John Chinaman, M. D.
THE ATLANTIC MONTHLY.
A Magazine of Literature, Science, Art, and Politics.
VOL. XXI.— MARCH, 1868.— NO. CXXV.
“LIU-KIANG, Province of Kiangsi,—best place to have choleramorbus in. Send for Tchung-tseen.”
Memorandum from my note-book,— at the service of any compatriot of mine who may meditate the “doing” of the Middle flowery Kingdom.
To have the cholera-morbus in China — especially to have it at Liu-Kiang, in the province of Kiang-si ; above all, to be attended by Dr. Tchung-tseen — is to enjoy the advantage of an experience peculiarly and richly Chinese, — an experience which, shrewdly and diligently improved, cannot fail to exalt you above the pretensions of the average explorer. Moreover, Liu-Kiang, in the province of Kiang-si, is not only the best, it is also the easiest place in China to get the cholera-morbus in ; all the conditions and inevitabilities of the town are favorable and consenting to that pathological predicament: the water is hard, the watermelons bitter, the duckeggs fishy, and the cucumbers stale. But the doctor is Tchung-tseen !
Not that there is but one physician in Liu-Kiang ; but that in Liu-Kiang, in Kiang-si, in China, in the Universe, there is but one Tchung-tseen, — Singular and Incomparable ; and, from the 1 clmng-tseen point of view, fishy duckeggs appear a privilege and choleramorbus a blessing, — a view which opens out to the picture-loving traveller what I venture to term the sublimely ridiculous Tchung-tsecnery — the broad god-man-and-devil-scape — of the Chinese medical panoramaIt was through the pains of cholera-morbus, as through an observatory window, that I surveyed the fantastic field ; and this pen-and-ink drawing that I am about to exhibit was sketched from that prepostetous combination of solemn nonsense, classic caricature, and spontaneous upside-downness and inside-outness and hindpart-foremostness which the Chinese call Nature, but which we call China. for there is this about China, which to the conscientious traveller is a great comfort, that when once you have been there and felt the country in your bones, when once a just impression of the people has been fairly astonished, amused, bewildered into you, you can never alter exaggerate or exhaust it. You may try your hand at the invention of facts, but you will find the truth too much for you; and the subject admits of as many ingenious and surprising combinations as the kaleidoscope,— you can no moie catch the image of it with a single pair of eyes, and fix it with a single pen, than, in photo-sculpture, you can seize all the aspects of the solid many-sided figure with a single camera, stationed here or there ; rather will you require a thousand mental cameras, directed at the same instant from a thousand prejudices upon a thousand customs.
Entered according to Act of Congress, in the year 186S, by TICKNOK AND FIELDS, in the Clerk’s Office of the District Court of the District of Massachusetts.
Chief in the picture, the central, salient figure of the fantastic composition, —_key as it were, to the illustrated rebus of absurdities, — is Tchung-tseen himself, A. M. (Knjin), M. D., LL. D., (Chin-tss), D.D.,— a happy compound of pedant, quack, fortune-teller, and spirit-rapper, flavored with a dash ot Confucian priest, “just for the look of the thing.” The A. M. and the LL. D. our friend has fairly won at the Competitive Examinations ; for the D. D. he is not responsible, — it is we who have conferred that degree upon him for our own convenience, as a sot tot algebraic sign, to represent the quantity of priestcraft that goes to the completing of the Tchung-tseen machinery; and as for the M. D-, that is assumed, or at best inherited. No “ I' acuity ” had the making ot Dr. Tchungtseen ; no Commencement glorified the end of his studies; no Professors of Anatomy and Obstetrics wink at each other when Tchung-tseen appears ; he has purchased no diploma at the stated sales of Latin indulgences to murder ; no maiden mutton lays its scath to Ins taste for parchment. He is leech the right inherent in every Chinaman to be actor, doctor, or cook, according to the Eight Characters, the Five Elements, and the Twelve Animals, which must absolutely determine the direction of his “ natural turn.” Neither emperors, nor mandarins, nor prefects, nor literary chancellors, nor imperial commissioners, nor big-wigs of the Forestof-Pencils Society, charge themselves with any concern in the matter, but philosophically dismiss it with atheoi) , it is to the interest of the sick millions, they say, to see that the Tchung-tseen of their choosing knows his business, and, if they have not brains enough for that, the sooner Tchung-tseen relieves the world of their stupidity the better for the brains that are left. Only in Section 297 of the Penal Code does the law descend, for once, from the severe elevation of its letting-alone, as if graciously to show us outside barbarians how much more shrewdly they order these small matters in China. “ A D11 one who shall exercise the profession of medicine or surgery without understanding it, —shall administer drugs or operate with a piercing or cutting instrument in a manner contrary to established rules and practice, and shall thereby contribute to cause the death of a patient, the magistrate shall convoke other men of the profession to examine the nature of the remedy such practitioner shall have administeied. oi the wound lie shall have made, and which has been followed by the death of the patient. II it should appear that the physician or surgeon has only acted in error, and without any injurious intention. he may, by a certain payment, obtain remission of the punishment inflicted on a homicide, in the manner established for cases of killing by accident; but such physician or surgeon shall be compelled forever to quit the profession.” 1
