lids to the cornea. Leang Kwangche.
age 44, from Sanshywuy. In consquence of the former inflammation
adhesion took between the lid and cornea, so as to render, the eye
useless. A probe was passed under the lid, and with a cataract
knivethe conjunctiva was detacked from the cornea to meet more
than half of, of which adheared. A very slight portion of the
membrance,remained, and that soon absorbed, and he had again a good
eye. A similar case of a little girl age 12 years old, affected bot
eyes had occured. In her right eye there was also stapyloma in
left the operation was successful, and she soon agian en
joyed good health.sight.

No. i726 Synechia posterior, with opacity of the cornea. Le
Taeyu, aged 35, of Keangnan, private secretary to the governor
of Canton, came to the hospital August 15th. From a former
inflammation of his right eye. the cornea had become opaque,
and the iris adhered to the lens, so as to form a pupil
irregulaf, and preternaturally small. This gentleman paid
weekly visits to the hospital for some time. Under the ap-
plication of tutty (impire carb zinc), and collyria of cor.
sub. to the cornea, the opacity was in a considerable degree
removed.

page 31

By means of belladona, the adhesion of the iris was detached, except on one side, the pupil enlarged, and the sight much improved.

No. 1951. Disease of the alveola process, &c. Chang she, aged 50, of Nanking. Her case is introduced, not so much on account of the disease as of the patient. On the 10th of October, an officer sent his compliments and desired me to see his wife who had an affection of the face, intimating also that it would be most agreeable to meet me in a boat. The hour was appointed, and the next morning a servant of the hoppo came to wait on me. A splendid boat had been provided in front of the foreign factories, with carpets and brilliant chandeliers, tea, sweetmeats, &c., &c., every thing in due order, for the occasion. An officer of high rank stood at the door. Stepping upon the boat, a swrvant took the umbrella from my hand, and held it over my head. The officer and his wife were each accompanied by three or four personal sssvants, male and femalem who seemed to be regarded as friends, and members of their family, beside other supernumeraries. He was an active and apparently intelligent man. Hearing the emperor's name mentionedm enquiry was made to know why, and I was informed that my patient was of imperial blood. Her female attendants were all of Tartar descent. It immediately occured that her features resembled the likeness I had previously seen of Taoukwang. Her dress was splendid. Her head was decorated with flowers, and abundance of gold. Ornament of various kinds were suspended about her person, among which were some superb specimens of crystalized rose quarts. No rouge was upon her face, and her feet were of natural size. The females that attended her were not much inferior to her in the richness and elegance of their persons and dress. Fott six months this lady had suffered much pain in the lower jaw. The face was swoluen, and an abs cess of the alveola process was formed. Several of the teeth were loose. Two of the lower double teeth were extracted, which afforded her immediate partial relief. She complained of rigors that occurred at 12 o'clock every night. The symptoms have been palliated and she was once reported convalescent, but soon after had a relapse. She is still under treatment, the nature of her disease being explained and she apprised from my first seeing her that it would require time to effect a cure.

No. 1992. Anomalous. Wang Le she, aged 49, a native of the province of Chile and wife of the chefoo of Kochow foo, who is a member of the Hanlin college at Peking.; she came to the hospital on the 18th of October. Once a beautiful woman,she is now a most unpleasant subject apparently from the mal-practice of a Chinese physician. She states, that originally she had a turning in of the eyelashes. The physician applied a plit piece of bamboo, nipping up a portion of the skin of the upper lid, and letting it remain on, till the portion sloughed off. When in sloughing condition, he applied a medicine which acted as a poison, and the new disease, thus created, extended to the nose, over the whole face, upon the top of the head, to the left ear, and under the chin, and was still in progress when she came to the hospital. The nose was reduced nearly to a level with the face and its septum destroyed, uniting both nostrils in one.

Page 32

The lips partook of the disease and were no longer able to cover her teeth. The crown of the head was covered with one large scab, and also the left ear. The lungs were affected, and without cough, she expectorated constantly. The edge of the eyelids with the hairs were quite obliterated and adhered to the ball of the eye; there was no escape externally for the tears. The discharge from the surrounding sores dried upon the cornea, and came off like scales; still she was sensible to the light. The patient could turn her eyes as far as the confinement of the lids would allow. The treatment commenced with a dose of calomel and rhubarb, and after that, 5 granins of the compound extract of colocynth was administered daily for some days. Emollient poultices, the parts were well cleansed with casteel soap, and warm water; after that, gave a lotion of the solution of sulphate of copper (4 grs. to the ounce), and the red precipitate and citrine ointment were interchangeable applied. Under this treatment, on the 5th November, the disease was quite arrested; the head and ears threw off the scab, and left a smooth glistening skin beneath. The bone has not been affected. Blisters have been repeatedly applied over the lungs, tincture of digitalis, tincture of squills, and wine of antimony, have been administered internally. She expectorated less than formerly, and her whole appearance is much improved. She now remains in the hospital, and has submitted to have the eyelids detached from the globe of one eye, and if the secretions can be restored, there is a prospect of considerable improvement of her vision. A son, twenty-one years old, who accompanied her, had long been afflicted with an extensive ulcer in the hollow of his foot. Of this he has a prospect of a speedy and perfect cure.

No. 2152. Amputation at the shoulder joint. Absorption of the os humeri and enlargement of the arm. Po Ashing, aged 23, entered the hospital on the 3d of November. Six years since, he fell from a house and broke the hymerus of the left arm, half way from the elbow to the shoulder, the lower portion passing upwards and backwards. Union so far took place as to render the arm serviceable, till six months since, in a crowd at a "sing song," it was again broken. From that time, according to his statement, the arm gradually became larger till it had attained its present enormous size. Beside being painful, the weight of it drew him quite one side; at several places it seemed ready to burst; the skin was bright and glistering, and the veins passing over it were numerous and much enlarged. There was no doubt if its containing fluid, and though no pulsation could be felt, apprehensions were entertained that the tumor might be of an aneurismal nature. November 14th, assisted by Messrs. Cox, Cullen, Jardine, and Bonsall, I punctured the arm, supposing that possibly it might contain pus, and that the necessity of amputation might be avoided; yet prepared, if disappointed in this, to remove the arm. On opening the abscess, a dark greenish fluid escaped, with considerable force, but soon became darker and more bloody. Sixteen ounces were first discharged, but the character of the fluid was not decisive. In the hope that the blood was from some small vein

Page 33

divided by the incision, and that there was deep-seated pus, the lank
acet was reentered nearly its whole length; but the same discharge
continued with a greater proportion of venous blood: thirty-two
ounces in all were discharged, and the aperture closed. All
were agreed that the only chance of life was in the removal of the
arm; but the exhaustion of the patient and absence of his father
induced us to postpone the operation till the next day, unless
subsequent symptoms forbade. At 3 o'clock p. m., it appeared that
the tumor, which had been dimished by opening it, had attained more
than its former size, and supposing that the vein which had been
opened was emptying itself into the tumor, and that there could be no
safe delay, the operation would have been performed immediately
but for the absence of the patient's friends. The next morning
(Nov. 15th), the circumference was still but thirty inches; the
integument having reached its maximum of distention, it appeared
as though the fluid was insinuating itself beneath the integument
about the shoulder joint, increasing the difficulty and hazard of the
amputation. It proved, however, to be mere tumefaction. The
father and friends of the patient had come, and given the agreement
usual in cases liable to fatal terminations; and the patient had
recovered very much from his previous exhaustion.

At 11 arm., the gentlemen present the preceding day were ready,
and all things were prepared for the amputation. The patient was
seated in a chair supported around the waist by a sheet; the
tourniquet was applied, also the subclavian artery secured by an
assistant; a single flap was fromed as recommended by Liston, the
extent of the disease not admitting the use of the datlin as prax-
tised by Cooper. With a large scalpel, two incisions were made
commencing on either side of the acromion process, and meeting at the
origin of the deltoid muscle, which was immediately dissected up:
the capsular ligament divided, the head of the lumerus turned out of
the socket, and another stroke of the knife upwards dissevered the
arm from the body. A gush of blood pointed out the axillary artery
which was readily secured. The time did not exceed a minute from
the application of the scalpel till the arm was laid upon the floor;
the patient was then put upon a bed, and the pressure upon the artery
removed. An excellent flap was formed, and dressings were applied
as usual. Afterwards the patient threw up the brandy and water and
other medicines.

The best representation of the arm after amputation, so far as shape
is concerned, is that of a large ham of bacon. It weighed sixteen
catties, each equal to 21½ pounds. Opening the arm at the place
where it was punctured the preceding day, a dark coffee-colored
fluid gushed out. There were eight or ten ounces of coagulated
blood in the cavity first opened, which was bounded by a cist that
formed the wall of others. It resembled cerus membrane. Opening
other cavities, there was a similar discharge and a quantity of
matter resembling putrid crassamentum, of a light and purplish
color, or like the disorganized lungs of persons who have died of
purplish-coler-pulmonary consumption. One of the cists contained
nearly half a pint of fluid, &c. Traced the brachial artery from the
axilla to the forearm, and also the veins. The artery was very small,
about one tenth of an inch in diameter, and its coats thin; veins
also small.

page 34

The radial nerve was considerably enlarged. The bone was entirely absorbed, except an inch of each extremity. Fro, these small portions a few spicula of bones projected. At the head of the humerus it appeared, till we discovered the absorption of the whole bone, as if nature had formed a new joint with the glenoid cavity within the head of the humerus. There were points of osseous matter, but the cists collectively were surrounded on the inside and back of the arm by a firm cartilaginous wall like the brisket of an ox, with tendinous fibres passing in every direction like the curly maple. The muscles were much diseased, and their tendons lost in the mass of cartilage, which near the elbow, was three or four inches in thickness. From tge elbow downward, the muscles were perfect. The forearm was oedematous, and considerable adipose substance was found under the integument. And when the arm was taken All who were present pronounced the case the most remarkable they had ever seen. The patient is the first Chinese, so far as I know, who has ever voluntarily submitted to the amputation of a limb.

At 5 o'clock p. m., the patient having awoke from sleep, asked what he might eat. Congee was given. The expression of his countenance was good; he spoke with a natural voice, complained of cold, though his body was of a good temperature, the skin feeling natural, with a gentle perspiration upon the forehead. Not much oozing from the wound, but little pain, and he was quiet: his pulse was 126. With a friend, Mr. H., I watched all night with the patient. At 1 o'clock next morning he wished to know if he might eat chicken. He occasionally started in his sleep, and when awake, spoke of his arm as if it were still on. From four till five o'clock, he slept quietly, and made no complaint of pain, though there were some febrile symptoms, and his tongue was white and the skin dry. At 6 o'clock I was wakened during the day, when the skin dry. As he sponged his body, and gave an ounce of Castor oil. Pulse from 4 o'clock 110; bowels were moved during the day, and all the symptoms became more favorable. On the 18th, the wound was dressed and found to be united, by the first intention, nearly the whole length of the incisions. Most of the sutures were removed. On the 21st, the dressings were changed again, and the remaining sutures slipped, and the wound had the most healthy appearance. Patient walks his room, his general health is good, and his strength fast restoring. His gratitude, and that of his father seem deep and sincere. In this place I desire to express my own obligations to Drs. R. H. Cox, J. Cullen, and W. Jardine, esq., who have often afforded me their able counsel and assistance. I should do injustice to my own feelings not to acknowledge the untiring intetest which Dr. Cox has taken in the operations of the hospital during the past year, lending his assistance upon each day for operations, and with no other reward than that of doing good.

A situation in which it is possible to become the occasion of hurrying a fellow being to the invisible world, and that in a moment, is one which nothing but a fair hope of possibly retarding his exit to that unexplored country, could prompt one voluntarily to take; and yet such is sometimes the unavoidable predicament of the physician and surgeon.

page 35

Whilst the consciousness of having done all in his power for the good of his patient, may mitigate the poignancy of his feelings when the means he employs to protract life become the occasion of shortening it: when successful, he experiences a pleasure, which can be purchased only at the price he has paid, the satisfaction of having instrumentally wrenched a hysband or wife, a parent or child, from the iron grasp of disease and death, and of receiving the blessings of the rescued captive and his equally grateful circle of relatives and friends. The retrospect of the past year recalls several instances of the latter character. Of all those who have been treated, not a solitary instance is recollected of a patient receiving any detriment by the means employed. It is gratifying to know that many hundreds have been materially benefitted: some have been blest with the hearing of which before they were deprived; with others, a long night has been succeeded by the blessed light of day; and others still, whose diseases uncontrolled would have terminated in total blindness, have been timely arrested. All which demand a return of thankfulness to the kind and liberal friends who have furnished the means, and of devout gratitude and praise to God, who has so abundantly blest them. The number of Chinese, including the patients, who have visited the institution, is probably not less than 6000 or 7000. They have witnessed the operations, and have seen the cures. They are from nearly all parts of the empire; they carry with them the intelligence of what they have seen and heard. Consequently, from provinces more remote applications are made, and new anomalous diseases are presented, and the desirableness is daily increasing of not only continuing the institution commenced, but also of establishing other departments, and of supplying them with men of requisite qualifications.

The past unsolicited liberality of friends and benefactors, in China, amounting to about $1800.00, excites the hope that they will continue their assistance, without which the institution must have been conducted on a much more limited scale: but to the benevolent and humane in Europe and America we must look for the professional men. Besides the fact, that the strength of an individual is incomпитent to sustain many years the labors and responsibilities of the existing institution, it is impossible, unaided, to extend the sphere of his professional labors. To all who have witnessed the pressure of the patients, it has been obvious that more and better accommodations are imperiously demanded. The number of the highest classes is, doubtless, much less than it would be, were there suitable rooms to receive them, where they would not be exposed to the gaze of the crowd; and the wards of the hospital have often been filled fuller than the health and comfort of the inmates would allow. These facts are not mentioned by way of complaint, but to show the true situation of the case to those who feel and interest in promoting the welfare of the Chinese.

Page 24

There was no demarkation between the tumor and the surrounding adipose substance; the integument over it could be separated only by the knife. It appeared like a dense collection of gristley globules secretion as in the other, and in both instances there was considerable exudation of this during the process. The lad is now quite well.

No. 2474. Dec. 26th. A young lady from Nanking. Le Awoo, aged 19, eldest daughter of a silk merchant from Nanking, had suffered from infancy, from a disease of the left eye. At time, a white spot, with afleshy excrescence, covered the apex of the cornea and the blood vessels were enlarged and passed over the cornea. The father was informed that the eye might, at least, be prevented from becoming worse, and perhaps the vision improved. He said he confided the case to my care; had he confidence, he should not have applied.

By repeated applications of lunar caustic, the fleshy excrescence was destroyed; the blood vessels were divided at the union of the cornea and sclerotica; the general health was attended to, and after applying leeches to the temples, a blister was ordered. New granulations soon filled up the depression in the cornea made by the caustic. The blood vessels of the cornea became indistinct and the sight was improved, and at a little distance, a stranger could scarely perceive that it differed from other eye. Just before the close of the term, the father and two daughters came to take a final leave, bringing presents, which were declined, saying it was abundant reward, and that the treatment of his daughter had been successful; but he would not take them away. The patient and his little sister, 13 Years old, then came into the room, and a servant with a large crimson blanket. The first impression was, this is a part of the present. It was however spread at my feet, and the two young ladies knelt upon it. They were authoritavely told it was not required and permitted to "kow Tow." They heeded it not, though I took the eldest by the collar to prevent it, both succeeded in brlagging their heads twice to the ground. This was done before a very large crowd gathering of patients and several Europeans. The father was dressed like an officer, and his daughters wore splendid silk gowns with the richest embrodiery. Since the case of the young man from the same country was so hopeless, it is fortunate the result be so satisfactory in the case of the young lady.

No 2637 January 23rd 1837/ Adhesion of the trasi. Chun At sun aged 14. of Nanhae, at seven years old had small-pox, in consequence of which the edges of the lid, of the right eye united, exceptat a small point, near each angle, completely concealing the eye. With a pair of small curved scissors, the lids were separated, and the fine black eye which had neither seen, nor been seen, for seven long years, was in amoment unhooded. This treatment simple operation impressed the spectators more than the successful treatment of half dozen pulmonic affections would. The case illustrates their ignorance of surgical science.

No. 2638. January 23d. Pterygium and excrescence. Chin Hoo, aged 52, of Pwanyu, had pterygia upon both eyes. Besides four pterygia on the left eye, he had a dark excrescence larger than a kernel of coffee upon the inside of its lower lid. These incumbrances had nearly rendered useless the good eye beneath them. This is an extreme example of the disease very frequently here. One of

Page 25

One the pterygia and the excrescence has been removed, and the patient was doing well at the close of the term.

Ascites. Several cases of abdominal dropsy have been treated during the last term. From a woman, 43 years old, who had been afflicted six years, 7gallons of limpid fluid were drawn off at one time. In a few days she was quite well. From another female, about 50 years old, at a second operation 6 gallons were taken. Her liver was so enlarged as to fill nearly one third of the abdomen. From a young woman, 5 gallons have also been taken away. As soon as it was known that she had been relieved, her incredulous friends came to see if what they had heard were true. The patient did not regard the pain of the operation, but wept for joy when it was over, and she saw her friends congratulating her. Two other dropsical females had each 6 gallons taken away. In one of them, after evacuating the fluid, four hard tumors were found, three inches in diameter, forming a square figure; theyupon-not be seen distinct -ly as the collapsed muscles of the abdomen lay upon them, and were movable from side to side, and towards the diaphram, but not below the umbilicus. †Probably, the attachment was superiory. The poor woman only desired to live till her son, about 25 years old,

should be married. Beyond this she had no desire of life. The same general treatment is adopted, as was related of the young woman in the first report, who seems to have been permanently cured.

The young man who had his arm amputated, enjoys perfect health, and is cheerful and happy, as though no misfortune had befallen him.

In the first report of the hospital, same remarks were made favoring the removal of the tarus for the cure of entropia, a practice which, though for a time it appeared to do well, experience corrects. In many instances, such is the peculiar curvature of the Chinese eye that the evil continues. There are no cilia to turn in upon the eye, but, in healing, the outer skin unites to the inner edge of the wound, and this, not being a mucous membrane, soon turns in upon the cornea, and is still a source of irritation. The present mode is, to make the same perpendicular incisions through the tarsi at the lowre angle of the eye, avoiding the puncta, and then, with a pair of forceps, invented by T: R. Colledge Esq. for the purpose, to take up a fold of the integument over the upper lid, and with curved scissors cut it out, leaving the fifth of an inch next to the cilia, as the hairs are more effectually everted than when a wider portion remains. The operation is completed, by uniting the edges of the wounds with three sutures, and applying adhesive straps. The second day after, the sutures are slipt, and in four or five days the patient is relieved. The forceps so convenient for the operation are made with curved blades, that fit to the convexity of the eye, and are as broad as the portion of the skin to be removed with a slight beard at each point of the crescent. A spiral spring holds fast the integument when seized. The experience of a large number of cases enable me to speak favorably of the undiluted liquor plumbi, to prevent the return of pterygia, which is not an unfrequent occurrence.

Page 36

Ophthalmia Hospital at Canton: the sixth quarterly report, for the term ending on the 4th of May, 1837. By the Rev. Peter Parker, M.D. The Chinese Repository, Vol. V1. Page 34.

Six hundred and fifty patients have been received during the last three months, making the whole number, since the opening of the hospital, 3350. A more extensive acquaintance with the diseases and character of the people, may soon enable me to give a different form and more variety to the reports. The interest in the institution continues to increase, and the sagerness to enjoy its benefits has never been greater than it is now. Limited to once in the week, has been very great. Sometimes not less than 200 or 300, and on one occasion about 600, including their friends, have been present during a single day. Notwithstanding the institution is designed for the blind, great numbers of all diseases are presented, and often their importunity is successful in gaining admission. The importunity is frequently seconded by those who have received some special benefit; and being intimately acquainted in the hospital, are free in their solicitude for friends. Regarding simply the present welfare of those afflicted with various and aggravated maladies, none can witness these scenes and not perceived the urgency of speedily extending these healing efforts. It is very unpleasant to refuse aid to those who are within the reach of remedial powers, because it is impracticable to do so, and treatment already received. There is a reason to fear that turning them away will have an unfavorable influence. They see others afflicted with disease of the eye, with tumors and fractured limbs, are healed gratuitously, but since they have a cough, a fever, or any other disease that requires the physician rather than the surgeon, they cannot be received. The experience of every month confirms the desirableness of the Medical Missionary Society, soon to be organized, through whose agency and that of its friends, here and Europe, it is hoped this desideratum may be secured. The most numerous classes of diseases during the last term, have been acute and chronic ophthalmia, cataracts, entropia, pterygia, nebulae, lippitude, and granulations of the lids, as may be seen from the following table, which exhibits 1st. diseases of the eyes, and 2d miscellaneous diseases.

List:

<table><tbody><tr><td>Amaurosis</td><td>22</td></tr><tr><td>Acute ophthalmia</td><td>49</td></tr><tr><td>Chronic</td><td>79</td></tr><tr><td>Purulent</td><td>14</td></tr><tr><td>Ophthalmitis</td><td>6</td></tr><tr><td>Conjunctivitis</td><td>4</td></tr><tr><td>Hordeolum</td><td>4</td></tr><tr><td>Cataract</td><td>62</td></tr><tr><td>Entropia</td><td>78</td></tr><tr><td>Ectropia</td><td>3</td></tr><tr><td>Trichiasis</td><td>10</td></tr><tr><td>Pterygia</td><td>35</td></tr><tr><td>Opacity and vascularity of the cornea</td><td>28</td></tr><tr><td>Ulceration of the cornea</td><td>20</td></tr><tr><td>Nebulae</td><td>59</td></tr><tr><td>Albugo-</td><td>4</td></tr><tr><td>Leucoma</td><td>7</td></tr></tbody></table>

<table><tbody><tr><td>Staphyloma sclerotica</td><td>2</td></tr><tr><td>Staphyloma</td><td>22</td></tr><tr><td>Onyx</td><td>4</td></tr><tr><td>Iritis</td><td>4</td></tr><tr><td>Lippitudo</td><td>38</td></tr><tr><td>Night blindness</td><td>1</td></tr><tr><td>Day blindness</td><td>1</td></tr><tr><td>Near sightedness</td><td>1</td></tr><tr><td>Synechia anterior</td><td>11</td></tr><tr><td>Synechia posterior</td><td>3</td></tr><tr><td>Myosis</td><td>5</td></tr><tr><td>Closed pupil with deposition of coagulable lymph</td><td>5</td></tr><tr><td>Procidentia iridis</td><td>6</td></tr><tr><td>Glaucoma</td><td>2</td></tr><tr><td>Choroiditis</td><td>4</td></tr><tr><td>Epiphora</td><td>6</td></tr><tr><td>Granulation of the lids</td><td>50</td></tr><tr><td>Complete loss of one eye</td><td>49</td></tr></tbody></table>

Page 37

<table><tbody><tr><td>Loss of both eyes</td><td>53</td><td>Encysted tumors</td><td>4</td></tr><tr><td>Mucocele</td><td>6</td><td>Hernia umbilical</td><td>1</td></tr><tr><td>Muscae volitantes</td><td>3</td><td>Hydrops articuli</td><td>1</td></tr><tr><td>Tumor of the lids</td><td>2</td><td>Rheumatism</td><td>2</td></tr><tr><td>Improperf/ cornea at birth, the sclerotica extending into its place</td><td>1</td><td>Gout</td><td>1</td></tr><tr><td>Adhesion of the conjunctiva to the cornea</td><td>2</td><td>Phthisis</td><td>2</td></tr><tr><td>Injuries of the eye</td><td>2</td><td>Aphone</td><td>1</td></tr><tr><td>Cancer of the eye</td><td>1</td><td>Dyspepsia</td><td>1</td></tr><tr><td>Disease of the caruncula lachrymalis</td><td>2</td><td>Deaf and dumb children</td><td>3</td></tr><tr><td></td><td></td><td>Fungus haematodes of the arm(?)</td><td>2</td></tr><tr><td>2d. Otorrhoea</td><td>2</td><td>Ulcers</td><td>1</td></tr><tr><td>Deficiency of cerumen</td><td>1</td><td>Opium mania</td><td>2</td></tr><tr><td>Deafness</td><td>3</td><td>Serofula</td><td>1</td></tr><tr><td>Disease of the lower jaw</td><td>1</td><td>Paralysis</td><td>2</td></tr><tr><td>Dropsy</td><td>2</td><td>Hare lip</td><td>1</td></tr><tr><td>Ovarian dropsy</td><td>1</td><td>Epilepsy</td><td>1</td></tr><tr><td>Cancer of the breast</td><td>1</td><td>Stone</td><td>1</td></tr><tr><td>Goitre</td><td>4</td><td>Stricture of Urethra</td><td>2</td></tr><tr><td>Sarcomatous tumors</td><td>2</td><td>Enlarged spleen</td><td>2</td></tr><tr><td></td><td></td><td>Arachnitis</td><td>1</td></tr><tr><td></td><td></td><td>Hepatitis</td><td>1</td></tr><tr><td></td><td></td><td>Enlargement of parotid gland</td><td>3</td></tr><tr><td></td><td></td><td>Fracture of radius and ulna (one year)</td><td>1</td></tr></tbody></table>

In diseases of the eye, and their treatment nothing special has occurred that requires notice. Several cases of tumors, are subjoined.

No. 2732. Encysted tumor. Wangke, aged 12 years, of Shuntih. This little girl is a slave, and was sold by her mother for $8 or 10. She was accompanied by the hospital by her purchaser, a very respectable and well bred Chinese woman, who said the child was not her offspring, yet she felt for her the affection of a mother, and though the blemish had been a sufficient excuse for returning her to the mother, she preferred not to do so; and having heard of the hospital in Canton, was at expense and time and money to bring her, with the hope of relief. She had an encysted tumor, about 16 inches in circumference at the base, situated upon the sarum, and to the right side. Its pressure had produced some absorption of the sarrum, and caused the os coxcygis to turn outwards. It was moveable, and hard pressure gave it no pain. There was weakness of the spinal column or of the lower extremities. After suitable preparation of the patient it was removed, and found to be attached by a peduncle of the size of a common quill, which entered one of the posterior sacral foramina. On dividing it, one of the gentlemen who assisted noticed a slight flow of milky substance from the point of attachment.

Page 38

A ligature was required to prevent the escape of the fluid from the tumor, which was distended with limip contents resembling a bladder of water. The wound was dressed as usual. The child was in a subconatose state for some hours after the operation, and slow in answering when spoken to, - perhaps from the oplate she had taken. In the evening and the next morning, her pulse ranged from 130 to 140, with considerable fever, and there was anxiety for the result. Calomel and rhubarb were given and brought away a quantity of large worms (lumbrici), and all her unpleasant symptoms subsided. The child's appetite became good, and the wound healed up by granulations in a little more than a month. She became the picture of health, and with, cheeks plump and soso, was discharged at the expiration of six weeks.

No. 2850. Mare lip. Ian Atang, aged 17 years, of Honan, was disfagued by this congenital malformation, which extended up into the left nostril, and two teeth projected out at the opening. These were removed and when the soreness subsided, the operation was performed. The union was perfect, and the dressing removed in about one week. Both the appearance and voice were very much improved.

An operation is sometimes performed by native physicians for this deficiency. It consists of applying an escharotic between the edges of the lips and as this sloughs out, the lips of the wound are brought together and healed up by granulations. I have seen four cases in which the operation has been performed. In one instance the upper lip was drawn so tight as to form a straight line, and with the underlip projecting, his appearance was very undesirable. Whether this was the fault of the operator or the necessity of the case did not appear. In another man the lip was drawn askew.

No. 2982. March 13th. Chun Fang, son of a tsotang of Shuntih, aged 50 years, was born in Cheihle. In consequence of vice his general health had been affected. He had ulcers upon his head not affecting the cranium. Eight months previously they had been cured, and blindness supervened. When he came he could see light, but not sufficient to walk without being led. He was encouraged to expect relief from the severe pain he experienced, and that the progress of the disease might be arrested, and possibly his sight improved. There was congestion of the blood vessels of the eye. One dozen leeches, which in this country are very large, were applied below the eyes. Twenty grains of blue pill and one ounce sulph. mg. were prescribed. The leeches afforded immediate relief, and the patient expressed his surprise that he could see to count his fingers. March 16th. the sight remained improved. The leeches had produced a very great tumefaction of the left side and glands of the neck. As he was costive, an ounce of castor oil was administered, and warm formentations applied to his face, with an oplate at night. March 29. Pulse 126. The right side of the face also affected; the swelling of the left subsided a little. Patient vomited five / five times last night. The most entire absence of redness did not suggest the erysipelatous nature of the disease. (another patient who had been operated upon for entropia, and who had been discharged returned about the same similarly affected with an erysipelas of a more aggravated character than * have ever witnessed. Both of these patients scarcely retained the appearance of a human face.)

Page 39

He was very weak, and had great difficulty of breathing, a dry cough, pains in the chest, tongue thickly coated and parched, and his bowels constipated. A decoction of lichen islandicus, gum-arabic, and liquorice, was ordered to be used freely. And a gargle of borate of soda, an ounce of salts, and an opiate, and warm pediluvium at bed time, were prescribed. The patient was to take congee or sago if disposed. March 30th. Decidedly better; bowels had been moved, and the same treatment was continued. March 31st. Patient unable to come. Difficulty of respiration, thirst, and debility, increased. His extremities were cold, and face smaller,--as reported by his servant, a very intelligent man. One ounce of castor oil and adrachm of the oil of turpentine were taken immediately, and gave calomel xiligrains, pulv.ipecac.vi grains, and sugar jounce, divided into twelve parts, one of them to be taken hourly, and 30 drops of oil of turpentine every hour, and half a grain of opium every three hours-- and two grs. of sul.quin. every two hours. The head was kept wet with a lotion of nit.potas., and the patient allowed to drink freely of the decoction of lichen islandicus, as usual. April 1st. The bowels were moved the last night-- the patient has a little appetite--raised considerable sputta, tongue better, and his extremities not so cold. The erysipelas better, and the same treatment continued. April 4th. not heard from the patient for three days. His servant reported him to be better. The disease had evidently subsided. He still complained of debility, and a diarrhoea. Appetite improved. Decoction of lichen and a lotion of nit. potas. continued, together with oxymel of scillae. April 8th. The patient was able to be brought to the hospital, but did not get out of his sedan. A course of tonic treatment was then adopted, first sulphate of quinine, and afterwards the saturated tartrate of iron. His servant occasionally returned to say he was convalescent.

While preparing the report the patient has returned, in his official dress, with presents &c. He enjoys good health. He said he was to set out for Peking in two days, and willed for directions respecting his health and sight, in future.

No. 2986. Sarcomatous tumor. Chang Achun, aged 43 years, of Canton city, had a large sarcomatous tumor upon the right side of his face. It commenced five or six years since. He was a stone cutter, and was much incommoed in his occupation by this pendent tumor. On the 15th of April it was removed in 4 minutes and 56 seconds., and the patient put to bed in 20 minutes. It was 14 inches in circumference at its base, and still more round its centre. It weight 2½ catties, -3lbs. The wound healed almost entirely by the first intention. In nine days the dressings were removed. The incision being made so as to bring the edges of the wound perpendicularly from the zigomatic progress, down posterior to the external angle of the jaw, and thence parallel with it an inch below, quite to the chin, the face was very little disfigured.

No. 3000. April 17th. Lew Akin, aged 12 years, of Taunchun, a village of Shuntih district, and the only child of her affectionate parents, had a steatomatous tumor upon the right hip, of a magnitude that required the patient to lean forward when she walked, in order to present her balance. Her health appearwd good, except that she was much emaciated. In ten days she had made surprising improvement under the general diet.

Page 40

On The 27th of April, the usual indemnity being given by the parent, the tumor was removed in two minutes and a fourteen seconds. Its circumference (exceeding that of her body) was two feet at base, and much larger at the middle; it was very slightly attached, and consisted of concentric layers of fatty substance, separated from each by a surrounding cerous membrane, till near the centre it was found of a much firmer structure, resembling cartilage. It weighed a few catties or seven pounds avoirdupois. Upon the third day, the dressings were changed; union had taken place to a considerable extent. In one week the whole wasso far healed that the child was able to walk in the room without pain to herself or injury to the wound. She is now in good health, more fleshy than ever before. Since the first twenty-four hours after the operation she has experienced but little pain.-The feelings of the father were particularly noticed by the spectators at that time of the operation. He was in the room, but the unsightly wound that presented, as the integuments retracted ten or twelve inches apart, the incision being about ten inches long, wastoo much for the father to witness without tears. He left the room, but the cry of his little daughter, when the needle passed through the integuments in applying sutures, soon recalled him, as soon to retreat. His vigilance in his attention to his only child, continually, day and night, have strongly exhibited the strength of natural affections, equalled only by his gratitude for the relief afforded his daughter.-I am indebted to Lamqua, who has taken an admirable likeness of the little girl, and a good representation of the tumor. The more interesting cases that have been presented at the hospital, he has painted with equal success, and uniformly says, that as there is no charge for "cutting", he can make none for painting.

No.3132. April 17th. Anomalous. Chun Ato, aged 44 years, of Nanhae, has long been affected with apparently a nervous affection. Six inches below the left knee, and in the tibial nerve, a small pimple began, painful from the first. It is now elevated about two lines above the natural surface. For two years the pain has been intolerable, coming on by paroxysms, four, five, and even eight times a day. She had one of the paroxysms at the hospital, when she grated her teeth like a maniac. The spot from being level was drawn in at the centre, and a local perspiration came out for an inch around. Pulse raised to 120 during the paroxysm. Her tongue was very good, bowels free, and she had a common appetite. Under a tonic treatment she enjoys a slight palliation, the recurrence less frequent, the pains not so severe. The patient is desirous of having it cut out.

The relief afforded to cataract patients, of which there have been more than in any preceding term, has been much as usual. The disturbance to the eye from the operation is ordinary as slight as that of opening a vein in the arm.

The gratitude and confidence increase rather than diminish. An old Tartar general, who had been some time in the hospital, and who was operated upon for cataract with which he was affected in both eyes, as he was leaving said, "I am now eight years old, my beard is very long (reaching his breast); I have been an officer forty years; and have been in all the provinces of the empire, but never before have known a man that does the things that you perform, and for which you receive no reward."

Page 41.

Oh, what virtue! the great nation's arm under heaven ther is
no other like you," and more in the same adulatory strain. It is
pleasure to go to the hospital at any hour of the twenty-four,
and witness the confidence and kind feelings uniformly manifested
by the inmates. Those who have received some especial benefit
often seen to want language to express their gratitude. In some
instances the blind of distant village have united and chartered
a passage boat to come to Canton, and have waited four or five days
for the hospital to be opened to the admission of new patients.
Justice to my own feelings, require a public and grateful acknow-
legment to the medical and surgical gentlemen, Messrs. Cox, Anderso
Cullen, and Jardine, who have so frequently and kindly afforded
their counsel and assistance in important operations.

(Since the preceding was in type, we have seen some extracts
from the Journal of Dr. Grand, written at Cormish in Persia,
during the early part of the last year. The same eagerness for
aid, and the same success, are witnessed there as here. Ladies
and gentlemen, chiefs and noblemen, Christians and Mohammedans,
came in great numbers, importunate for medicines. Many, and
among them a son of the governor, were anxious to learn English.
A young mirza brought with him one of Henry Martyn's New
Testaments, "given him by a French lady. We are glad to see
such laborers coming eastward, and hope they will push for-
ward to Central Asia. -We ought to add here, that, according to
a statement published in the Register and Press dated the
11th instant, $5,230 have been subscribed for the Medical
Missionary Society. The Ophthalmic Hospital is supplied with
the requisite pecuniary aid from this fund.)

