Volume 49 · Issue 09 · 1935

The progress of medicine is recorded in the history of mankind of the past twenty-five centuries. It is a record of struggle to win by toil the secrets of nature concerning man's body and its disturbances by disease and accident. Gradually facts have gained general acceptance by verification. These facts have been classified and organized and concepts in harmony with these facts have been established regarding the structure, the function and the disturbances of the human body. Thus scientific medicine bas been slowly and carefully built up, and today is the foundation upon which stands the structure of medical practice.

Medical Education as a part of the national educational program has been duly emphasized since the establishment of the National Government of the Republic of China in 1928. A Commission on Medical Education was then organized by the Ministry of Education to plan for the improvement of medical education in China. The National Health Organization has also been taking a great deal of interest in the initiation as well as planning of the work of the Commission.

The ideal medical curriculum for China has been much under discussion in recent years, and has lately been considered by the Commission on Medical Education of the Ministry of Education.

Two points of view prevail in regard to the main objective of higher education. One held the advancement of knowledge per se as the outstanding achievement of a college or university. The other emphasizes that direct improvement of people's life must be considered as the aim of college education.

This paper may be looked upon as a general introduction to a discussion on medical education as developed in Szechwan and in our particular mission institution. The matters discussed are on various subjects related to the main theme.

I am asked to write an article on "Ecomomics of Medical Schools and Hospitals in China" and urged to treat the subject in as practical a way as possible. Without any special training in economics, I wonder why this request should come to me.

The statistics herewith presented for the years ending June 1934 are based on reports received directly from the medical schools in China. Similar data for 1932-1933 was published in Vol. 47 of the Journal. Two schools, Manchuria Medical College and Hongkong University, are not included in the tables, because no replies were received from them.

The decision of the Ministry of Education of the National Government to assume the registration of nursing schools in China and its correlary the registration of graduate nurses under the National Health Administration, is the realization of the wish of the nurses of China for many years.

Mankind is born into the world to spend a lifetime in the effort to live. This effort consists of trying to adapt themselves or the world as they find it and of adapting the world to themselves as they want it. In Order to adapt either themselves or the worId much must be learned both of facts and techniques. The child's whole life is consciously a period of learning. The life of the adult can be no less a period of learning, especially for those who are not content to adapt to a simple routine. How often does the man or woman in late middle age say "I have learned how to live only as life is almost over."

Dr. Harvey Cushing has aptly remarked: "As the calorimeter tells the activity of the patient's metabolism, so may you determine the plus or minus activity of the local profession in any district by the condition of its library.

Health has been recognized as an essential objective in the process of social evolution of a nation. Since the establishment of the Ministry of Health under the National Government in 1928, effective measures have been taken toward the realization of this objective. State medicine is being accepted as the most logical policy - an idea based on the best socio-economic principles.

In the Canton Hospital there hangs a unique painting of Doctor Peter Parker, the pioneer medical missionary to China. It shows him with Kwan Ato, the young assistant whom he chose to teach as an apprentice. The painting is far more than a portrait; it is a symbol of the way in which, through these years of the century ending in 1935, the medical missionary has conceived it to be his duty and his opportunity, not merely to dispense medicines for the relief of the sick, but unceasingly to train workers who should be able to carry on the work commenced by him. In a very real sense, therefore, the hundredth anniversary of the beginning of hospital work in Canton is also the centenary of modern medical education in China. No other spirit could possibly actuate the modern man who views his task on any permanent basis. He must reproduce himself if his life and activity are to last. It is natural, therefore, that, over and again through the years, as one hospital cornerstone after another has been laid, the chief address of the day has laid emphasis on the fact that this new building was to be a place for healing, a place for teaching and, so far as possible, a place for inquiry into the causes of disease. The three go hand in hand.

In 1934 Mr. Fu Meng-chen, a well-known historian in China, published two articles in the "Independent Critic" (No. 115), strongly advocating the promotion of scientific medicine. It is a matter for congratulation that a leader of the intelligentsia should have such a clear understanding of the adaptation of applied science to the improvement of living.

Those connected with the Committee on Admission of any medical school are primarily interested, when examining the credentials of candidates for admission, in the amount of instruction the individual student has already received in the fundamental sciences, chemistry, physics and biology, and in the quality of that instruction.

Under the term leprosaria we mean all definitely organised leprosy hospitals, settlements and colonies. Mere leper villages to which lepers are assigned by local authorities with a small amount of public financial support are not included under this term. ThHre are a good many such villages especially in the southern provinces. Organisation is little, financial support is small and the inmates support themselves mainly by begging in the neighbouring cities.

The Central Executive Committee of the U.S.S.R. point out that although the total number of students of the higher medical schools increased from 26,100 in 1928 to 48,000 in January 1934, and the number of higher medical schools from 25 to 48 for the respective years, the training of doctors remains unsatisfactory owing to the poor guidance on the part of the People's Commissars of Public Health of the Union.

The most pressing problem in health work to-day in the R. S. F. S. R. is the lack of trained personnel.

In November of this year, the centenary celebration of the Canton Hospital founded by Peter Parker, a Yale graduate who came out to China as a missionary doctor, marks the coming of modern medicine in China for exactly a hundred years. For at least the first three quarters of the century, medical education and service were undertaken as private enterprises, largely by foreign medical missionaries.

The development of medical education has been so extensively reviewed in the past few years that the justification for another paper is the symposium nature of this number of the Journal and then only provided that the subject is presented interpretively. The Report on Medical Schools in China (Faber-1931) (1) and Medical Schools in China (Lee T'ao-1933) (2) cover the subject comprehensively from almost every angle. The establishment in 1935 of the Medical College of the Central National University as the fifth of the "national" medical schools and in 1934 of the Kwangsi Medical College as the sixth of the "provincial" medical schools are interim additions to Lee T'ao's survey.

World-wide changes in the quality of living and in the structure of society have been affecting the applications of medical science everywhere during the past decade. The conditions that determined new phases of medical practice, in the main, are as follows.

For many years, owing to lack of suitable teaching institutions. hospital dispensers were trained in their individual hospitals by doctors who were already overworkEd and lacked the specific knowledge for such teaching. Within the last decade, however, several schools have been opened with the express purpose of providing adequately equipped pharmacists.