After which, it is pleasant to reflect that our Western system of medical and surgical practice is so wise and conscientious in its plan, and so pi udent and impartial in its operation, that we have no use for Section 297 of the Chinese Penal Code. Besides, even were we less favored of Heaven in this respect, Section 297 would by no means suit our case. What rash neSs ! ” cried Master Ting, when a desperate doctor would have acupunctured Father Hue, —“what rashness. Do we know how these European bodies are made ? How can you te what you would be sticking your needle into ? ” . . .. _
And it is a significant consideration. that, in spite of Section 297, “such physicians and surgeons ” do swarm like frogs in China, bribery being popular there, and coffins cheap, and literary bachelors an innumerable fry, who must be served up as doctors, schoolmasters, or actors. So that, after all, Section 297 but serves to show that any man in the eighteen provinces may practise medicine, who is prepared with influence or impudence, sapecks or pluck, for the six possible predicaments (more or less probable, according to the pressure of the professional jealousy, or official rapacity he can provoke) of inquest, lawsuit, fine, imprisonment, torture, beheading ; and any other man may cheerfully be his patient, who is already provided with a neat style of burialcase, and a wheelbarrow-load of paper clothing and mock-money to be burned at his grave. True, there is a so-called Imperial College of Medicine at Peking, but it is little more than an exclusive club for professional mutual admiration, or, at times, a convocation of medical referees for arbitrament in cases of malpractice or medical jurisprudence, under the rules laid down in that infallible text-book, Si-yuen, “The Washing of the Pit.” The red and gold diploma of the Peking College of Medicine hangs in Tchung-tseen’s office by way of an advertisement; but it it did not, the Dean and Faculty would still have no more power to restrain him from dispensing the supernatural treasure of red pills, than the executive committee of the Honest Injun Society for the Suppression of Hocus-Pocus can hinder him from prescribing the Three Manies and the Nine Likes as a prophylactic in severe cases of superannuation.
Tchung-tseen was, formerly, family physician to a mandarin at Nganking; but having intrepidly declared himself a disciple of that innovating “Anatomical School ” of Chinese medicine which holds that “ there are arteries which proceed from below to above, and veins that proceed from above to below ”; that the heart is sometimes found on the left side of the body, and the liver on the right; that the ligneous principle in a patient’s organization may be reconciled to the igneous principle without the intervention of boiled watermelons ; and that a dislocation is not necessarily irreducible because it does not yield instantly to a plaster of pounded tumble-bugs. — he was dismissed to make room for a more conservative theorist. Whereupon he retires to his native town of Liu-Kiang, and having hung out his shingle, and advertised in the Herald, as consulting physician and practitioner at large, he applied himself to a course of reading so tremendous, that the sound of the titles merely of the works lie crammed must have fallen like a “long roll ” upon the tympanum of KuangTai Uong, the deaf God of Surgery. There were the Chan-ski Yi-thmig, Chan-shi’s Universal Medicine; and the Yithung Ching-me, The Principal Veins of the Empire of Medicine, traced by Wang-keng-theng; and the illustrious Wang-shu-sho’s Mekine, On the Pulse; and the Chi-sM-hin-hinan-cku, the Redwater Blue-pearl; and the Ting-paoku-kmi-ki-ian, the Amended Mirror of Ancient and Modem Medicine, compiled by King-sin, and edited by his son ; and Fung-tse-tchan’s Kin-naHgpi-lo-tsa-ching, Motley Silk Bag of Deep Learning on Diseases ; and Fungyi Pao-kian, the Precious Mirror of Japanese Medicine, by the Corean Pliusun ; and the Emperor Hoang-ti’s Ling-tchu, the Temple of (Medical) Reason ; and the Peu-tshas King-mu, Natural History of Necessaries ; and Liu-hias’s Liu-hung-yo Sing-pao-tchi, on the Nature and Preparation of Medicines ; and, finally, the Peu-tshaskang-mu of Li-shi-tchin, Continued by his Son, Li-Khian-yun, and Illustrated by Li-Khian-tchung: an astounding compilation, in forty awful volumes, De Omnibus Anatomical, Surgical, and Obstetrical Rebus, et Ouibusdam Botanical, Therapeutical and Pharmaceutical Aliis.