---

Page 44

## 2d. Miscellaneous.

<table><tbody><tr><td>Abscess of the ear</td><td>1</td><td>10*</td><td>Paraphymosis</td><td>1</td><td>1*</td></tr><tr><td>Abscess psoas</td><td>1</td><td>4</td><td>Fistulae-in-sane</td><td>1</td><td>6</td></tr><tr><td>Abscess of the thigh</td><td>2</td><td>2</td><td>Tinea capitis</td><td>1</td><td>4</td></tr><tr><td>Abscess of the parotid glands</td><td>2</td><td>2</td><td>Scrofula</td><td>6</td><td>13</td></tr><tr><td>Abscess of the arm</td><td>2</td><td>3</td><td>Enlargement of parotid gland</td><td>2</td><td>5</td></tr><tr><td>Abscess of the hand</td><td>1</td><td>6</td><td>Asthma</td><td>2</td><td>5</td></tr><tr><td>Abscess of the head</td><td>4</td><td>7</td><td>Croup</td><td>1</td><td>3</td></tr><tr><td>Abscess of the face</td><td>2</td><td>7</td><td>Bronchitis</td><td>1</td><td>1</td></tr><tr><td>Disease of the lower jaw</td><td>2</td><td>11</td><td>Bronchial flux</td><td>1</td><td>1</td></tr><tr><td>Luxation of the lower jaw</td><td>1</td><td>1</td><td>Phthisis</td><td>1</td><td>1</td></tr><tr><td>Otitis</td><td>2</td><td>2</td><td>Aphonia</td><td>1</td><td>1</td></tr><tr><td>Otorrhoea</td><td>2</td><td>24</td><td>Pneumonia</td><td>4</td><td>5</td></tr><tr><td>Deficient cerumen</td><td>9</td><td>8</td><td>Ethmoidis/hereditary</td><td>1,2</td><td>5</td></tr><tr><td>Deposition of cerumen</td><td>2</td><td>8</td><td>Herpes</td><td>1</td><td>5</td></tr><tr><td>Malformation of meatus</td><td>2</td><td>2</td><td>Impetigo</td><td>3</td><td>5</td></tr><tr><td>Imperforate auditory foramen</td><td>2</td><td>2</td><td>Psoriasis</td><td>1</td><td>1</td></tr><tr><td>Deafness</td><td>2</td><td>20</td><td>Acne</td><td>1</td><td>1</td></tr><tr><td>Nervous affection of the ear</td><td>3</td><td>1</td><td>Disease of the antrum</td><td>1</td><td>5</td></tr><tr><td>Polypus of the ear</td><td>1</td><td>25</td><td>maxillare</td><td>1</td><td>8</td></tr><tr><td>Dropsy</td><td>1</td><td>25</td><td>Diseased gums</td><td>1</td><td>3</td></tr><tr><td>Ovarian dropsy</td><td>3</td><td>11</td><td>Hare lip</td><td>5</td><td>6</td></tr><tr><td>Califlower excrescence of the uterus</td><td>1</td><td>1</td><td>Opium mania</td><td>2</td><td>15</td></tr><tr><td>Hydatids of the uterus</td><td>1</td><td>1</td><td>Paralysis of the arm</td><td>2</td><td>2</td></tr><tr><td>Scirrus</td><td>1</td><td>1</td><td>Hydrocephalus</td><td>2</td><td>6</td></tr><tr><td>Amenorrhoea</td><td>1</td><td>4</td><td>Dyspepsia</td><td>3</td><td>6</td></tr><tr><td>Cancer of the tongue</td><td>1</td><td>1</td><td>Urinary calculus(removed 3)</td><td>3</td><td>7</td></tr><tr><td>Cancer of the breast</td><td>3</td><td>10</td><td>Stone in the bladder</td><td>2</td><td>5</td></tr><tr><td>Cancer of the face</td><td>1</td><td>4</td><td>Deaf and dumb child</td><td>1</td><td>5</td></tr><tr><td>Goitre</td><td>5</td><td>15</td><td>Dumbness</td><td>1</td><td>7</td></tr><tr><td>Banulae</td><td>1</td><td>5</td><td>Hepatitis</td><td>3</td><td>3</td></tr><tr><td>Enlarged tonsils</td><td>1</td><td>3</td><td>Funous haematodes</td><td>1</td><td>6</td></tr><tr><td>Polypi of the nose (benign)</td><td>1</td><td>7</td><td>Ulcers</td><td>3</td><td>11</td></tr><tr><td>Polypi of the nose (malignant)</td><td>2</td><td>7</td><td>Needle thrust into the body below the sternal notch</td><td>1</td><td>1</td></tr><tr><td>Obliteration of nares</td><td>2</td><td>2</td><td>Needle thrust into a child's hand, &c.</td><td>1</td><td>1</td></tr><tr><td>Polypus of the ear</td><td>1</td><td>1</td><td>Double thumb</td><td>3</td><td>5</td></tr><tr><td>Hernia inguinal</td><td>2</td><td>7</td><td>Aneurism</td><td>2</td><td>2</td></tr><tr><td>Hernia umbilical</td><td>1</td><td>4</td><td>Wart filling one nostril</td><td>1</td><td>1</td></tr><tr><td>Chronic cystitis</td><td>1</td><td>1</td><td>Worms(Lumbrici)</td><td>2</td><td>6</td></tr><tr><td>Enlargement of the spleen</td><td>4</td><td>7</td><td>Haemoptysis</td><td>1</td><td>1</td></tr><tr><td>Abdominal tumors</td><td>3</td><td>7</td><td>Rheumatism</td><td>2</td><td>4</td></tr><tr><td>Encysted tumors</td><td>2</td><td>11</td><td>Arthritis</td><td>5</td><td>5</td></tr><tr><td>Sarcomatous tumors</td><td>5</td><td>25</td><td>Hydrops articuli</td><td>5</td><td>2</td></tr><tr><td>Tumors from each ear</td><td>5</td><td>5</td><td>Falpitation of the heart</td><td>2</td><td>2</td></tr><tr><td>Curvature of the spine</td><td>9</td><td>9</td><td>Thrush(ulcerated mouth and lips)</td><td>2</td><td>2</td></tr><tr><td>curvature of the ankle</td><td>1</td><td>1</td><td>Diabetes mellitus</td><td>1</td><td>1</td></tr><tr><td>Paraphlegia</td><td>2</td><td>3</td><td>Caries of tibia</td><td>1</td><td>1</td></tr><tr><td>Paraphymosis(natural)</td><td>3</td><td>2</td><td>Epilepsy</td><td>2</td><td>2</td></tr><tr><td>Whitlow</td><td>2</td><td>2</td><td>Elephantiasis</td><td>2</td><td>4</td></tr><tr><td></td><td></td><td></td><td>Enteritis</td><td>1</td><td>1</td></tr><tr><td></td><td></td><td></td><td>Disease of the heart</td><td>1</td><td>1</td></tr><tr><td></td><td></td><td></td><td>Distortion of the hand from small-pox</td><td>1</td><td>1</td></tr></tbody></table>

Page 45

No.3320. May 1st. Artificial joint of the forearm. Chay Aching, aged 27, of Canton. Eleven months ago he fractured the radius and ulna of his right arm. An artificial joint had been formed, which admitted inward motion to an angle of perhaps 60° it was without pains or tumefaction. On the 27th May, the ends of the fractured bones were grated upon each other for some minutes. The arm was then extended and the bones brought into their proper place, and confined by splints and a roller. The following night the patient complained of much pain, and urged the removal of the splints. They were continued, however, for three days, when, to his great delight, the bones were united and the wrist-arm was straight. Short splints were then substituted, leaving the hand and the wrist free. These were worn two months more. The man has now a useful right arm.

No.3362. May 12th. Injury from torture. Aching, a gardener in the vicinity of Canton, was accused by an envious relative to the government, as a smuggler and concealer of stolen goods. Accordingly he was siezed, and kept in the city a fortnight, sitting at the door of an officer, as aculprit, and beaten in the mean time was examined by torture, made to kneel on sharp spikes, and beaten upon his face and above his knees and ankles, in a most cruel manner. His foreteethwere knocked out. Twenty persons of this native village coming forward and testifying to his upright character, and offering their own heads if he could be proved guilty, the innocent and industrious poor man was liberated, but not till after he had paid $300! His ankles and knees were in an ulcerated condition from the previous application of the bamboo. The wounds presently healed, and the man is cruelty and injustice of the officers of the government.

No.3488. May 22d. Cartilaginous tumor. Too Run, aged 41, a shoemaker of Pwanyu, had been afflicted seventeen years with a large unsharpen tumor upon the left side of his neck. It hung pendulous from the submaxillary, extending backwards over the external jugular vein and caroid artery, forwards to the opposite side of the trachea, and downwards to the breast. For the last ten year its growth was rapid, and from its magnitude it had become very cumbersome. It was as large as the man's head, and so hard as not to yield to the pressure of the thumb. Centrally it was diseased, and having been perforated by the escharotics of the-a Chinese practitioner, it emitted a most offensive discharge. The aperture was half an inch in diameter, and as regularas if formed by a drill. The patient kept it close with a stopple, evrey morning evacuating some ounces of off encive fluid. His constitution had began to suffer. On the 19th June assisted by Mr Cox, Cullen, and Jardine, the tumor was removed in about five minutes. Several large veins of considerable size were divided In making the inferior horizontal incision, an inch of the integument above a larger superficial artery, was not divided till the dissection, of the tumor was nearly completed, and then, by compressing the artery before dividing it, very little blood was lost. The tumor was two feet in circumference, and weighed 7 lbs. The patient scarce uttered a groan. In twenty minutes he was comfortable in bed. "His was about 1 o'clock P.M.: at 3 o'clock 3 o'clock and at 5 o'clock his symptoms appeared favourable and there was but little ozzing of blood. At 9 o'clock he complained of phegm in his troat, and did not, breatht as easily as usual, and yet made no complains that the bandage was too taught. His brother depended upon to which with him and to call me, if any change occurred. At one o'clock A. M. a servant called; and when I arrived at the hospital the poor man was apparently gasping his last. He was very bloody and had evidently made a desperate struggle without success.

Page 46

to loosen the bandage. The neck was intantly freed of the roller.
His pulse was just perceptible; his extremeities were already cold; he
foamed at the nose, and breathed stertorously, as in apoplexy.
His mouth was immediately cleared of phlegm, and his nose of blood,
stimulants were applied and also administered internally, and bottles
of warm water put to his feet. He soon received and spoke, and his
breathing became easy.

The dressing was loosely applied at first, but the incision being
rather horizontal, nearly from ear, the blood that settled upon
the lower side, not escaping, acted as a wedge, causing suffocation.
Probaby the brother fell asleep, and awoke only by the almost dying
struggle of the patient. Two or three minutes delay in coming to his
relief might have been too late; after reapplying the dressing, he
had a comfortable night, and in one month was perfectly recovered.
He had repeatedly visited the hospital. His constitution has wonder-
fully recovered from the inroads of the disease, and he again enjoys
excellent health, and evinces unbounded gratitude. He seems to re-
gard the favor received, as conferring on him full liberty to in-
troduce any and all his diseased friends. This is very uniformly the
case with principle of human nature to explain it, unless it be
that of implicit confidence.

No. 3556 May 22d, Scirrous breast. No She, aged 48. of Pachow, near Whampoa, an artificial flower maker, had been afflicted with a cancerous breast for six years. The diseased gland was about four inches broad, six long, and two or three thick. She had long experience lancingating pains. There was some enlargement of the veins, and the part nearest the axilla was soft and just ready to burst. The axillary glands were not affected. The patient complained of pains in the region of the kidneys. The tongue was a little foul, and the pulse natural.

On the 21st of June, the breast was removed. Threadhesion of the
integument to the gland, protracted the operation to twenty minutes,
which the patient endured with the fortitude characteristic of her
sex. Her husband and son were present, who commanded their feelings
remarkably, and spoke cheeringly to their suffering friends. The
most painful sensations were caused by diving the nerves at the base
of the gland. Considerable febrile symptoms occurred the following
day, but they soon subsided. She rapidly and perfectly recovered,
and on the 1st of August was discharged. In October she returned
in good health. This is the first instance of the extirpation of
the female breast from a Chinese, and few operations could exhibit
in a stronger light their confidence in foreign surgery, yet it was
submitted to with the utmost cheerfulness, both in this case and
another hereafter to be noticed.

No.3763. June 19th, Ascites. Wang Yuen, aged 23, a weaver, had had
an accumulation of fluid for four years: cause not ascertained.
The abdomen was about six feet in circumference. On the 21st of June
in the presence of several medical gentlemen, twelve gallons of
fluid were drawn off, weighing sixty cats, equal to eighty pounds
avoiarpuppis. After the water was discharged and the wall of the abdo-
mencollapsed, the liver, stomach, heart, and uterus, were felt dis-
tinctly. The ribs and sterum were spread out of their natural position,
forming an immense cavity, bounded by the diappragm and natural in-
tegument. This was filled with cotton pledgets, and a bandage applied
around the thorax and abdomen.

Page 47

around the thorax and abdomen, which was tightened daily, gradu-
ally bringing it to its natural place. It seemed incredible that,
with such a bulk and weight, the young woman could walk at all,
especially as her feet were as much too small as her body was too
large. It required some practice, after its removal, before she
could walk comfortably alone. She appeared in health, independent
of this immense reservoir of fluid. She experienced no inconvenience
from the operation, and has in one week was discharged. Since my
return from Japan, she has visited the hospital, and was in fine
health. She was so altered that it was necessary to refer to the
records of the hospital to identify her. There is no reaccumulation.

No.3790. June 19th. Sarcomatous tumor. Yang she, aged 20. of Hwayuen, had a tumor pendulous from the chin and larynx. It commenced ten years since, and the last six years had been very cumbersome. The attachment beneath the chin was five inches in circumference. Centrally and horizontally it measured two feet three inches, and vertically three feet two inches. It extended below the umbilicus, but not so far as to rest in the lap; consequently its weight was sustained by the attachment, and the patient had to sit constantly in a bracing posture, to prevent its drawing down her head. The natural features were distorted, the cheeks being drawn tense by the weight of the tumor. The muscles on the back of the neck were preternaturally large, having been in constant action. A native practitioner had applied a ligature which remained sufficiently long to produce a permanent circle scar. Probaby, while the ligature interrupted the return of the blood in the veins, it did not compress the arteries, nor benumb the nerves: the pain must have been great and the result doubleful, had the destruction of the tumor been affected

Being in her fifth month her case was the more critical. It was at
this time determined to take a voyage to Japan; but whether she
was pre-apprized of this or not, and feared I might not return,
she and her friends were urgent to have the tumor removed then,
though the objection to it was distinctly stated. Perceiving the
confidence of the patient and anxiety of her friends, with the
approbation of several medical gentlemen, I complied with her
wishes; and on the 21st June, the tumor was removed in 12 seconds,
and the patient dressed and in bed in 24 minutes. Two arteries
of considerable size required ligatures; the veins upon the lower
side were very large, exceeding the natural size of the jugulars;
the skin, fasciae, veins, and arteries formed the principal attach-
ment. With the exception of a single point, an inch in diameter, the tu
tumor was as distinctly from the surrounding parts, as an egg
from its nest.

Seldom has there been less apparent suffering from so serious
an operation, as there was manifested by the young woman. The
wound healed kindly without any unpleasant symptoms. Her first
attempts to walk were awkward, having lost so much "ballast." In
one week the healing process had far advanced, when, at my depart-
menture from Canton for Japan, Messrs. Cox and Anderson, resident
physicians, most obligingly took charge of her and the preceding
cases, and such others as were in the hospital, and required attention
They have also continued their assistance on each day for operation,
weekly.

Page 48

In seventeen days she was discharged quite well. December 17th she returned, in excellent health and spirits, bringing her robust little son, two months old. Her features have assumed very much their natural form.

On 14th October, her grandfather returned to inform me of her health, bringing some trifling presents, with the following note accompanying them.

"The autumnal margold emits its fragrance and reflects its fresh tints, whilst I bring some trifling articles to repay your kindness, for having, by your deep skill, restored my grand-daughter to health. May your name, sir, be transmitted to fosterer for thousand ages, and may the benefits bestowed last ten thousand years! My whole family join with me in wishing you the enjoyment of happiness, and that you may be permitted, by your extraordinary practice, to assist and protect mankind. I beg you will receive this present with a smile. Yum Yute of Hwa heen, knocks his head and pays his respects".

No.4016. Extirpation of scirrous breast. Woo She aged 43, of Whampoa, was introduced by Mo She, too late treated for the same affection, of which she herself had been relieved. Woo She had had a scirrous enlargement of the left breast for three years. It was about the natural size of the full breast of milk. The tumor was well defined and strictly a local affection. Her constitution was perfect.

On the 1st of November the breast was removed in eight minutes, and the patient in bed in twenty. Her fortitude exceeded all that I have yet witnessed. She scarcely uttered a groan during the extirpation, and before she was removed from the table, clasped her hands, and, with an unaffected smile, cordially thanked the gentlemen who assisted on the occasion. The breast consisted of masses of gelatinous matter, surrounded by dense cartilaginous substance, which, at the base was nearly ossified, quite beyond the power of medicine, iodine not excepted, to remove. She experienced comparatively little inconvenience during her recovery. The edges of the wound healed chiefly by the first intention, but there was some suppuration of the parts beneath. An attack of dysentery upon the 16th day impeded the healing a little, but she soon recovered from it, and in about four weeks was discharged perfectly well. The natural amiability and cheerfulness of this woman and her little daughter, twelve years old, attracted the attention of many who vitited the hospital during her stay. Surely, natural sweetness of the temper exists in China.

No.4142. October 23rd. Harelip. Lo Asan, aged 3, of Heang-shan, a very interesting and intelligent girl, the idol of her wealthy parents, who would not have withheld any morderate sum, had it been necessary, to remedy the unpleasant malformation. The division of the lip and roof of the mouth extended up into the nostril. The operation was successful.

Page 49

The second and the third day, she had a considerable fever; as tis subsided, the wound healed rapidly and perfectly, in ten days. Her friends were greatly delighted, and sent presents of tea and fruits of various kinds, and a valuable crape shawl. These operation were declined in vain. "They are not for pay, but an expression of gratitude." Four persons were in constant attendan upon this little girl. She was amused by a pack of arithmatic cards, with red and black dots on them, by which she learnt to add, and subtract. She answered any questions for the same defect have been performed during the term. In two instances, several teeth and a portion of the palate, were removed. In one case the patient was discharged quite well in one week.

No. 4186. November 20th. Steatomatous tumor. Yuen Aking, aged 35, of Kaouyaou, had a tumor on the left side of his neck, orinating near the vertebrae, and passing out between the scaleni muscles; it was partially covered by the trapezius. It had attained a troublesome magnitude, nearly spherical, and six inches diameter, and was yearly increasing. November 29th, the tumor was extirpated. A portion of the anterior edge of the trapezius was necessary removed, and also of the scaleni muscles. The tumor lay between successive layers of muscular fibres and fasciae, which became more indistinct as they approached its centre, several of the transverse processes of the cervical vertebrae were exposed, covered only by the tendinous aponeurosis of their appropriate muscles, when the tumor was removed. The woman kindly healed by granulations in five weeks. The removal of the tumor affects slightly the raising the tip of the shoulder, and bringing the hand over the head. There was much suppuration from the division of themuscles. The patient became quite robust, and left a few days since, with the most unequivocal manifestations of gratitude.

No. 4370. Stapyloma. Ye Maouchang. A youth of 16, had lost his right eye entirely, and had also a staphyloma of the left. A part of the cornea protruded so far as not to be covered with the lids, yet a portion was clear and admitted light. He was introduced by a Hong merchant with particular request, that, if it were possible to benefit him, he might be treated. He was encouraged to expect the eye might be reduced to its natural size and the degree of sight still be retained. With this, he and his friends were satisfied to have the operation performed. The staphylomatous part was removed, the aqueous humor only escaped. The wound soon healed. The eye came to its proper size, and the vision was increased rather than diminished. His uncle, a literary gentleman, remained with him until he was nearly well, and, on leaving, presented two scrolls, on which he had written some account of the case, with a stanza of poetry. The scrolls are large about four feet long, and ten inches wide; and the poetry is written in large characters in the middle, perpendicularly, with the explanation on each side of it. The following is a translation, which may be interesting as a specimen of Chinese taste and customs. The comparison between the celestial luminaries, appearing from behind the clouds that had concealed them, and the blind restored gradually to a sense of light, is happy.

Page 50

"Dr. Parker, of the flowery-flag nation, sailed over the ocean, and came to Canton, with healing medicines. All men feel gratitude towards him. My nephew, Ye Maoushang, had been blind ten years, With a metallic instrument, he opened his eyes, and gradually restored vision. Therefore I have prepared these scrolls to record his deed.

(Signed) Chang Kwokin of Lingkang.

"The clouds and vapors rolling off, quickly appeared the sun and moon.- His art's true badge, the knife, he grasped, And therewith op'd the way to sacred light."

Death from Epilepsy. Aking, 38 years, of Koauyaou, was found nearly dead in the street. He had been in an epileptic fit three hours when¹ saw him. Many hundreds of his countrynem had seen him, out all' passed by on the other side.' After explaining to the by-standers and one of the police, the nature of the case, and the uncertainty of his recovery, judging from his symptoms, I offered to take him to the hospital, provided his body should be removed without trouble in the event of his death. This was acceded to. The usual treatment in similar cases was adopted. The severity of the paroxysm was soon mitigated, and in fourteen hours he had so far recovered his senses that he was able to give intelligent answers. In a short time, some of his friends came and expressed grateful feelings for the care taken of him, but soon left, though requested to remain with the sick man. Thenext day, a brother came, who said he had been subject to these attacks for about three year, and they usually lasted twelve hours. Upon the second and third days he had some fever on the fourth and fifth, he was able to walk about the house, and to take congee, and his recovery was expected, -he-had about a few hours after my leaving the hospital on the fifth day, he had a relapse and died suddenly. His brother and friends came the next morning, and were grateful for the care bestowed on the deceased. A rude coffin was soon provided, and without change of apparel he was borne to his rest in the grave.

No. 4565 A second instance of death occurred, in the case of a young woman, aged 27. Her own account of herself was briefly as follows. She had enjoyed good health since the birth of her first child, two years since. More than a year ago she had a small swelling of the size of the duck's egg, just beneath the false ribs, on the right side, and at the same time commenced a curvature of the spine. Ten days last, an abscess formed in the lumbar region, which burst of itself. The discharge was great at the time, and since. When she came to the hospital, her case appeared hopeless, but her emaciated form, and the affecting narrative of her feelings, early bereft of her father, enlisted my warmest sympathies, and I could not at once extinguish her last hope of her recovery.

Page 51

She was told that she might remained a few days, when her case should be fully explained. Shortly the high fever, which she had had daily, subsided; the abscess was attended to; and tonics were administered; and she was gradually improving. But about ten days afterwards, I was called to her, early one morning, when to my surprise, I found her dead in the arms of her mother. The patient was not aware of the fact, and was told that her daughter had better be laid on the bed. After remaining her that all must die, and that the Supreme Ruler would decide as to the best time, I informed her that her daughter was dead, and requested she would not yield to excessive grief. She commended her feelings remarkably, and calmly said her "destiny is fixed."

The deceased was a young woman of extraordinary intelligence, and unlike the majority of her sex in China, had read much. She was a dutiful child, and said that her desire of life chiefly that she might provide for her parent.

The following are a selection of incurable diseases, which have been presented at the institution.
No. 3438, May 22d. Aneurism Choo Akwei, a young man 20 years old, of Manchow in Pwanyu, has an aneurism of the supercapularius and subclavian arteries. It commenced five or six years since. At first, a slight tumefaction, widely diffused over the scapula of the left shoulder, was perceived. The aneurismal tumor is now two feet in circumference, at its base, and eight inches in its smallest transverse diameter. The pulsation is distinct in every part of it. Ignorant of its character, the native physician had applied escharotics, and nothing but the great thickness of the skin of the back, preserved the man from a fatal consequences of so rash an expedient. The rush of blood from under the clavicle is fearfully especially when heard through the stepthoscope. The passage of the blood is also very distinct to the touch. Pressure above the clavicle interrupts the pulsation in the tumor, which becomes sensibly smaller by continuing it a few minutes. It is impossible to determine the extent of the disease. Apparently, it extends along the subclavian till it is lost beneath the sternum. It appears as though this artery were dilated to the diameter of an inch or more. Under these circumstances it has been deemed judicious and humane not to interfere. The patient is of a slender constitution, his pulse is about its natural frequency but irregular, as is also the action of the heart.

No. 4099, October 25d, Elephantiasis, Tang Pahe, aged 25, has elephantiasis of the left leg, which from the knee to the ankle, is nearly of a uniform size, and its average circumference about two feet! The young man enjoys good health, and his only suffering is from its great weight. It is but a few years since it began.

No 4503 December 18th, a similar case of elephantiasis prepresented. Wang Teenpwan, 26 years old, a student from Sinning, came a journey of 21days, to ask advice.

Page 52

He had been troubled, some years, with an enlargement of the
left leg, which, from the knee to the ankle, was from 2feet to
30 inches in circumference. The disease in this case seemed
to be confined to the integument, and formed a large cylinder,
freely moveable about the muscles and parts beneath. The motions
of the leg were perfect.

Several patients with enlarged spleens, of a very aggravated
character, have appeared. I am inclined to think, that affections
of this class are numerous in China. In some instances the
spleen entirely filled the abdomen. Partial benefit has been
conferred in a few cases, but the long treatment required under
the most favorable circumstances, much exceeds the perseverance
of the patient.

Abdominal tumors. As the benefit of autopsy cannot be had in
China, we cannot speak definitely of this class of diseases,
which is most frequent in females. Some of these, also, filled
the abdominal cavity, and much distended its parieties.

Scrofula, as might be expected from the filthy habits, and
improper diet of some of these Chinese, is common, and some-
times exhibit itself here in its most frightful forms, a
affecting all the glands, the head, and indeed, the whole system,
particularly the joints.

No. 4572. December 18th. Fungous haematodes. Tsee Chingho, 61
years old, a native of Nanhae, has a fungous haematodes of
the left eye of the face. Six months since it began with in-
flammation, and pain of the eye, which soon protruded so as to
prevent the closing of the lids. Its expansion over the face
now forms a disk six inches by four. There is a similar excre-
scene starting from the cheek beath it, just over the antrum.
Several others, not yet through the integuments, are starting
out of the left cheek, and a small one from the nose.

A few minor operations may be here briefly noticed. Two young
women had a tumor, pendulous from each ear, in one case half
an inch in diameter, and in the other an inch and a half.
These were occasioned by heavy metallic earrings. Four or five
similar cases have occurred, and the tumors have been removed,
without destroying the natural shape of the ear.

A respectable young lady, 18 years old, from the city, had a
small tumor in an ulcerated state upon the crown of the head.
Unwilling, as that age particularly, to come to the hospital,
her father requested me to meet her at the house of a friend,
just without the city. She was prevailed upon to have it re-
moved at the hospital. In one week the tumor was quite well.

A second encysted tumor, of the size of a hen's egg, upon a
man's head, just above the mastoid process, has been removed;
and a third, from a man 46 years old, situated below the left
ear, rather deep-seated. There was a fourth case also, a lad
16years old, who had a sarcomatous tumor, four inches in dia-
meter, which was situated just below the left ear. These were
all removed and the patients speedily discharged.

Page 53

An unusual number of cases of ascite have presented. Besides the one above named, the following may be noticed.

No. 4173. Lesingyaou, a Tartar, who is connected with the hoppo's office, was relieved of 28 catties of limpid fluid. No. 4270.

Lew Ayuen, aged 61 of Taeleih had between five and six gallons of chocolate-colored fluid in the abdomen. After discharged it, a large and a hard tumor was found, apparently orinating from the liver. It was not very tender to the touch.

Here I close their review of the institution, during its two years existence. Of the 4575 patients that have been received, many are remembered, as well as their deep solicitude, and that of their friends as they have waited to know their prosects, and their joy when they have been relieved. The recollection of the hundreds that will never see light, has revived the sorrowful sensation previously felt. They were too late. Some of the latter class were just entering upon life, they were in perfect health, but, for the want of timely assistance, the orb of light has been to them early and totally extinguished. There is some mitigation, however, in the reflection, that, whilst various surgical operations have been performed, through the divine blessing, none have proved fatal; that many young persons have been saved from a life of blindness, and that others have regained the vision actually and (without some kind interposition) forever lost. It has often delightful to witness parents again enjoying the sight of their children, whose prattlings and blooming countenances had never more greet them their eyes, had not the cataract thrust aside. From many, those protuberences and incumbrances, which rendered their possessors monsters, and life a burden, have been successfully removed. The cancer, threatening its victim with death, has been once and again extirpated from the mother's breastbosom. The misplaced, and in some instances large, reservoirs of useless and cumbersome fluid, have been dried up, and health has grown again smiled upon the previously despondent sister and parent. Too these results, the friends and benefactors who have promptly sustained the institution, are refered as their best reward, whilst the most grateful acknowledgments are tendered them, in behalf of the thousands whom their charity has benefitted. Especially thanks are due to the medical genitemen, who have repeatedly and so cheerfully lent their important aid, particularly to Messrs. R.H.COx, and A. Anderson, who have continued their valuable assistance each week upon the day devoted to operations. And also to William Jardine, esq. who, notwithstanding he has long ceased from practice, retains all his interest in his former profession, and even in the pressure of business in one of the largest commercial houses in Canto. has ever found leisure to attend to the calls of the suffering humility. Facts are constantly occurring, which show the increasing confidence of the Chinese in foreign surgery, and the widening extent to which the knowledge of the operations spread. As illustrative of the former, Howqua, the senior hong merchant, has presented $300 to the institution; and in proof of the letter, numbers are have come journeys of several weeks to avail themselves of its benefit. A district magistrate from the province if Hoopih, in the interior of China, has come a journey of weeks to be treated for blindness, and is now an inmate of the hospital.

Page 54

The importance of training young men for the medical profession in China was early felt, and I am happy to state, for three years, of good promise, of the aged 16, 17, and 19 years, are now connected with the hospital. They have already made respect- able proficiency in the English language, and are valuable assistance in the compounding medicines and administering the prescriptions. The eldest is responsible and active youth, and besides his tution, receives $5 per month wages. Some minor operations upon the eye, as the entropia, and pterygium, he has dexterously performed: he has served now more than a year. The second is the farthest advanced, of the three, in his own language, having been designed for a literary life, till the death of his father (who held an office in government), more than a year since, deprived him of the means pursuing his studies. He is partly sustained by the Morrison Education Society. The third, who is a young man of good talent, is wholly supported by his father, and is to remain at least five years.

I cannot close this report, without adverting to another circumstances, not the least interesting to those who have at heart the best welfare of the empire. I refer to the opportunities constantly presented of exhibiting the spirit and principles of our most holyn religion, of frequently pointing out to them the consequences of vice, and of inculcating principles of temperance and morality. Seasons pecuniary favorable occur of showing them the vanity and falsity of idols, and of making them acquainted with the true God. And these advantages will increasing, as our knowledge of their language and religion increases, and as we are advanced in their confidence and obligation.

74 A.

<table><tbody><tr><td>2d. Abseess psoas</td><td>1</td><td>Deficiency of cerumen</td><td>3</td></tr><tr><td>Abscess of the head</td><td>3</td><td>Malformation of meatus</td><td>1</td></tr><tr><td>Abscess of the face</td><td>1</td><td>Deafness</td><td>6</td></tr><tr><td>Disease of the lower jaw</td><td>2</td><td>Nervous affection of the ear</td><td>1</td></tr><tr><td>Otitis</td><td>1</td><td>Dropsy</td><td>6</td></tr><tr><td>Otorrhoea</td><td>-2</td><td>Ovarian dropsy</td><td>2</td></tr><tr><td>Scirrus uterus</td><td>-1</td><td>Fibrous tumor</td><td>1</td></tr><tr><td>Cancer of the breast</td><td>3</td><td>Tumors of each ear</td><td>2</td></tr><tr><td>Goitre</td><td>-2</td><td>Scrofula</td><td>6</td></tr><tr><td>Enlarged tonsils</td><td>1</td><td>Aphonia</td><td>1</td></tr><tr><td>Polyp of the nose</td><td>2</td><td>Lichen</td><td>5</td></tr><tr><td>Closed anterior nares from ulceration of the fauces</td><td>1</td><td>Hare lip</td><td>2</td></tr><tr><td>Hernia inguinal</td><td>3</td><td>Opium mania</td><td>4</td></tr><tr><td>Hernia umbilical</td><td>2</td><td>Paralysis of the arm</td><td>2</td></tr><tr><td>Enlargement of the spleen</td><td>2</td><td>Hydropcephalus</td><td>1</td></tr><tr><td>Abdominal tumors</td><td>1</td><td>Dyspepsia</td><td>1</td></tr><tr><td>Encysted tumors</td><td>4</td><td>Urinary calculus</td><td>2</td></tr><tr><td>Sarcomatous tumors</td><td>16</td><td>Deaf and dumb child</td><td>1</td></tr><tr><td>Steatcomatous</td><td>2</td><td>Ulcers</td><td>3</td></tr><tr><td>Cutaneous</td><td>5</td><td>Double thumb</td><td>2</td></tr><tr><td>Tumor of the hairy scalp</td><td>1</td><td>Worms</td><td>2</td></tr><tr><td></td><td></td><td>Rheumatism</td><td>2</td></tr><tr><td></td><td></td><td>Thrush (ulcerated mouth and lip)</td><td>2</td></tr><tr><td></td><td></td><td>Distorted foot and leg from burning in infancy</td><td>1</td></tr><tr><td></td><td></td><td>Dislocation of the radius at the elbow</td><td>1</td></tr></tbody></table>

As heretofore official gentlemen have been my patients. One, aluded to in the last report, has been long resident in the hospital. As illustrative of the character of the Chinese in the higher ranks and remoter provinces, and as it is our object to give impartial reports, his case in here introduced.

No. 4535. Dec. 18th 1837. Ching Chungyew, aged 56, is a native of Keangnan. For several years he was a district magistrate in the province of Hoopih. As this date he came to the hospital, having made a journey of six weeks, to reach the provincial city. There was something imposing in the person, and prepossessing in the urbanity, of this gentleman. He came in full dress, and and on being introduced, he fell upon his knees, stating his case, and what he had heard of the institution, and entreated with strong feeling that he might be admitted. During his administration as a magistrate, he said, he was often compelled to examine official papers to a late hour of the night, and from a long continuance of this practice his eyes failed him.

Page 74 B.

It was extremely painful to find his case was nearly hopeless. There was adhesion of the iris to the lens in both eyes; and in the right; the irregular pupil was nearly closed, and the lenses were slightly opaque. He was just sensible to light. The little prospect of benefitting him was explained, at the same time a willingness expressed to do the utmost for him. He replied, "I shall be extremely grateful for the slightest degree of vision that can be restored," and that death was almost preferable to his helpless condition. He remarked, however, that he should be entirely reconciled, if received. Whatever might be the result. In this he has his promise.

