BANCROFT LIBRARY THE LIBRARY OF THE UNIVERSITY OF CALIFORNIA THE PRACTICE OF MEDICINE Bl THE CHINESE IN AMERICA, BY STEWART CULIN. OF PHILADELPHIA. REPRINTED FROM THE ant) Surgical TReporter. MARCH 19, 1887. A Bancroft I REPRINT FKOM THE MKDICAI, AND SURGICAL REPORTER OF MARCH 19, 1887.] THE PRACTICE OF MEDICINE BY THE CHINESE IN AMERICA. By STEWABT CULIK, of Philadelphia, Pa. Many of the Chinese stores in our Ameri- can cities keep a supply of Chinese drugs, and all of them sell Chinese proprietary medicines, such as pills to aid digestion, the "red pills,"* Shd hi it/if for cholera, catarrh snuff, and other specifics compounded in the Canton drug shops. These are always neatly packed and labeled, and accompanied with printed directions for their use. But there is often a regular drug business, usually carried on by a separate company, in the stores, and a supply of drugs comprising many, if not all, of those called for in their practice, contained in numerous boxes and drawers on one side of their shops. Here, often, a Chinese doctor, usually some poor and broken-down student, who ekes out a living by assisting at. the drainings of the lottery, has his office. With a desire to learn something of the method of treatment and obtain some prac- tical knowledge of the Chinese materiamedica, 1 recently called upon a doctor connected with one of the principal Chinese stores in Philadelphia, and requested him to prescribe for a cold on the chest from which I was suf- fering. The doctor was a pleasant-mannered man of about forty years of age. Resting my hand upon a book, he carefully felt my pulse, first on the ' 'ft wrist and then on thfc * The red pills, .vr.. ;.~, sp ^kni of l>y the Abbe line ,.ud other travtlris, are 1 ighTy i-sleeined amonn the Chinese here as a specific for diarrhoea and h >wel complaints. Their entire composition is :i secret, but they are known to con- tain oalom. 1 and" the aromatic root of a water plant, she. hZnvg. A ball of eftrth ca led shim sil, "toad butter," which ; he toad carries in his mouth durini; the dry time in autumn (sic), is repu eri to form an active Ingredient in the sh<3hiU. They are said to lose their virtues after being ke^t loiiger than a year. fin the absence of Chinese type, the Chinese words are rendered in the English equivalents of the Canton dialect, *coording to 8. Wells Williams. right, delicately compressing the artery and gradually relaxing the pressure. Then, without inquiring about the symptoms of my complaint, he wrote the prescription, a fac simile of which is herewith reproduced. sr * The fifteen medicines called for are all of vegetable origin. The following transcrip- tion of their names, with some notes on their properties, and the quantities indicated in the prescription, may not be without inter- est.* Shan WH (a root highly valued as an aphrosidiac, said to have received its name fron Ho Shau Wu, a resident of Szechnen, who lived unmarried until the age of 54 years, when he discovered the peculiar qual- ities of this root. He then married and had several children, and his life was pro- longed by its use to the ripe age of 110 years X 4 is 1 in (15.08 grams.) Uit chi (a root from Szechuen, a tonic), 2 ts' in (7.54 grams). Kau chaok (a plant of hair at crown of root from Fukien province) 4 is' in (15.08 grams). Kat kang '(be) wort, root of the Platy- codon grandiflorum, a tonic and stomachic), 3 is' in (11.31 grams). Pak cheuk (root of Pcenia aJbi flora, a tonic, sedative, and alterative), 2 is' in (7.54 grams). Pak shut (a sweetish sort of root; a tonic much valued as an aid to digestion ; from Chehkiang province), 2 Is in (7.54 grams). 2V 2' skat (the seeds of the Euryale ferox ; a tonic; from Kiang-su province), 4 is' in (15.08 grains). Ch" un pui (a demulcent ; from Szechuen province), 3 is' in (11.31 grams). Unts'am (a root used to check internal hemorrhage and for coughs and colds ; from Che'h kiang province), 3 ts' in (11.31 grams). Ckak se, (a root taken for diseases of the kidneys, MS its name implies, a diuretic), 3 /*' in (11.31 grams). 2V an k' au (dried roots of the Gend- uriiKsa, givtn in cases of rheumatism and fever), 3 ts' in (11.31 grams). Tsb yan (seeds of a species of Rhamnus, probably the Rhamnus soporiferus, a sopor- ific), 2 Is' in (7.54 grams). Tang fa, " Winter flower" (flowers of a plant resembling the chrysanthemum) 4 is in (15.08 grams). Song pak (the white skin from the roots of die mulberry tree). 