And having stuffed all that power of learning into the carpct-bag of his memory, for handy reference, Tchungtseen is prepared, like Sam Weller’s depitv sawbones,” to letch out his “wolatilly” for bowel complaints, a yellow wolatilly, corresponding to the element of Earth, and denoting the direction Middle ; and for affections of the heart, a red wolatilly, corresponding to the element of Fire, and denoting the direction South ; and it, under a treatment thus fancifully tuned to the doctrine of correspondences, any patient shall be so unreasonable as to become delirious, Tchung-tseen will acupuncture his elbow at the “ crazy-bone,” and jar his head for dislocated brains. Good practice, and backed by the authority of all the regular lights, from Full-III, the “ heavenly Emperor,” who lived before Hippocrates, and invented the Eight Diagrams, to FungShin, the Seal of Secrets, who first applied smoked moonshine to the cure of warts.
“RESPECTFUL AND DISINTERESTED PANEGYRIC.
“Blown on ihe Golden Trumpet of True Report,— by NganYin, first tablet of the Sublime Han-Lin (Sorest of Pencils) College; Tzc-Lu,of the Imperial Academy, Imperial Commissioner and Biter ary Chancellor; and Ky-Nung-Ptcheng,Dean of the Faculty of the Illuminated Hall of Medicine at Peking: In honor of Tchung-tseen of ihe Province of Kiang-si, tip-top Sage and first-chop Healer.
“Towers arc measured by their shadow, and great men by those who envy them. Envy has taken the measure of Tchung-tseen, and found him lofty. This is to adorn him with the capital of just and prudent applause. For the foundation of Tchung-tseen is deep,— it is set in the dark bowels of mystery ; and his pinnacle is high, — it glows in the light of Truth ; his feet are planted among the secrets ot Earth, and his head is lifted among the discoveries of Heaven. Envy and deride Tchungtseen if you are proud and foolish, honor and imitate him if you are humble and wise ; for he has wished to promote the good of others, therefore he has secured his own. But do not think to flatter him. Flattery is his wife ; he listens to her politely, but does not believe her. He lias more roots than branches ; he cannot be overthrown by the wind. Only let us invoke that which he has no right to silence, his learning, — and publish that which lie has no right to conceal, his skill.
“ When the Immortal Worthies first sent forth Tchung-tseen, to sprinkle over suffering humanity the waters of the Panacea Well, he set out hurrahing to his heart, and warbling the BrightBlossom Ode, — like a well-bred man, accepting the commission with modesty ; like a brave man undertaking its duties with confidence ; like a kind man hollowing Benevolence with alacrity. No coolies and asses went before him, a pompous train, panting and groaning under bloated hampers and bursting sacks. His furniture, compact and precious, he carried with simplicity, himself, — in his head, all the maxims of Hwang-te the medical Emperor, all the arts of Li-tung the immortal leech, all the prescriptions the philosopher Ko hid up his sleeve, all the charms the magician Fun unwound from his queue, all the reading of Wu-ti the Founder, all the rules of Shun-shimin the Reckoner, all the reasons of Tai-tsung the Wrangler, all the hard words of Khian-Iung the Critic in his blue bag, all the golden simples of Yenfo, ail the tangled compounds of Sunking, all the pearl pills of Sai-kui, all the ruby plasters of Hu-kek-ne. With the eyes of Loo-feli (‘the Sun-beam’) he perceived, with the touch of Kahyung (‘ the Magnet of Differences ) lie discriminated, with the precision of Nien-Ching-Yew (‘the Index’) he defined, with the power of Tsze-jin (‘ the Jasper Charm ’) he prescribed. The world felt better.
“Tchung-tseen neither advertises nor juggles; his talents are their own sign ; when you seek him you can find no other doctor, though a thousand get in the way. Where there is musk there will be perfume ; to smell it one need not stand in the wind. He is no blind fowl, pecking at random for worms ; his knowledge is sure. He does not climb a tree to hunt for fish, nor turn over the liver to look for diseases of the lungs. lie does not send you an olive on the pate of a Buddhist priest, nor engage to perform impossible cures, or turn summersaults in an oyster-shell. He is no toad in a well contemplating a patch of sky ; the strong calm eye of his philosophy surveys the Universe as from a dome, and takes in at a glance all real and all imaginable things,— the demonstrations of Science, the delusions of Ignorance, and the devices of Imposture. He knows that all errors have but their brief season ; that alter a hundred millions of objections, sophisms, lies, the smallest truth remains precisely what it was before ; and so he waits, and smiles. And his charges arc very moderate.
“ Diseases, when he calls them, answer to their names ; and spirits, vapors, principles, elements, forces, assort themselves before him, like feathers under the fingers of the flower-maker. At his bidding, disorders the most complicated resolve themselves into their several members ; and form, action, color, sound, have each a tongue to tell him what they mean. As his large benevolence knows no distinction of persons in the ranks of the afflicted, so his conscientious genius appoints no degrees of interest to the various styles of disease, but applies itself with equal science and concern to the bunion on the big toe of the mouse-catcher and the cataract in the eye of the mandarin. The medicaments he dispenses are of miraculous virtue, and the gratitude of his patients has transformed the garden of his good works into a grove of fragrant almond-trees. Expensive incense burns night and day before his door. When the Emperor hears the name of Tchung-tseen uttered lie shuts his eyes and exclaims Ah ! Ten hundred thousand millions of Celestial Worthies and quintessentially beatified Sages will pass an eternity of arithmetic in computing the number of bis radical cures without the use of mercury. And his charges are very moderate.