His habits were full, his pulse, from 90 to 100, was strong and bounding. The first object was to reduce him by chathartics, and then by leeching. Belladonna immediately detached the adhesion of the iris to the lens in a degree, and the old man was elated at the change in his sense of light. In the course of a week or ten days strychnine was applied to a blistered surface at the external angle of each eye, one eighth of a grain at first, and increased to a grain, when the effect of it was painfully senseible. Subsequently a seaton was inserted in his neck, which was attended with free discharge. This, old gentleman seemed to regard as the most barbarous part of the treatment, and in my absence for a fortnight, discontinued it at his own discretion. Belladonna was applied at intervals. In March the strychnine was administered internally in one eighth grain pilla three times daily, and increased to one fourth grain. This was continued some weeks when the spasmodic effects of it upon the system became manifest. Oncasionally the patient thought he experienced a flash of light - for it was momentary-early in the morning, but perseverance with the strychnine for some time, varying the constitutional treatment according to symptoms, did not restore the vision. As a last resort, it was proposed to depress the lens, for in repeated instances of 'black cataract' with less opacity, good sight had been restored. This sensitivity of light encouraged the hope that the retina and optic nerve had not entirely lost their function. The case was explained to the patient; that if sight was not restored he would only be as before, and the pain of operation was trifling. It was the only thing that remained to be done, and that were he my patient could do no more, than what had been done for him. His feelings were quite overcome and he shed tears, not less grateful than of sorrow, and desired the operation to be performed. Early in April the lens in this left eye was depressed. No inflammation followed. He slept as quitely the following as the preceding night. The degree of sight remained much the same. In about a fortnight he was discharged, when the poor man wept like a child. He was probably as sincere a worshiper of an imaginary deity as the heathen world ever produced. He was a devoted follower of Budha. Hours were spent daily in his worship, and in extempory addresses. He was much of the time attended by two or three servants. His personal servant was as old as himself, with a long flowing jet black beard, and was unwearied in his attention to his blind master.

Page 75

A few days subsequently to his leaving the hospital the servant returned with a card and the following testimonal.

"already it has said, that there is nothing greater, than to preserve the heart, to benefit men, and to heal their diseases. Hence saying, "the excellent physician, the noble statesman," both are equal extolled. To explain my meaning, the present Dr. Parker, is an American, intimately acquainted with the art of Ke and Kwang." He embarked upon the ocean and came to Canton and established a hospital, practicing medicine gratuitously; and from his own stores bestowing medicines and other necessary things, endeavoring to heal all, both far and near. Daily he treats several hundred, with kindness, and for a long time, without weariness. Therefore the eqithet 'benevolent ship for affording universal help.' is most appropriate to him, even these four characters."

慈航普濟

But as mankind reverence and bless the illustrious Goddess of mercy, so Dr. Parker, with heart of parental tenderness benefiting the age, will become like the ancient Buddha- it is impossible to limit his greatness.

"I held an office in Hoopin more than thirty years, and accidentally, in the eight month of the 17th year of Taoukwang (1837) both my eye lost their sight. Hearing medicines failed to be efficacies. His celebrity reached my ears. I then relinquished my office, came to Canton, and repaired to the hospital to be treated; and although my sight is not yet restored, nevertheless I have received the Dr.'s diligent attention, and became inseparably attached to him. Truly it is impossible to forget to feel grateful towards him, and accordingly I have written and present him this testimonal.

He then proceeds to give a brief sketch of his personal history in the following words.

*Celebrated Chinese physicians of antiquity.

Page 76

"Under the heavenly dynasty, by imperial order and direction, was conferred on me the honorable office of seenchih (director and controller of affair). Previously, I had held an office in Haukan heen, in Hauoyung foo (in the central province) of Hoopin, and was temporarily, an assistant magistrate in Eshing heen in Seangyangfoo; having obtained at the quinquenial examination upon the distinguished-honorary title of choe, I am waiting for promotion upon the distinguished ocean (the arena of life). I Ching Chungyew, worshipping have written this testimonal."

No. 4552. Distortion of the hand, December 18th, 1837. Woo Chingsew, of Pwanyu, aged 20, at the age of 13, had the small pox by which the tendon of the middle finger of the right hand was so cicatrized that growth was interrupted, but the other parts were of the hand continued their natural growth, and consequently the hand was distorted in a singular manner. The knuckle of the middle finger was back on the radius and ulna, which having continued to grow, carried the wrist down about two inches and a half below the attachment, and the hand was nearly useless. On the 25th of March, the withered tendon was divided, and the cicatrizied skin on the back of the hand. The tendons of the other fingers were all exposed, and that of the thumb divided. Immediately the hand was partially restored to its natural position, and by three in dressing it with splints, it was rendered tolerably straight again. The naked tendons were at length covered with granulations and in about six weeks the patient was discharged, the wound having healed up. He was able to move her thumb and fingers, and by exercise the hand will probably become useful again.

No. 4605 Tumor of the scalp. December 18th, 1837. Dow Tangshow, aged 23, a laborer of Tungkwan, a young man of a lymphatic temperament, had a singular disease upon the hairy scalp, of ten years growth. When he came to the hospital a mass half the size of the head, hung loose over his right ear and down upon the back of the neck, being situated principally on the crown, back, and right sides, of the head. On the 25th of April the operation was performed. The integuments were considerably thickened, but separate from the unformed mass beneath, which was dissected out, exposing the pericranium beneath. The loss of blood was considerable and the patient's fainting rendered it necessary to hasten the operation, so that a small portion of the fatty substance at one or two points was left, which otherwise had been removed. The portion of the scalp taken away was nearly large enough to cover one third of the head. From the loss of blood, the patient lost flesh for a week or a fortnight, but from that time he much improved and has now more than regained his former health. The wound healed kindly and perfectly in about eight weeks, and he was discharged on the 19th June.

Page 77

No. 4606. Gourd-shaped tumor. December 18th, 1857. Kwan Nanking, aged 42, of Nanhae, also of a lymphatic temperature, had a tumor pendulous from the left side immediately over the hip joint, precisely resembling a gourd. Its bulbous portion was about one foot circumference, and its neck four or five inches long, and the circular attachment of its peduncle about two inches diameter. Its lower part was in an ulcerated state. On the 28th of February it was removed and the patient was presently well. Its singular form and attachment entitle it to notice.

No. 4849. Case of malpractice. June 1858. Le Sanying, aged 27, of Hwa heen, one year previous to her coming to the hospital and a tumor of the size of an hen's egg, upon the forehead. The Chinese as usual applied escharotice, by which it was converted into an ulcer of a bad character. A more pitable object seldom presents itself, than was this woman at her first visit. The ulcerated tumor spread over a surface of three or four square inches. Another tumor had also attained the size of a small orange under the left ear, and a third had commenced over the temporal artery of the right side near its origin. The pulse was feeble, the countenance sallow, and without speedy relief the patient must have died. The ulcer on the head was first cleansed by poultices, and afterwards adhesive straps and firm bandages were applied-tonic administered, and the whole assumed a healthy appearance. The tumor under the ear has been removed, and new skin has covered a considerable portion of the sore on the forehead. Had the tumor been left to itself by the native physician it might have been easily removed, and the young woman saved a great deal of suffering. Her case is still doubtful.

No. 4903. Tumor of a peculiar character. March 5th, Choo Yihleang, aged 31, a shoemaker of Kaouyaou, had a tumor on the right of the neck, as large as it appeared from a front view. It was situated beneath the sterno-cleido-mastoideus muscle, and the superficial fascia. It extended from the ear to the clavicle, and from upon the trachea to the posterior edge of the above muscle, which was drawn very tense above it. When the patient entered the hospital it was firmly fixed, scarily admitting a perceptible motion in any direction. At a point on the surface near the apex was indicated a slight collection of fluid. The patient was blooming in health, and resolutely desirous of its extirpation. He was admitted to the hospital, and in the course of a week or ten days, after repeated examinations it was determined to extirpate it, though it was manifestly more movable- a fact that the patient also observed. With the advice of several surgeons who had seen the patient, it was determined to extirpate it, though it was possible the external carotid artery might require a division in the event. On the 25th of April the operation was performed, assisted by Messrs. Cox, Jardine, and Holgate. Precaution was taken for trying the carotid if necessary. The patient took 25 drops of laudanum half an hour before coming to the table. The preceding day he requested not to be tied, assuring me he would not momentarily alimb, or speak a word. When the moment arrived, instead of skidding from the crisis, he put one hand on the table and skipped upon it with great agility, as if joyful in the prospect of being freed of

Page 78

his troublesome companion.

The incisions were made in the direction of the muscle, from
the mastoid process to the clavicle. A small portion of the
anterior edge of the mastoid muscle was divided, but to our
great satisfaction soon after the incisions were completed,
the tumor readily separated from its nius, and in four minutes
was completely out. A few small arteries that were divided
soon contracted, and gave no further trouble. But two veins
continued to discharge their contents so copiously that neither
cold water or pressure would stop them, and ligatures became
indispensible. One upon the external jugular apparently, (for
when natural positions are so altered we cannot speak confid-
ently) and upon a large branch of the same, passing under the
lower jaw. During the operation the patient was perfectly
collected, and did not utter a groan: spoke with natural voice
when spoken to, and repeatedly requested the operator might
not be alarmed, The tumor weighed 5 lbs. It was surrounded by
a firm wall an inch thick, resembling in hardness the full
grown cocoa nut, except at one point: then came another layer
of three quarters of an inch of white puppy substance, and
centrally there were several ounces of milky fluid quite
inodorous. The large muscle resumed its natural place, the
wound healed chiefly by the first intentions and in twenty
days the patient, in good health and with unequivocal senti-
ments of gratitude, returned to his family. Thus the case that
often attends the removal appeared formidable in prospect,
has really proved of less trouble than often attends the re-
moval of the tumor but a hundredth part of its size. It has
been the more interesting as being the first instance in which
I have applied a ligature to a vein. But the result favors the
conclusion that, veins may be tied with as much impunity as
arteries. In the present instance one ligature came away of
itself on the 13th, the other on the 14th day.

No. 5075. April 2d. Yin Yaouwei, aged 30, a farmer of Nanhae,
had a tumor three inches diameter beneath his right ear, in
an inflamed state, very painful, and fast tending to sup-
puration. This was also removed on the 25th of April in six
minutes. The adhesion was rather firm to the integument above,
and to the angle of the jaw. The submaxillary gland was exposed
to view. In fifteen days the patient was discharged quite well

No. 5111. April 11th. 1838. Large tumor. Woo Kingshing, aged
49, a fisherman from Shihsztow, near the Bogue, ten years
since had a small tumor just below the clavicle on the left
side. It had now attained a very great magnitude resembling
in figure a tenor viol. Superiorly it extended over the shoulder
to the spine of the scapula and from the acromion process to
the trachea, and from the axilla to the sternum, and as the
breast, carrying that gland down before it.

Page 79

The circumference at the base was three feet three inches! Its
perpendicular length was two feet, and its transverse diameter
from the axilla to the sternum one foot eight inches. It was
very vascular, especially the upper portion of it, which was in an
inflamed and ulcerated state, and the principal vein that returned
the blood of the tumor-near the clavicle-when distended with
blood from a pressure upon it, was apparently half an inch
diameter. There was a deep longitudinal fissure, and ulcers
at several points, from which there was a constant discharge,
of blood, lymph, and pus. The weigh of it had become ex-
mely burdensome, and several times a day the patient experienced
severe paroxisms of pain, causing him to groan aloud, at which
times he laid his tumor upon the floor and inclined himself
upon it. In this position he spent the principal part of his
time day and night. His countenance and furrowed brow expressed
unequivocally the calamity he suffered. His friends were much
delighted on being told that it probably could be removed with
safety, but the old man had been too long accustomed to express-
ions of suffering to yield to those of joy, and in his feeble
condition was less sanguin probably in the feasibility of
separating him from his old companion. He desired to return to
his family for a few days previous to residing in the hospital;
he was prescribed for and went home. On the 2nd of April he
returned. Having undergo half a month's preparatory treatment
on the 2d, of May, assisted, as usual in cases of magnitude, by
Messrs. Cox and Jardine, and several other friends, the operation
was performed.

Thirty drops of laudan were given the patient half an hour pre-
viously, and after placing himself upon the table, the tumor
was elevated for eight or ten minutes to return its blood to
the system as much as practicable. As the surface was extensive
and the veins large and numerous, it was deemed best not to
make the incisions the whole length at first, and the result
confined the judiciousness of the measure. Two incisions were
first made from the breast upwards as high as the clavicle or
a little above. The gush of venous-blood was considerable, and
the first steps less encouraging than was anticipated. On ace
count of previous inflammation, and the long pressure made by
the weight of the tumor, and the patient's reclining upon it,
as it lay on the floor, the dissection was almost as difficult
as that of the skin on the bottom of the foot. Perceiving this,
the operation appeared most formidable, and the result scarcely
doubtful, but it was too late to retrace our steps, and besides
it was hoped the work of dissection would be confined to the
surface, and that it would be readily relieved at its base,
but in this we were also disappointed. The dissection of the
lower portions being finished- the first incisions upwards
were completed, and then commencing below the tumor, it was
turned upwards- firm ligametous bands uniting it to the muscles
beneath, it required division by the knife at nearly every
inch of surface throughout its base, and at its clavicle the
attachment was particularly strong.

Page 80

The tumor was extirpated from below to a little distance above the clavicle, when the patient began to faint and to be convulsed, and his pulse was scarcely perceptible. Stilts, brandy and spirits of ammonia, were administered by assistants, and the operation continued. He soon revived and the tumor was immediately after laid upon the floor, being just sixteen minutes from the commencement, and not a ligature was required. The wound was united by sutures and adhesive straps, dressed as usual, and the patient was soon after laid to bed. The tumor consisted of an almost cartilaginous mass, and at points it was firmly united by a tendinous band. The tumor nearly ossified in some places and was of white color. It weighed 15 pounds avoirdupois, and it was estimated by the best judges present that there was a loss of about two pounds of blood.

I remained with the patient two hours after, and as his pulse was scarcely perceptible and his extremities cold, bottles and tins of warm water were applied to his feet and abdomen, and more stimulants were administered. The latter caused the stomach to reject what it had already received. He soon after perspired and fell into a gentle sleep. His pulse gradually became more perceptible, and did not vary much from 100. In the evening he took a little congee but soon rejected it, and was much under the influence of the opiate during the night. The next day he had very much rallied, but complained of strangury, probably caused by the laudanum and brandy of the preceding day. An ounce of castor oil was administered, and a decoction of chamomile flowers and mucilage of gum arabic were given him to drink; the symptoms subsided in the course of next day, and the patient gradually revived. On the third day the dressings were partly removed, at the superior portion where the integument was almost diseased, one or two of the sutures were giving way with a slight slough. They were removed, and undiluted laudanum and poultice, were applied to the part. The lower portion was healing kindly. The next day the slough had not extended, and the whole began to assume a healthy aspect. On the fourth day the man had so regained his strength and spirit, as to salute me with a smile and to feel sensible of his good fortune, and remarked that his sufferings were less than formerly experienced from the presence of the tumor. Tonics, wine, bark, and quinine, were administered, and a generous diet ordered. The first ten days he lost a good deal of flesh, but since then the scale has turned in his favor. In twenty days all below the clavicle was firmly healed, and the large cavity above was most rapidly filling up with granulations. No fever supervened upon the operation. On the 19th of June the old gentleman was discharged in perfect health, forming a great contract with his former emaciated appearance.

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No.5119. May 5th. Tumor of the skin. Wang Waekae, of Kanuyaou, aged 45, a man of doubtful character, had numerous small tumors of the skin, of a light flesh color and smooth shining surface, situated about the arms, breast, neck, and head. In the latter position one had attained a great size, hanging pendulous from his left ear, to which it was attained by a pendulous of two inches diameter, to an almost immovable base formed by a similar disease of the skin, an inch thick, extending over the mastoid process and upwards and backwards over five or six square inches. Both the base and the pendulous portion were traversed by small ducts, discharging fecid mass removed, but was impatient if the others were touched. Considering the age of the man it seemed inexpedient to remove the firm base, but it was easy to excise the unsightly jewel that hung dangling upon the breast, impeding his labor. His wishes were complied with. On the 20th May the operation was performed in a very short time. It was more like cutting green hide, than flesh. In the centre of the neck of the tumor, was a cluster of small arteries, eight of which required a ligature. The loss of blood was trifling. The tumor weighed four pounds. On being laid open the ducts, above onticed, were found to traverse the whole mass, chiefly longitudinally like the bronchiae of the lungs, sending off branches in all directions, lined with a pus secreting membrane.

The singular appearance of this man excited strong suspicions, particularly with his countrymen, that he might belong to a band of ruffians. His eyes were usually fixed upon the ground, his manners were most foroiding, and his answers to questions brief as possible. He bore with great impatience the necessary dressings upon the tumor, and repeatedly removed them at the option against the strictest injunctions, and was daily restless to be away, though he was provided with things necessary for his comfort. On the tenth day, the ligatures came away and soon after the patient disappeared and has not been heard of since. There is no apprehension of danger from the wound as it was small and fast healing. The manner of his absconding strengthens the suspicions that he was a bad man, and but little accustomed to the civilities he received and witnessed in the hospital.

No.5331. May 14th, Steatomatous tumor. Chin Take, a farmer of Nanhae, 32 years old, had a tumor situated upon the inside of his right thigh, beneath the satorius muscle and the fascia of the fascia of the vastus externus, extending from the nates to within two or three inches of the knee. The satorius muscle was carried out of its natural position four or five inches upon the tumor. It measured at its base two feet and a half. It has been ten years in attening its enormous size, greatly impeding the man in walking and in his labor. One the 13th June, assisted by Messrs Cox and Jardine, the tumor was removed, in forty and a half seconds from the first incisions

Page 82

It weighed eight catties or ten pounds and a half. One artery of considerable size near the popliteal, required a ligature. The substance of the tumor was very yellow, and being divided, freely exuded an oily fluid. June 14th, a.m., the patient had some fever with an irregular jirking pulse of 112. Castor oil, sulp. mag. and Seidlitz were given which, one after the other were rejected as soon as taken, m. cal and rhei. were given and not vomited. At 4 o'clock his bowels were moved to his great relief, June 15th: the patient's bowels were again opened. pulse 78, but little fever and not much pain in the leg. He was in good cheer and wishes to exchange his congee for heartier food. June 14th, slightly feverish, appetite indifferent, June 17th, dressed the wound and found it in a desirable condition, fast healing up. From that time all pain has gone on well, and he has a prospect of a speedy and perfect cure.

No. 5583. June 14th. Diseased breast. Kwan Meiurh, of Kaouming, 45 years old, a silk embroiderer, had a preternatural development of the left mamma, which commenced two years ago. Six months before she came to the hospital, she called a Chinese physician who applied to it a succession of plasters. Soon after the integument ulcerated and the protruded. She was much emaciated and the breast, one third as large as her head, came down as low as the umbilicus, when she stood up, and layed upon her arm in the recumbent posture, presenting a large raw surface, exuding blood and the natural secretion of the gland as it was irited by the clothes. At various points were seen the lacteal ducts greatly enlarged. Her pulse 90 was feeble, the disease was strictly local. The patient justly remarked, 'the sooner it was removed the better!' A few grains of ollie and extract of colocynth were given her every other day, and on the 20th of June, assisted by Messrs. Cox, Jardine, and Holgate, and Dr. Mallat of Manila, the breast was removed. In the morning before the operation, the patient being asked if she feared it, replied in the negative, that now if a turn to the right hand or to the left, incline forward, or backward I am in pain, but in cutting of my breast is but a single pang, 'The composed and confiding manner in which she came to the operation could not escape the notice of the gentlemen who were present. Apparently no child ever lay in the arms of its parent with more confidence of safety, than this woman lay upon the operation table under the knife of a foreigner. In two and a half minutes the breast was extirpated; no artery required a ligature. The patient just removed her lips as a small remaining portion of the gland was dissected out; but regained the natural expression of her countenance before she was carried from the table. No fever followed: next day the pulse was 102. On the 21st removed the dressing in part-union by first intension was taking place. The third day the patient was walking from room to room, happy in her deliverance from so gloomy a prospect and such suffering as the disease and the maltreatment it had received, occasioned. She is most rapidly recovering.

Page 83

Cataracts. Eighty-four cataract patients have presented during the last term, and 466 since the opening of the hospital. The usual routine, it occurred on one occasion in the last term, that fourteen patients were operated upon for this affection at the same sitting. Several instances are recollected of spontaneous absorption of the cataract, but in only two cases did the patients regain their sight. One of these had tolerable vision. Of the many interesting cases of this disease, the following one, of a brother and sister, is particularly serving of notice.

No. 4714. Lae Sheensing, aged 19, and No. 4747, Lae Ahing, aged 21, of Sanshuy, were both blind from cataract, brother ten and sister twenty, years. When they came to the hospital accompanied by their parents, they were scarcely sensible of light. Their countenances were pale and corpse-like, and their vacant motionless eyes were set with milk-white cataracts, as with pearls. The iris was naturally sensible to the stimulus of light, and readily dilated and contracted. The cataracts were couched or lacerated according as the case required. The a slight inflammation followed the operation in one eye of the young woman affecting the iris, and causing irregularity of the pupil. Otherwise the operations were satisfactory. The brother and sister were discharged in about one month, enabled to behold each other's face for the first time, for years, though dwelling in the same house. An expression of animation and intelligence played upon their countenances in lieu of that of themarble statue which before characterised them. With sentiments of deep gratitude the happy son and daughter, and equally joyous parents, returned home together. One month subsequently they revisited the hospital blooming in health, and with sight so far restored as to enable them to see to read.

No. 2231. Death of Wang Keking. The case of this man who had a congenital tumor of unqualified magnitude, was mentioned in the Fifth Quarterly Report. On the 26th March he was seized by a violent fever which terminated fatally in three days. I was not apprized of his illness till his death was reported. I immediately repaired to his late residence, and was shown the way into his room, where his two youth widows, and a little daughter, clad in sackcloth, were upon their knees on the floor by the side of the corpse, with incense and wax candles burning before them. After retiring from his room, it was explained to the father and brothers how desirable it was that the tumor should be examined, the service it might be to the living, and the inconvenience of putting the corpse with the tumor into the coffin; they affected assent, but must first consult the widows and mother. The father soon returned, saying it would be agreeable to him to have the examination, but the mother and wives of the deceased could not assent, 'they feared the blood, and that the operation might occasion pain to the deceased.' After returning home, the kindness of a friend enabled me to offer a present of $50 to the family, provided they would permit the autopsy. A linguist was sent to negotiate with them, but in vain. Probably $500 would not have overcome their superstition. In January a final consultation of several medical and surgical gentlemen was held upon his case. A majority thought the chances against an operation, others considered them equal.

Page 34

It is with gratitude to Him, to whose blessing it is to be
ascribed., that we once more repeated the fact that, no fatal
termination has attended as yet an operation at the hospital,
though in two or three instances of great intricacy there has
been out has a hair's breath escape from death. This circum-
stances no doubt has had an important influence in producing
the unbounded confidence of all who apply for relief, among
whom have been, the past term, persons of various ranks, and
from the remote parts of the empire, from Ningpo on the east,
and Feking on the north, to the borders of Tartary on the west,
The generous remittances of medicines, surgical instruments,
and a skeleton, from friends in New York and Philadelphia, dem
mand and receive our most grateful acknowledgement.

Page 85

Ophthalmic Hospital at Canton: the ninth report, being for the quarterly term ending December 31st, 1838. By the Rev. P. Parker, M.D.
The Chinese Repository, Vol. V11 page 569.

To the friends and supporters of the Medical Missionary Society in China, the following report will afford new pleasure. It evinces the stedily advancing influence and importance of the Society's operations. The growing confidence reposed by the people in the skill of the foreign surgeon has been strongly displayed, in the degree of readiness with which they submit to painful operations, and even to the loss of limbs-although this is so strong greatly opposed to their prejudices, as well as to their principle, that the body, received perfect in form from one's parents, should be committed in no less perfection of form to its last resting place in the tomb of earth. A Chinese female (the first, so far as we know, at least in modern times) has submitted to the operation amputation of their breasts, on account of cancerous disease in an advanced stage-Their increasing reliance on the western physician's knowledge of disease and its cure has been shown, in the accession of an unusually large number of official persons, some of them men of high station.

Among these, may be mentioned Wang, acting judicial commissioner of this province, who was first seen, at the commercial house of one of the Hong merchants. The chief object of this gentleman was to be enabled so to appear and report of himself before the emperor, that want of health might not stand in the way of his promotion. He was immensely corpulent, and his chair was carried by four beares (the number allotted to his rank), with an equal number of supporters. His compained was hemiplegia. His desires were very moderate: it would entirely satisfy him if he could but walk twenty rods, and beaded to go through the requisite ceremonies of kneeling and bowing in the presence of his superiors. As he is still under treatment of the particulars of this case will be given hereafter. Another visitor of rank was New, the chief magistrate of the district in which the factories are placed, and the officer, consequently, who appeared, so acceptably to foreigners-to disperse the mob collected before the factories-on the memorable 12th of Dec., when a little longer delay might have been placed the lives and property of the foreigners in imminent jeopardy. The application of this officers is especially interesting, as, from his situation, he is the proper authority to take cognizance of the hospital, had it fallen, as an innovation, under the displeasure of the local government. But by personally receiving aid from it, and by speaking of it in terms of commendation to his friends, he is virtually sanctioning it, and giving it influence among the people, by whom it is extensively known that through it he has been essentially benefitted. His nephew and several of his friends have also been received as patients, and some are still under medical treatment.

Page 86

In one of his visits, he likewise introduced Hingan, a footseang or colonel, who had recently been in command of the forces stationed in defence of the capital of Wangse, and was then on his way to Peking. This officer was suffering from rheumatism: as he did not returne a second time, he was probably compelled to continue his journey to Peking sooner than he had at first anticipated. One other officer may here be named-Lew seunpoo (a civilian, whose function is nearly that of a European aid-de-samp). to the governor of these provinces. Unlike the others just mentioned, who have preferred their requests for medical attendance through Howqua, or some other of the hong merchants, and have arranged to be seen at the commercial houses of those gentlemen, in preference to coming with the multitude to the hospital-this officer came to the institution, and on one occasion remained to witness the operations that were being performed. He was much interested to see the depression of the cataract, to hear the patient, who had been blind for seven years, exclaim, immediately on the removal of the needle, 'I see light' and to observe her count, in a minute after, the fingers held up before her. He was particular in his inquiries, wishing to know how long she had been blind, if much harm would not follow the operation. On his return, a week after, he found the patient had already been discharged, not the slightest inflammation having followed, and he sleep at night not having been in the least degree disturbed.

These encouraging circumstances notwithstanding, it ought not to be supposed that all prejudice is yet overcome. Instances to the contrary occasionally occur. After the particular desire of a friend, a brother of one of the hong merchants, who was considered dangerously ill, requested to be attended, at his own house. He was found very sick, but apparently not beyond the power of European medicine to recover. A favorable prognosis was given, which had the undesirable effect of encouraging him to try native remedies still longer. The danger of a day's delay was pointed out: it might involve fatal consequences; it would be the height of folly to defer calling a fire-engine to a burning house until after all other means of extinguishing the flames should be first tried-an argument likely to be well understood by a Chinese; but remonstrances were in vain, "The foreigner's prescription, "I cannot read, and how can I know what he is giving me". It is in accordance with Chinese habits to see the prescriptions of their physicians, and of men acquainted with books, many have studied the different medical theories that are upheld among them, and pretend to some knowledge of the pulse, the diseases of which it affords diagnosis, and the appropriate remedies. Yielding to his prejudices, the patient, after trying a little longer his own physicians, died a victim to his folly. Just before his death, he desired the foreigner physician to be again called in, but it was then too late.

["Page 88", "Miscellaneous Diseases.", "Inflammatory disorders:", "Rheumatism - - - - - - - 6", "Thrush - - - - - - - - 2", "Abscesses - - - - - - - 5", "Arthritis - - - - - - - 2", "Fistulae Mammae - - - - 1", "Fistula (in ano) - - - - 1", "Ulcer (chiefly of lower in extremities) - - - 3", "Ulceration of fauces - 1", "Inflammation of \" - - - 1", "Constitutional diseases:", "Ascites - - - - - - - - 2", "Anasarca - - - - - - - 6", "Opium mania - - - - - - 8-", "Scrofula - - - - - - - - 9", "Diseases of the organs of Circulation:", "Palpitation:", "Chronic Bronchitis - - - 1", "Diseases of Digestive organs of Respiration - - - - - - - - - - - - - - - - -

Page 39

Case of Tinqua. (See the second quarterly report, case No.1243)
Mortification of the right foot. Immediately after arriving
from Macao, in the beginning of October, a message was received,
stating that this old gentleman had a foot in an advanced
stage of disease, and was anxious to have it examined without
delay. He was greatly delighted when I called, and said he had
desired to send for me to Macao, but was told that I could
not leave hundreds for him a single individual. Mortification
had already far advanced. The great toe, and the toe adjoining
had sloughed off, and the blueness extended up yhe ball of the
foot and had involved two other toes. No regard had been paid
to his bowels. Ginseng was their sheet anchor, and except a few
similar drugs their only remedy. His pulse was on some days
quite imperceptible below the bend of the elbow, particularly
in the left arm. Thenatural of the disease was explained to
him, that it was inexpedient to amputate the leg, but his
only hope was in restoring the tone of the digestive organs,
and rousing the system generally, with the desire, that a
line of separation might be formed, if not at the metatarsal
joints, at least at theankle. Blue pill, with minute quantities
of croton oil, was employed as an aperient, he being unwilling
to take salts or castor oil. His native physician was allowed
to continue his ginseng, &c, showing me his prescriptions daily.

Tonics, port wine, tincture of gentian, and preparation of
iron, were applied to his foot. The old man sent his sedan
chair morning and evening, and I as often attended the dressing
of his foot. In one week the foot and general symptoms were
decidedly improved, and the last day but one general symptoms
of my attendance, as I entered his apartment, he said with
much animation, "You are my doctor," and repeated it several
times. But the next day, through the interference as it after-
wards appeared, of his female supernumeraries, he requested me
to cease my vitits for two days, during which he wished to do
nothing to his foot. However, I called, desiring to see him
without prescribing, and with some hesitancy was admitted,
when it appeared that his foot had been dressed by a native
doctress, who had put on an indefinite quantity and variety
of salves. The old man seemed dejected and scarcely spoke aloud.
I saw him but once after this, and then in company with one
of his oldest European friends, when it was plainly pointed
out to him, that by the course he must pursuing, he was leaving
the disease to itself, that the treatment was utterly futile,
out that if he would resume that under which he had began to
to amend, there was still hope for him. He seemed obliged for
the call, and had he been as independent as when in health,
no doubt he would have accepted the counsel that was overruled
by his domestic cabinet. On the 20th November he died, and
the usual obsequies were such as to comfort with his rank and
opulence while alive. Had leisure permitted, it would have
been interesting to witness the ceremonies from time to time,
and to obtain a full account of them; particularly as showing
a coincidence between the obsequies of the Chinese, and the
ETAPUS of the ancient Greek, who are said to have been ac-
customed to bury with their dead, horses, clothes, arms, also
the gifts of friends, and whatever was dear to the deceased.

Page 90

Some days elapsed before calling at the house of the deceased. The numerous presents of friends were then pointed not, such as tablets with themost flattering eulogies, as well as servants, men and women, animal, as the swan, the crane, the peacock, goats, horses,&c.all of paper, intended to be sent by fire to serve the convenience and gratification of thedeceased in the other world. The most striking thing was a pile of his official robes from his large full boo-ts, to the button upon his cap, also of paper. And over the urn in which all were to be burned, was his title, and the year when he received it, with a small scroll like parchment containing a facismile, in that world to which he had gone, the rank he held in this, his credential would be complete. This man had associated with foreigners for some years, and amassed an independeny fortune. He was distinguished for his decision of character, and for his good sense upon all the ordinary affairs of life, andyet, this is his end; and these thehopes andprospects, at least in his friends'estimation, with which he has entered eternity!

No.5707. Oct.27th.Scirrhous breast, Lew Fuh, aged 50, of Sehea, a village in Pwanyu, had had a scirrhous affection of her right breast for six months.At the time of entering the hospital it was very large and hard. The integument over it was entirely involved in the disease; it presented a singularly rough and red, warty surface, and there was a foul discharge. The whole was firmly adherent to the base.Axillary glands much enlarged and indurated. The patient was very corpulent. At times she experienced sharp shooting pains. Pulse very feeble but quick; tolerably good appetite. Little encouragement was given that it could be extirpated with success. She was permitted, however, to remain in the hospital in order to try the efficacy of pressure. Blue pill and extract of colocynth, combined with small quantity of opium, were prescribed, to be taken occasionally. Also two grains of extract of conium, three times daily, and one grain of extract of hyosciamus at bedtime. Carrot poultices were applied by night, and firm pressure by day. Decided improvement was soon apparent, the breast diminished and became less fixed. On the 2dNovember the patient rubbed the breast with her garments and caused a hemorrhage of several ounces,The Chinese dresser applied a solution of alum which arrested the bleeding, but the patient complained of much pain for half an hour.On the 5th December, in removing the dressing, a still more copious hemorrhage was produced. The pulse was but sixty, and very feeble, on the 6th December, when the patient was furnished with the same medicines which she had been taking, and advised to go home for one week, continuing the bandaging and poultices.

She returned as directed, improved by the change of air; but on the 16thDecember, had a spontaneous hemorrhage of twelve or fifteen ounces, which left her very weak and pale, and it was obvious that a few more such drafts of blood would fatal.It was then decided, if she should in any good degree rally, before a recurrence of the bleeding, to remove the breast, as the only chance of protracting her life.Accordingly, on the 22dDecember, the breast was extirpated.

Page 91

The husband was made acquainted with the critical condition of his wife, that a speedy fatal termination was probable if the disease was left to itself, but possibly the removal might be successful. He gave the usual indemnity.

The breast, and also the glands of the axilla, were removed with facility, and with much less apparent suffering, than another woman had experienced from the same operation immediately before. But on making the first incision, one of the gentlemen assisting explained, "what have we here! this is not blood." The fluid from the veins appeared like bloody water. The wound was soon dressed, and the patient was placed comfortably in bed, and the same gentleman expressed it as his opinion that she would recover more rapidly than the other. She continued comfortable, and three hours after the operation took some congee, and seemed to like it, but at 9 o'clock P.M., her respiration became labored, the pulse languid, and extremities cold. Warm brandy and water were given, hot water applied to her feet and hands, and she was thus rendered more comfortable. On returning to the hospital, one hour after, the pulse was found feeble and breathing more difficult, but the other patient was heard, in a room beyond, vomiting, and, regarding her as most needing attention, this patient was left. In about fifteen minutes, the vomiting of the other having been checked, the patient was returned to this patient, and found her already dead!

The corpse in a little time was removed to a retired room, where it remained till preparations could be made for its burial. The bereaved husband felt very sensibly his affection. They had lived together in great harmony for nearly thirty years. He had already became care-worn with his most assiduous attentions to her day and night during her sickness, and so far from being dissatisfied, he often spoke of the trouble he was causing. After the customary mourning was over, he returned and repeated the expression of his sense of obligations.