4 ts' in (15.08 grams). Hau p'o/c, ' thick bark " (the bark of a tree from Szechnen), 3 ts' in (11.31 grams). A clerk in the store weighed out the differ- * The writer is iml Meil to the Catalogue o f the Chinese 'mpirial Maritime Customs Co, leotmn at the l!ni ed Sta-es luivriiuiioiial l-.xhibitiuii, 1W7G, Mn.,//cu 187u, lor much of the information used in preparing these notes. ent articles with a small Chinese balance, and deposited them together on a piece of paper, first powdering the c/i l tin pui in an iron mortar, and roasting the tsb yan in a pan ; the pale cheuk was moistened with whisky before being placed with the mass. All was then put in a pot with four large cups full of cold water, and boiled for half an hour. The decoction I was enjoined to drink warm before going to bed. Should this medicine have failed to re- lieve me, the doctor, upon my next visit, would have varied his prescription. The charge for the medicine was fifty cents, the price of each ingredient being computed separately. The doctor's fee was one dollar, this being the usual charge for each tonsulta- tion. Their expenses are paid when they make visits at a distance. The doctors, called i shang, of whom there are now four in Philadelphia, are usu- ally from the Sam Yap, or" Three Districts," immediately adjacent to Canton city. They are much better educated than the mass of the people. None of any repute at home come to America, but it is said there are several very skillful ones in San Francisco and some of the western cities, who have a large practice among Americans. Those in New York and Philadelphia rank very low in their profession, in the estimation of their countrvmen. They are all dignified with the title of sin shang, equivalent to master or teacher, the only title of respect current among the Chinese in the American cities, and shared with the men who manage the drawings of the lotteries. A slight knowledge of medicine is general among the people. They have been accus- tomed to take medicines from their child- hood, when their mothers, by a kind of sortilege, selected some simple prescription to relieve their infantile complaints. The study of the physician's art is not confined to their doctors. Many others buy and read works on the subject that are sold in their stores, in which very exact directions are given for the treatment of all the dis- eases known to them. The book generally referred to is the Tsung e kam kdm, or " The Golden Mirror of Medi- cine," a collection of medical works compiled by order of the Emperor Kienlung, in 1740. The Canton reprint sold here is contained in forty small octavo volumes, the first thirty of which are devoted to nuifo, or "internal medicine," while the remaining ten comprise the Kam kdm ngoifo, or " Golden Mirror of External Practice," by 'Ng Him. The price of the complete set here is about $2.25. While the Chinese in our eastern cities are superstitious, and cherish manv of their native beliefs, they do not worship any par- ticular god of medicine, and the practice of medicine among them is comparatively free from superstitious observances. Sick people sometimes burn copies of the charms found in the popular works on divination and magic, and drink tea made from the ashes, but this is done with very litile serious belief in the efficacy of such treatment. In cases of prolonged illness, a friend of the sick person is sometimes sent to the local shrine of Kwan tai, the divinity generally worshiped, to burn incense and ask the will of heaven as to his recovery by throwing the divining sticks. Diseases which do not succumb to the treatment after being correctly diagnosed and the right medicine administered, are looked upon as due to the influence of a spirit or devil. Hysteria is generally re- garded as an evidence of demoniac posses- sion. The people as a class are very healthy ; venereal diseases and the complaints result- ing from an excessive use of opium are the most common. They call upon their own doctors whtn ill, but are much averse to taking foreign medicines or submitting to the treatment prescribed by American phy- sicians. They regard opium as a specific for colds and many complaints, and in slight dis- orders resort to their pipe before consulting a doctor. Chinese ginseng is highly valued for its supposed strengthening and life pro- longing qualities (it is not looked upon as an aphrodisiac), and is taken in the form of pills or made into a tea by many of the older men in the spring of the year. Amer- ican ginseng is seldom if ever used here. Calomel is prescribed in syphilitic dis- eases. Quinine is known as kam kai nap, doubtless a Chinese transcription of cinchona and that sold in their stores is imported from China. It is prescribed for violent chills, and is looked upon as a very strong and dan- gerous medicine. With a few exception?, mineral remedies are seldom employed, and roots, barks, and herbs, administered in the form of teas, constitute the principal drugs used. Many of these are not regarded as possessing any particular virtues, arid some are retained solely through a tradition of cures once Affected by them. Custom has ordained that a prescription shall contain a number of ingredients, of which, may be, two or three only are considered to have any direct effect. The doctors show much solicitude about administering any medicine that may cause a fatal result, owing, no doubt, to the penal- ties inflicted in China upon such misadven- tures, so that their treatment in general, if not beneficial, does no particular harm to their patients.