“ The memory of Tchung-tseen is infallible, and the dimensions of his nose are conformable with dignity ; his heart is tender and his fist is spherical; his speech is impressive and his spectacle - glasses, set in tortoise - shell frames, are two inches and a half in diameter; the length of his queue is regulated by the exactions of public opinion, and his manners are according to the Rites ; he has an auspicious mole under his left eye, — and his charges arc very moderate.
“ As for us, let us play a few airs on the flute, and listen to the tune of the Dragon refrain,”
Inscribed in golden characters on seventeen rolls of crimson silk paper, at the Imperial City.
Tadsing Dynasty, Hien-fung, second year,mid-winter month,on a fortunate day.
Tchung-tseen has, as I have said, his theories, more or less startling, from the Chinese point of view. For example, he holds that there is a difference between arteries and veins, that in most Chinese subjects the blood is conveyed by these in opposite directions, but not always downward by the arteries, nor always upward by the veins ; that the heart is a part of the machinery by which this hydraulic process is carried on; and that under certain circumstances, depending upon the disposition of the five rulers, elements, colors, or directions, and the relation of the male and female principles of nature, the blood undergoes a change in passing through the lungs. He has one name for the brain and another for the spinal cord, but has not yet discovered a nervous system,— that is, he had not when I was in Liu-Kiang. in 1852. He has a pulse for every organ but the brain ; but as to the relative positions, forms, and uses of the viscera, his notions did not strike meas perfectly coherent, — in fact, I understood him to say that we dream with the liver and sweat with the lungs ; and that, — something about the Yin and the Y'ang which he failed to demonstrate clearly, but, — whenever in the system the principles of cold and moisture prevail over the hot and dry influences, the superior pulse of the spleen is disturbed by the dislocation of the green bone of the pancreas, and the consequence is fever and ague.
In the theory of Tchung-tseen every organ of the body is allied to one of the five elements, Earth, Wood, Metal, Fire, Water, which are either hot, cold, moist, dry, or windy. These again correspond to the Five Directions, Middle, East, West, South, and North, and are represented by the Five Colors, Yellow, Green, White, Red, and Black. Thus the heart, being allied to the element Fire, corresponds to the direction South, and is represented by the color Red. Consequently, all derangements of the heart must proceed from excess of the principles of Heat and Dryness, and should be treated with black medicines, corresponding to the direction North, and representing the element Water. And the bowels, being allied to the element Earth, correspond to the direction Middle, and are represented by the color Yellow. Consequently all disorders of the bowels must proceed from excess of the principle of Wind, and should be treated with medicines compounded of black, red, green, and white ingredients, corresponding to the directions North, South, East, and West, and representing the elements Water, Fire, Wood, and Metal, by which alone in combination the element of Wind can be opposed and repelled.
A lovely system! so natural in its simplicity and harmony, that in theory it reads like an idyl, and in practice it must be one of the pleasures of imagination to be killed by it. Any mandarin or mountebank can explain it to you, and if after that you will die, so much the worse for you. Emulate, rather, the astuteness and docility of Father Hue at Kuen-Kiang-hien,2 when wrenched with excruciating spasms, and turned inside out with vomitings as preposterously sudden and profuse as those which are said to overtake the sacrilegious wretch who mocks the idol Kan-wang-ye, he was soothed and cheered by Master Ting and the officious officials, who explained to him that he was ill, and that his noble, and distinguished malady proceeded from a disturbance in the equilibrium of the vital spirits.
“ The igneous principle,” they said, “too long fed by the excessive heat, had ended by exceeding beyond all measure the proper bounds assigned to it, and consequently a fire, so to speak, had been kindled in the sublime organization of the patient’s body. Consequently, also, the aqueous element had been dried up to such a degree that there no longer remained to the members and organs the humidity necessary to the performance of their natural functions ; thence proceeded those vomitings, those pains in the patient’s illustrious stomach, and that generally disordered state which it was easy to perceive in the face of the respectable sufferer, and which produced such violent contortions.”
In order to re-establish the said equilibrium, it was necessary only to introduce into the body a certain quantity of cold, and to lower the extravagant temperature of this igneous principle by restoring the due proportion of aqueous principle, — being at the same time very careful not to permit the igneous principle again to develop itself to the point of absorbing the aqueous principle. There was a very simple method of bringing back into the body this beautiful harmony.