No. 5721. Oct. 30th, 1838. Osteo-medullary sarcoma of the right wrist. Means Yen, aged 34, from the neighborhood of Hwate, 'the flower gardens.' In October 1837, the disease commenced, at the head of the radius, and it had gradually increased until it now measured one foot seven inches around the wrist, and about the same at its base. It had never been remarkably painful, neither had the discharge of blood been great. The patient's countenance was very sallow, and face and extremities generally oedematous, particularly on the right side. The monthly discharges were interrupted about the time the disease began. The patient had a morbid appetite, eating as much as in health. Pulse feeble and frequent; occasionally a few grains of blue pill and colocynth were administered, and opiates at night, with a view of improving her general health. Several medical gentlemen saw the patient, and among them Dr. Guilbert of the French frigate L'Artemise. All were agreed that it was advisable to amputate the arm, without delay. Though the patient did not understand what was spoken, she learned or surmised, from a gesture inadvertently made, that amputation was proposed, and with great determination subsequently remarked to another, that

page 92

that she would sooner die than submit to the operation. In a daysthe state of the case was explained to her, that in the opinion of several medical men she could not live long unless the arm was removed, that the operation would not be ex-tremely painful, and that it was her only chance for protract-ing life. She urged her helplessness without her right hand, but amditted it was better that one limb should be sacrificed than the whole body. However, in a few days, she resolved to go home. After twenty days she returned, manifestly im-proved in her health from the medicine she had taken, though the fungus had increases. The operation was again proposed to her and her husband. Each consented, but as it was an extraordinary affair he wished first to consult her relations . He didso, and wrote back that they confided entirely in my judgment, but ill health prevented his return.

The patient still consented; the 15th December was fixed upon for the operation, and on the previous evening everything was in readiness, but the next morning when visited, she, with a toss of her head, emphatically exclaimed, "No cutting! no cutting!" and holding up two fingers she added, "give 200 dollars and you may." The patient is an exception to all that have ever yet visited the hospital. She quite understood the kindness that had been shown her. Food, and female servant to attend constantly upon her, had been provided, and-when, hearing that her husband's health would not permit him to return to see the operation, she expressed a fear that if he was absent and she should not perfectly recover, he might declin supporting her-she was assured that if he deserted her, she should not be provided for. It seemed at this time that she thought me anxious to multilate her, and that I would give her price to do so. It, This, however, she subsequently disclaimed, and said that it had been suggested to her by another, that if she could obtain this sum, it would make her independent of her husband for support. In a few days the man came, and suggested begged my forgiveness, and observed that it was not the Chinese custom to except the physician to pay for healing his patient. She also seemed ashamed for her ingratitude, and both desired that the arm should be amputated, and gave the usual indemnity, which was the more necessary as the patient had by long delay became very feeble. She was just able to be lifted from her bed to the table. A medical gentleman who saw her on Monday, learning that it was proposed to amputate the arm on Wednesday, expressed his opinion, that she would not live to see the day. It was noticeable a few days before this, that the pulse at the bend of the right arm was 90, while it was 112 in the wrist of the other; but the momentum was proportionably greater in the right arm. On the 12th December, during the time of the attempted execution of an opium dealer, and the consequent rot, in the front of the factories, all was quiet at the hospital, and the operation was performed.

Page 93

The arm was removed by the flap operation, four inches above the elbow. An opiate was administered half an hour before the time for operation, also grains of blue pill, and ten ext. of rhubarb. The patient after her decision was fully formed contemned the idea of pain, and at the moment of sawing the bone inquired when that part of the process would take place. She had a comfortable night following, and the bowels were moved in the morning, her pulse being 114, and rather feeble. Her appetite soon became strong, and on the 15th was indulged quite to the jeopardy of her health, when, being called to her, the abdomen was found much distended, the pulse accelerated, skin hot, and respiration very difficult. An ounce of castor oil was immediately administered. The next morning she was again comfortable. On the 16th, the arm was dressed, and the lips of the wound had united to a considerable extent by first intentions. On the 17th about noon¹ found her with a bowk of oily sausages, which she was devouring even without rice. When told not to eat them, she was much displeased, and quite lost her temper. For a few days she had diarrhea, which yielded to the effects of opium, hydrargyrum cum creta, and castor oil. On the 14th day after the operation the ligature came away, the wound being healed except at the point of the ligature. From the moment the arm was removed, the patient began to be convalescent, and she declared, she was more comfortable the night after the operation than on that preceding.

The examination of the forearm evinced the propriety of the amputation above the elbow. The disease evidently commenced in the marrow of the radius and near the head, and then involved the bones and soft parts in the common disease. The radius and ulna were diseased as far as the elbow, the marrow having assumed a brownish hue. The tumor was surrounded by a plate of bone the thickness of the pericranium, which being sawed through exposed a mass of matter of the consistency of brain. There were a few appertures at which this medullary substance had protruded and expanded itself like a mushroom.

About the 10th January, the patient was told she might go home whenever she pleased, but she preferred remaining still longer where everything was provided for her.

In the 19th January, the husband having returned for her, she was discharged in excellent spirits, and both were very thankful. The action of the liver had been excited, her skin had become soft and natural, and the prospect is that she may live for years, and enjoy good health. The opportunity was improved in impressing upon them their obligations to the living God, and author of all their mercies.

No.5723. October 30th, 1838. Bite of a serpent. Leang Lun, aged 54, of Shuntih, is a snake catcher by profession. On the 22d, September, he was bitten by a venomous serpent, the woo-juh shay or black-flesh-snake. It was now the thirty-ninth day after receiving the wound. From long familiarity with the snaky tribe, he had become too incautious, and grappled the serpent, with his hand at such a distance from the head as permitted it to seize the back of the hand. Immediately, the hand became swollen, and his sufferings were very great. He was unable to give any satisfactory account of the treatment adopted. He

Page 94

He said, however, that every remedy had been employed with
little success. The constitution had recovered in a measure.
from the shock, but the hand was much swollen, the fingers were
destroyed large, stiff, and cold, the integuments of the back
of the hand were destroyed, the tendons were exposed, and the
general health was suffering.

Blue pill, ext. of colocynth, and glauber's salts, were given
from time to time, and when the pain was excessive opium in
pill. Emollient poultices, and leeches were repeatedly applied,
and the hand elevated. Also at the suggestion of Dr. Guilbert
of the Artemise, much benefit was derived from keeping the
wound covered, when the poultice was not on, by a pledget of
soft lint filled with the mucilage of linseed. Though that
gentleman apprehended the ultimate loss of the fingers, he may
be happy to learn, that the whole hand has been preserved, the
wound has healed, and the patient, having abandoned his old
pursuit, has become a chair-bearer, and enjoys the use of his
hand, though the wound ulcerates occasionally.

No.5770 Cancer. Yoke, aged 45. of Shaouking had a scirrhus affec-
tion of her left breast that commenced in May last. At first
it was not large than a betel nut, but now it involved the
whole breast, and the glands of the axilla and neck. The shoul-
der and arm were also uneven, resembling on a large scale the
pits of the small pox, and the whole mass was very hard and
painful. The pulse being 112, tongue natural, bowels free, and
appetite good.

An unfavorable prognosis of course was given her, but she was
permitted to remain a few days that she might see if her case
could be palliated. Five grains of blue pill, and as many of colo-
cynth were ordered for her, and two grains of the extract of
conium maculatum three times daily and one of hyosciamus at
bed-time. A lotion of creosote was applied to the breast, accom-
panied with pressure, the integument at points was soon des-
troyed, and a discharge excited. With the view of cleansing it,
the carrot poultices was occasionally applied at night. On the
19th November, discontinued the conium, &c, and began with iodine,
six drops only of the tincture three times daily in a wine
glass of sweetened water, and an ounce of salts to be taken
in the morning. No material change till Nov. 21st, when violet
inflammation took place in the swollen arm. Pulse was 120, an
ounce of castor oil was administered immediately, and ten drops
of antimonal wine every hour, camomile tea ad libitum and a
spirit lotion applied to the arm. At 8o'clock p.m. the patient
was better. At bed-time a full dose of calomel and jabap was
given. Nov. 22d, The bowels were moved during the night, and
early in the morning it was reported that she was better, and
had eaten a bowl of congee; at a quarter beforela. m. her
servant having gone below to prepare tea for her, returned
soon after and found her dead.

Page 95

No.5806. Fungus haemotodes of the eye. Ho Mungmei, aged 76, a farmer of Tungkwan, had a fungus of the left eye, which began ten years since. It was of a circular form, about three and a half inches in diameter, and not broken. The patient was advised not to have anything done to it, as it was becoming more and more inflamed, to apply a lotion of the nitrate of potassa and occasionally to take a gentle aperient.

No.5895. Fistulous breast. Chow Hea of Tsangching, aged 33, a boat-woman, presented her husband with three daughters at one birth, but being poor sent them all to the foundling hospital. Her breasts were neglected and became fistulous, the right mamma was perforated in many places when she came to the hospital, and the discharge of milk and pus was copious. With attention to her general health, and frequent injections of the solution of nitrate of silver or sulphate of copper, and with gentle pressure, the sinuses healed up, and the breast was well again in about four weeks. Had she not so far lost the affections of a mother as to give up the whole trio of daughters, and she retained but that one of them, she probably would have escaped the suffering that she thus brought upon herself.

No.5935. Hydatid of the breast. Tang Haou is a maiden lady of Nanhae, in this province, aged 50. She first applied for the treatment of a chronic affection of the eye, but becoming acquainted with others in the hospital who were under treatment for diseases of the breast, she at length overcome her diffidence, and disclosed the real object of her coming to Canton. Nothing very peculiar in the character of the disease, entailed her case to notice. A circumstance occurred, however, showing some of the fruits of the early propagators of the gospel in China, and renders the case an interesting one. The mammary glands of both sides were very small, the hydatid appeared much like a sarcomatous tumor occupying the place of the left breast, globular in form and about two or three inches in diameter. On the 19th December the operation was performed. Upon making the incisions, a quantity of gelatinous matter of various colors, white, yellow, and purple, and of firm consistency, escaped. The cist was readily removed and the wound healed kindly and with great rapidity. On the first incision the patient exclaimed "Jesus save me! Jesus save me!" and repeated the same words many times. Nothing could have been more unexpected. The difference of the deportment of this woman from other Chinese was very noticeable. She appeared sincere in her attachment to the Christian religion, and said several hundred in her neighborhood are of the same faith, and that it was 200 years since they had been in possession of their knowledge of the Savior, and of the 'holy mother'.

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No. 5874. Nov. 17th 1838. Cancer of the breast. Soo He, 42 years old, of Pwanyu, a very robust and corpulent woman, had a cancer-ous disease of the breast, that began six months previously to her coming to the hospital. the breast was large, red, and hard, and the glands of the armpit were also affected. The pain at times was very great. She was not encouraged at this time to expect that it could be removed, but was told that she might remain in the hospital a few days, and attempted should be made to ally the inflammation and retard the rapid progress of the disease. She was put upon a spare diet, and repeated purges and leeching were employed. At length an abscess formed, and as it oroke and discharged, the inflammation subsided and the whole mass became more movable, so that it seemed practicable to remove it all with the knife, which the patient was very desirous to have done.

December 23d, the same day that New Fuh was operated upon, her breast was removed. The morning the patient awake in fine glee, and having made her toilet and painted her face, she placed a chair, laid out a mat, and requested 'the doctor' to sit down, that she might know tow, that is bow her head to the doctor floor. It was sad to think how insensible she was to the suffering before her. However, her courage only failed with the loss of the blood and strength. The operation was unusually severe. On account of the corpulence of the patient, the previous inflammation, and subsequently ulceration, the tumor was not well defined. The extent of the incisions were of great extent from the axilla to the lower part of the breast, and very deep through the adipose substance. A cluster of inflamed glands of the armpit were also removed, and one of considerable size. The loss of blood was copious, and several arteries required ligature. After being dressed and laid in bed, she rejected the too hearty breakfast she had eat-en, and for some time complained of pain in her arm, but not in the wound. At 6p.m. she became composed and grateful, and was lavish of her encomiums. "While the doctor is here, I have no fear. Had I not met with him, my disease must have proved fatal. seen same to same, the doctor has much gall, i.e. great couarge, to have undertaken the operation!"

At 10 p.m. vomiting recurred, pulse 120; gave two drops of creosote in pill. In a short time she voided a worm (lumbricus) from the mouth, after which she became more easy, but for 48 hours slept but little. Opium in any form did not agree with her. December 24th. Dressed the wound in the morning and removed all the sutures; gave her twenty drops of laudanum, which produced vertigo, so that the female servant became much alarmed, and, on my entering the room, was engaged in pinching the patient's nose and violently rubbing the temple with green ginger, which she had first masticated. She was told that it was the effect of the medicine, and she would soon be better. At 9p.m. her pulse was 110, an even, easy pulse, with no great heat of skin, and rather moist. The patient constantly groaned but more especially when she was spoken to. In a few she began to amend, healthy granulations sprung up, and large quantities of adipose substance and discharged perfectly well fascia came away. On the 21st January, she was discharged perfectly well, in excellent spirits and very thankful. She is naturally a woman of much nerve, great presence of mind, and decision of character.

Page 97

It has been mentioned that this operation was performed the same afternoon that Lew Fuh's breast was removed. The two patients were in separate wards, and when the latter died, precautions were taken to conceal from the former the fact, least she should be too much alarmed for herself, but a little girl, indiscreetly, notwithstanding strict injunctions, informed her of the event. She perceiving the dissatisfaction that had been occasioned by the child's indiscretion, in place of showing any alarm, said, "It is no consequence, I am aware of the difference in our case; she has been past recovery for some days; she was older than myself, and upon the operation table she was not sensible to pain, to feel pain (in such circumstances) is better, our symptoms are not alike, and I am no way alarmed." Asher breast was dressed one day she remarked that the goddess of mercy whom she consulted, told her she should recover in the foreigner's hands, and that the winter season was also favorable. She was told it was the living God of mercy to whom she was indebted, and not to any idol. She rejoined with much emphasis, "Kwanyin haou?" the goddess of mercy is good, and repeated it, that her recovery under these circumstances should confirm her faith in the idol. I am not surprising, though it is painful that the gratitude due to God should thus be lavished upon imaginary deities. Subsequently to her return home. Which was on the 12th January, she returned in blooming health and vigor, and made the hall of the institution resound with her expressions of gratitude. She also brought a present of fruits and other trifle. She remarked that for several days her house was thronged by visitors from her village to see what had been done for her. She left an invitation to come and dine at her house, which is about four miles distant.

No.5943. Dec. 23d. Excision of the tongue. Tsung Kin, aged 22, of Haenan, a fruiterer. This young man had been sick of pulmonary consumption for more than a year. Some altercation taking place between him and his parent one day, the letter said, "it is better that you should die, " which so irritated the son that he expressed himself harshly; and subsequently reflecting upon his undutiful conduct, he was much charmed, and as a self-punishment cut completely off half an inch of the end of his tongue! They represented the hemorrhage as being very copious, but this was arrested by a styptic of a native physician, which was of a highly astringent nature. Some of the same was afterwards obtained, but its composition is a secret, and the property of the man who sells it. It somewhat resembles course yellow snuff, adhered firmly to the wound and formed a strong coagulum with the blood, and sufficient was added to supply the place of the piece of the tongue lost. It was six and thirty hours after the event when I was first called to this patient, the tongue was of its natural shape, tipped with black. The patient, and friends were much alarmed at this time, but they were assured nothing was to be apprehended from the wound of the tongue, but the original disease was of an aggravated character. The next day the styptic came away, a solution of the nitras argenti having been used a few times. The wound appeared healthy, but the other symptoms increased in severity, and in about one week the patient died. Two days after, his brother returned and requested the piece of the tongue (which had been preserved in spirit), that it might be buried with the body, urging that for a person to be minus one member was very bad.

Page 98

No.5985. Horn upon the crown of the head. Chow Keatseuen, aged 31, a florist, of Shuntih, had a horn upon his head just to the right of the 'bump of vereration.' The patient stated, that some years since he had an encysted tumor upon his head, the integument of which was destroyed by escharotics and the fluid escaped. the germ of the horn was this exposed. Its growth had been gradual. Sometime previous to coming to the hospital half an inch or more had been cut off. At this time the remaining truncated cone was a full inch high and two inches in circumference, at the base. It was attached wholly to the integument of the scapp, and gave great pain if pulled. Dec. 19th it was removed. Two elliptical incisions were made as to take out the whole of the integument in which it originated. This was preternaturally soft, and the veins and arteries were unusually large and numerous. The wound was brought completely together by sutures and adhesive straps, and in about one week it was quite well.

No. 6071. Dec. 14th. Tumor pendulous from the upper lip. Kwo Pe, aged 27, of Shuntih. Several years since, this amiable young woman found a tumor commencing on the right side of the upper lip. It had now attained the size of her fist, and hung pendulous, reaching below the chin, and carrying the under lip to the left side, it not only greatly disfigured her, but impeded her speech, and required to be supported when she ate. Dec. 19th the tumor was removed by the hare lip operation, two arteries of considerable size were divided, one needle was introduced, and two or three sutures. A sufficiency of the upper lip was preserved to bring the point of union of the angle of the mouth, so that when united there seemed to have been but one incision from that point, straight to the outer edge of the nose. Dec. 22d. The third day from the operation, the first time of dressing, the needle was removed. The wound had nearly healed by first intention, and on the 5th, only a piece of sticking plaster was required. In a few days more she was discharged perfectly well, and her natural features nearly restored. She showed her gratitude and respect by not kow-towing, knowing that it was offensive.

No. 6100. Dec. 24th 1838 Constipation and nephritis. Lew, magistrate of Nanhae, which comprises half the city of Canton, and the district lying west and northwest of it. He is commonly called simply the Nanhae. This morning lowquq, the senior hong merchant, sent a request that would call at his house to see the Nanhae, who was desirous of consulting me professionally. At 2 o'clock p.m. a messenger was sent to announce the gentleman's arrival. On entering the room where he was, he rose with great deliberation and saluting me, in a common complimentary expression, said, that "he had long been looking for me."

The account which he gave of himself, and of the treatment which had been adopted, was as follows:-

Page 99

" That his illness commenced on the tenth of August last, at which time he suffered much from bodily heat and perspiration, but had no chills. In the course of a few days his spirits failed. or a couple of days at this time he was much troubled with eructations. It was not till after ten days that his bowels were opened, -when he obtained some relief. Another period of seven or eight days then elapsed, before his bowels were again opened; after which his feverish feelings left him, and he was able to take some food with comfort. He was, however, greatly troubled with phlegm, and cough at night. His mouth was dry, but without much thirst.

"On the 29th of August, he began to move about a little. the physicians said that his pulse was good, but the bulbod and aeration were deficient, and directed him to take astringent medicines, as Korean ginseng, &c, &c..

"After taking prescriptions of this kind ten or twenty times, he was troubled with feebleness of the thighs and legs, and on account took in addition 'tiger's bone' and hartshorn,

"At this end of September, he began to go out, and to attend to his official duties, and from this time forward he had to be out every day. About the middle of October he became sensible of great susceptibility to fatigue in his limbs and body, demanding frequent rest in a reclining posture. To this succeeded a sense of heaviness about the saccrum, as also for a period pains between the ribs and in the abdomen, constipation followed for a period of upwards of 20 days! Some fragrant powders were administered, and then found these ailments somewhat abated, namely, the heaviness and pain, and the constipation. But he never felt the loins altogether easy. At the same time, however there was pain neither in the sinews nor in the bones. After opened one-in the long constipation had been overcome, his bowels continued to be opened once in about ten days."

Such were the symptoms and progress of his disease for more than 100 days, previous to his applying to me. At this time he complained most of pain and stiffness of the back, disabling him from performing the usual ceremonies of bowing and kneeling, as its required in his official station. There were also occasional pains in the iliac regions. His appetite pulse was 96. His tongue was coated, his eyes turgid, and his appetite indifferent. These had been inflammation of the kidneys, and at this time the purulent deposition in the urine was very abundant.

An aperient of the blue pill and colocyntj was ordered immediately and the next day, the following:

R. Pill Hydragari, c creta grxj
Gum. alo. soc. gr. vjii
Ant. Tart. gr. ji.

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Fiat massa, in pillulas duodecum dividenda. S. One to be
taken every night.

R. Pulv. uvae. ursi. oz. ss.
Pulv. Doveri grain xlvjii.

Fait pulvis, in chartulas duodecem dividendus. One to be
taken every thrice daily in a cup of tea.

A small quantity of strong mercurli ointment was to be applied
over the liver with friction every morning, and a large plaster,
( emplast. ferri. oxidi, rubri.) was applied to the lumbar re-
gion. It was allowed to eat mutton, poultry, and wild game, rarely
cooked and in morerate quantities, also ripe fruits, as apples,
and pears cooked, and dates and grapes, avoiding oily and titter
generally, were prohibited. He was requested to take exercise
in the open air daily.

During the interim of his visits, he written reports of himself,
by which his immediate and rapid amendment was shown. This treat-
ment was commenced continued till 31st Dec., when the Nanhae
made his second visit, and expressed himself much obliged for
the relief he had already experienced. At this time the uris
was omitted: a free use of mucilage copaiba of gum Arabic, with f
fifteen drops tincture of digitalis, and five balsam copaiba
thrice a day, were substituted. In fourteen days the urine be-
came nearly natural.

In a week from the previous date, he made his third and last
visit, accompanied by Hingan, the military officer of Wangse
already alluded to. A remarkable improvement was apparent at
first glance. The use of his limbs was much easier. The lively
expression of his countenance, and the sparkling of his eyes
noticed at his first visit, and he did not fail to express,
both in words and actions, his sense of obligation. Essentially
the same treatment was continued another week, though from this
time the Nanhae seemed to consider himself convalescent, present-
ly inquirers were privately made, as to what present would be
most desired, that it was a sufficient reward to know, that
his health was restored. Official gentlemen often alluded to
the recovery of their friends Lew, otherwise did not hear
more of him till the approach of the Chinese new year, when,
notwithstanding the wish expressed to the contrary, his pre-
sent was sent. It consisted of a brace of wethers, two boxes
of tea, two sets of procelain cups and saucers, such as are
used in this country, and two pieces of silk also ten Span-
ish dollars for the young men in the hospital. The money was re-
turned. Similar presents of silk and procelain were sent to
the gentlemen who had kindly acted as interpreters, and who
had translated the prescriptions and correspondence with the
Nanhae, who does not speak the dialect of this province.

Page 101

It is due to one of these gentlemen to mention, that it was
he who suggested to this officer, whom he met at the city
gate, the idea of seeking foreign aid.

A supply of medicines, with directions for occasional use;
were sent him through Howqua, with a note acknowledging his
presents, and stating that they were accepted only as an
expression of his sentiments, and that remuneration was not
desired; also conveying to him the fact that the object of the
intention is strictly benevolent.

The erroneous deductions that have been made, here and elae-
whwere, from the small number of opium patients, deserve cor-
rection. The institution is ostensibly for the cure of ophtha-
mic diseases, all other affections are exceptions. of more than
6000 patients but about half a dozen cases of fevers are report-
ed, yet Canton and its vicinity enjoy no peculiar exemption
from this class of diseases. So of all diseases- exception
those of the eye, and other strictly surgical- every few of
them are ever noticed in the institution. It is evident, there-
fore, that the ophthalmic hospital affords no criteria, by
which we can ascertain the number of opium smokers. who are
suffering from that habit. Besides the specific character of
the hospital, it should be known, that comparatively few of
the victims to the opium mania have moral resolution remaining
sufficient to attempt an emancipation from its most deplor-
able effects. Personal observation has furnished abundant
evidence of the appalling extent of the evil. Repeated instan-
ces have occurred in which officers have assured me they have
been addicted to the vice, some 20 and other 30 years and more,
and though they would give large sums of money never to have
formed the habit, they desire of recovering from it. To say
that tens of thousands in this city and vicinity, including
women as well as men, use the drug, would, it is believed,
be milder estimate. In some other districts and provinces
the number is said to be still greater than in Canton.

Page 135

TENTH REPORT.

of the
Opthalmic Hospital, Canton, being for the year 1839.

The peculiar circumstances under which the modified operations of the physicians have been carried on at Canton, show to an extent which it could not have been known, the degree of confidence felt by the provincial government itself, in the utility and benovelent purpose of the institution.

The opthalmic hospital continued much as usual, but with increased prosperity, up to the 23rd March when foreigners, one and all were de rived of their servants, and in a manner of their liberty. At the commencement of the state of beings, a few indoor patients were de sired, by the senior Hong Merchant to remove, and the hospital was closed. After a while, however, the officers on guard around the factory began to seek medical aid, and though they permitted no communication with the people in general, they presently gave admittance, to the physicians house, to men of rank, who were allowed a greater measure of liberty in visiting the factories. On the withdrawal of armed soldiers and collies, the number of patients gradually increased, but with a greater preponderance than before of official people, yet others were not wholly restrained, from seeking relieve of their maladies, females even overpassed the prejudices against the entering the factories of foreigners. As it was in August, that finding his private residence too small for the reception of increased patients, and unsuccessful in every endeavour to return to the building formerly occupied, the physicians removed to the premises of the Canton Dispensary of Messrs Cox and Anderson. Commands were issued by the Chungchee against any natives passing in front of the natives, bet they men, women, or children this was applied chiefly to the females, who were anxiouse in consequence that no females should be received as patients. A few days after a young man of about sixteen, from the family of Kwanchee, this officer of like rank as Chungchee, both being what we may call brigades, was associated to him, in the control of foreign factories, and the breach by one from his own family, of his colleagues orders reduced these at once to a dead letter. Three was no longer any hinderance to the access of females, they came however, with more of research than formerly and some beggeg in the boats to see the factories, or at their own residents, in the suburbs of the city, so that the evil of exclusion from the former hospital have not been without its advantages, in as much as it has been given to a rise to a more a frequent access into private families, than otherwise would have been thought requisite. The young woman from Kwanchee, family came with a cataract of both eyes, and though she would not remain as in in door patient, but returned as soon as the cataracts were operated upon, the operation was completely successful.

The smaller number of patients attending, in consequence of various consences has happily let more leisure for prosecution the study of the language, and for acquiring facility of writing it, as well as of translating of it.

Page 137

General and Constitutinals
Disease

<table><tr><td>Rheumatism</td><td>25</td></tr><tr><td>Aritisis</td><td>7</td></tr><tr><td>Fever,intermitten.</td><td>4</td></tr><tr><td>Thrush</td><td>1</td></tr><tr><td>Anas-arca</td><td>7</td></tr><tr><td>Scrofula</td><td>16</td></tr><tr><td>Syphilis</td><td>7</td></tr><tr><td>Dentition</td><td>1</td></tr><tr><td>Opium-mania</td><td>15</td></tr><tr><td>Absesses</td><td>14</td></tr><tr><td>Furunculus</td><td>1</td></tr><tr><td>Periositis</td><td>1</td></tr><tr><td>Ulcers</td><td>23</td></tr></table>

Disease of the Bones.

<table><tr><td>Disease of the hip joint</td><td>4</td></tr><tr><td>Caries of tiba</td><td>1</td></tr><tr><td>- of is Calcus</td><td>1</td></tr><tr><td>- of submaxillary</td><td>2</td></tr><tr><td>- of Trochaner major</td><td>1</td></tr><tr><td>- of ribs</td><td>1</td></tr><tr><td>Curavuture of spine</td><td>2</td></tr></table>

Preternatural and diseased growth.

<table><tr><td>Malformation of throax</td><td>1</td></tr><tr><td>Nasal polypi</td><td>2</td></tr><tr><td>Tumors polypi</td><td>11</td></tr><tr><td>- cutaneous</td><td>1</td></tr><tr><td>Tumor abdominal</td><td>2</td></tr><tr><td>Cancer of the breast</td><td>3</td></tr></table>

Injuries.

<table><tr><td>Fracture of baothbones</td><td></td></tr><tr><td>of the both legs</td><td>1</td></tr><tr><td>Tendo achillis partially</td><td>1</td></tr><tr><td>divided</td><td>1</td></tr><tr><td>Singular enlargement in the</td><td></td></tr><tr><td>left iliac region.</td><td>1</td></tr></table>

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In conformity with past practise, some more particular notice is
subjoined of a few cases, chosen, in general less from interest at
daching to them the medicinal point of view, that form circumstances
in them illustrative of the Chinese character, customs and actions
and habits of thought and action.

No 6017 Caries of submaxillary and fracture of legs. Ho Che, aged 30
a native of Pwanyu district of Canton, by profession a fortune -
teller. This unfortunate man's case is introduced, to illsutrate
the ill effects arising from want of surgical aid, in instances
where, with it, cure must be most sure. At the age of seven he fell
from the roof of his house and by the fall broke the fibula and
tibia of both legs, and the fermur of both thighs. These bones were
never set, and the man became a cripple for life. That was not de-
rive the entire power of locomotion seems most strange. The fibula
and tibia united, at the angle of 45 degrees and the femur too, at
an abtuse angle; so that with the bending of the knee joints, the
legs well high assumed the form of hoops. By means of resting his
body on high stools the man was able to draw his limbs afetr him
and so by a sort of vermicular motion to betake himself from palace
to place. A few minutes of surgical aid, at the time of accident
would have saved him from incalculable suffering and helplessness.
It was for extensive caries of the lower jaw, under which he has
been suffering for four years, that he applied for relieve.

No.6564. July 25th. Epilepsy. A child of the ganchasezor chief jud
icial officer, of the province of Kwangtung, aged 4. After all, the
preliminaries regarding the sitting of the judge, the merchant and
the doctor, had been settled, and the ganchasez sent his child to
the commercial house of the sendor hong merchant, being himself
from accompanying the little gentleman, as he had intended, a number
of friend supplied his place/. The particular case of the child
were with the physicians request, written out and as it may serve
to elucidate Chinese ideas of medicine, and to show to their ext
ent of the knowledge (or the acutal depths of their ignorance)
and English version is here inserted.

This little child was born in the departure of Kwaneling in
the province of Kwanse in the 12th month of 15th Year of Taokwan g
(1835-1836) He was the next Year, vaccinated in the nostrils (that
is by injection of vaccine of μεγα verius in the pledge of the
nostrils) and several pustules appeared. After this he continued
on well, till the spring of the 17th Year (1837) when he had inter
mitten fever, and soon after the meales. The physician mistakenly
gave him "tingfan" a powerful bitter, and the child was immediately
seized with epilepsy. On this he gave some tens of doses of a
compound benzoine, amber and sulphuret of mercury; but completely
removing the elieptic symptoms. In the nith month of the same year
the treatment was varied, and the circulation the breath (or ether
ial essence ) were employed. On this one cccex dose was given
after about a hundred doses were administered, the eliepsy was in
a trifling degree relieved, the child began to eat a littel rice
and in mid summer of the 18th year he began to walk; bu to keep
him comfortable it was daily to use a dose of the above named
medicine.

Page 139

To want it, or to change it for another, occasioned him uneasiness. The symptoms of the disease are now less marked, and the paroxysms, less severe, but the use of the senses is not fully recovered. He is unable to speak: if he wishes to eat he cries; give him food, and ceases crying. Each day, he eats a teacupfull of rice, as often, perhaps, as twice or thrice; well-flavored viands, fish, or flesh, he also eats. He wants understanding to lick with his tongue, or to use his teeth to masticate the food, so that when he eats rice it is requisite that a person feed him, mashing the food for him; anything hard, in however small a degree, he cannot eat; and everything therefore must be carefully examined. All metallic or mineral remedies absolutely retard the recovery. He is in a sense idiotic. Though betel-nut; howpih, or rhubarb are daily administered to 'circulate the breath,' yet its passages are not all free. An 'infallible emplastrum,' with a 'never failing bolus' in its centre, is to be applied, tomorrow, to the abdomen. I do not know if there be any prescription that can heal the child: but I beg the physician of great celebrity to take his case into consideration and let me know'.

The reply to this note is here given, in order to introduce the further remarks which it elicited from the father. -"The account of your child's sickness, yesterday given, was very perspicuous. Epilepsy is very difficult to cure, and often the best treatment fails. Commencing at birth, it is seldom cured: if it begin at the time of denitition, recovery is frequent, after the teeth have come out: if caused by worms, it is easily cured. The most favorable age is between four and ten years, occurring at the age of fourteen or thereabouts, at twenty-five it generally terminates only with life. Supervening upon measles is an unfavorable circumstance.

"This disease is believed to exist in the brain and nervous system. In foreign countries, it is often customary to examine the body after death, and in several hundreds who have died of epilepsy, the cerebellum has been found diseased, the color being changed, and the substance become too soft. Of cause this disease cannot be cured in a few days. I cannot give a favorable prognosis in the case of your child, much less promise a perfect recovery; but † will do my best for him. If after one year, the child be not recovered, do not be disappointed. Should he recover, the physician will, next to his parents, be the most happy, - It is favorable that the child is now better than he was, that he can walk, and eat rice. As you inform me that all mineral and metallic substances retard the cure, I will not at present use them, but will commence with those from the vegetable kingdom, such as oils and powers. As to the 'infallible emplastrum,' you can do as you please; but while taking one kind of medicine he ought not to take another."

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The following are the further remarks elicited by the foregoing reply to the father's first statement:—"The explanation respecting the symptoms of the epileptic disease has been received; it is perspicuous and fully comprehended by me. I have further to remark, whenever heretogore he had a paroxysm he has invariably grasped his head firmly with both hands, or pressed it against a table, or wall. Usually, his hands are also raised to his throat.

"That existing disease is seated, as you explain it, in the brain and nervous system, I believe; and having evidence that you have already discriminated the disease, you can truly prescribe medicine in good adaptation to it. That my child, having met a man whom Providence has sent, will surely be healed, I entertain not a doubt."

In answer to oral inquiries of the friends who accompanied the child, some other particulars had been given. When the paroxysm commence, the color of the face does not change: after it has set in, the lips quiver a little, and the child rolls his eyes, inclines his head against a table or chair, and grasps his feet with his hands. In reply to an inquiry regarding the 'aura', it was said that he has sometimes chills, at other times heat. At times, his saliva flows out at the corner of the mouth. During more than two years and a half, the voiding of only one worm has been observed. He always cries when at stool, and seems to have pain in the abdomen.

The details of the treatment of this interesting child are very prolix, nor is there any peculiarity in the case to merit special attention. Anthelmintics were prescribed in the first instance, and a similar treatment continued, until a considerable number of worms had been expelled from the bowels. Afterwards, the nitrate of silver was employed, with blisters to the back of the head. Laxatives with anthelmintics were continued as required. The improvement in the child has been considerable, and appears quite satisfactory to his fond parents. During six months, he has had but two slight epileptic fits; he appears to have increased in intelligence, and has gained a degree of cheerfulness very pleasing to those who witnessed his previous state.

Some other selections from the father's numerous and minute notes had been marked for insertion: but what has been already given will suffice to show the amount of knowledge that native practitioners had been able to afford him of the disease. It is to be in mind, when reading these, that it is the practice of all Chinese, possessing what is deemed among them a liberal education, to philosophize upon the disease to which they become subject, and therefore to expect from their medical attendants minute explanations of the causes of the disease to be treated:

Page 141

as they often seem to expect the practitioner to prove the
reality of his rationale of disease by citing some of the
symptoms that have marked it previous to his being called in,
these explanations are often very oracular. It may be added,
taught of the nervous system the Chinese have hardly any correct
conceptions, consequently not so much as a name that can be
used with propriety: the 'breath,' or ethereal essence, of the
circulation of which through the body they so often speak,
seems to correspond, though attended by many erroneous or pure-
ly imaginary connections, to the nervous fluid or influence.

No. 6316. Jan. 28th. Aneurism. Kan Jooluy, aged 38, of the
Nanhae district in Kwangtung. This man had an aneurism on the
right side of the top of the head, apparently from anastomosis
of the temporal arteries. There were numerous abnoral veins
and arteries of preternatural size. The aneurismal sac was făat
and not well defined; about an inch deep, and three inches in
its transverse diameter. Pulsation distinct, but on pressing
upon the temporal arteries for a few minutes it sensibly
diminished.

No. 6565. Hernia. Lin Tsihseu, the imperial commissioner, late
governor of the two lake provinces (i. e. Hookwang), now of
the two wide provinces of Kwangtung, and Kwangse. Professionally,
ther is nothing in this case to make it interesting, indeed
the patient was not ever seen, but it is thought that it may
not be uninteresting to give some account of intercourse with
so distinguished a personage, one whose acts have been the
proximate occasion of rapture between two such powers as Eng-
land and China: the one the most widely combined, the other
the most anciently united, and second but to one in extent,
on the face of the globe.