“Everybody knows that green peas are of an extremely cold nature ; let a certain quantity be boiled ; let the respectable patient drink the liquor,— and so the fire will be put out.”
A mandarin of Kuen-Kiang-hien suggested that, nevertheless, the convulsed and vomited missionary should use the liquor with extreme caution, lest he should dangerously develop the principle of Cold ; but Master Ting was “sure he might take with impunity double the ordinary dose, as he had remarked that the temperament of the average outside barbarian was incomparably warmer than that of a native oi the Central Flowery Kingdom. ’
It was finally unanimously agreed that all that was necessary was green peas, boiled cucumbers, and watermelons, to restore the humidity essential to the harmonious action of the organs. And then the regular practitioner arrived,— a little roundabout Tchungtseen, of redundant plumpness, inordinate spectacles perched on a rudimentary nose, ceremonious manners, and a gray tail tipped with a red string.
“ I have learned,” said he, “ that the eminent patient was born in the countries of the West. Maladies vary according to die region ; those of the North do not resemble those of the South, and so on, and so on. So likewise with remedies, and so on. We must take good care not to treat the men of the Western Seas in the same manner as the men of the Central Nation. By some means or other the cold air has penetrated into the interior, and has put itself in opposition, in many of the organs, with the igneous principle ; hence arises this struggle, which must necessarily manifest itself by vomitings and convulsions. We must therefore combat the evil with warm substances.”
“ That’s the thing,” said Master Ting. “That’s just what we were thinking! ”
“ The nature of this noble malady,” continued the Doctor, “ is such that it may readily yield to the virtue of the medicines and disappear very soon; and, also, it is quite possible it may resist, and the danger may increase. This is my opinion on the subject, after having studied the various characters of the pulse.”
“ Here’s wisdom,” thought the philosophic missionary ; “but it’s all the same to me. For are we not enjoined in the Floly Scriptures to honor physicians in case of necessity ? and this is a case in which obedience to the precept combines the compulsion of an emergency with the free-will of an act of faith.”
Tchung-tseen’s theory of the pulse is barbarous and stupid and presumptuous enough to make his fortune in any land of fools, newspapers, and clergymen’s testimonials, He attributes to it an endless variety of nice peculiarities and subtile indications, which he reduces to a classification wildly fanciful, and practises the same routine in applying the condition of the pulse to the diagnosis of the case as in adopting the remedies. Especially does he devote awful thought and scrupulous discrimination to the relative condition of the pulse on the two sides of the body and in different regions of the system.3 He holds that there are different pulses, corresponding to the heart, the lungs, the liver, and all the other organs ; and that to feel the pulse scientifically you must fed them all, one after the other, and sometimes several together, in order to determine their several relations. Hue’s Tchung-tscen played on his patient’s twenty-four pulses with all his fingers, as on a piano-forte, and maintained a protracted telegraphic correspondence, as it were by House’s system, with his twenty-four insides.
When Tehung-tseen would prescribe for your cholera-morbus he begins by dipping the end of a stick of Indian ink into a cup of water or tea, and rubbing it on a small black tile. With the ink thus formed he traces, by means of a camel’s or cat’s hair pencil, his prescription on a very ample sheet of paper, in characters of equally generous dimensions. When he has written a large page he reads it first to himself in a low and solemn sing-song, and then he reads it to you, crawling horridly among the senseless forms of words with the long black ghoulish nail of his right forefinger, — at the same time expounding to you in a key so excruciatingly sharp that it cuts keenly into your sensitive nervous network like a verbal vivisection, all the devil-possessed jargon of the Yin and the Yang, of elements, directions, principles, forces, colors ; and enumerating the ingeniously multiplied ingredients of his witch’s brew, — gums, juices, powders, barks, leaves, roots, heating or cooling, moistening or drying, congesting or dispersing, — for each devoted viscus a plague-appointed drug.
The materia medica of Tchung-tseen is sufficiently eccentric. He has ginseng and the flesh of fowls to warm and strengthen the viscera ; asses’ glue and birds’-nests as mild and tranquillizing tonics ; silkworm moth, dried red spotted lizard, and stalactite, to increase the natural fire ; tortoise-shell, human milk, and pork, to nourish the secretions ; stags’ glue, dogs’ flesh, and walnuts to strengthen the kidneys ; lotos seeds and nutmeg as warm and tonic astringents ; pomegranate-skin, oystershell, and dragon’s bone and tusk, as cooling astringents ; iron-filings, loadstone and gold and silver leaf, to repress weakness ; onions and orange stalks as cold diaphoretics ; camphor, musk, dried scorpion, cicada, and centipede, spotted and black snake, shed snake-skins, and tigers’ bones, to disperse wind ; yam, and soy made from pulse, to disperse moisture ; turnip seeds and root, and skin of marsh-melon, as emetics ; putchuk, betel-root, shaddock-peel, dried silkworm chrysalis, and ordure, as mild equalizing resolvents ; rice-paper plant and sliced China root to absorb moisture ; soapstone, amber, and red beans as laxatives ; pistachio nuts, mica, and concretions from the bamboo to suppress phlegm ; watermelon, bamboo shavings, persimmon tops, verdigris, sea-shells, pearls, bears’ gall, and warm water, as cooling purgatives ; sliced peony, mulberry-leaves, hartshorn shavings, and rhinoceros-horn shavings, to purge away fire ; almonds and buckwheat to repress humors ; lilyroot and turtle-shell as mild digestive aperients ; brown sugar, scallions, rabbits’ milk and cuttle-fish bone, to warm and nourish the blood ; cypress tops, rabbit’s flesh and saffron to cool it; dried varnish, plums, dragons’ blood, peach seeds, arrow-root, old copper cash, madder, dried leeches, red marble, goats’ beard and cantharides, as astringents of the blood; betel-root, quicksilver, and native calomel, to destroy worms ; ivory shavings, resin, elephant’s skin, preparations from toads, to disperse poisons ; honeysuckle flowers, green peas, and dried earthworms, to expel poisons ; and, finally, alligator’s gall for hydrophobia, to accelerate parturition, and to disperse carbuncles and pustules, — as in the days of Marco Polo.
Though the turbid, greasy, dirt-colored draughts of Tchung-tseen are legitimately disgusting to eye and nose (in reverting to my experience at LiuKiang I shudder at the remembrance of them), I have to confess that they are deficient in that quality of unmitigated nastiness which so familiarly attests the genuineness of our Western doses. They have for the most part an insipid sweetish flavor, and though it cannot be fairly claimed by their dispensers that “ children cry for them,” still they can be got past the palates of that irrational and refractory class of patients without recourse to the harsh expedient of holding the kicking sufferer’s nose. The ingredients are usually boiled together in baked clay, long enough to blend completely their medicinal properties, and the uninviting brew is then administered cruelly hot.
Before I passed from the sick-list of Tchung-tseen to the roll of men fit for service, I tasted with favorable results the virtues of that forlorn hope of the Chinese leech, the famous red pills,— Ling-pao-you-y-tau, the Supernatural Treasure for all Desires. These are true homoeopathic globules, scarcely of the bigness of a pin’s head, and the dose is from two to two dozen, according to the gravity of the case. In Peking they enjoy a prodigious celebrity, and are unanimously extolled as a universal panacea, warranted to cure the most intricate nosological Chinese puzzle to be found in the advertisements of quacks or the imagination of hypochondriacs. Their composition is a secret in the possession of a single family in Peking; by them transmitted from generation to generation of their own blood and name, and jealously guarded. The odor of musk that the pills emit is not peculiar to them, but merely their inevitable share of the all-pervading Chinese smell.
“The Supernatural Treasure is perhaps the most active sudorific known to the medical world ; but its modus operandi is remarkable.” A single one of these little red globules reduced to powder, and applied to the nose like snuff, provokes a succession, preposterously prolonged, of thrilling sneezes, until the whole body protests, and breaks out in violent perspiration. This powder is sometimes used to determine a prognosis ; if a pinch does not make a sick man sneeze, the Chinese say he will certainly die in a day ; if he sneezes once, he will at all events not die till to-morrow ; and hope revives and grows in the exact ratio of the number of sneezes, and the vigor with which they are delivered. The oracle is appealed to with peculiar confidence in cases of cholera ; it the patients can be made to sneeze with a red pill, the prognosis is favorable, even ia the stage of collapse.
Tchung-tseen is his own apothecary; the prescription he expounds at the house of his patient he presently compounds at his own, — a practice that naturally provokes certain objections, not utterly unreasonable. The ingenious variety and prodigious quantity of drugs that commonly enter into the composition of a Chinese recipe have from time to time excited, in the minds of even the most tractable and accommodating patients, a mild suspicion that there may be collusion between Tchungtseen the doctor and Tchung-tseen the apothecary, founded upon identity of interests, — that Tchung-tseen the doctor may sometimes prescribe costly or superfluous ingredients with an eye to the advantage of Tchung-tseen the apothecary ; that the former may even “ make a case,” and the latter “keep it going,” for the benefit of both ; or that Tchung-tseen the apothecary may be tempted to tamper with the instructions of Tchung-tseen the doctor with a generous solicitude for the sapecks of the “ concern.” Out of this reluctant and blushing suspicion has arisen a custom essentially Chinese. Tchung-tseen and his patient engage in a debate, more or less tart, touching the necessity and price of the remedies recommended, — other members of the family taking lively part in this odd chaffering, and urging the doctor to prescribe “ common cheap drugs ” ; they even inspect the red-paper charm as they would any vulgar commodity, and coolly strike out such ingredients as they may consider dispensable or too costly. Should Tchung-tseen protest that by this summary process of censorship the effect of the medicine will be rendered slow or doubtful,—they grant all that, and take the risk ; what if the delay or doubt should redound to the benefit of the patient ? They have a sly notion that it will all come to pretty much the same thing in the end. “ One prescription,” says Hue, “ is as good as another, and whether you absorb more or less of their black brewages will probably make very little difference.”