His first applications, during the month of July, were not
for medical relief, but for translation of some quotations from
Vattel's Law of Nations, with which he had been furnished:
these were sent through the senior hong-merchant; they related
to war, and its accompanying hostile measures, as blockades,
embargoes, &c., they were written out with a Chinese pencil.
An expose of views in regard to opium was also desired, and
a general prescription for the cure of those who had become
victims to its use. In reply to this, an explanation was writ-
ten in Chinese, to the effect that opium was classed among
the poisons* by scientific men of the west, but at the same
time, like arsenic and other powerful articles of the materia
medica, is a valuable medicine in the hands of the skillful
physician—that, when taken in excessive doses, it is capable of
producing death in two ways, first by its effects upon the
heart and circulating system, producing apoplexy, and secondly
by its influence upon the brain and nervous system. Two

*Vide Silliman's Chemistry, vol. II page 488. Art. opium.

Page 142

Two instances were cited, in which the physician had been called to attend men who have used opium as a means of self-murder; these were given as affording evidence of the effects upon the circulating system. Some explanation was also afforded, of the matter in which by its gradual influence, the use of opium undermines the whole constitution. And it was then pointed out, that the treatment for recovery of those suffering under its use must vary, according to the quantity taken, the length of time that the habit had been formed, the age and state of constitution of the patient, &c., and consequently that there was no specific; each case must be treated according to its own particular symptoms. The treatment adopted, it was added, is to pay attention primarily to any existing disorder of the digestive system or lungs (the first, as had been explained, to suffer), not wholly forbidding the accustomed indulgence until the systems of disease should begin to yield and the cinstitution to rally, - then gradually to diminish the quantity of opium, till it should be altogether dispensed with. To give weight to this principle of treatment, a very simple illustration was made use of, - the difference between a child being made, at the risk of life to throw itself down from a giddy and dangerous height, and its being enabled step by step to descend from it, as by a flight of stairs,¹t was stated, in conclusion that this gradual treatment would ordinarily, if directed against a habit of long standing, require a period extending from two or three months to a year or two; and that some cases would occur for which recovery could not be anticipated-²these explanations did not satisfy the commissioner: he was not content to believe that there was no specific; and he sent a second time to desire some compound, so many mace or candareens' weight of this and that article, to be taken as a substitute by those addicted to opium, and to be gradually reduced in quantity till perfect rescue from the evil should be effected.

It was about the same time that he first sent to me, through the Manhae district magistrate and Howqua the senior hong-merchant, for medical to cure him of hernia.¹ A full explanation of the nature of the disease was sent in Chinese, and also a diagram representing the anatomy of the parts concerned in the case, as well as the mode of treatment by Europeans: it was added, that an instrument for the relief of it could be applied, but it was important to have it first adapted by a surgeon. Here came the difficulty: he was fearful of admitting a foreigner to any approach to intimacy. Immediately afterwards, public duties called his excellency down to the Bocca Tigris, and no further applications were made till autumn, when an officer an old associate at Peking, who had himself been alresdy relieved by the application of a truss, came and requested that he might have one to take to the commissioner also.

Page 143

The importance of its being well adopted was urged, also, that if it were so, the case might be aggravated: the man shrewdly replied, that he, having worn one so long, might be supposed to understand something about it. ... A month or two more elapsed, when two young men of the commissioner's suite came to the hospital as patients. One had hernia, the other a cutaneous affection of the head and face. A truss was applied to the former, who was much delighted, and said, he had a friend a higher officer having a like diseased affection, of immense size-as large, from his friend could not come out to see, or be seen by, the physician. Still it was declined to send a truss. The next morning, the comprador, (the responsible head-servant,) came in great alarm, some one having suggested that the two men from the commissioner had no disease, but come out as spies. He was assured that there was no lack of disease, and besides, they had both sent their cards that morning, with a present, and a message that they would call again. While yet speaking, the gentlemen came in, accompanied by the Peking 'interpreter of western languages,' and a brother of 'the man who desired a truss,' whosename they wish to conceal. The attempt at concealment, the intrepeter was told, was useless, for that months before all particulars of the case had been stated in writing and become well known to the physician. Upon this, the younger brother of the commissioner took up and engrossed the conversation, making particular inquiries about my native country, travels in other countries, &c.,&c. He then stated that his brother had a hernia of great dimension, and, that as he was about his size, a truss that would like to take away not only the one thought best fitted, but a variety, of which, after selecting one, he would return the rest. It was in vain to persist longer: the only half dozen trusses that remained were given to him, but have not been returned. The young man, also, who had been fitted with one that day before, said that, that which he had received answered admirably, and begged one or two more, to replace it when worn out. Though told that the number of cases of hernia in Canton was great, that he saw all of the trusses that remained, that his would last a year, and that more might be obtained in the meantime, he was little satisfied to be refused.

The truss sent to his excellency, it has been reported, answered tolerably well, excepting that when he coughs the contents of the abdomen are liable to descend. From the account of his symptoms, he also appears to be asthmatic: he has received a little medicine as such, and in acknowledgement has returned a present of fruit, &c., It may be added, that his excellency has inquired particularly regarding the ophthalmic institution, and has been correctly informed with respect to this, as well as like institutions in other countries: he has expressed himself favorably with reference to it; and many of his suite have been daily attendance at the hospital:

Page 144

the fear that is entertained, however, of deviating from established usages in regard to foreigners, a fear pervading all ranks, is strongly illustrated by the above details, as also the mutual suspicion prevailing between officers of the highest ranks in the empire.

Wang, a taoutae, or intendant of circuit, from Kwangse, and lately acting as judicial commissioner here, who was alluded to in the last report as being effected with paralysis of the left side, is still a patient. When the foreigners were immured within their factories, and he was unable to obtain foreign aid, he applied to a native practitioner; and, when called to him again, which was not till the 1st of November, he was found in a sad condition. His legs were dropsical, and swollen to an enormous degree, and the old gentleman expressed his anxious fears that he must soon die.

Laxatives and diuretics were immediately prescribed, which removed the swelling of his legs and dropsical symptoms, with almost incredible rapidity; and by careful attention to his diet and regulation of his bowels, his general health has wonderfully improved, general remedies for his palsy have been employed- bleeding from the arm and along the spine, blisters, strychnine continued until the full effects of it were manifested on the system, eletricity, &c., The paralysis still continues, however, but expecting that, he is now in good health and eats, drinks, and sleeps, as well as ever.

He is amusing, talkative, old gentleman, and is very fond of dwelling on the circumstance of his father being one of the legates attending lord Macartney's embassy from Teensin to Peking, the Van tazhin of the account of that mission. After Mar'a'rney, S'tan'ton, and Thoma S'tan'ton, (lord Macartney, sir G. L. Staunton, and his son, then a little boy, the present sir George Thoma Staunton.) he has often inquired with interest, he even wears, at this day a pair of spectacles given by G. L. Staunton to his father. For a number of his friends, male and female, in Kwangse, where his family yet remains, medicines have, at his earnestly reiterated intreaties, been prescribed, after careful endeavors to understand from his mintue explanations their cases.

In a few days after the departure of most of the English residents from Canton, Chin Tsungloo, aged 53, a member of the Board of Rites at Peking, and lately from Yunnan, visited the factories, to be treated for a neuralgic affection of his head, involving his hearing. He has been much benefitted, but is still under treatment, the cure having been interrupted by his absence at Kwangse during a part of the summer.

Page 145

In concluding the report of cases, a word or two may be deemed necessary to show why the cases of men of rank have appeared so much oftener and more in detail than those of the lower classes. First, from the unrecognized position of foreigners in any other capacity than as merchants, the officers of the government have greater advantages for forcing more particular attention, and this state of things has been enhanced since the tighter drawing of the restrictions by the commissioner during the last year; and secondly, the officers being more instructed, are better qualified to converse and express opinions as to their own diseases, as well as on other things; they also more frequently write down both opinions and the expressions of their feelings after cure: while the lower classes rarely prepare any descriptions of their cases, but merely answer in few words the inquiries of the physician; and to express their feelings after cure are generally obliged to restore to the mechanical medium of getting a pedantic scribe to draw out a flowery address, which is indeed not uncommon even with the better classes, who have less excuse for it. In reply to the remarks that the lower classes may often express their real feelings more characteristically in speech, and that while in the house as in-door patients may acquire confidence to converse on many subjects, and may say many things worthy of remembrance,— it must be admitted, that such a proficiency in speaking the language has not yet been attained as to enable the physician to draw out much of such conversation, or readily to understand many of the more reflective remarks of patients: it is comparatively easy to talk intelligently on the ordinary subjects affecting their bodily health or pains; but to discount the things that develop mind requires very high attainments in the knowledge of a language. With what is written, it is somewhat different, as matter not at first understood can be studied over and over, and with the advantages of native assistance.

One or two papers which had been marked for translation, as throwing no little light upon Chinese ideas of medicine, are omitted, from what of time sufficient to deal fairly by them.

Page 1

Eleventh report of the Ophthalmic Hospital at Canton for the term commencing 1st January and ending 17th June, 1840. By the Rev. Peter Parker, M.D.

The preparation of this report at its proper time in 1840 was prevented by many unexpected departure for the United States in July of that year. But notwithstanding the period which had since elapsed, it is thought that some of the cases possess sufficient interest to continued the regular series of reports.

Repeated notices have been given of Wang Haiwan, yet another allusion to his estimable old gentlemen may not be uninteresting. Subsequently to opening the hospital in the Danish factory, at a time when commissioner Lin threatened to exterminate the English at Macao, irrespective of its other inhabitants, H.E. Wang evinced a degree of gratitude and condescension seldom manifested by officers of his rank towards foreigners. On arriving at the hospital, and seating himself at the hall, he ordered his attendants and all the other Chinese to leave the department, and then inquired of me, if it were true, as he had been informed, that I contemplated going to Macao. Receiving an affirmative answer, he said, with manifest solicitude, "donot go! And if you have friends residing there, write them to come to Canton, for I am in the secret of Lin's determination to storm Macao, and the heights of the lapa, and soldiers and cannoh have already been sent thither for the purpose. " There is no reason to doubt his belief that the attempt would really be made, and this kind act seems referable only to his sence of obligations and his friendship. Previous to his departure for Shensi, he insisted upon having my likeness which was exchanged for his own. When he had embarked, he sent to invite me to a final interview. He was on board a boat divided into four departments: the two first were for the gentleman who owned it and his attendants and family, the third for the judge, and another for servants. No excuse would avail to decline partaking of the refreshment he had provided, and what rendered the interview more pleasant, the ladies and children came into the judge's apartment, and conducted with much propriety, although the attendant linguists remarked that they did not understand decrum by conversing with a foreifner. Wang Haiwan, returned to Shensi, where he died early in 1843.

Yu, the provincial treasurer, fifty-three years old, applied for medical advice, February 3d, 1840, from an affection of the kidneys. Hedesired to see me but owing to a long standing fuel between himself and Lin, he was afraid to do anything might give the commissioner a pretext against him. He dared not even come to the hospital of the hong merchants as other high officers had done, and week after week passed away without being able to attain his wishes, until Tang Tingching left for Fukien, in September, when it was proposed that I should accompany the escort of the governor, to the

Page 2.

Fati, and there prescribed for him. But owing to some delay in the governor's arrival before night come on, Yu sent his compliments saying he was unwilling to detain me longer, He was however prescribed for as well as the accounts he gave of his disease could enable me and partial relief was reported, but a after a short time he died.

No. 7119. Tung I'tsau of Kiaying chau, aged 73, a clerk of the hoppo's, came to the hospital February 24th, with chronic ophthalmia and exuberant granulations of the lid, of some years' continuance. Pulse 84, with considerable congestion of the vessels of the lid eye. Sixteen leeches were applied to the temples, and the sulphate of copper to the granulations, and a collyrium of the nitrate of phate-of-copper silver was orderto be used daily, and calomel and rhubarb at night. March 2d, pulse 86, syringed the eyes, scarified the lids, and applied the sulphate of copper in the solution and substance, and a laxative pill to be taken daily. (R. Alo. soc. pulverized Rhei aa 1 calomel 10 grs, m. divided into ten pills one taken every night, and all stimulants to be avoided) March 12th, same treatment continued. May 26th, the patient had obtained very great relief. Lunar caustic was applied to conjunctiva of the lids, and a solution of copper(4 grs to the oz. ) was dropped in the eye daily and the laxative pills continued. He sight must have been lost invitably, had he depended upon native practittioners- indeed it was nearly so when he first came. Under the above treatment, the recovery was rapid, he persevered in, had soon been completed.

After long experience, the perference is decidedly given to the sulphate of copper rether than any other application, in case of granulations of the lid on accout of the beautifully smooth surface it leaves, when the granulations are cured, Nitrate of silver will remove more rapidly, but the conjunctiva are not so delicate and natural. When very prominent and abundant, the lunar caustic with or without scarffying may be used a few times at first, but the sulphate of copper should be employed in giving the final polish to the conjunctiva, The same observation applies to the treatment of the remarkable fleshy thickening of the cornea often produced in severe and protracted cases of granular lids.

No. 7137. Heuraggia. February 26th, 1840. Chau Shauling, aged 59, of Shangtung, now holds the office of prefect in Shauchau fu in this province. This athetic and dignified officer both in stature and deportment, came with all his cortege to Howqua's hong to be examined for a mysterious affection of his face. His account of it is taht "having taken cold in the hollow cavern of the left cheek, it continued a long time, and afterwards was transformed and became a worm.

Page 3

When the worm was first produced, it sometimes caused chills, at other times it begot fire; occasionally, when this occurred, it caused the fire to dart up to the eye, so that it became visible. Afterwards, having pierced the body of the worm which was exceeding firm, with a needle, and on removing it perceived upon its point, something like a piece of simple cerate; still the worm was not killed by the needle. Subsequently, it gradually changed into a vapor exceeding cold, and the fire, was expel led. At this time it could neither produced wind nor fire, and still the worm survived. Then fiery medicine was applied to attack him, but the vermin very dexterously betook himself out of the way, as the medicinal aura arose the face, the worm either retreating and taking up its residence in the tongue, or fleeing to the back of the neck. In every way it has been impossible to expel it, and so it has been for more than twenty years, and now I respectfully request the distinguished doctor to heal it at once".

He had a neuralgic affection of the portia dura and its branche of the left side. In an account of the nature of the disease was given him in Chinese, which dispelled the worm from his imagination, and a laxative of blue pill and extract of colocynth, and sulphate of quinine, extract of conium, preparations of iron, and a succession of blisters over the course of the nerve, afforded him speedy and essential relief.

This case is introduced as a good illustration of erroneous hypothesis to which the uneducated and superstitious mind will resort for an explanation of diseases whose nature and cause it does not understand. Those who have experienced ticdoloreux will admit the pain itself is quite sufficient, without the discomfort of imagining one's person traversed by worms at their pleasure. If such superstition finds credence with an officer of his standing and comparative intelligence, what must be the amount of needless suffering experienced by the less enlightened?

No. 7243. March 13th, 1840. Hwang aged 29, a merchant from Hwuichau, came to the hospital suffering from an injury received some months previously from the bursting of a swivel. The portion of iron was distinctly felt by the probe, situated beneath the fleshy part of the biceps muscle, and near the humerus. There was much tumefaction of the arm, considerable discharge, and general irritation of the system. After allaying this by ateratives and poultices, a deep incision was made in the direction of the fibres of this muscle, and a portion of the barrel 3 ins. by 2/3 in., and about 1/2 in. thick, was extracted. This arm speedily and perfectly recovered.

No. 7067. Periostitis of the forearm. Chin Hu. set. 26, a stu dent of Pwanyu came to the hospital in January, 1840. This young man, the son of a gentleman of wealth, and suffered much pain from his arm for about eight months. There was at this time much swelling of the forearm and hand with redness and oedema, and irregularity of the surface of the bones, particularly of the radius.

Page 4

He was a young man of florid complexion and full of habits, and had a strong pulse. He was ordered to adopt a spare diet. Blue pill and colocynth pill were taken from week to week. Lugol's tincture of iodine, or the hydriodate of potassa, were administered internally, intermitting them occasionally as they began to affected the stomach. The tincture of iodine, the unguentum potasse hydriodati, the unguentum hygrargri and blister together with leeches and bandages, were alternally put on the arm, while suspended. About one hundred leeches were applied at different times. Under this irregularity of the surface of the bones, and some stiffness of the fingers, but it was liable to constant relapsed. He states that during continued the preparations of iodine with which he was provided. Since the hospital was reopened in 1842, this young man has returned, and the arm presented no vestige of its former disease.

No. 7116. February 23d. Ulcer. Tau Fukien, aet. 44. a district magistrate from Chekiang. This officer applied for the cure of an ulcer of 20 years' growth, which had destroyed the principal part of the gastréc-nemius muscle, and was still extending its ravages; the ankle was also anchylosed. Tonics and alteratives were internally administered, and the ulcer dressed, occasionally poulticing it, and applying in sulphate of copper, or nitrate of silver, according to circumstances, and at times employing Turner's cerate, or adhasive plaster and rollers. At the expiration of nearly four months, the constitution was much invigorated, and the ulcers nearly healed. The gratitude of this man, and his afflicted with periodical insanity, and several children of delicate constitution, and numerous official friends were also introduced by him for medical aid.

This officer, accompanied by his family and numerous friends, visted the hospital a few days before it was closed. Hearing after my arrival at acao, that I was about to leave China, he sent his servants thither from Canton to renew the expressions of his gratitude, and express his gera regret that time did not permit him to come in person, and to convey his best wishes for a properous voyage. He recently sent his servant to report his continued health, and to say that at the festival of the new-year, he will visit Canton, and pay his respect in person.

No. 7247. March 14th. Compound fracture. Mih o. aet. 60 of Pwanyu, belonging to one of the Whampoa chop boats. In discharging a bale of cotton, having raised it to the side of the boat, by some accident in fell back, and his feet passing between two of the flor planks, he was held as in a vice, while the bale fell back upon his breast, and fractured the tibia on the right leg, near the upper third. Portions of the sharp points of the tibia protruded through the flesh and were removed.

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After the inflammation was subsided, and the parts adjusted as well as a practicable, the immovable splints or starched bandage was applied with the happiest effect, enabling the old man to hobble about upon his crutch in a very short time with impunity. Previous to closing the hospital the following June, he was discharged well. He has recently reported himself, and stated that since 1840, there has been a little exfoliation of the bone, but he is now tolerably well.

No. 7256, March 16th. Cutaneous tumor. In Chiwan, aged 28, of Nanhai, had been incommoded for ten years with the tumor pendulous from the nates of the right side. It extended as low as the knee, and was about two feet in circumference at its bulbous portion. It was extirpated with little loss of blood, leaving just healthy integument enough between the tumor and anus to introduce the sutures. The surface of the tumor was irregular, and the skin of a dingy blue color. The structure of the tumor was peculiar, resembling the thickened and indurated integument of keloids, and traversed by sinuses, like the pulmonary bronchia, and which were lined by smooth shining cerous membranes.

No. 7351. Warts. As an official attendant, aet. 54, of Kauyau, had two large warts, one upon the front of his neck and the other in his groin; the latter was fully three fourths of an inch in diameter. Both were removed by ligatures, and a few applications of lunar caustic were made to the base of the warts after they came away.

No. 7285. Arch 21st. Elephantiasis. Liu, aet. 20, of Sin-hwui, had been afflicted several years, with this burdensome disease. He was put upon the use of corrosive sublimate, according to the formula of Prof. Zondi, (R. Cor, sub. 12 grs, Make 120 pills, to be taken alternate days, beginning with one pill, and increasing the number by one each time.) at the same time giving an occasional saline purgative, allowing a spare and easily digestible diet. Tincture of digitis was also administered 15 to 20 drops thrice a day, and frequent bleeding, blisters, and firm bandages, and an elevated position of the leg was enjoined. In about six weeks, the leg from being 18 inches round, was reduced nearly to its natural size, except that the integument had not contracted at all. As with the absorption of the cellular and adipose tissue, and hung flabby about the leg. The foot remained considerably enlarged. But on leaving the hospital and resuming his work, there was a prediposition to the return of the disease.

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On the reopening of the hospital in 1842, the patient returned with his leg larger than ever. The same treatment was resumed, the patient kept in the hospital, and the bandages applied, and the leg elevated. It soon began to decrease again, but about two months after, a most violent erysipelas supervened upon repeating the leeches. One or two mornings following their reapplication, the patient complied of having had a sleepless night, the leg was excessively woolen, and of a deep red color as high as the knee. The patient was under great apprehension and cried aloud. A small strip of emplastrum cantharides was applied around the thigh, just above the knee. A full dose of calomel and rhubarb was administered at once, and then the following powder was ordered: (R. calomel, 12grs pulv. ipecac 20 grs; pulv, opii. jii grs; mix, divide into 12 parts, one to be taken every three hours:) and a solution of corrosive sublimate was constantly applied to the erysipelas surface. The erysipelas did not extend above the blister, and in about ten days it was cured. The skin peeled off, and the tumefaction continued to diminish till the leg became of its natural size and appearance. The patient remained sometime after this, continuing essentially the same internal treatment though when the symptoms manifested the influence of the corrosive sublimate, Lugal's tinc. of iodine, or hydriodate of potassium were substituted. Six months subsequent to his discharge, he presented himself at the hospital in excellent health, and with scarcely a perceptible difference in the two legs, except some slight traces of the disease remaining in the foot.

No. 7489. Elephantiasis of the scortum. Chu Shunyih, aged 33, of Kwansi, came 30th April. afflicted with this cumbersome disease, similar in its character to that of Hu Lu, who was operated upon in London by C. A. Key. (see Chi. Rep. vol. III., p. 489. ) This was a pear sharped tumor, about one foot in diameter, at its bulbous portion. The penis was completely buried in the mass. The same mode of treatment was adopted as in the case No. 7285. viz, leeching, bandaging, and the internal use of corrosive sublimate. In three weeks, it had diminished one half in size. The treatment promised the most satisfactory results, when the patient becoming alarmed by the warlike preparations of the Chinese then in progress, and the daily expectations of "English troops, sudenly disappeared from the hospital and has not been heard of since.

No. 7553. May 9th Gun-shot wound. Chin, a lad of 17 years, a native of Sinhwuy, a fortnight previously, as he was wor-shiping at the tombs of his ancestors, received a ball in the back of his right forearm, from some recruits of commissioner Lin, who were practising in the neighborhood. The bullet was extracted from the opposite side, and the wound soon healed.

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No. 7700. June 2d. Gangrene. Liangshi, an orphan girl of 19 years, of Sanshwui, was attacked with gangrene of all the fingers and thumb of the right hand. The line of separation formed regularly a little below the knuckle joints. The last operation before leaving Canton, was to amputate the four fingers and thumb, and to furnish medicines and directions for subsequent treatment. The amiable young media woman wept as she saw one finger after another removed, apparently not so much from the pain it occasioned, as from the process of destruction set up, and to which in some form or other her whole body must ultimately be subjected, (as had recently been the case with both her parents.) and from reflections upon her orphan and helpless condition. One of my pupils was so much moved by witnessing her tears, and listening to the simple narrative of her forlorn and indigent circumstances, that from his own scanty resources, he placed a couple of dollars in her hands, and could not conceal the emotions of humanity excited in his breast.

By some means intelligence spread that the institution was to be closed, temporally at least, as my return depended on the course events might take. Consequently, about two hundred patients with their attendants and friends, on the 17th of June, the day the hospital was closed, and those who had come for the day first time, knocked their heads upon the ground, and laying hold of me with their hands, intreated with tears that they might be healed.

Table of diseases presented at the hospital from 1st January to 17th June, 1840.

<table><tbody><tr><td>Acute ophthalmia.</td><td>40</td><td>Semblepheron</td><td>1</td></tr><tr><td>Chronic</td><td>152</td><td>Mucocele</td><td>2</td></tr><tr><td>Purulent</td><td>6</td><td>Leucoma</td><td>11</td></tr><tr><td>Scrofulous</td><td>7</td><td>Staphyloma</td><td>11</td></tr><tr><td>Ophthalmitis</td><td>-1</td><td>Chronic iriris</td><td>8</td></tr><tr><td>Entropia</td><td>-57</td><td>Closed pupil</td><td>1</td></tr><tr><td>Entropia-</td><td>9</td><td>Glaucoma</td><td>1</td></tr><tr><td>Pterygia</td><td>-29</td><td>Muscae volitantes</td><td>5</td></tr><tr><td>Encanthis</td><td>1</td><td>Myosis</td><td>2</td></tr><tr><td>Beubulae</td><td>40</td><td>Amaurosis</td><td>10</td></tr><tr><td>Ulcer of cornea.</td><td>1</td><td>partial</td><td>7</td></tr><tr><td>Cataracts</td><td>35</td><td>Mydriasis</td><td>1</td></tr><tr><td>Lipotudo</td><td>17</td><td>Onyx</td><td>2</td></tr><tr><td>Xeroma</td><td>1</td><td>Fungus haematodes</td><td>1</td></tr><tr><td>Quivering lids</td><td>1</td><td>Loss of one eye-</td><td>11</td></tr><tr><td>Tumor of the lids-</td><td>2</td><td>Loss of both eyes</td><td>9</td></tr></tbody></table>

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Extracts from The Medical Missionary in China.

By William Lockhart.

Hurst and Blackett, Publishers. London. 1861

P.116. At Shanghai when Dr. Medhurst and the writer proceeded to that city in 1843.

P.120 In 1805 Mr. Alexander Pearson introduced the practice of vaccination at Canton, and therefore he left the country in 1832 he had the satisfaction of seeing his effects so much appreciated that a large vaccine institution was established in that city. A native surgeon, whom he had instructed in the art of vaccination, superintended the institution, which is still maintained with success. During Mr. Pearson's residence in China he vaccinated very many. Bir G.Staunton translated a tract on the subject for Mr. Pearson, which was extensively circulated and was very useful. Several editions of this tract, with alterations and improvements, have since, at various times, been issued. The invaluable blessing it refers to has proved so great a boon, that to have been the means of its introduction in-to so populous a country is no small honor. The name of Alexander Pearson will therefore be associated with those of the benefactors of mankind.

In 1820 the Rev. Dr. Morrison, in conjunction with Mr. Livingston, surgeon to the H.E.I.C., opened an institution for relief of afflicted Chinese, and for the purpose of gaining some knowledge of the native mode of treating disease. This dispensary was conducted by native practitioners, under the superintendence of these gentlemen, and many patients were benefited during the period of its continuance.

In 1828 Mr. College, surgeon to the H.E.I.C. factory, opened a hospital at Macao, which was supported by the liberality of the Company and private merchants, and so conducted by him with most encouraging success. The institution became the topic of conversation throughout the provinces, praises and gratitude were heaped upon the manager by the beneficiaries and by their friends.

Mr. College gave his attention chiefly to diseases of the eye, in the treatment of which he found the native practitioners particularly ignorant; and during the five years in which his other duties permitted him to continue the institution more than 6000 Chinese were gratuitously relieved. He urged the various missionary societies the desirableness of employing medical missionaries as pioneers in their Christain works, and several papers which he wrote for this purpose had considerable influence in directing attention to the subject.

- - - 000- - -

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The idea of making the practice of medicine an auxilliary
in introducing Christianity to China, was first practically
adopted by the American Board of Commissioners for the Foreign
Missions, and the Rev. Peter Parker was sent out with that view.
After some time, which was spent in the acquisition of the lan-
guage, he opened an ophthalmic hospital in Canton, in the year
1833.

P.124 A society to be called "The Medical Missionary Society in China".
Ophthalmic Hospital at Canton continued

till June 1840, when it was closed

P.124 During the years 1836-37 Dr. Parker continued the ophthalmic hospital at Canton with growing success,

P.125 Owing, however, to the want of a medical officer to conduct this institution, it was shortly closed on the return of Dr. Parker to the latter city.

In January 1839, the writer of these pages, connected with
the London Missionary Society, arrived in China, and the hos-
pital at Macao was placed under his charge. It had not been
long open when the measures of the Chinese Government against
the English compelled him to again close it and to leave Macao.
This was in September 1839, and, the hospital was not again
opened until June 1840; the interval being passed at Batavia,
in the study of the language under the Rev. Dr. Medhurst. The
occupation of the island of Chusan in that year gave opportunity
of beginning a hospital at Tinghai, the capital of the district,
whither I proceeded at the end of August with that object.

I returned to Macao in 1841, remaining there during the per-
iod of hostilities between England and China. When the treaty
of Nanking was settled, in 1842, I went to Hongkong, in the
hope of proceeding to Chusan, but was detained in the former
place till the spring of 1843. In the interval I superintended
the building of the Medical Missionary Society's hospital at
Hongkong, which was afterwards placed under the charge of Dr.
Hobson. The building bought for a hospital at Macao was then
disposed of, as it was thought more desirable to have the
hospital in a British colony than in the Portuguese settlement
of Macao. Again I proceeded to Chusan early in 1843, and for a
second time opened a hospital there, to which the natives flock-
edas during my former visit. At the end of that year I left
the island of Chusan for the newly-opened port of Shanghai, the
most northerly of the consular positions secured by the new
treaty for the residence of merchants and other foreigners. A
hospital was commenced there early in 1844, of which a fuller
account will be given in the pages which follows-

"When the British had been expelled from Macao, in 1839, the hopes of the friends of the Medical Missionary Society were encouraged by the arrival of two additional medical Missionaries, Dr. B. Hobson, of the London Missionary Society, and Dr. W.B. Diver, in connection with the American Board of Commissioners for Foreign Missions.

Page 3

The offer of their services being accepted by the society,
the hospital at Macao was placed under their joint charge
upon Mr. Lockhart's departure for Chusan. Dr. Diver's health
failing obliged him to leave China and return to the United
States. The institution was thus left in the sole care of Dr.
Hobson, who has pursued his labours with unwearied industry,
and has succeeded in establishing among the Chinese the same
confidence which has proved such an encouragement to others
who have given themselves to the same course of usefulness."

P.130 In 1844 Dr. Parker reports that, after an absence of two
and a half years in a visit to America and Europe, he re-
opened the hospital at the end of 1842, in the building where
it was first commenced. After speaking of the generosity and
liberality of Howqua, the well-known Hong merchant to whom
the building belonged, and who only charged no rent, but or-
dered his comprador to make all needful repairs and alterations.

P.131 "Besided the hospital at Canton, others will, we have every reason to hope, shortly he in full operation at Shanghai, Ningpo, and Hongkong. Mr. Lockhart is now prepared to go to Shanghai or Ningpo, whichever may be deemed most eligible for the establishment of a hospital.

P.132 "Dr. Hobson has recently removed to Hongkong, and in four or five weeks will have a hospital in operation there. After mature deliberation and much discussion, the society came to the conclusion that it was on the whole desirable that the hospital should be removed from Macao to Hongkong.

P.142 The medical missionary of the London Missionary Society now at Canton, Dr. Wang-fun, was a pupil in one of the mission schools. Showing much ability he was sent to Edinburgh by the benevolence of some foreign merchants at Hongkong, and sustained there for several years. He acquired a thorough education, and passed through the University with much honour, taking several prizes, receiving his diploma and degree, and was honoured by the encomiums of his professors as one of their most creditable students. He offered his services to the London Missionary Society, and being accepted was sent to Canton, where he laboured assiduously, noticed in a subsequent chapter.

and by the force-minded gentleman to be at
his control as to its appropriation, the two-fold difference
ended in the naming by Dr. Parker of a committee of the Medi-
cal Missionary Society in Canton.

If may be allowed to make a brief reference to some
of the earliest friends of the Medical Missionary
Society who by their liberality and personal exertion
did so much for its establishment and support.

From the names of many English and American residents
whose lasting honor it is to have materially helped
the work it will not be deemed invidious to select the
names of J.R.Morrison Wm Jardine Launcelet Dent and
Alexander Anderson.

The first two of these died in 1843, and the society's
report for the following year states: "Since the publication
of the last report we have had to explore the death of two
of the earliest supporters of the Society-Wm. Jardine, esq.,
and J.R.Morrison, esq., and we would like this opportunity
of recording our appreciation of the important services they
rendered to the society, and our high estimate of their bene-
volent character. Theirs was not a charity that gave of their
abundance merely to the subscription in aid every good work,
and counsel and assistance to benevolent undertakings. By the
death of Mr. Morrison, who was recording secretary, the so-
ciety has been deprived of a most efficient officer"

Mr. Jardine came to China as surgeon to one of the Hon.
East India Company's ships, but settled in Canton and founded

general support, and by the aid of European countries.

his control as to its appropriation, - the two-fold difference
ended in the naming by Dr. Parker of a committee of the Medi-
cal Missionary Society in Canton.

Page4

the celebrated merchantile firm that bears his name. He was always ready to aid Dr. Parker with his professional knowledge, in consultation as well as in operation, and took a warm interest in all that was done at the hospital

Mr. Alexander Anderson, the successor of Mr. College as surgeon to the British factory, was in private practice in Canton and Macao. He was one of the most energetic supporters of the society, not sparing his help(as I have often experienced)in any way in which it might be required. At a meeting held in 1845 was passed the resolution, "That the society are deeply sensible of the disinterested and important services rendered during a long course of years by Mr. Anderson, and that the secretary be instructed to convey to him the feelings of the society on that subject. And, now that he is about to take his departure from this part of the world, that they unanimously tender him their best wishes for his future prosperity and happiness" Mr. Anderson afterwards passed several years in America and Scotland, and died recently after long and painful disease.

Mr. Dent, one of the worthiest and most influential of the English merchants in China, was amongst the foremost in whatever tended to the good of his fellowmen. By his liberality and his earnestness in conducting its affairs, he was of essential service to the interests of the society, and did much to insure its success. He died a few years after his return to England.

In 1845 a series of circumstances produced dissension in the Medical Missionary Society, which, owing to the enlarged opportunities and the favourable prospects opened for medical missions in China at that time, had not so detrimental a result as might have been feared. It will suffice for the purpose of this history to state the occasion of a division in council which ended in the formation of a second society claiming the name and position of the Medical Missionary Society.

The society, originally formed in Canton, had been used to convene many of its meetings in Macao. The foreign community chiefly residing in Hongkong at this period, a proposal was made that meetings should be held in the latter place as well as in Canton. Exception was taken to the proposal, and there being a difference of opinion also to the use to be made of a sum of 5000 dollars which had been collected by Dr. Parker, partly in England, but chiefly in America, for the purposes of the Society, - supposed by the committee to be at their treasurer's disposal for the Society's general support, and by the force-named gentleman to be at his control as to its appropriation, - the two-fold difference ended in the naming by Dr. Parker of a committee of the Medical Missionary Society in Canton.

Page 5

In this way two societies of the same name were in existence—the one in Hongkong, with the history, constitution, and prestige of the original institution; the other in Canton, which also claimed to be thus regarded. For some years after this the two societies carried forward their benevolent purpose, but the sphere of such institutions had so enlarged during the progress of the events in China, and local necessities of the various hospitals which had been established, as to have dispensed with the rival distinctiveness of these two societies and buried their differences in the common origin of that wide, Christian benevolence, which called into being the first of all Medical Missionary Societies in Canton, in 1858.

While the effects of the Medical Missionary Society in Hongkong were sustained for some years with much efficiency, its medical officers at a distance found that ample funds from the liberality of foreign residents in the locality were available, which enabled them to form a society on the spot. This localising in several places of the means and agencies of the society at Hongkong, has oohiated the necessity of its meeting for some time. The society in Canton still continues its operations in that city. Dr. Parker vigorously pursued his work for some years, until his departure from China. The operations of the hospital under his care and that of his colleagues will come up for further notice.