The heartless haggling usually ends by the doctor’s abating the price of his “ potecary stuff,” on the principle of selling at a sacrifice to save a customer. But when lie has made his last concession, and still maintained that upon the presence of this or that juice or powder the cure depends, “ a family council is held, actually in the presence of the patient, in which the question of life or death is coolly put, and frequently arguments are brought forward to show that, considering the advanced age of the patient, or the hopeless nature of the malady, it may be better not to incur a useless expense, but quietly to allow matters to take their course. After having closely calculated what it will cost to procure these possibly useless medicines, it is not uncommon for the sick man himself to take the initiative, and decide that it will be much wiser to reserve the money to buy a fine coffin, since one must die sooner or later, and it is well worth while to give up perhaps a short remnant of life in order to make sure of a handsome funeral. With this sweet and consoling prospect in view they dismiss the doctor and — the sitting being prolonged— call in the undertaker.” Between the stoicism and the irony is hard to choose.
Other Tchung-tseens there are to whom Acupuncture (invented in China no man knows how many centuries ago) is the whole stock in trade, or the Moxa, all their store, — not for rheumatism exclusively, or deep-seated pains, or sprains, or swellings of the joints, but for all the ills that flesh is heir to, — a Perry’s Pain-Killer-or-Curer, and a Radway’s Rough and Ready Relief.
Profoundly ignorant of anatomy, the special study of which is at once interdicted by law and discountenanced by public opinion, the Tchung-tseen of acupuncture insinuates his long needle (sometimes red-hot), not altogether with capricious recklessness as to the spot where he shall poke it in or the depth to which he shall bore. He has a method, fantastic in its physiology and blind in its routine, but yet erected upon a foundation of millions of costly experiments, — costly to the subjects of them in fatal results, and to the explorers in fines, imprisonments, and bastinadoes ; for Chinese sayans are indeed indcfatigably and prodigally inquisitive, unterrified, and regardless of expense ; the nicest manipulators, and endowed with prodigious .powers of observation, discrimination, and penetration ; in the department of acupuncture, they may be said to stick at nothing in sticking at everything.
Contemplating the human corpus as a huge animated pincushion, they have determined on the surface of it three hundred and sixty-seven points, to which they have attached particular denominations, according to the relation which they imagine them to bear to the supposed insides ; and in order to “ practise ” without compromising the safety of the race, they have contrived small copper figures, in which diminutive holes are pierced, representing the three hundred and sixty-seven points ; the surface of the figure is then covered with paper, and the student is required to place his needle without hesitation upon the spot under which is the hole corresponding to the point at which he would be required to operate according to the affection named.
“It is prescribed, in performing the operation of acupuncture, to turn the point of the needle upward when it is wished to go counter to the course of the blood, and downward if you desire to proceed with it. An unreasonable or awkward puncture is to be corrected by making punctures on other corresponding points. In a syncope following a severe fall, the upper part of the throat opposite the larynx is to be punctured to a depth of eight lines. In pains in the loins, the hams are to be punctured ; in dry coughs, the external and hinder part of the arm, to a depth of one line, or the middle of the front of the arm, or the base of the little finger.” 4
Inoculation is extensively practised by Tchung-tseen among the children of his curacy. Small-pox, he explains, arises from a poison introduced into the system ab utero, as is proved by the occurrence of the disease but once during a life. “ This poison is associated with the principle of heat, and remains concealed till it is developed through the agency of some external exciting cause.
. . . . The ancients possessed the knowledge of inoculating for (or planting) the small-pox ; it has been handed down from the time of Chin-tsung of the Sung dynasty (1014 A. D.), and was invented by a philosopher of Go-meishan, in the province of Sze-chuen.
. . . . The spring and autumn are the most favorable seasons for inoculation,— or any time when the weather is moderate. A lucky day should always be chosen ; the nth and 15th days of the moon must be avoided. The mddus operandi is by introducing into the nostrils a. piece of cotton-wool impregnated with the variolous lymph, or with the crust rubbed down with a little water ; or the crust dried, and reduced to powder, may be blown up the nose ; or the child may be dressed in the clothes that have been worn by one who has first had the small-pox.” 5
The inoculation must affect the viscera, and then the fever commences. The procession of the morbific “influences ” is marshalled in the following order ; “ The nose is the external ori-
fice of the lungs ; when the lymph is placed in the nose, its influence is first communicated to the lungs which govern the hair and skin ; the lungs transfer the poison to the heart; the heart governs the pulse, and transfers the poison to the spleen ; the spleen governs the flesh, and transfers the poison to the liver ; the liver governs the tendons, and transfers the poison to the kidneys ; the kidneys govern the bones ; the poison of the small-pox lies hid originally in the marrow of the bones ; but when it receives the impression from the inoculation it manifests itself, and breaks out externally.”†!