Thus, while the Medical Missionary Society, as originally organised, has been dissolved, the work it had in view has in no degree been retarded. It had, perhaps, completed its work. When foreigners were restricted to Canton and Macao it was possible to meet the demands of medical benevolence by a committee of management of the spot. This work was done well by the Medical Missionary Society, and its effects will not soon passed away. Now that foreign intercourse has become so extensive, the Society could not be expected to overtake the requirements of distant stations. These being so amply provided for in other ways, the necessity for it, as originally constituted, has ceased.

The following remarks are abridged from the addresses to medical students, published by the above society in 1856. Dr. Coldstream, in his lecture on the spread of the Gospel,

says:—"I have adverted to the fact that it was on the occasion of Dr. P. Parker's visit to Edinburgh, that the first movement was made towards the formation of our Medical Missionary Society. The committee then formed had for its object exclusively the collection of funds, as an auxilliary to the society in China. Shortly afterwards, in November 1841, the suggestion was made by Sir Culling Bardley, to form an independent society in Edinburgh, with the endeavour to form a centre of interests and action, with regard to all medical missionary affairs, but which should direct its first efforts to supply pecuniary aid to the Medical Missionary Society in China, and to the Syrain Medical Aid Association in London, and the society was constituted which afterwards became the Edinburgh Medical Missionary Society.

Page 6

Dr. Abercrombie was the first President. He took a lively interest in its proceedings, and frequently attended the meetings, proving himself as wise in counsel as he was energetic in action."

Dr. Hobson in report of Shanghai hospital for 1858 writes
A work was prepared in Canton, eight eight years ago, on
the subject of anatomy and physiology, avoiding all theore-
tical opinions. This has been extensively read and very fav-
orably received, and has proved a good foundation for what
was to follow.

"The next treatise was on the properties of air, light, heat, and electricity, and the elements of astronomy and natural history, designed as an introduction to these varied branches of natural phenomena,

"This has been succeeded by a work on the principles and practice of surgery; by another on midwifery and diseases of children; and by a fifth, on the practice of medicine and materia medica, together with a medical vocabulary, in English and Chinese, to explain and fix the terms used,

P.160
Shortly after the appearance of the first of the series, it was republished by the highest Chinese officer at Canton—the viceroy of the province. He had the illustrations recut, and printed separately, and made up into rolls, according to a favourite Chinese custom. Since then, the different volumes as they appeared have been republished by the natives. Government officers, native physicians, literary men of every rank, and persons from all parts of the kingdom, have earially sought for copies, and received them as a valuable boon. The last information of their acceptanee is to the effect that the Japanese, to whom, soon after intercourse with that people commenced, the works were sent, have also republished them, but leaving out all the reference they contain to the Christian religion, or their Western origin.

Before Dr. Hobson left Shanghai, the foreign merchants there expressed their approval of these valuable works by subscribing the sum of 2000 dollars, for the publication of a large edition of the series.

P.166
At this period, 1847, the use of sulphuric aether was first adopted, 1847, in the hospital, to relieve the pain in operations, according to the method of Dr. C. Jackson of Boston. Dr. Parker expresses the delight with which he witnessed the effects of this anaesthetic agent in causing the patients to feel no pain while being operated upon. It was tried in several cases; some of the patients requested that they might have the administration of the aether repeated, on account of the pleasure they experienced during its action.

(7)

P.171 A Chinese artist, Lamqua, to show his appreciation of the value of the Canton hospital to his countrymen, took the portraits of many of Dr. Parker's more remarkable patients, first showing the malady from which they suffered, and then the appearance after the patient was cured. These paintings from an interesting series of characteristic maladies, and when Dr. Parker was in England, on one occasion, he presented a set of them to the Museum of Guy's Hospital, where they excite the surprise of the students and visitors.

P.175 The work at the hospital was continued with its usual efficiency in 1852 and 1853, although it devolved in great degree upon the native assistants. This was owing to the necessary absence from Canton of Dr. Parker, who was at this time appointed United States Minister in China.

P.176 In 1855, the total number of patients entered in the hospital records, since its opening twenty years previously, was reported as more than 53,000. During the previous year, 1854, the place had been closed for some time, owing to the disturbed state of the city, besieged by the army of the Triads.

P.176 The report of the meeting of the Canton society in 1856, states that Dr. J.G.Kerr, of the American Presbyterian Mission, had consented to take charge of the Ophthalmic hospital, during the absence of Dr. Parker from China, and that the hospital had accordingly been transferred to the care of Dr. Kerr in May 1855. The report for that year was destroyed with other papers by a fire on the premises of the Presbyterian mission, but the work of the hospital was fully maintained, and during the year five cases of lithothmy and several other operations had been performed. Thanks were accorded to Dr. Parker for the gift of his stock of medicines on his departure for the United States; to the Hong merchant, Howqua, for the continued use of the hospital building free of rent; and to Dr. W.G. Dickson, for his various operations for stones, and for his counsel and assistance on other occasions during the year.

P.178 On December 14th, 1856, the hospital building was destroyed by fire, when the foreign factories were burned by the Chinese, owing to the hostilities which had broken out between the Chinese and the English in that year. For twenty-one years had the operations of the medical mission been carried forward in the premises, which, since 1842, had been generously given free of rent by their owner Howqua, which favour was to be continued as long as the building should be used for hospital purposes. Most of the medicines were kept at the dispensary, which was destroyed by the fire October 29th, 1856; the hospital furniture and the general apparatus were all lost in the conflagration of December. The building itself, in its arrangements and ventilation, was ill adapted to its purpose, and its locality was favourable, as being too far removed from the river,

(8)

It is greatly to be desired, on behalf of the future efforts of medical missionaries in Canton, that a suitable building be obtained, in view of the improvements of modern hospital may be secured.

P.179 In April 1848, after considerable difficulty, Dr. Hobson obtained a house in the western suburbs of Canton, at Kum-le-fow, situate on the banks of the river, and in a population neighbourhood.

P.185s before stated, Dr. Hobson had to leave the hospital in October 1856. For some time after the premises were vacated, the people in the neighbourhood, who, a few years before, had been adverse to the renting of a house in that district to a foreigner, voluntarily took charge of the hospital building and all that they contained. They preserved them from an excited populace, punished two or three persons who were detected pilfering, and intended to hand the premises over uninjured to the original occupier on his return. They had no expectation of the distress that would be entailed on all classes by the obstinate conduct of their Governor, nor any idea of the severe pressure of continued hostilities, with the increase of destitute persons in the city. Their protection of the hospital was gradually and of necessity withdrawn, and soon after nothing remained but the bare walls.

P.196 Dr. Hobson removed to Shanghai in February 1857, and carried through the press his work on surgery, which is spoken of in another place; and when, in the latter part of that year, the writer was compelled by domestic circumstances to return for a time to England, Dr. Hobson took charge of the Chinese hospital at Shanghai, and carried on all the work for more than a year, until failing health made it necessary that he should seek a renewal of strength by a return to his native land.

In 1858, Dr. Wang-fun a Chinese, after the completion of his medical course in Edinburgh, was sent out by the London Missionary Society as medical missionary at Canton. Upon the occupation of that city by British troops in 1858, he proceeded thither, and after a little time regained possession of the hospital at Kum-le-fow. He repaired the premises which had been much injured, and recommenced the work of the hospital, which is still actively and successfully prosecuted.

P.202 The hospital at Hongkong, built on one of the hills to the eastward of the town of Victoria, was opened by Dr. Hobson on June 1st, 1843.

P.207 At the end of 1847 the directors of the London Missionary Society being desirous of renewing their mission in Canton (where there had been no resident English missionary since the death of the Rev. Dr. Morrison), Wished Dr. Hobson to proceed thither, and to seek in a quiet and unobtrusive manner, by friendly intercourse, and the exercise of his medical skill to obtain a permanent footing in the midst of the Chinese population.

Page 9

P.10 The old port of Amoy, where formerly the Spanish trade was carried on for many years, was opened to general foreign intercourse in 1843. It had been for some time occupied by our troops as a military station, and Mr. Abeel and Dr. Boone had resided there as missionaries since the beginning of 1842. On November 1843, Dr. Hepburn of the Presbyterian Church of America, being accepted by the Medical Missionary Society, proceeded thither, and began his labours in connection with Dr. W.H.C cumming, who was unconnected with any missionary society, could not, at first, he received one of their medical officers. He, however, supporting himself from his own resources, laboured zealously, and had a large measure of success amongst the Chinese. His health failing in 1847, he was obliged to discontinue his work and return to America.

The committee, however, had assisted him with funds for his hospital, and in 1843, in company with Dr. Hepburn, he carried on the work of the hospital in the city of Amoy with great success.

P.20 Our next station is Ningpo.

P.21 In 1843, Dr. D.J.Macgowan, medical missionary of the Baptist Church of America, arrived in China, and after some months' stay at Hongkong proceeded to Chusan and Ningpo, in which place he went to reside at the end of the same year.

In 1844, Dr. B.D.McCartee, of the Prebyterian Church of America, was also accepted as an officer of the Medical Missionary Society, and proceeded to Ningpo. In the absence of published reports of his labours, it may be said that with diligence and skill these labours were prosecuted, and were followed with success. Besides a dispensary at his own house, Dr. McCartee devoted himself to the visitation of the sick at their own homes.

Dr. Macgowan reported in 1845, that the hospital at Ningpo was permanently opened in April of that year.

Page 10

P.235 In July 1843, the Medical Missionary Society's station at Chusan, which had been relinquished on the departure of foreigners from the island in February 1841, was re-occupied, and the hospital which I opened at the time was carried on with partial interruptions until January 1844. At this period the port of Shanghai being opened for foreign trade, and affording unusual facilities for the successful working of the design of the society, it was resolved to remove the hospital to that city.

P.236 Two visits were paid to Shanghai towards the end of 1843, when efforts were made to obtain a house. In January 1844, the hospital at Chusan was closed, and the operations of that Society were begun at Shanghai in the following months. As soon as the hospital was opened, and its purpose known, crowds of people came daily to the house, urgently, often boisterously, requesting to be attended to.

P.242 The work of the hospital was transferred to the new building in July, 1846.

Page 102

Medical Missionary Society: regulations and resolutions, adopted at a public meeting held at Canton on the 21st of February, 1838. The Chinese Repository, Vol. VII. Page 32.

At a public meeting, called by T. R. Colledge, esq., the Rev. P. Parker, M.D. and the Rev. E. C. Bridgman (G. T. Lay, esq. attending on the part of Mr. Colledge), which was held in the rooms of the General of Commerce, at Canton, on the 21st of February, 1838, it was proposed by the Rev. P. Parker and seconded by R. Inglis esq., that Mr. Jardine take the Chair.

This being unanimously agreed to, the chair was accordingly taken by W. Jardine esq., who stated, that the object of which the meeting had been called was, the organization of a Medical Missionary Society, in conformity with a plan which had been for some time in contemplation, and in reference to which certain suggestions had been published, about eighteen months previously, by the gentlemen by whom the meeting was called.

The following Resolutions, relating to the organization of the vontemplated Society, having been read consecutively, were then severally discussed and adopted.

On the motion of G. Tradescant Lay, esq., seconded by the Rev. E. C. Bridgman, resolved,

I. "That, in order to give a wider extension, and a permanency, to the effects that have already been made to spread the benefits of rational medicine and surgery among the Chinese, a Society be organized at Canton, under the name of the Medical Missionary Society in China: that the object of this Society be, to encourage gentlemen of the medical profession to come and practice gratuitously among the Chinese, by affording the usual aid of hospitals, medicine, and attendants. But that the support or remuneration of such medical gentlemen be not at present within its contemplation".

On the motion of R. Inglis, esq., seconded by J. Archer, esq., resolved,

II. "That the officers of this Society consist of a President, Vice-presidents, a Recording Secretary, a Corresponding Secretary, a Treasurer, and an Auditor of account, to be elected by ballot, annually: That these officers collectively form a Committee of Management, for performing the business of the Society: That, in the absence of the President, the duties of his office be performed by the senior Vice-president, that is, by the Vice-president whose name shall stand first in order on the ballot list: that any vacancy occurring between the annual meetings be filled up by the committee: And that the Secretaries and Treasurer render every year a Report of the operations of the Society.

Page 103

On the motion of J. Maltheson, esq., seconded by captain Hine, resolved.

III. "That persons subscribing fifteen dollars annually be considered members of the Society during the period of their subscription: That donors to the amount of one hundred dollars at one time be constituted member for life; And that donors of five hundred dollars at one time be constituted directors for life?"

On the motion of J. Robert Morrison, esq., seconded by the Rev. P. Parker, resolved.

IV. "That an annual meeting of the Society be held on the last Thursday of September, in each year, for the election of officers and the transaction of general business: That the President be empowered to call a special meeting of the Society, at the request of the committee of management, or on the application of five members; And that the committee regulate the times of its own meetings"

On the motion of T. H. Layton, esq., seconded by G. Tradescant, resolved,

V. " That this association shall have a Library, to be called "the Library of the Medical Missionary Society in China?." and to under the control of the committee of management, by which, donations of books, &c., may be accepted."

On the motion of H. M. Clarke, esq., seconded by G. T. Lay, esq., resolved,

VII. "That all real estate or other property belonging to the Society be held on behalf of the same by a Board of Trustees, to consist of the President, the Treasurer, and the Auditor of accounts."

On the motion of the Rev. E. C. Bridgman, seconded by G. T. Lay, esq., resolved,

VIII. "That candidates for the patronage of the society must furnish satisfactory certificates of their medical education, approved of by the society sending them out, - with testimonials from some religious body as to their piety, prudence, and correct moral and religious character. "

On the motion of Alexander Maltheson, esq., seconded by T. H. Layton, esq., resolved.

Page 104

IX. "That this society will not assumed the right to control any individual acting under its patronage, or to interfere with or modify the instructions he may have received from the society sending him out: That it will, however, except a strict observance, of any general regulations for the management of its institutions, and a filigent study of some one dialect of the Chinese tongue, on the part of those who receive its patronage: And that it will reserve to itself the right of withdrawing its patronage, at the discretion of the committee of management, from any individual who may, from non-compliance with its regulations, or from other causes, incur its displeasure."

On the motion of G. T. Lay, esq., seconded by the Rev. P. Parker

X. "That at each institution under the patronage of the Society a book shall be kept, in which shall be inserted, in a fair and legible hand, an account of all important medical or surgical cases: And that, in order that this may not interfere with the other important duties of the Physician or Surgeon, any assistance necessary for keeping such a register shall be defrayed by the Society."

On the motion of Edmund Moller, esq., seconded by G. T. Lay, esq., resolved,

XI. "That the Committee of Management be empowered to appoint agents in Great Britain and America, to receive and transmit to them any sums that may be paid on behalf of this Society."

After these resolutions had been severally discussed and adopted, it was moved by Robert Inglis, esq., seconded by A. C. Maclean, esq., and resolved

"That the members of this Society are deeply impressed with a sense of the services which Mr. Colledge and Dr. Parker have rendered to humanity, by the gratuitous medical aid they have afforded to the Chinese, which services have tended to originate this Society: And that the members trust to the philanthropy and zeal of those gentlemen to carry the purposes of the Society into effect, and to enable it to perpetuate the benefits which have been already conferred."

It was then moved by James Matheson, esq., seconded by R. Turner, esq., and resolved,

"That the thanks of this meeting be presented to T. R. Colledge, esq., for the responsibility and trouble taken by him in purchasing and putting into repair a convenient and suitable building for a medical institution at Macao: That the said building be accepted by this Society, on the liberal terms of Mr. Colledge's offer; And that the Trustees be authorized to take the necessary steps for the transfer of the property."

Further resolved, "That the meeting now proceed to the election of officers."

The following officers were duly elected: President, T. R. Colledge, esq.; Vice-presidents, Rev. Peter Parker, M.D., W. Jardine, esq.,

page105.

G. T. Lay, esq., Rev. E. C. Bridgman; Recording Secretary, A. Anderson
esq; Corresponding Secretary, C. W. King, esq.; Treasurer, Joseph
Archer, esq.; Auditor of Accounts, J. C. Green, esq.

At a meeting of the Committee of Management, held on the 23rd
of Februar, some alterations were made in this list. R. Inglis
and A. Anderson, esqrs., were added to the number of the Vice-
presidents, and J. R. Morrison, esq., was appointed Recording
Secretary in the room of Mr. Anderson.

The following officers form the Board of Trustees: Thomas Richardson
College, esq., Josepe Archer, esq., Hohn Cleve Green esq.

Thanks having been voted to the Chair, the meeting was then adjourned

---:-:-:-:-:-:-:-:-

Minutes of a public meeting of the Medical Missionary Society in
China, held in the rooms of the General Chamber of Commerce, on
Tuesday, the 24th of April, 1858, the Rev. Peter Parker, M. D.
Vice-president, in the chair.

The minutes of the general meeting held on the 21st of February
last having been read, it was,-- in reference to certain changes
subsequently made by the committee of management in the list of
officers On the motion of Richard Turner, esq., seconded by the
Rev. E. C. Bridgman, resolved,

"That the provisional changes made by the committee of management
in the list of officers of the Society be confirmed by this meeting.

The following resolution, passed by the committee of management on
the 23d of February last, was read, viz: "That Mr. Colledge, Dr.
Parker, and Mr. Bridgman, be requested to draw out a general state-
ment of the objects and prospects of the Society, its regulations,
and other particulars of its organization, for the purpose of pu-
blication, the same to be submitted for approval to a general meeting
of the Society." The address that has just been read be accepted,
and that, agreeably to the resolution of the committee of management,
it be printed, accompanied by the list of regulations, and other
particulars of information regarding the state and prospects of
the Society".

On the motion of Robert Inglis, esq., seconded by J. Archer, esq.,
resolved,

"That this meeting, having heard that an application is to be made
to the proprietor of the building now occupied as a hospital in
Canton to repair and enlarge it, is of opinion, that Dr. Parker shoul
should, for the following reasons, be requested to avail himself
of the time required for such repairs and alterations to proceed
to Macao, to open, and for three or four months to take charge of,
the hospital there These reasons are, that there are now many cases
in Macao calling for early attention, whereas in Canton most of
the cases of old standing have been relieved,--and that a great
advantage will be experienced in the new institution being opened
by a person acquainted with the language and habits of the Chinese,

Page 106

rather than by any one, a stranger to their language and
habits, who may hereafter arrive."

On the motion of Joseph Archer, esq., seconded by W. Bell, esq., resolved,

"That this society views with pleasure the prospects of an early increase in the number of its medical cooperators in this country, and that it trusts the hospital, both in Canton and Macao, may enjoy, erelong all needed superintendence, in the presence of least two surgeons in each."

On the motion of W. Jardins, esq., seconded by J. C. Green, esq., resolved.

"That with a view of increasing the existing pecuniary means of the Society, the Secretary be empowered to call a general meeting, a few days subsequently to the publication of the pamphlet now about to be printed."- The meeting then adjourned.

## ADDRESS

In October, 1836, after mature deliberation, and encouraged by many whose views were in accordance with our own, a few suggestions relative to the subject of providing medical aid for the Chinese were drawn up, and published. The hope then cherished has been realized, the first public act- the organization of a new institution- has been completed. And it is in compliance with a resolution of the committee of management of this institution, that we have now once more the pleasure of explaining our object, and of inviting the cooperation of all those who wish to mitigate the sufferings of their fellowmen.

The object of this Society is, as stated in the resolutions passed at its formation, to encourage the practice of medicine among the Chinese, to extend to them some of those benefits, which science, patient investigation, and the ever-kindling light of discovery, have conferred upon ourselves.

In the midst of many improvements, and surrounded by numerous social advantages, the Chinese are nevertheless deficient in medicine and surgery, and acknowledge this deficiency by their conduct, whenever they can avail themselves of the well-directed skill and the superior adroitness of foreigners. The love of ease and the hopes of health lead mankind to accept assistance, whereve they can find it, to forego their prejudices, and sometimes to make large sacrifices, even upon a very slender prospect of recovery. The Chinese, though exclusive in all their policy, from no exception to this rule, for they have come in crowds to the ophthalmic institution, submitting to operations and medical treatment with unbounded confidence, and obtaining health and restoration, through the means of the physician, with every mark of the most unreighed respect and thankfulness.

Page 107

Our course, then, is clear, a road to usefulness is thus open before us, a great people stand in need of our assistance in this way, and are withal very glad to receive it. To restore health, to ease pain, or in any way to diminish the sum of human misery, forms an object worthy of the philanthropist. But in the prosecution of our views we look forward to far higher results than the mere relief of human suffering. We hope that our endeavors will tend to break down the walls of prejudice and long cherished nationality of feeling, and to teach the Chinese, that those whom they affect to despise are both able and willing to become their benefactors. They shut the door against the teachers of the Gospel, they find our books often written in idioms which they cannot readily understand; and they have laid such restrictions upon commerce that spirit of invention, and that freedom of thought, which it uniformly excites and fosters, whenever it is allowed to take its down course without limit or interference. In the way of doing them good, our opportunities are few, but among these, that of practicing medicine and surgery stands preeminent. Favorable results have hitherto followed it, and will still continue to do so. It is a department of benevolence peculiarly adopted to China. Ordinary modes of conveying information fail to attract the regard of the Chinese. Hence their groundless fears and suspicions of us continue unchanged. If a ray of light flash unexpectedly source, but as an ignis fatuus, calculated only to mislead. Could we dispel these fears, and make known to them the true character and desires of the civilized western nations, many are sanguine that a more friendly policy would be adopted towards us. And in the department of benevolence to which our attention is now turned, purity and disinterestedness of motive are more clearly evinced than in any other. They appear unmasked; they attract the gaze, and excite the admiration and gratitude of thousands.

"Heal the sick," is our motto, constituting alike the in-junction under which we act, and the object at which we aim and which, with the blessing of God, we hope to accomplish, by means of scientific practice, in the exercise of an unbought and untiring kindness. We have called ours a mission-ary society, because we trust it will advance the cause of mission, and because we want men to fill our institutions, who to requisite skill an experience add the self-denial and high moral quantities which are essential usually looked for in a missionary.

or the agents by whom we are carry object into execution, we must look to the Missionary Boards and Committees in Great Britain and the United States. They have their power to help us, and are best qualified to select men that are fitted to execute our designs.

Page 108

We do not engage to support such individuals, and therefore
shall leave them free to cherish all the better feelings of
an honorable independence. We offer them hospitals, with every
other necessary and suitable accommodation, and means of
effecting good. In these hospitals, we require for the patients
the same uniform and well-considered attention, which are en-
joyed in the institutions and tried character are indispen-
sible for the successful prosecution of the work. For after the
Society has done all it can do, by way of preparation, its
direct influence on the Chinese is to be exerted through the
agents it employs: on them, therefore, the destinites of the
Society are suspended. If they fail, it fails. Their success,
is its success. Too much care cannot be bestowed on their se-
lection. But in character and in practice they should be very
every way good men. The constitution of the Society has been
framed so as to guard as far as it is in its power to guard-
this point.

By the employment of such an agency the way will be paved to
a higher place in the confidence and esteem of the Chinese,
which will tend to put our commerce and all our intercourse
with this nation upon a more desirable footing, and to open
avenues for the introduction of those science and that reli-
gion, to which we owe our greatness, by which fit us for the
enjoyment of a better life hereafter. And it will not be denied,
that these form desidemata of no ordinary interest and importance.

There are other advantages, which, though they be of a subordi-
nate kind, are not without their value. Among the first we would
refer to the benefits, which are likely to result to medical
science by cultivating it in China. Countries are not less
characterized by the form and nature of the soil and it pro-
ductions, than they are by the prevalence of certain maladies
and a partial or complete exemption from others. The contem-
plation of disease as influenced by the position and height
of a country, its inland or maritime location, and the general
habits of the people, conducts the students to a most engaging
range of medical philosophy, while it discloses many important
lessons to assist him in the way of benefitting his fellow
creatures. The advantages derivable from such a contemplation
have been acknowledged at all periods, and in all quarters.
To secure these advantage, it required, that a book should be
kept in all the institutions connected with this Society, into
which an entry will be made of all important cases, with a
notice, not only of the disease and the treatment pursued, but
also of the provinces habits, and other circumstances bearing
upon the history, of each individuals. Such books will in time
be curious and instructive documents, and such as will ene
able us to glance at the penetralia of domestic and social
life in China, which we now can only read of, or view at a
distance, from the very outskirts of the country.

Page 109

It will not require much illustration to show, in the second
place, that information will be obtained in this way of the
highest value to the missionary and the man of commercial enter-
prise. The general state of feeling in this vast and thickly
populated country, the partialities and prejudices of the peo-
ple, can only be seen by us through a very questionable and im-
perfect medium. The want and sources of a territory so diversi-
fied and extensive are only known to us by such an intercourse
with the people, as this institution will afford, the truth will
be learned in some measures, and answers to many questions,
which we are now interested to ask, will be obtained, for a sick
man will often deal frankly with the physician, however he may
be disposes to conceal facts, or garble his statements with any
other person.

Another advantage will be education of the young Chinese in
those branches of science that belong to medicine. Facts show
that Chinese parents are not altogether blind to the desirable-
ness of placing their sons in our hospitals, as three are al-
ready under tuition in the institution at Canton. Young men
thus instructed, will gradually be dispersed over the empire,
travelling for pleasure, honor, or reward, and will dispense
the benefits of a systematic acquaintances with the subject,
whether they go. The success of their measures will render
them respectable, and of course will rebound to the credit of
those also from whom they have learned the art. Their patients
will not only hear, but feel that the people from the west
are good men. The effect of such influences will be silent,
but powerful, for there is something irresistibly impressive
in a benevolent action, especially when it appears to be from
the imputation of interested motives.

The Society recommends the study of the Chinese language, be-
cause to question a patient through an interpreter is a circu-
tous and often a very doubtful process. A knowledge of the lan-
guage, will open another door of inquiry, namely in relation
to the substances used in Chinese pharmacy, and to their pecu-
liar mode of preparation. As the reciprocations of health and
sickness are various in different countries, so Providence has
displayed a corresponding variety in the distribution of reme-
dies. This correspondence between the prevailing disord-ers
of any country and the remedies which the hand of nature has
provided, is often very striking, and will become more so as
the subject is investigated. We may therefore look for a great
many valuable additions to our dispensaries, while an extend-
ed acquaintance with diseases under new modifications will
help to enlarge and complee our system of nosology. With a
small stock of Chinese phrases, great immediate good may be
effected, but to accomplish extensive and permanent good, an
acquaintance with their language, and with their treatises on
the theory and practice of medicine, as prevailing in the coun-
try, is dispensable.

Page 110

This is requisite, also, to enable one to write works by
which their erroneous systems may be revolutionized. A man's
usefulness will be in proportion, ceteris paribus, to his
knowledge of the language. If knowledge be indeed power, then
is that of the language of China, on the part of those who
would benefit the Chinese, emphatically so.

We have alluded to the revolutionizing of the erroneous systems
of the Chinese. But little argument is needed to prove the
urgent importance of effecting such a revolution. A few facts
will suffice to snow it. Authors of medical treatises, enjoy-
ing a high reputation and imperial patronage, are found to extol
the efficacy of many secret remedies and vaunted specifics.
And all, or most almost all, adopt the common vagaries concer-
ning the influence of the elements in causing and affecting
disease. Persons in the highest rank of society believe in as-
trology, and consult the almanac in order to select an auspi-
cious day for applying to a physician, though that day may
not come till their disease has advanced beyond the control
of human skill. The Chinese admit their ignorance of medical
science, especially of surgery and anatomy. An amusing and
ridiculous compound of astrological dogmas and dissertations
on the influence of the elements, like the 'Ethers and Elements'
of heraclitus, takes the place of the well-established prin-
ciples of physiology and chemistry now received in the west.
As yet we are aware that any correct knowledge regarding the
circulating of the blood obtain in China. Observation, however
has taught them, that the frequency and force of the pulse
are not the same in sickness and in health. By deducing
from this circumstance unfounded notions on the subject of
pulsation, a Chinese practitioner, on observing the character
of the pulse in the last stages of disease, will hazard a pro-
nosis of the number of hours the patient may have live. In the
indefinite use of the word by the Chinese, and of by
Pythagoras, we observe a remarkable coincidence. By both the
same term is often employed to designate veins, arteries, nerves,
and tendons.

It has been sometimes objected, that to attend to the diseas e
of men is not the proper business of a missionary. This object-
ion may be shortly answered by a reference to the conduct of
a Savior and his apostles, who, while they taught mankind
things that concerned their eternal interests, were not in-
different to their bodily sufferings. Why he was pleased to
do by his Divine power, and what they did by miraculous en-
dowments, no one can in these days pretend to effect. But we
are commanded and encouraged to imite them, by the use of such
means as knowledge and the exercise of a genuine charity will
furnish. The importance of education has long been admitted,
and none regard its requisite expense as a preversion of sacred
funds, not that education can make the pagan a Christain,
but because it is one of the best auxiliaries.

Page 111

Neither has it been considered a misapplication of money, or of the missionary's talent, to employ science as an instrument wherewith to sweep away the foundation of idolatrous systems, not that science can convert a heathen, but that by demonstrating to him the falsity of his religion, it may prepare the way for him to seek the truth. A similar rank and equal consideration are what we ask the-truth for the healing science and practice.

A peculiarity of the Medical Missionary Society in China is, that it addresses itself to the consideration of all. The man of science and philanthropist, who look especially to immediate benefits, are here interested. And to the sympathies of those who, while they equally appreciate the desirableness of contributing in every feasible manner to the welfare of their species for time, contemplate with unspeakably more solicitude those interests which are eternal, it presents an irresistible: an overwhelming: claim. When we reflected upon the present state of surgery and medicine in China, the suffering that is experienced, the lives annually and needlessly lost, and advert to the time when similar ignorance was the misfortune of the nation of Europe; and when we consider the rational basis upon which science is now established, and our facilities for imparting it to other, the obligation upon enlightened nations becomes imperative, to improve the opportunity afforded, of imparting to others the incalculable benefits received from the application of chemistry and natural and inductive philosophy to the subject of health, in the investigation of the causes and phenomena of disease and the means of controlling it.

The world is a whole: and as the human race approximates to the perfection which it is destined to reach, the principle of union and fellow-feeling will become more and more influential. A Bacon, a Newton, or a Franklin, is not to be monopolized. Such men belong not merely to the nation that gave them birth, but to the whole world. They were doubtless designed by Provinces to be blessings not merely to a single age or country, but to all successive ages, and to every land. Upon those first enjoyed the boon, rests the obligation to extend universally their principles, which, whenever permitted free ingress, will produce similar results in China. Surely no accumulation of arguments is required to prove a case so clear. If the principles is admitted that our race is one, then the remoteness of the empire for which we plead cannot neutralize the obligation.

The facilitate cooperation in the observance of this obligation, agents are appointed in the principal cities of England and America. About $9,000 have been contributed in China and its vicinity within the last two years to this cause, but whilst friends here encourage the expectation of a continuance of their aid, the society must look to the affluent of happier lands for its principal support.

Page 112

When we survey the vadtness of the field, the ggod to be effected,
and when, reflecting upon the immense resources of the western
hemisphere, we compare these with the small portion of wealth
required to secure the desired object, we are confident that
benevolence- disinterested like its author, and as expensive as
the woes of man are extensive, will not withold the means.
A
rare opportunity is here afforded to the philanthropist of
doing good-of enjoying the felicity of imparting to others,
without diminution to himself, some of his richest blessing. He
is invited to unite in accomplishing a great, immediate, and
positive good-is encouraged by the hope of immediate success,
to aid in uniting to the great family of nations this long
severed and secluded branch, and in introducing among this peo-
ple not only the healing art, but in its train the sciences, and
all the blessings of Christianity. To the various missionary
Boards whose cooperation is sought, we would respectfully say,
iminate Him whose gospel you desire to publish to every land.
Like Him. regard not as beneath your notice the opening the eyes
of the blind and the ears of the deaf, and the healing all man-
ner of disease. Until permitted to publish openly and without
restraint the truths of the gospel, neglect not the opportunity
afforded of freely practicing its spirit, scatter to the utmost
its fruits, until welcomed to plant the tree that produces them-
the "tree of life".

(Signed) T. R. Colledge, P. Parker; E. C. Bridgman.
April 14th 1838.

Page 103

First report of the Medical Missionary Society's Hospital at Macao, for the quarterly term beginning 5th July, and ending 1st Oct., 1838. By the Rev. P. Parker, M.D. The Chinese Repository, Vol. VII. page 411.

In accordance with a desire expressed at a general meeting of the Society in May last, the Hospital at Macao was opened on the 5th of July. Previous engagements to return to Canton, and the absence of any other medical gentleman to take charge of the establishment, rendered it necessary temporarily to close it on the 1st of October. It is with great pleasure that the report for this term is now submitted to the Society and its friends.

Often has the sincerest gratitude been felt towards the Genevolent members of this Society, who have produced such as asylum for the affected Chinese, and to the respected President by whose judgment the spot was selected, when, walking through its capacious and numerous apartments, I have witnessed the comfortable accommodation afforded to the inmates, to many of whom it seemed almost a palace, in comparison with the narrow cells which they call their homes. The building is capable of accommodating two hundred patients. It has nineteen spacious rooms on the second story, well ventilated; and as many corresponding ones on the ground floor; a garden, and extensive compound, with three wells of water- in the rear; and a yard in front. The building is of bricks strongly built; and the whole of the ground (say a third of an acre) belong ing to it, is surrounded by a substantial wall. It is in a healthy locality, overlooking the inner harbor,,and has good access both by land and water.

It is delightful to contemplate the yearly augmenting relief that may here be afforded to the suffering Chinese. It is cheering and encouraging to regard the facilities that here exist, for the instruction of the young men of China in the principles of rational medicine and surgery. May the institution prosper every way- may there be no lack of men to conduct its operations, or of means to support and increase its usefulness-may it be the fruitful parent of many like institutions, under the conduct of Chinese, who shall have acquired the skill and science of the west, and shall have imbited the benevolence and purity of the gospel.

Seven hundred patients were received into the Hospital during the term, towards the close of which many had to be sent away, from the inexpediency of receiving them for a few days only. Fewer important surgical cases presented themselves, in proportion to the whole number, than had previously been the case in Canton.

Page 114

with a few exceptions, the task of gaining the confidence of the people had to be commenced de novo. The suspicion and reserve at first manifested were greater than ever from Canton. The arrival, however, as patients, of gentlemen from Canton, and occasional visits of some who had been cured there, and those of others personally acquainted with previous operations, tended very much to alter the feeling of the people. An unexpected auxiliary in effecting this change was found, too, in sundry of their idols, who, according to the interpretation of the Chinese priests, encouraged a large number of their votaries to apply to the foreign physician with assurance of success.

The following is a tabular statement of the numbers of each of the diseases that came under observation during the term.

<table><tbody><tr><td>Fevers</td><td>4</td></tr><tr><td>Inflammatory disorders:</td><td></td></tr><tr><td>Abscesses, chiefly about the head</td><td>27</td></tr><tr><td>Carbuncles</td><td>10</td></tr><tr><td>Fistulae (in ano)</td><td>2</td></tr><tr><td>Rheumatism</td><td>25</td></tr><tr><td>Thrush (ulcerated mouth and lips)</td><td>2</td></tr><tr><td>Ulcers, chiefly of lower extremities</td><td>66</td></tr><tr><td>Whitlows</td><td>5</td></tr><tr><td>Spasmodic diseases:</td><td>Asthma</td><td>8</td></tr><tr><td>Constitutional diseases:</td><td></td></tr><tr><td>Dentition</td><td>2</td></tr><tr><td>Dropsy</td><td>4</td></tr><tr><td>Opium mania</td><td>4</td></tr><tr><td>Scrofula</td><td>12</td></tr><tr><td>Diseases of the organs of circulation:</td><td>Aneurism</td><td>1</td></tr><tr><td>Diseases of Respiratory organs:</td><td>Pneumonia</td><td>12</td></tr><tr><td>Diseases of Disgetive organs and the connected parts:</td><td></td></tr><tr><td>Diarrhea</td><td>7</td></tr><tr><td>Dysentry</td><td>2</td></tr><tr><td>Dyspepsia</td><td>2</td></tr><tr><td>Foetus</td><td>8</td></tr><tr><td>Worms</td><td>4</td></tr><tr><td>Pterygium</td><td>30</td></tr><tr><td>Entropia</td><td>40</td></tr><tr><td>Ektropia</td><td>1</td></tr><tr><td>Trichiasis</td><td>1</td></tr><tr><td>Lippitudo</td><td>26</td></tr><tr><td>Hordeolum</td><td>2</td></tr></tbody></table>

Diseases of the Liver and its connected parts:

<table><tbody><tr><td>Hepatitis</td><td>2</td></tr><tr><td>Enlargement of the spleen</td><td>1</td></tr><tr><td>Diseases of Generative organs and its connected parts</td><td></td></tr><tr><td>Amenorrhea</td><td>1</td></tr><tr><td>Ovarian dropsy</td><td>2</td></tr><tr><td>Prolapsus vaginae</td><td>1</td></tr><tr><td>Urinary calculi</td><td>2</td></tr><tr><td>Diseases of the Nervous system:</td><td></td></tr></tbody></table>

<table><tbody><tr><td>Neuralgia</td><td>1</td></tr><tr><td>Paralysis</td><td>5</td></tr></tbody></table>

Diseases of the ear:

<table><tbody><tr><td>Cerumen deficient</td><td>3</td></tr><tr><td>Deafnesse</td><td>11</td></tr><tr><td>Meatus auditorius wanting</td><td>1</td></tr><tr><td>Otorrhea</td><td>9</td></tr><tr><td>Polypus of the ear</td><td>1</td></tr><tr><td>Tumor of the ear</td><td>2</td></tr><tr><td>Ears rent by heavy ear-rings</td><td>7</td></tr></tbody></table>

Diseases of the eye:

<table><tbody><tr><td>Ophthalmia, Acute</td><td>23</td></tr><tr><td>Chronic</td><td>106</td></tr><tr><td>Neorum</td><td>2</td></tr><tr><td>Purulent</td><td>16</td></tr><tr><td>Rheumatism</td><td>1</td></tr><tr><td>Ophthalmitis</td><td>2</td></tr><tr><td>Granulations</td><td>20</td></tr><tr><td>Preternatural, and diseased growth:</td><td></td></tr><tr><td>Polypi of the nose</td><td>3</td></tr><tr><td>Tumors, Cutaneous</td><td>1</td></tr><tr><td>Sarcomatous</td><td>10</td></tr><tr><td>Cutaneous diseases</td><td></td></tr></tbody></table>

["Page 115", "Musoclele - - - - - - - - - - - - - - - - - - - -

On the 19th I embarked, and early on the 22d, arrived at Macao, and I now earnestly beseech the Doctor to heal my blindness. In the 15th year of Taoukwng (1835), and the seventh month, my right eye became diseased, and at this time I am unable to see light. In the second month of the present year I was grievously afflicted, by carelessly taking cold. Under medical treatment my disease ceased, but afterwards the eye became daily more and more blind, and now only a glimmering of light remains. I earnestly entreat the Doctor to heal me: my gratitude will then be boundless."

The gentleman had cataracts completely formed in both eyes, and upon the cornea of the right eye was a slight nebula. The cataracts were depressed in both eyes. No inflammation followed in either, the lens in the left eye partially arose, and, a fortnight from the first operation, was re-depressed with success. At the extirpation of three weeks the patient was told he might return to his family whenever he chose. He wished to remain longer, and it was not till the first of September that he left. Previous to his return, he dined with me in European style, after which he was delighted to see the ships in the harbor from the terrace and pointed out the elevations on the opposite side of the inner harbor, and said that "his heart dilated with gratitude in proportion as his eyes were opened to the light". This man was attended by a son 40 years old, and three servants. His deportment was uniformly that of a gentleman, and he was always ready to communicate intelligence, upon whatever subject interrogated. Being from the vicinity of Beijing, it was interesting to learn from him the customs, and to gain local information, of that part of the country, and in return to answer his numerous and intelligent inquiries respecting the nations of the west.

Since my return to Canton, he has called and reported himself in excellent health. He informed me that since recovering his sight he had received a new appointment from the government, and was immediately to go to the part of the province in which he was to enter upon the discharge of the duties of his new office, rejoicing in a second youth. His case is mentioned not for any thing worthy of especial notice in a medical light, but as an example of the advantages the hospital will afford for free intercourse with Chinese of respectability and intelligence.

No. 257. Aug. 8th. Nasal polypus cured by sulphate of zinc. Hwang Luh of Macao, aged 20, had a polypus that descended from his nostril a thrid on an inch, being attached to the posteriorsuperior turbinated bone. It just filled the nostril, was of soft character, and had occasionally bled. The sulphate of zinc in substance was applied to the polypus. The next day the patient complained of much pain and soreness.

Page 107

A strong solution of sulphate of zinc, one scruple to two ounces of water, was substituted. The next day the sulphate of zinc in substance was again employed and that patient directed to use the solution twice daily. On the fifth day he returned and said he was cured! The excrescence had sloughed away, except a small portion of its attachment. The same treatment was continued, and on the ninth day the whole had disappeared. The patient presented himself some time after, and there was no return of the disease. This is the most remarkable case of the efficacy of this mineral in nasal polypus that I have witnessed, but not the only one.

No. 341. Aug. 19th. Hypertrophy of the arm. Woo Shing aged 27. a laborer of a village in the neighborhood of Macao, had a great enlargement of the left arm, which commenced at birth. It resembled elephantiasis of the lower extremities, except that it was confined chiefly to the muscles and integument of the inside of the arm. At the bend of the arm it was eighteen inches in circumference, and thence it gradually diminished upwards to the opposite side of the insertion of the deloid muscle, and downwards to the wrist. A hard glottal mass appear to be attached to the bones at the elbow, distinct from the general disease. The surface was excoriated and red, and there was constantly a limpid discharge. This and the weight of the tumor was the chief inconvenience. This patient was languid, tongue white and glossy, and the vital powers enervated.

Aug. 21st. In consultation with Dr. Lindsey, surgeon of H. M. ship Wellesley, and Mr. Anderson, surgeon to the superintendents of British Trade, it was resolved to test the efficacy of iodine, both internally and externally, and should this not succeed, as a 'dernier ressort' to amputate the arm. The tincture of iodine was applied, gradually increasing the quantity from half a drachm to a drachm daily, and the arm was bandaged and suspended. Lugol's tincture of iodine was administered internally, beginning with ten drops, three times a day, and gradually increasing the quantity to twenty drops. As the pulse was quickened and some epigastric uneasiness was produced, the tincture was omitted for a few days, then resumed. Blue pill and Ext. colocynth was taken occasionally, as the symptoms required. The arm became softer and considerably diminished, but upon omitting the Iodine and bandage for a short time, it returned to its former size. The same treatment was resumed and continued till the close of the hospital stay when the patient was provided with the same medicines to carry home; but was told that amputation would probably be the only means of permanent cure, and whenever he was prepared for that he could come to Canton.

No. 457, Aug. 27th. Chaou Tinkwei, aged 1 year. The child was of a fair complexion, and delicate skin. Her lower extremities were covered by warty excrecesences, some single, others in clusters, many of them of the figure and size of a mulberry.

Page 118

At first hyd. cumcreta 5 grains at night, and cal. mag. in the morning were ordered, and the sulphur ointment applied externally. On the 4th September a solution of nit. argent. four grains to the oz. was applied by a feather to the excrence, some of which were ulcerated. In one week the mother returned with the child, saying that the lotion was very good and desiring more. The disease was fast healing the same treatment was continued, and in about three weeks the little girl was well.

An unusually large number of cutaneous affections of every variety has presented.

### Hare lips.
Twelve patients with this malformation have been received, and in several instances in one week from the operation the patient has been quite cured. The fortitude of these little children has been very noticeable, they appearing often through the whole operation, almost insensible to pain.

The nevus materna, in the table of disease, was of dark crimsom color, affecting the upper lips and extending over the nose and forehead. His profile as viewed from the left side represented a hæmorrhage, which was considered by the man as resembling a hog's snout being large and well defined. The man, aged 27, and also his mother, regarded it as a great mortification.

### Abscess of the thigh.
Supervening upon fever. Hwang Yueme, aged 17, of the district of Hwuchow, a student resident at Mongha village, near Macao. About the first of September, when called to this young man, he was a mere skeleton, excepting his thighs, which were very large. He was filthy in the extreme, and large sores had been formed on the sacrum and elbow from his long confinement. Fluction was very distinct in both thighs. Feeling unable to be removed to the hospital he was prescribed for at his house, and the next day he reported that one of the abscesses had burst and discharged about 4 quarts of pus, and he felt much relieved. The second day I revisited him and opened the abscess of the opposite side, which discharged an equal quantity of pus with the other. The next day, he was removed to the hospital on a litter, being informed of the severity of his illness, but that everything should be done for his comfort and for his recovery, though the latter was scarcely to be expected. He and his father were grateful for the offer.

The daily discharge was very great. Tonic were administered during the day, and opiates at night. The abscesses were carefully dressed once or twice a-night daily, and bandages applied. In about four days after bursting of the abscesses his tongue and the roof of his mouth became coated with a thick yellow crust, which, after the lapse of about one week came off and left the surface quite smooth and red.

Page 119

His pulse was still small, and thick, and ranged from 100 to
120. The father was that a fatal crisis was fast approach-
ing. He went to a fortune teller, who cast the horoscope. He
came back delighted-exclaiming, he will not die now, and pre-
senting a paper, showing that a man born upon the day his
son was wuld not die then. "We still lingered on, the discharge
becoming more fetid, and his body more lothsome. The day
previous to his decease he seemed bewildered at times, cried
saying his aged grandmother in his native place had been dead
more than a month, and grieved that he had not been present
to administer to her comfort, filial feeling being the 'ruling
passion strong in death'. On Sabbath morning, just a fortnight
from entering the hospital, his immediate release seemed certain.
At 2o'clock p.m. it was manifest he could not survive many
hours. He had his senses fully. He was remained that one could
feel but little regard at leaving an old house just ready
to bury its inmates in its ruins, provided a new and commod-
ious one were presented in its stead, a comparison he full
well understand, for it was a change he had experienced.
He listened attentively. He was then informed that he must
in a few hours experience a still greater change, but that
were mansions prepared on high, to which the Savior( of whom
he had previously heard) would welcome all that trust in him.
He seemed pleased with the idea, wather than agitated at
the fact, about 9 p.m. The father was less reconciled to the
event, and when told his son was dead he could not believe
it. but insisted upon giving him some "strong medicine".
His son being already unable to swallow, he was authorita-
tively told that he should not increase his suffering by so
doing. In a little time his sufferings were all ended. His
father then attempt that all was over with his son, he pre-
pared a portion for himself, which he swallowed quickly,
exciting in us the apprehension thst he had taken opium.
It proved however to be otherwise. The body was intered in
the course of the night, without much troubling the hospital.

Aneurism spontaneously cured. A girl, 16 years old, a fort-
night previously entering the hospital, received a blow from
a playmate with a Chinese pillow (which is a cylindrilcal
apparatus of bamboo), upon the left temporal artery, high on
the forehead. There was at the time a flat tumor extending
nearly to the ear, to theouter angle of the eye, and down
upon the cheek. A fluctation was felt, but no pulsation
except a very slight one in the temporal artery, extending
about an inch from the wound. There was neither pain nor
redness. Aware that if necessary the artery could be readily
divided or taken up, a small incision was made through the
integument at the most prominent point, and a small probe
introduced, upon an elastic membrane, which yielded to pres-
sure, but immediately resumed its place as that wasremoved.

Page 120

A lancet was introduced perpendicularly just sufficiently to puncture the membrane. Arterial, mixed with streaks of coagulated, blood escaped. Sponges of cold water were applied to the surface and stytics to the puncture; the hemorrhage stopped without difficulty. Three days after this the aneurism was carefully examined, and not little handled. It was concluded on the next operation day to take up the artery, but on entering the ward early next morning, several patients exclaimed that the tumor was half gone. A very perceptible diminution had taken place, and a small hard ball, formed an elevation above the injury of the artery. An elapsating lotion was applied during a few days, and the swelling gradually lessened. A compress and bandage were then substituted, and in a fortnight, when the hospital was close-d, the whole had disappeared, except the remains of the ball, now less in size than a tamarind stone, and no inconvenience was felt;

No external ear. A third case of a Chinese without an external ear or meatus auditorius has presented. The lad was 16 years old. His hearing was good in the right ear only.

Asthma of children. The eight cases of asthma were mostly of children under 10 years, living in small boats, and from infancy exposed to every variety of weather.

The disappointment of patients, who came in numbers up to the day of leaving, increased the regret felt, that no medical gentleman had arrived from England or Ameriac to continue the operations, as there had been encouragement to expect, a physician of Glasgow having been reported in private letters to be about to embark from London in April. The addition and repairs to the Ophthalmic Hospital at Canton having been completed, and the period having arrived when, accordingly closed to public notice previously given, it should be reopened, it was impossible to prolong the term at Macao, and the hospital was accordingly closed on the 1st of October. It is with much pleasure, however, the letters have been received, stating that a surgeon of experience was on the point of embarking from London for China, in August last.

It is learned with much satisfaction, that the object of this Society has been favorably regarded both in England and Scotland. Sir Henry Halford, President of the London College of Physicians, in an address before the College, reported in London Medical Gazette for February last, in habitting to allude of the suits of successful medical practice, took occasion to allude to the operations of this Society with approbation of its principles, among the individuals present were: H.R.H. the duke of Cambridge, the archbishop of Canterbury, the duke of Wellington; Sir Robert Peel, and many distinguished members of the Church, the Bar and Senate. The address is said to have been listened to with great attention, and to have excited general interest. What will be the result remains to be disclosed.

Page 122

First annual report of the Medical Missionary Society
in China, read at a public meeting, in the Hall of
the General Chamber of Commerce, Nov. 20th, 1838.
The Chinese Repository Vol. VII. Page 419.

Little more than half a year having elapsed since the
'suggestions', first published in 1836, were fully acted
upon the formation of this Society, your committee, in t
this their first report, have but few remarks to offer.
From the great interest taken in the objects of the Society,
both by those resident here and by passing strangers, as
evinced by the pecuniary support afforded, and by the fre-
quent visits paid to the hospital, they feel assured, how-
ever, that in future reports there will be no want either of
topics for reflection or themes for rejoicing and thank-
fulness.

In compliance with the request of the Society, made to
Dr. Parker at its last meeting, the House at Macao, recently
purchased for a Hospital, was opened to patients during
the past summer, and remained open from the 5th of July
to the 1st of October. In the interim the Hospital House
at Canton was thoroughly repaired, and three new rooms
were added, by which the means of affording accommodation
to in-door patients have been greatly increased. These
repairs and alterations having been completed, and the
time which had been named to the patients in Canton for
Dr. Parker's return being elapsed, it became necessary to
close, for a reason, the Hospital at Macao. Hopes had been
entertained that the arrival of a physician from England
or America would have averted this necessity. Though these
anticipations have been disappointed, your committee never-
theless have cause to believe, that the means of re-opening
the Hospital at Macao will shortly be afforded. They have
credible information, that a medical gentleman of experience
would embark from England, in August last, for this country,
by the way of Batavia, under the auspices of the London
Missionary Society. * His arrival in China may therefore
be looked for ere the close of the present, or at an early
period in the coming year.

The report of the quarterly term, during which the Hospital
at Macao was open, is now in the press, and will shortly
be published. The number of patients during the term was
700, which added to the number during the eighteenth quarterly
terms in Canton, afforded a total of more than 600 persons,
who, by the pecuniary aid of this Society, and the personal
exertions of the senior Vice-president, have, with but few
exceptions, received permanent relief from suffering, -while
a large number of them have been restored from partial or
total blindness to all the blessings of good and useful
sight. The almost uniform success of the medical and surgical
treatment at the institutions of the Society,

Page 123

the growing confidence of the Chinese, which is the natural
result of this, their grateful sense of the benefits conferred
upon them through the skill and philanthropy of foreigners, -
are so many powerful encouragements to perseverance in the
pursuit of the noble objects for which we are united. And so
perserering, we may look forward with confidence to the time,
when, having afforded to the intelligent youth of China a good
medical education, we shall no longer confine our efforts to
the small circle within which our residence is now circumscribed,
but may be enabled first to send forth our practitioners, and
ultimately perhaps to follow them ourselves, through the length
and breath of the empire. It cannot be requisite to do more
than merely allude to the advantages that must result from the
impressions which thus be everywhere made in our favor. - advan-
tages affecting us all alike, whether engaged in mercantile
business, or in the pursuit of science, or in conveying to the
ignorant and the debases, principles of knowledge, calculated
to elevate, to enlighten, and to benefit both in this life and
in the life to come.

Having alluded to the report of the Hospital at Macao, it may
be appropriate to draw attentin to two passages in the prefat-
orey and concluding remarks that accompany it. Dr. Parker, in
referring to the house, which was purchased, and put into bre-
pair by Mr. College, with a direct view to its being occupied
as an institution of this Society, thus speaks: - "Often has
the sincerest gratitude been felt towards the benevolent members
of this Society, who have procuced such an asylum for the affect-
ed Chinese, and to the respected President whose judgment first
selected the premises, when, --walking through its capacious
and numerous apartments, --I have witnessed the comfortable ac-
commodation afforded to the inmates, to many of whom it seemed
almost a palace, in comparison with the narrow cells they call
their homes. The building is capable of accommodating two
hundred patients. It has nineteen spacious rooms on the second
story, well ventilated; and as many corresponding ones on the
ground floor; a garderm and extensive compound, with three wells
of water, --in the rear; and a yard in front. The building is
of brick, strongly built, and the whole of the ground (say a
third of an acre) belonging to it, is surrounded by a substantial
wall. It is in a healthy locality, overlooking the waters of the
inner harbor, and having good access both by land and water."

In concluding his report, Dr. Parker remarks; "It is learned
with much satisfaction that the object of this Society has been
facorably regarded both in England and Scotland. Sir Henry
Halford, President of the London College of Physicians, in an
address before the College reported in the London Medical Gazette
for February last, in exhibiting some of the results of successful
medical practice, took occasion to allude to the operations of
this Society with approbation of its principles. 'Among the in-
dividuals present were H. R. H. the duke of Cambridge, the arch-
bishop of Canterbury, the duke of Wellington, sir Robert Peel,
and many distinguished members of the Church, the Bar, and the
Senate.'

page124.

The address is said to have been listened to with great attention, and to have excited general interest. What will be the result remains to be disclosed. It is occasion of gratulation that the subject has thus been commended to the attention of men who have it in their power in various ways to promote it, and we anticipate with confidence a result favorable to the advancement of our objects and promotive of the welfare of the vast population of China.-- From a widely circulated Scottish Journal, it appears that our objects have also been auspiciously commended to the attention of the enlightened and philanthropic public of that country."

It remains only to refer to the Treasurer's accounts, whereby it will appear, that, notwithstanding the necessarily heavy outlay, arising from the purchase and partial furnishing of the Hospital at Macao, a balance of $780.71, still remains to the credit of the Society. This balance will not, however, be sufficient to meet the current expenditure of the Hospital in Canton alone. And our hope being, speedily ultimately from the difference of situation and extent of premises, afford the best school for the medical education of young Chinese), as well as to continue and extend our operations in Canton,--the aid of a bebevolent public is looked to for the requisite means. The increasing interest taken in our objects affords sufficient assurance that an appeal to that public will not be made in vain.

Page 125

Medical Missionary Society in China: remarks made at its
first annual meeting.
The Chinese Repository. Vol. VII. page 457.

The report of the committee of management having been read
(see our last No. p. 419.)G. T. Lay, eq., then rose to
move its acceptance, and spoke in terms nearly as follows:-

"It is necessary that I should take up any time in insisting
upon the value of medicine and surgical aid: every one who
has felt disease himself, or witnessed it in a friend or re-
lative, has had the conviction of their worth and importance
brought home to him and made a part of his mental associations.
The Chinese have a materia medica that is well supplied with
drugs, they display great variety, neatness, and care in their
pharmaceutical operations, we see them busied in dispensing
prescriptions, while the size of the shop, its furniture, and
every circumstance about it, combine to assure us, that every
thing is done in conformity with a steady and comprehensive
system. The manifestations of disease, and the various phases
which it puts on, from its first beginning till it terminates
in death or recovery, have in many cases been well marked
and faithfully recorded by them. Their experience which resem-
bles the experience of most of us of Satyrion, embraces many to deal
successfully with remittent fevers and other maladies, which,
according to their classification, arise from cold or bad air, or
from some disturbance of the healthy equilibrium. But where
Disease assumes a malignant character, where its treatment
depends upon a proper knowledge of the situation and function
of the parts affected, or extirpation is called for, it is
clear, that it is far beyond their reach, and must be left
to its own course, with the certainty that it could only be
made worse by their interference. It is here that the man
with the enlightened knowledge and the surgical adroitness
of the west finds an appropriate field, and does for a Chinese
what no native practitioner can do for him.

"But there are other advantages, besides the relief of human
suffering, however great that may be, which are intimately
connected with the objects of this Society, and deserve our
most attentive consideration.

"In the first place, it teaches us what the Chinese really
are. We have become accustomed to hear of their prejudices,
their exclusive spirit, their repugnance to and distrust of
foreigners. Now in this respect our hearsays and all our sur-
mises are completely overset by what we may see any day at
our hospitals. Crowds of Chinese of both sexes, afflicted with
all kinds of disorders, soliciting aid in the attitude of res-
pect and numility, and listening to advice and assurances, as
if nothing but absolute truth could fall from the lips of the
physician.

Page 126

To behold a female, unaccompanied perhaps by a single friend or relative, brought in and tied hand and foot to the operator's table, and there submit to a most painful operation, without uttering a sigh or a groan, teaches us, in terms that can neither be misunderstood nor prevaricated, that a chinese, upon proper grounds, is able to exercise the most unbounded confidence in the wisdom and goodness of the stranger. We learn, what I rejoice to find proofs of from different quarters, that he has most keen perception of what is good for him, and courage to embrace it, whenever it can be made apparent to him; that he has a stock of good sense and good feeling upon which, whether we seek to make him wiser by our sciences, or better by our religion, opens to us prospects of the most encouraging and delightful character.

"In the second place, it makes the Chinese acquainted with the authentic nature of our principles, and the kindness of our feelings towards them-a most necessary preliminary in the work of doing them good, whether it be in matters touching this world or that which is to come. There is nothing more obvious than that a Chinese entirely misunderstands our character and situation; he thinks we have no institutions for learning, are strangers to the softer refinements and courtesies of life, and recognise no moral distinctions, are unconscious of the intrinsic beauty of a vituous action, When assured that he labors under a mistake, he hears with incredulity in his locks, when he witnesses proofs of wisdom and goodness, he is filled with wonder and surprise. We find by experience, that he is not apt to forget either our good words or our good deeds, but if there were any oblivious tendency in this way, it would be corrected by the restoration of sight to the blind, the removal of excrescences that preyed upon the vitals of the sufferer, and so on, for he bears a testimony which he will convey to his grave, written with indelible characters upon his body, that China, with a swarming population, cannot produce a man, that can at once vie in skill and humanity with the stranger. Where could we find a better pledge, abetter earnest to assure them, that our science is founded on truth, our religion full of benevolence? If we have patience to give these endeavors time to work, such a convict, waxing stronger and stronger, is inevitable,--the collateral results, of unknown magnitude and importance.

"In the third place, we shall have opportunities of studying the mind of a Chinese, and of tracing all its essential characteristics. We shall find out wherein it differs from our own, what it has in common with ourselves: for a sick person, as by a sort of instinct, opens his heart as well as his case not more frequently there than in China. All ranks, ages, and sexes, tell their story, and reply to questions, with child-like simplicity, and make good what philosophy would teach us, that to speak the truth is a quality naturally inherent in the will of man.-

Page 127

Everything about their domestic history, ways of thinking,
social feelings, may the very penetralia of their hearts and
dwellings, are brought under contemplation, and thus we may
gather hints and reflections which will be hereafter of the
highest value to us.

"In addition to these advantages, we may mention the influence
the enterprises like the one before us are likely to exert
upon medical science itself.

"(1) Maladies, in their nature and frequency, differ in different
countries. A disorder which is transient and occurs only here
and there in some places, may be studied in all its features
again and again in others. The phenomena which the same disease
exhibits in one place, it never assumes in another, —a consider-
ation that leads us to make a difference between such as are
common to it in all places, and such as are not, and so to
delineate with philosophic accuracy what its essential character
consists in. If at the same time we attend to the climate, soil,
water, and relative situation of the country, with the diet and
habits of the people, we give new and wider bearings to an im-
portant part of medical study—the existing causes of disease—
and, of consequence, the means by which they may be avoided.
By this means we shall be able to complete our system of noso-
logy, and to make out a uniform encyclopedia of diseases.

"(2) If the existing causes of disease have a kind of geor-
graphic distribution, the appropriate remedies seem to have
its peculiar drug as well as its peculiar disorders, as if the
same providence that sent the affliction sent also its cure
with it. Each country has its pharmacy, remarkable for some
drug not found elsewhere, and generally proves after investi-
gation for more comprehensive than we were at first inclined
to suppose. The Chinese and the Japanese have each their own
both of which abound with excellent and powerful medicines.
Now by practicing among the natives, we are made acquainted
with these remedies, their modes of application, efficacy, and
so forward, by ways that are as good as actual experiment, with-
out any risk. Hence we are enabled to enlarge our knowledge of
remedies, and to enrich our pharmacopoeias with an account of
suostances hitherto unknown or antired.

"(3) Every nation and tribe has what we may call its national
therapeutics and nosology. It has some conceptions of disease
peculiar to itself, some modes of treatment not observed else:
where. In principle and extent they may be very humole, in de-
tail united with error and mistake, but I think we should have
to search a long time before we found one that would not afford
us one fact for our information, or one hint to awaken our cur-
iosity.

Page 128

these subjects would necessarily fall under the notice of an
enlightened practitioner, who with patient kindness had given
himself up to the purpose of doing good, which he would not
fail to record and communicate to the world for the benefit of
science and humility.

"I am so impressed with the importance of these considerations that I have determined to make the system of gratitude relief for the sick in some sort universal. I may not succeed in my first attempts, but I will continue, while life and health last, to pursue my object till I have attained it. We have societies for giving the Bible, the gospel, useful knowledge, and so on, to the world, - we will have also a society for giving the benefits of rational medicine to the world. Humanity shall be taught to flow in new channels, and to wear names and designations unused before. Science shall earn new honors, and gain fresh accessions to her strength. The motives that incite us to deal out our good things to all mankind are of the highest and noblest kind, while the success that waits upon every attempt invites us to bring all the means we can spare and lay them upon the altar of Him who giveth liberally and uporaideth not. On my return to England, I shall not forget the promise I made to this Society at its formation, for I am sure it needs only to be known in order to be supported."

He then moved, J. C?Green, esq., seconded, and it was unanimously-

Resolved, That the report which has been read be accepted, and
printed under the direction of the committee.

The Treasurer's accounts, duly audited, were then read, and
laid upon the table. It appeared that the disbursements of the
Society had been, during the year, $1741; the receipts since
10th May, $754; and that the balance in the Treasurer's hand
was $780.

Lists of books, instruments, paintings, and medicines, that had
been presented to the Society, having been read, it was-

On the motion of W. Bell, esq., seconded by W. S. Wetmore, esq.,

Resolved. That this Society gratefully acknowledges the valuable
donation of works on ophthalmic surgery, the surgical instru-
ments, and specimens of morbid anatomy, received from T.R. Col-
ledge, esq., its President, as also the donation of books, &c.?
received from other gentlemen.

Page 129

The chairman then stated, that Mr. Colledge, on his recent de-
partment from China, had left nearly the whole of his medical
library behind, with the desire that it should be offered to
the Society on condition of his being enabled in return to
furnish himself with a similar library in England. The prices
not having been attached to the several works, the committee
were unable to state the precise value of the collection:
the balance in the treasurer's hands, however, did not seem
sufficient to authorize the appropriation, at the moment, of
any sum for the purchase of the kooks. He went on to state,
that the books were nevertheless being priced, and the expec-
tations were entertained of being enabled to meet the cost of
them without burthening the funds of the Society, or applying for
a private subscription from the member.

A series of By-Laws, referred at the last General Meeting for further consideration, was read; when it was-

On the motion of W. S. Wetmore, esq., seconded by W. Blenkin

Resolved, That the By-Laws just read be sanctioned, and printed
with the Report of the Committee

The Chairman having called a ballot for election of officers,
it was on the motion of W. Blenkin, esq., seconded by Heer-
jeebhoy Rustomjee, esq.,

Resolved, That the gentlemen now forming the committee of man-
agement be requested to continue in office until the next an-
nual meeting.

The Chairman begged to say a few words, before dissolving the
meeting. He would revert to the address made to the meeting
that morning, by Mr. Lay. Sincerely did he wish that gentle-
man all success in the effects which he had expressed his in-
tention of making, on his return to England, to set on foot a
Society with purposes like those of this Society, but with a
wider range. That gentleman is in possession of the peculiar
advantages of an eye-witness. Having visited many of the isles
of the Pacific, and the Indian archipelago, also Lewchew, and
having for some time resides in China, he can speak of the
things that he has seen and testify of what he knows. He has
been enabled to assure himself personally of the readiness of
many of the nations, living out of the pale of Christendom and
of western civilization, to avail themselves of the medical
skill and kindness of European practitioners. He has seen their
confidence, their gratitude, and can justly appreciate the adapt-
edness of such means, as preparatives for the attainment of those
blessings in which rest the highest ends of man's existence.
He is aware, too, of the sanction such operations receive from
that Book to distribute which he left his family- the lively
greetings of that family may be soon unalloyedly enjoy!

Page 130

Medical Missionary Society's Hospital: appointment of Mr. Lockhart to the charge of that at Macao: inquest held on the body of a deceased patient in that at Canton.

The friends and well-wishers of the Medical Missionary Society in China will be gratified to hear the advances which that Society is making towards the attainment of a permanent and sure footing in this country, its labors having received the tacit sanction of the government, and its means of exertion having been increased by the arrival of a new fellow-laborer, in the person of W. Lockhart, esq., an experienced surgeon, selected by the London Missionary Society as their agent in this country. Mr. Lockhart reached China towards the close of last month, and having offered his services to the Medical Missionary Society, has been appointed to the charge of their hospital at Macap, which was first opened by Dr. Parker during three months, last summer, and will this year be reopened by Mr. Lockhart, as soon as he shall find himself qualified, by a sufficient knowledge of the language and character of the people, to commence his labors among the Chinese.

The manner in which the government has given its tacit sanction to the operations of the Society is in the first place, by the application of several officers of rank in Canton for medical aid, and in the second place, still more strongly, by having held an inquest on the body of a patient (who haddied in the hospital, having no friend or relative in attendance), without having either at the time or subsequently expressed in regard to it a single word of disopprobation. This, in relation to an institution sustained wholly by foreigners, is no small step gained; and tends to confirm our belief, that, were we to manifest in many matters a less imperious and a more kind and considerate spirit, the Chinese government would speedily abate a large measure of its suspicions of the encoaching character of those living beyond the pale of its civilization. The subjoined letter from Dr. Parker to the Editor of the Canton Register will show the particulars regarding the inquest referred to.

Dear Sir, - Allow me to state briefly the occasion of the Nanhae Heen's visit on Saturday last. On the 2d instant, a woman from Sanshuy arrived at the hospital, affected with dropsy and disease of the heart and liver. It was late in the day when I saw her; unable to walk she had called a chair, though she had nothing to pay to the bearers. She entreated me to have compassion on her; that she was a solitary being without parent, husband, or child. The boat in which she came had returned, and I could not send her back to the river side to perish there. The chairbearers were paid and the woman told to quiet herself, she should be compassionated, be provided with food and other comforts, and though her disease was very bad, we would do what we could.

Page 131

It was some time before she was able to walk up the stairs,
and she breathed with great difficulty. Unable to lie down she
stood upon her feet nearly the whole of her time day and night.
Under medical treatment in a few days the swelling of the legs
subsided, and on the 6th several gallons of fluid were drawn
from her abdomen, showing a great enlargement of the liver. The
nights following she was much relieved, and able to sleep in a
recumbent posture; but on the 11th it was evident she could not
live long, and it was proposed she should return to her home.
She said there would be no boat before the 15th, when she would
go, and it being the commencement of the Chinese new year, I
could not procure a boat for her. On the 13th, about 5 p. m. she
fell backward in her chair and expired in less than an hour. As
she had no friend or relation, it was necessary, to prevent any
possible future trouble, to have her buried in the legal way.
The hong merchants accordingly petitioned the Nannae to hold
the required inquest on her body, and give order for her inter-
ment. The result of their petition was quite satisfactoty. On sat-
urday this officer, according to form, held an inquest upon the
body, and then ordered it to be buried. Everything was made as
pleasant as possible, and, so far as could be judged, both the
magistrate and the hong merchants were perfectly satisfied. The
event is an important one, as the institution is now brought
distinctly before the government; and if no edict follows, such
silence will be tacit recognition of the institution; and it has
seemed as though this was a point the cohong have desired. The
measures adopted have been to prevent and not to create difficult-
ies.

It is worthy of remark that the magistrate by whom this inquest
was held had himself been a patient of Dr. Parker's for some
time immediately preceding his official visit to the hospital
and had perfectly recovered from his maladies, a providential
circumstance to which may be attributed a portion of her unwilling-
ingness to give any trouble beyond what his official duty rendered
necessary.

Page 132

Hospital at Canton Reports of the Medical Society in China, for the Year 1839 or The Chinese Repository Vol.VIII. p.674

Dr Parker's tenth report of the cases in the Ophthalmic Hospital, at Canton will occupy the principal portion of the following pages. The Committee embrace the occasion of publishing the report, to give to the friends and members of the Society a brief statement regarding its present conditions and prospects, as well as its proceedings during the first Year.

A simple allusion to the disturbed state of affairs here, through the year, to the unsettled position of foreigners, will show why, after the initial meeting in November, 1838, its member and friends have not once been assembled, during the year 1839.

It may be presumed, from the posture of general political and merchantile affairs, that the proceedings of the Society must have been already arrested, since the month of March, last Year. This, indeed, for the time was, and partially it continues to be, the case. During the months of restrain within the factories at Canton, The months namely, April and May, the ophthalmic hospital was shut up by the senior Hong merchant, acting under high officers, or in expectation of such an order, and in fear of reprehension. A few cases was notwithstanding attended to in private manner, at Dr Parkers' own rooms and after the foreigners from their constrained release in Canton Patients continued to receive in this way, until their increasing numbers rendered some other arrangement necessary.