It is an enviable advantage in the practice of Tchung-tseen that his instructed and imposing conjuration is energetically seconded by the vulgar but devout hocus-pocus of his patients and their friends, who — by the aid of some peddling rascal of a Tauist priest, and with all the cheap machinery of gongs, bells, candles, incense, meat and wine offerings, mock-money, red and yellow paper, old cash, straw sandals, white cocks, paper effigies and clothing, metallic mirrors, pictures, black beans, yeast balls, fantastic lanterns, paper boats, coffin-nails, cash-swords, tortoise-shells, sculls, the Tall White Devil and the Short Black Devil, and all the multitudinous manifestations of the Chinese Bugaboo — proceed with vigor to avert the anger of gods and the enmity of the dead, to propitiate “ the Destroying genius ” and expel the mortal influences, to flatter Ioh-Uong-Chu-Sii, the God of Medicine, to recall the spirit of the sick, to engage the favor of the goddesses of small-pox and measles, to propitiate the Five Rulers, and to disperse unhealthy vapors. Without the support of this various diablerie, it is difficult to imagine what Tchung-tseen would do. Continually threatened with fines and rods, and cages, it must be a grateful relief to his mind to share his responsibilities and his dodgings with the Gods of Medicine and Surgery, the Five Rulers, and the Male and Female Principles of Nature.
And yet, mortality in China is not, in proportion to population, greater than in the United States ; the average, in number and atrocity, of Tchung-tseen’s bad jobs does not exceed that of the celebrated Professor Hippocrates Jones. The Chinese contrive to live as long as we do, in spite of Tchung-tseen, and octogenarians are as numerous in Peking as in New York, although we have H. J., — mortifying, not to say alarming, facts for the consideration of the next American National Medical Convention. “ When a physician,” says the demure Hue, “ lias succeeded in curing promptly and radically a malady presenting the most grave and dangerous symptoms, it is to little purpose to pass a learned condemnation on the methods he has employed, and endeavor to prove their inefficiency. The sick man has been healed, — he is again in the enjoyment of perfect health ; that is the essential point. There are few people who would not prefer being saved in the most irregular and stupid manner to being killed according to the most approved and scientific methods. It is indisputable, for instance, that there exist in China medical men who know how to treat the most decided cases of hydrophobia; and it matters little that, in the course of their treatment of this frightful malady, they expressly forbid any object containing hemp to be shown to the patient, under the idea that it would neutralize the effect of the remedies.”
Wherefore, should it be your fate to be overtaken by the cholera-morbus in Liu-Kiang, in the province of Kiang-si, send for Tchung-tseen with confidence, take his boiled peas and watermelons with faith, and trust in Providence with desperation. And then, if you survive the adventure, for the honor of “ the Gaudy Banner,” pay his bill. Remember that his profession, as they order these matters in China, is neither glorious nor lucrative ; that his visits are not charged for at all ; that his complicated “ simples ” are sold cheap, and always on credit; and that it is the custom in his country not to pay for medicines which the patient may fancy have done him no good : so that my poor Tchung-tseen earns three dollars to collect one. Remember, too, that if you should be so heartless or so thoughtless as to die, it might be the death of him.
In China there are doctors for internal diseases and doctors for external, doctors for cold diseases and doctors for hot, doctors for moist diseases and doctors for dry, doctors for diseases of wind and doctors for diseases of water, doctors for “mulligrubs” and doctors for “ miseries,” doctors for women, doctors for babies, and doctors for old men. But Tchung-tseen is the seventh son ot a seventh son, — forty-nine doctors in one, forty-nine times muddled! And he is also, at least, a thousand years old, with ten thousand theoretical whimseys and empirical zigzagries to find his way through.
The deportment of our friend is eminently dignified, and his manners are scrupulously polite : a professor of ceremonies might learn of him. When he meets you on the way, “he places the fingers of one hand over the fist of the other in such a manner that the thumbs come against each other, and then, standing a little off, he raises his hands gently up and down in front of his breast, as it were shaking hands with himself.”
Seven times has Tchung-tseen bowed down, with candles and incense, before the tablet of his ancestors, to inform them that, in consequence of their respectable virtues, he, their grateful descendant and representative, had been preferred to new degrees and honors by the grace of the Emperor. Thus his filial piety is distinguished.
He lives according to the Five Cardinal Virtues, -—benevolence,righteousness, politeness, wisdom, and fidelity.
He teaches according to the rites, practices according to his lights, and charges according to your means and his own necessities.