The removal of the English portion of the community, and with their medical attendant, from Canton to Macao, to remain at the latter place, left Canton what had been the Canton dispensary. The day of the American portion of the Community (as well as some foreigners) at Canton, having at the same time, to enabled Dr Parker to remain and continue the performance of their duties, it was to the Canton Dispensary that he proceeded when he found it impossible longer to continue to receive the increased number of patients in his own house and the sendor Hong merchant still being unwilling to allow the place occupied heretofore as the ophthalmic hospital to be again opened. All further details regarding this institution will be found transmitted by the doctor himself to the Committee. The summary of the cases will point out, that, though diseased of the eye still preponderated, and the original name of the institution is retained, yet it is no longer pecuniary an opthalmic but has become a general hospital.

The Hospital at Macao which has been opened by Dr Pakre in July and closed when he returned to Canton in October 1838 remained unoccupied until the 28th of February 1839. William Lochart M.R.C.S. in connection with the London Missionary Society having then arrived from England, and the offer made by his as to the services having been accepted by the Committee, the hospital house was placed under his charge. Engaged, at first, chiefly in the study of the language although he did occasional receive patients such as demanded immediate care yet he did no open the hospital until the 1st of July and even then to admit very limited patients.

Page 133.

It continued thus down to the middle of August, when he was involled in theseverities directed in general against the English and those in their employ. the departure of all the natives from the premises virtually closed the hospital, and shortly after, at the end of the same month, he was compelled by the Chinese to leave, in common of his country men, and to embark on board ship. After waiting for half a month he saw no speedy prospect of being able to quietly reside again in Macao, and anticipated that for some months there would be increased reher than diminished difficultie in China, he thought it advicable to visit Batavia, and pusue his Chinese studies under the tutision of Mr Mehuurst, author of the Dictionary of Hookem dialect. He consulted with several indivigal members of the Committee (a meeting under the circumstances being out of question) and with their advice to do so, requesting Mr Brigman, as one of the vice-presidents on Shore at Macao, to take charge of the house until a better aspect of affairs should invite his return. Mr Brigman, in consquence is now temporarily resident there, where he has been recently been joined by Wm.B.Diver M.B. M.R.C.S. from the United States, and by Benjamin Hobson, M.D. (with his family) from England both of whom have signified their intention, at a suitable time, to offer their medicial servifes to the Society. This occupation of the hospital buildings have received the sanction of the Committee.

Mr Lockhart received in to the hospital, between the 1st of July and the 15th August, 187 patients. These were as it is usually the case in Chin Out Patients attending at such times as requied to let the progress of the cure to be observed, or to renew their supply of the medicines, with but a very few exceptions requiring indoor treatment. The committee will leave it to Mr Lockhart himself, when he shall return to resume his labors to give such particulars regarding them as it may be deemed by him worthy of notice.

It is their hope, that foreign intercourse with China is about to be established on a sounder and more honorable basis than hitherto and that their opportunities of usefulness both by practice and by medicine, and by teaching its true principles, will erelong be increased.

The committee have found it necessary to make some provisional appointment of officers. Mr Wetmore who became treasurer on Mr Archers departure from China and Mr Green the auditor of accounts having both retuned to their Native country, Mr Snow and Mr Leslie have been requested to fill their places, and will therefore stand, in conjunction with MR Colledge, as trustee of the Society's real estate. Mr King also having left China, Mr Brown of the Morrison Education Society, have been requested to take on him the duties of Corresponding secretary. The 1st of officers connected according to these changes is as follows:-

COMMITTEE OF MANAGEMENT.
President, Thomas R. Colledge Esq.

Vice-Presidents.
Rev. Peter Parker, M.D.
William Jardine Esq.
Robert Inglis Esq.
Alexander Anderson Esq.
R. Tradescant Esq.
Rev. E.C. Brigman

Recording Secretary - J. Robert Morris

Corresponding Secretary.

Rev.S.R.Brown.

Treasurer.

P.W.Snow Esq.

Auditor of Accounts.

William Leslie Esq.

TRUSTEES.

Thomas Richardson College.

and William Leslie, Esq.

Peter Wanton Snow.

Mr College return still being impossible, and the vice presidents
having no specific no duties to perform, it appeared necessary to
supply the places of Mr Jardine, Mr Inglis, and Mr Lay, although ab
sent from China, still less to elect a President.

The statement of accounts rendered at the first annual meeting
on the 29th of November 1838 show a balance to the Society's credit
of $780.71. At Mr Wetmore's departure from China, on the 20th of August
1839, this balance has been increased to $2039.71. A further addition
of $320 was made between that date and the 31st of December, making
a total of $2359.71. Again this has been charged for the expences
of the hospital at Canton $571.26. comprising the following items:-

For board fuel, repairs, &c----$141.63.

For Native assistants and servants 255.83

For medicine 149.80.

$571.26.

For the expences of the hospital at Macao something is also due,
but the account having not been previously made up to Mr Locharts
departure, has not yet been rendered. It appears then, that on the 1st
of January, 1840 the balance in hands of the treasurer was $1758.45.

It only remains for the committee, in concluding this brief
statement to offer, on behalf of the Society, thankful acknowledgements
to its pecuniary supporters, and also to Mr Jardine for a valuable
collection of works, lately the property of Mr Colledge, to Mr Lay for
a number of Medical books and medicines, and to Mr James Jackson of
Boston, Massachusetts, and Mr Richardson bookseller of London for
several works on medicines. Particulars of various contributions will
wise appear.

Page 146

July 1840

On the 5th, having previously closed the hospital in Canton,
Dr. Parker embarked in the Niantic for New York; he has
gone with the expectation of returning to resume his labors
in the summer or autumn of next year.

From the Chinese Repository, vol. IX. page 167.

Minutes of a general meeting of the Medical Missionary
Society in China, held 1st July. 1841, with its second
annual report.

The Chinese Repository, Vol X. page 448.

The Second Annual Meeting of the members and friends of the Society was held at the residence of A. Anderson, esq., at Macao, on Thursday, the 1st July 1841. At 2 p. m., the Rev. E. C. Bridgman, vice-president, took the chair. There were present, the Rev. Messrs. Bridgman, Boone, Ball, and Roberts, and A. Anderson, W. Lockhart, S. W. William, W. Bell, W. Leslie, W. Blenkin, P. Young, J. R. Holliway, B. Hobson, John Slade, J. R. Morrison, esquires.

Mr. Bridman opened the meeting, by observing, that the
friends of the Society had now been called together with
the view of informing the public of the proceedings of
the Society, and of affording the members an opportunity of
electing new office-bearers.

The report of the committee was then read, detailing the
proceeding of the Society's agents since the last general
meeting, on the 20th November, 1838; the continuance of
Dr. Parker at Canton until the close of June, 1840, when
he proceeded on a long purposed visit to the United States;
The consecutive arrivals of Mr. Lockhart and Mr. Hobson
from England, and of Mr. Diver from the United States, and
the return of the latter gentleman to America, owing to
continued ill health- The treasurer's account showed a bal-
ance in the hands of the treasurer, on the 30th of June, of
1861 dollars, carried to the credit of the Society, - after
an expenditure, since the 30th of November, 1838, of little
more than 1700 dollars.

The medical reports of Messrs. Hobson and Lockhart, of the
hospital at Macao, since August 1st, 1839, and at Chusan
between September 1840, and February 1841, were also read.
It was then moved by Mr. Bell, seconded by Mr. Blenkin,
and resolved.

"That the several reports which have just been read be
accepted and approved."

Page 147

Moved by Mr. Blenkin, seconded by Mr. Williams, and resolved.

"That the best thanks of the meeting be returned to Messrs. Lockhart and Hobson, for their very able services, and interesting reports".

Mr. Hobson returned acknowledgements both for himself and Mr. Lockhart.

The meeting then proceeded to ballot for the election of office-bearers. The result of the ballot was:-

President T. R. Colledge, Esq.,

Vice-Presidents,

Rev. P. Parker, M. D.

Rev. E. C. Bridgman.

W. Jardine, Esq.

Lancelot Dent, Esq.,

R. Inglis, Esq.,

William Bell Esq.,

A. Anderson, Esq.

James Matheson, Esq.,

C. T. Lay, Esq.,

W. Blenkin, Esq.,

Recording Secretary. J. R. Morrison, Esq.,

Corresponding Secretary. Rev. S.R. Brown.

Treasurer. W. Delano, Jr. Esq.,

Auditor of Accounts. W. Leslie, Esq.,

On the motion of Mr. Hobson, seconded by Mr. Boone, the thanks of the meeting were returned to the committee for their past services.

On the motion of Mr. Leslie, seconded by the other members of the committee, the thanks of the Society were returned to Mr. Morrison, for his services as secretary.

On the motion of Mr. Anderson, seconded by Mr. Lockhart, the committee were instructed to collect the annual subscriptions due, and to endeavor to improve the funds of the Society, by obtaining donations in its behalf.

The meeting then adjourned.

E. C. Bridgman, Chairman.

SECOND REPORT.

The disturbed state of affairs in China for two years past, and the frequent dispersion of the community incident upon that condition of things, have hitherto prevented the committee of management from calling together a general meeting of the Society since the time that its first stated meeting was held, in the month of November, 1838.

..................

Page 143

The objects of the Society have in the meanwhile, however, by no means been neglected, and, although its operations were for a time hampered by the state of public affairs just alluded to, yet have the institutions maintained by the Society yielded, upon the whole, not less of happy results than in the days of greater freedom from disturbing influences.

It is a year since the committee, in publishing the hospital reports thought it their duty to give to the public some particulars of their proceedings during the time that have intervened since the friends of the Society had met together. But as there may be those now present who have not had opportunities of persuing that statement, it will be not appropriate here briefly to recapitulate the particulars of what was then published.

When the whole English community had been compelled by the proceedings of the Chinese government to leave Canton, Dr. Parker was enabled, as an American citizen, to remain there. The house which had hitherto been always occupied by him as the Ophthalmic Hospital had been shut up, during all the time that the foreign community was held in confinement, from March to May, 1839; and to repeated requests afterwards made that it might be reopened, the senior hong-merchant invariaoly returned a decided refusal. Dr. Parker was so fortunate, however, as to find a convenient place for receiving applicants (very few in-door patients being admitted.) in the dispensary of Messrs. Cox and Anderson, both then at Macao. The report of his proceedings there during the year 1839, as also a previous report for the last quarter of 1838, have been already published by the committee. Dr. Parker remained at Canton till the month of June, 1840, when, upon the establishment of a blockade of the port, he closed the hospital; and; with the full approbation of the committee, took that occasion to pay a long-purposed visit to his native land. He went with the expectation of returning to resume his labors here after an absence of a year or two.

At the time of the Society's last meeting, the 20th of November, 1838, the hopes entertained the arrival of a physician from England or America, to extend the Society's operations had not yet been realized; and after the hospital at Macao had been kept open by Dr. Parker, during the months of July, August, and September, it had become necessary to close it on the return of that gentleman to his usual field of labor at Canton in October. In the following January, however, the expectations of the Society were gratified by the arrival from England of William Lockhart, esq., m.r.c.s., a gentleman of whose high professional talents and character most of the members present have long since become acquainted.

Page 149

He came out in connection with the London Missionary Society; and having immediately offered his services to the committee, they were not less immediately accepted. On the 28th of February, 1839, the hospital at Macao was accordingly placed under his charge. The study of the language engage all his attention at the first, and the hospital was not therefore, formally opened( though some few patients were received). until the 1st of July. Unfortunately, it had not been long open, when the measures of the Chinese government against all bearing the name of Englishmen, compelled Mr. Lockhart, on the 13th of August, again to close it.

Seeing little to be done at that time, Mr. Lockhart, with the approbation of those members of the committee whom he was able to consult, resolved on spending some months at Batavia, with the view of further studying the Chinese language under the tuition of Mr. Medhurst, and of gaining an acquaintance with the Chinese in those parts. He left China in September, 1839, and did not turn till towards the close of June 1840.

In the interim, two other medical missionaries, Wm. Beck Diver, M.D., from the United States, and Benjamin Hobson, M.B., M.R.C.S. from England, the former in connection with the American Board of Commissioners for Foreign Mission, the latter in connection with the London Missionary Society, had arrived in China, and notified to your committee their desire of offering to the Society their services. This offer was made, and their services accepted on the 1st of July, last year; and Mr. Lockhart having August 1st, reopened the Macao Hospital, these gentlemen gave him their assistance until his removal to Chusan at the end of that month, when the hospital was placed, for the future, under their joint care. In December, however, Mr. Diver's health failing, he was compelled to take a voyage for its recovery; and finding little benefit from a short trip, taken in the first instance, to the United States. Mr. Hobson has continued in charge of the hospital till now, receiving assistance from Mr. Lockhart, since that gentleman's return from Chusan in March last. Mr. Hobson's report is in the hands of the secretary, and will be read to tye meeting.

During the time that Canton was thrown open to merchants of England, by the occupation of the river by the British forces, in April last, Mr. Hobson made a renewed attempt to reoccupy the hospital at Canton; but the senior hong-merchant continued to refuse permission for the old house to be reoccupied. It was in contemplation to engage another house, but looking at the uncertain posture of affairs, and the probability of having soon again to close it, that step was not taken.

Page 150

Allusion has been made to the removal of Mr. Lockhart from Macao, in August last year, to Chusan, and the meeting will have pleasure in hearing the interesting report of his operations there. He opened his house, in the town of Chusan, or Tinghae, on the 13th of September, and it was constantly crowded with applicants for medical relief from that time till the day of his embarkation, the 22d of February, when the removal of all British forces from thence of course rendered his longer stay there impracticable. While waiting to be guided by the progress of events in the choice of a new station, Mr. Lockhart continues to improve himself in a knowledge of the language, and to afford assistance to Mr. Hobson in the care of the hospital at Macao.

The number of patients that were admitted into the hospital at Canton during the year 1839, was about 800, making an aggregate, since the commencement of the Institution in November, 1835, of about 7000. For the six months of 1840, that it remained open. Dr. Parker has left no report; but the eagerness for medical aid, and the number of patients, were never greater than at time he left Canton, on the 17th of June, - The number of patients admitted to the hospital at Macao, during one month, and a half of 1839, and eleven months (from August 1st to June 30th) of 1840, - 41, was 1457, - making, with those admitted during three months of 1838, a total of 2150. At Chusan, during a period of little more than five months, amid much greater opportunities of free access to the people, the number of patients attended to was 3502.

The treasurer's accounts are submitted to the examination of the meeting. In those exhibited at the first annual meeting in November, 1838, after an expenditure, during three quarters, of $1741.85, a balance was shown of $780.71. The expenditures since that date has been $1631.07, and the receipts $2411.98, leaving a balance in the bands of the treasurer, at this date, of $1561.62.

It remains to be observed, that, owing to the departure from China of several office-bearers of the Society, the committee have found it necessary to make some provisional appointments, which they hope will meet the approbation of the meeting. Mr. Wetmore had become treasurer on Mr. Archer's departure from China, when he and Mr. Green, the auditor of accounts, both notified their return home. Mr. Snow and Mr. Leslie were then requested to fill their respective places. But Mr. Snow being also called away, it became necessary to fill up anew the office of treasurer: Mr. Delano accepted it, at the request of the committee.

Mr. King having also left China, his duties of corresponding secretary. Though the president and all but two vice-presidents are at present absent from China, yet as these officers have no specific duties to perform, it has not appeared necessary to supply their places.

In conclusion, the committee have hope, that the Society will feel satisfaction with the proceedings of its agents; and with this hope they now resign their offices into the hards of the meeting-they cannot refrain from expressing gratitude to Him whose creatures we all are, for opportunities afforded them of benefiting their fellowmen, while they look forward, with confident expectation to continually enlarging fields of usefulness, and increasing opportunities of conveying to the minds of their patients the healing influences of moral care, and especially of the hopes that the Gospel alone offers.

Report of the Medical Missionary Society's operations at Chusan in 1840-41. By W. Lockhart.

The island of Chusan having been brought under British influence, it was judged desirable by the committee of the Medical Missionary Society, to send one of its agents to T'inghae, the chief town of that district, with the view of establishing a Hospital there, for the relief of the natives, and for carrying on the subjects of the Society, as far as possible, and thus in a few station to test the advantages of this means for obtaining a beneficial influence over the minds of the people.

Accordingly, the operations of the M. M. S. were commenced at Chusan, September 13th, 1840, and terminated February 22d, 1841; during this period, as will be seen by the list of cases, 3502 patients were attended to.

At the first establishment of the hospital, the inhabitants did not understand its object; but by attention being paid to some of the sick, who were in the streets, and by explaining to others that medicine would be given for the relief of their ailments, if they applied for it, some few were inducted to attend; and shortly afterwards great numbers came daily at all hours, desiring that medicines might be given to them. At some times as many as 200 old and new cases presented themselves in one day, but this large number was unusual; from 80 to 120 being the common amount on fine days during the lattest weeks the hospital was open.

Page 152

Besides attendance on such persons as restored to the
hospital, several were attended at their homes; by which an
opportunity was given to observe the managements of families
in that part of the country, and freer intercourse maintain-
ed with the people, than might otherwise have been practic-
able. Occasionally, when parties were sent to various parts
of the island, visits were made to distant villages, and
medicines afforded to many afflicted with disease; and where
the case could not, for various reasons, be attended to at the
moment, cards of direction were given, to enable them to
come to the city, where they could receive the required aid-
Papers stating the nature of the hospital were also sent to
the villages; and in a short time patients came from all parts
of the island, seeking relief; also from Nipgpo, Hangchow
foo, (the capital of the province), and other neighboring
towns on the main, as well as from Pooto, Lowang, and other
islands: many Fukkeen men from the trading junks at Sing-kea-
mun (large seaport town at the S. E. point of the island)
were applicants. Indeed, the number of patients from the city
itself was very small, compared with those who came from
a distance. During the last six weeks of residence, the num-
ber of individuals who came from Lowang, a large island about
30 miles south of Chusan, was sometimes 40 to 50 in one day.
Of these, some, who required frequent attention, remained in
the city; others came and went as their medicine was expended,
or according to the time prescribed to them.

Page 153

Report of the Medical Missionary Society's operations at Macao in 1840 -41. By Benjamin Hobson.
The Chinese Repository, volX. page 465.

In July, 1838, the Society's hospital in Macao, as mentioned in a former report, was first opened for the reception of patients. It was closed on the 5th Oct. following, the consequence of the absence of any other medical officer to take charge of the establishment.

On the first of July, 1839, it was reopened, but owing to the extraordinary events of that year, it was found necessary to suspend its operations on the 15th of the subsequent month. During that short space, 167 persons applied for medical relief. Although medicines were administered for some months afterwards to occasional applicants, the doors of the hospital were again thrown open to receive either in or out-patients until August, 1840.

From that time up to the present (June 39th, 1841). with the exception of occasional interruptions from the unsettled states of affairs, there has been a portion of each day devoted to this department of the Society's operations.

The capabilities of this institution have not as yet been fully tested, both from its recent origin, and the fear and disquietude which pervaded the native community a few months since, as well as from a reluctance to allow its medical duties to encroach upon the time that was necessary to devote for acquiring some attainments in the language: all of which have induced a less extensive opening of the hospital than otherwise would have been desirable. But now, judging from the increase of attendance for the last few months, from this city, and the numerous and populous towns and hamlets in this vicinity, it is reasonably anticipated that its influence and usefulness will rapidly advance.

The cases that have come under treatment have been varied, but as will be seen from the subjoined list are chiefly surgical. A few of the more important ones were admitted into this house, and if their circumstances required it, a small allowance of money was granted to buy rice and fuel. Many more would have gladly availed themselves of the convenience which the wards afforded, and it been considered expedient at the time to receive them. While speaking upon this subject it may not be out of place to observe, that when the hospitals are not under the surveillance or jurisdiction of Chinese officers, as they have been at Chusan and Macao, there are most pleasing facilities afforded for distributing religious books, and holding free intercourse with the people.

Page 1

Chinese Repository
July 1844

Vol. XIII P.369-377

Proceedings of the Medical Missionary Society in China.
as exhibited by a report of its general committee of
management, with reports of its medical officers, &c.,

(The friends of medical mission in China will, we doubt
not, receive with equal satisfaction and approbation this
report of the general committee, drawn up by the acting
secretary, With it, we received the reports of Drs. Hobson
and Lockhart, the first of which immediately succeeded this
article)

Owing to the scattered state of the members of the Medical
Missionary Society, no opportunity has occurred of conven-
ing a general meeting since the 28th September, 1842. The e
committee, however, have much satisfaction in commencing
to them, and to others interested in medical missions, the
uninterrupted success that has attended the labors of the
medical officers, and the increase in the number of those
devoting themselves to this sphere of missionary exeration,
and who are now occupying the different places open to
intercourse with foreigners.

The hope then entertained, and expressed in the report
published at the commencement of last year, that the peace
with China would afford enlarged facilities for the prosecu-
tion of the labors of the medical missionary, and of others
interested in the temporal and spiritual welfare of this large
portion of our fellow-men, have been fully realized. In the
Hongkong and in all the five ports, excepting Fuchau fu,
institutions have been for some time open affording opportune
tities for an extended and scientific medical practice, with
advantages, by the intimate and friendly relation that springs
up between the patient and his physician, to communicate to
them the truths of the gospel. And while the eagerness, every-
where evinced by the Chinese, to avail themselves of the skill
of foreigners, affords ample scope for doing them much direct
and immediate good, the unrestrained intercourse now enjoyed,
gives the most pleasing facilities for imparting religious
instruction and teaching the things concern their eternal welfare.

Shortly before the last report was drawn up, Dr. Parker had
returned from America, and reopened the hospital at Canton. The
very strong desire of the Chinese to enjoy the benefits of
the institution after it was reopened, and the confidence dis-
played by them in Dr. Parker, are highly gratifying. From 21st
Nov. 1842, to 31st Dec., 1843, the number of patients who had
resorted to it for medical treatment, was 3501, and while Dr.
Parker has been devoting much time to their relief, he has
bestowed great attention to the instruction of the Chinese
youths who have placed themselves under him.

Page 2

One of them Kwan Tau, his senior pupil, has been found competent to keep open the institution, (during his temporary absence from Canton.) attending principally to diseases of the eyes, to which he has paid most attention.

During the last summer, Dr. Lockhart, who had been preparing himself, by studying the northern dialects of the language, to reside in whichever place might be deemed the most elegible, proceeding to Chusan, distributing medicines, and attending to the diseases of such as he met with, in his visits to that place and "ingpo. In accordance with the resolution previously formed, of making Shanghai the scene of his labors and permanent residence, he proceeded there in the course of the winter, and was enabled to open a hospital in the end of January. He has not yet had an opportunity of sending a detailed report of his proceedings, but from his private letters to Dr. Hobson and the acting secretary, we learn that the applicants for relief have been more numerous than he can attend to, average a hundred daily from the city and population districts around, from Suchau, and from the imperial grain junks.

He has successfully couched many cases of cataracts and one was extracted from a native practitioner from Suchau, - a gratifying mark of the confidence that he is placed in him, and of the readiness with which the Chin -ses acknowledge and superior skill of foreigners at least, in this branch of science. "I have already administered medicines, "he says, "to 3000 people at Shanghai all coming to my house; I do not intend, however, always attending to so large a number of patients; but I wish to commence the practice fairly; and while I wish to use them." He writes in good spirits, and feels grateful that he is at last settled, in so advantageous a sphere for the development of his mission. The residence of the Rev. Dr. Medhurst at Shanghai, and his intention of imparting to those seeking medical relief, the healing truths of the gospel, is a subject of much gratification; and we heartily join with Dr. Lockhart in hoping that their united labors may abundantly secure the objects they have in view.

In alluding to the hospital at Hongkong, we have much pleasure in referring to the accompanying interesting report from Dr. Hobson, of his labors in that institution. The hospital has now been open since the first of June last, and has been eagerly sought by the Chinese around; the number of those who have resorted to it, (3924) being much greater than had been anticipated. The large proportion of in-patients that Dr. Hobson has been enabled to treat in its wards, is worthy of notice, as giving more full and lengthened opportunities of conversing with them on religious subjects; and it is with much satisfaction, that we direct our attention to the residence, at the institution, of Agong, a native Christian of age and experience, and with the patients.

page 3

Agong devotes himself to the propagation of Christainity among his countrymen and with the assistance of The Rev, Dr. Legge of the London Missionary Society, who spends a portion of each week in instructing the patients in the word of God, Dr. Hobson in enabled largely to use those means, which, he hopes through the Divine blessing, will lead to the spiritual improvement of this people. This is carrying out fully the objects of medical missions, and it affords us much pleasure to record the attention that is now paid, here at other places, where hospital have been opened, to combine the labors of the spiritual teacher, with the medical practice of the physician.

We would also allude to the proficiency that was exhibited by his pupil Apun,-when examined upon the anatomy and diseases of the eye;-and to the care and attention that has been bestowed in communicating to him a general knowledge of medicine. With regard to forming a class for instruction in physical science, from among the boys educated at the Morrison Education Society's establishment, we cordially join with Mr. Hobson in his views, and we are happy to state that attention has already been directed to the subject; a proposal of that kind from Dr. Hobson, having been favorably received by the trustees of that institution, and the Rev. Mr. Brown, the principal, having been instructed to make arrangements with him to carry the plan into effect.

Before quitting the subject of the hospital at Hongkong, the committee wish to express their thanks to Dr. "obson, for his valuable report, and their satisfaction with the perseverance and ability he has shown in the management of the institution that has been committed to his charge,-and their accordance with the enlightened views he adopted in carrying out the objects of the Society.

In November last, Dr. Hepburn, whose application to be received as a medical office of the Society, had been previously circulated among the members of the committee, and approved of, and whose services are now formally accepted, proceeded to Amoy. Dr. Hepburn is a missionary in connection with the Rebyteraan Church of America, and having resided a considerable time at Singapore, and there studied the Chinese language, (the dialect spoken among the Chinese at Singapore being the same as that around Amoy.) he was enabled at once to enter upon his appropriate labors. At Amoy, he found Dr. Cumming actively engaged in the practice of his profession among the Chinese, and enjoying the same opportunities of doing good, that the medical missionary has found, wherever he has commenced his labors in this country. Dr. Cumming, not being connected with any of the Missionary societies in England or America, has been received as a medical officer of this Society, but his zealous labors among the Chinese have been observed with much interest; and the committee recommend that the money advanced by private individuals, last year, to enable him to carry on his medical practice, should be paid from the funds of this Society.

Page 4

Drs. Hepburn and Cumming have their institution located in the city of Amoy, where they enjoy extensive intercourse with the inhabitants of the city, and of the adjacent country. No report has yet been received of their operations, but we understand the number of patients resorting to them is very large and increasing, and they feel pleased with the open field of usefulness that is before them. It is with the greatest satisfaction that we learn, that Mr. Abel, who has been sometime residing at Kulang su and Amoy, and who is so well known as a zealous and faithful missionary to the Chinese, devotes a portion of every day, among those who come to the institution, in conversing with them on religious subjects, and directing their minds to him who healed both soul and body. We would hope, the lovingkindness that animates his earnest appeals to turn from the worship of idols to the living God, combined with the disinterested exerations for the cure of their physical maladies, may prove the means of leading many to the way of life, May he who giveth the increase proper their work!

In addition to the hospital in these four places, where the medical officers of the Society, in conjunction with the other missionaries, are occupied in healing the sick, and preaching the gospel of Christ, a similar institution was open for some time at Ningpo, during last summer and autumn, under the care of Dr. Macgowan. Dr. Macgowan, a missionary of the Baptist Church in America, arrived in China last year and offered his services to the Missionary Medical Society. His application was favorably received by the members of the committee, in the same manner as that of Dr. Hepburn, but owing to the difficulty in holding a public meeting, he is only now formally accepted as an officer of the Society. He proceeded to Ningpo, and that city being considered well adapted as a place in which to carry out the practice of his profession among the Chinese, while the study of the language however occupied the principal share of his attention. Private business has obliged him to leave China for a short time, but he is still studying to obtain a knowledge of the language, and to otherwise prepare himself for the work he has under taken.

We are glad to have this opportunity of welcoming to China Dr. McCartee, a missionary of the Prebyterian Church of America, During the few months that he has been here, he has attended to the Chinese language, and improved opportunities to observe the routine of practice pursued by Dr. arker and Hobson in the institutions under their care. Dr. McCartee proceeds to Ningpo which he will make the field of his labors at first occupying only a portion of his time in attending to the diseases of those around him, and when his knowledge of the language enables him to converse freely with the Chinese on religious subjects, he will open a hospital under the patronage of the Society.

Page 5

We have now briefly noticed the position of the Society, and
the labors of the different medical officers; and we rejoice
to record the increasing amount of good that has been effected.
Since the publication of the last report there have been attend
ed to- exclusive of those who have come under the care of Drs.
Hepburn and Cumming, and Dr. Macgowan, from whom no reports-hav
have been received- upwards of 12,000 patients who have not un-
ly had relief administered to their bodily sufferings, but
many of whom have had opportunities of hearing the Bible, and
of the way of salvation offered to man.

Since the commencement of the medical missions in China,
and the formation of this Society in 1838, for the purpose of
assisting those missionaries who have availed of the practice of
the medical as a means towards the introduction of Christ-
inity, and of spreading among the Chinese the benefits of
rational medicines and surgery, upwards of 30, 000 have sought
aid from the skill of the foreign physician, submitting free-
ly to whatever was recommended, by those whom before they had
looked upon as uncivilized, ignorant, and barbarous. Many are
thus brought into immediate contact with the scientific attain-
ments of men from other countries, and made to feel the benefit
of a skill to which they have not attained. Some may be induced
to inquire, and find that in many branches of knowledge
their countrymen are far behind, be led to seek instruction in
the variuos departments of science and philosophy, to the im-
provement of their intellectual and physical condition. The
readiness withwhich parents have placed their children under
foreign teachers, shows that some are a live to the advantages
of a European education; and the attainments in the science of
medicine, which have been already exhibited by young men, who have
studied in the hospitals of the Society, gives good ground
to hope that the advantages of these institution will be rapidly
extended throughout the empire.

The progress of a knowledge so much beyond anything they
possess, and so different from the erroneous systems, with which
for ages, they have been alone acquainted, must indeed be slow,
very slow, among a people so exclusive and wedded to their pre-
judicies as the Chinese; step by step it must be- but every step
in doing good, however small, and however far short of what
we would fain see, is an encouragement to proceed, and- her
here we have every reson to be grateful for the success that has
attended our efforts, for the opportunities affording of reliev-
ing the sufferings of our fellow-men, and of imparting the light
of knowledge and truth. Six able and zealous men are now
engaged in this cause, the majority of whom have attained a f
knowledge of the language that enables them the labors with
confidence and hope. And, from the different institutions under
their care, we may anticipated hearing of educated young Chinese,
who have been instructed in the sciences connected with
the healing art, and impressed, we would anxiously hope, with 4
the truths of the gospel, despersed over the empire, and dispensing
among their countrymen the benefits of the knowledge
they have acquired.

Page 6

The prospect is encouraging: "and when we survey the vastness of the field-the good to be effected," says the appeal in behalf of the Society in 1838; "and when reflecting upon the immense resources of the western hemisphere, we compare these with the small portion of wealth required to secure the desired object, we are confident that benevolent disinterest ed like its Authors, and as expansive as the woes of men are extensive, will not withold the means. A rare opportunity is here afforded to the philanthropist of doing good-of enjoying the felicity of imparting to others, without diminution to-himself some of the richest blessings. He is invited to unite in accomplishing a great, immediate, and p positive good-is encouraged by the hope of immediate success, to aid in uniting to the great family of nations, this long severed and secluded branch, and in introducing to this people, not only the healing arts, but in its train the sciences and all the blessings of Christianity. To the various missionary Boards whose cooperation is sought, we would respectfully say, imitate him whose gospel you desire to publish in every land. Like him regard not ad beneath your notice the opening the eyes of the blind and the ears of the deaf, and the healing all manner of disease Until permitted to publish openly and without restraint the true truths of the gospel, neglect not the opportunity afforded of freely practicing its spirit. Scatter to the utmost its fruits, until welcomed to plant the tree that produces them-the tree of life"

"And when it is to be brought to mind that the 30,000 people who have sought relief at the institutions of the Society, upwards of two thirds have been attended to during the last four years, and that in that time, no call for subscriptions has been made on the community here, -we doubt not, but that the appeal, which is now made, to contribute to the support of these institutions, will be responed to with the liberality which the foreigners in China have always shown when a good was brought before them."

Since the publication of the last report, we have had to deplore the death of two of the earliest supporters of the Society, W. Jardine esq., and the Honorable John R. Morrison; and we would take this opportunity, of recording our appreciation of the important services they rendered to the Society, and our high estimation of their benevolent character. Theirs was not the charity that gave of their violent character, abundance merely to the subscriptions in aid of its funds; they entered heart and hand into every good work, and their time and attention was ever ready, to give council and assistance to benevolent undertakings. By the death of Mr. Morrison, as recording secretary, the Society has been deprived of a most efficient officer.

Page 7

We have to acknowledge the receipt of £50, forwarded to Dr. Lockhart from the Juvenile Missionary Association Crecent Chapel, Liverpool; of a donation of $500 from Andrew Jardine, esq., and to return our thanks to them, and to others, who have contributed, to acknowledge a communication to the secretary from the Ladies' Association at Hackney, acquainting us that a case of instruments has been forwarded by them, to supply the place of those lost by Dr. Hobson in the attack upon the house of the Morrison Education Society in 1843; of a case of medicines having been shipped to Dr. Lockhart; and of a sum of £75 being received, and placed at the disposal of the Society, for the interest they have shown in the operations of the Society, and the valuable assistance they have rendered to medical missions.

In conclusion, we would pray that the blessing of God may rest upon the labors of those who are devoting their lives to spread a knowledge of Him and his Son, -May they see the work of the mental in shedding abroad the glorius light of the gospel, and in removing the moral darkness that surround them.

Alexander Anderson, V.P.
Acting Secretary.

P.S. - Since this report was drawn up we have to acknowledge the receipt of Dr.arker's reports now in the course of publication, and of Dr. Lockhart's report of his proceedings at Chusan and Shanghai, and to express the thanks of the Society for the same.

Page 8

Report of the Medical Missionary Society's Hospital at Honkong under the care of B. Hobson, M.B. In a letter to the acting secretary.

The Chinese Repository, vol. X111. Page 377.
(med. Mis. Soc. Hos,
Hongkong, June 1944)

Sir,

Understanding that a meeting of the Committee will be convened as early as circumstances will permit, I beg to send you (as the acting secretary of the Society,) some account of the hospital under my charge.

My report commences from the 28th September, 1942, when the last general meeting of the Society was held. From that date to the end of January following, and when the hospital premises in Macao were disposed of, there were upwards of 1,000 cases of disease treated, of which number 46 were admitted into the house.

It is not needful for me on the present occasion to enter into any detail respecting these, nor need I refer to my removal to this country colony, except to express my ac knowledgments to the trustees and principal of the Morrison Education Society for accommodating me and my family for two months in that institution, by which I was enabled better to superintend the building of this hospital, which was first opened for the reception of the sick on the 1st of June last. From that time to the present, I am thankful in being able to state there has not been a single day's inter ruption to the discharge of my medical duties.

It affords me also much pleasure to present to the Committee a favorable account of the prosperity of the institution; for, considering the short period it has been commenced with, the task of gaining the confidence of the natives of these parts de novo, and other circumstances, the application for medical and surgical aid has been much greater than I had reason to anticipate.

From 1st June to 31st August, there were 1311 out, and 106 in-patients.

1st September to 30th November " " 963 " "
and 132 in-patients.

1st. December to 28th February," " 592 " "
and 150 in-patients.

1st. March to 31st May, " " 482 " "
and 168 in-patients.