The Introduction Into China Of WesternMedicine: A Case Study In Tuberculosis (1900-1967)

The purport of the Dissertation is to explor the thesis of"Introduction into China of Western Medicine"from the perspective of the History of Tuberculosis. Tuberculosis is a chronic infectious disease caused by Mycobacterium Tuberculosis, Pulmonary Tuberculosis the most common. Pulmonary Tuberculosis progresses slowly with a long course; cough, bloody sputum, low fever, night sweat, fatigue, emaciation, these symptoms will last several months, years even decades. Advanced patients often die of various complications. Before Liberation, Prevalence and Mortality of Tuberculosis were very high. Since 1945, due to the wide aplication of effective antibacterial drugs such as streptomycin, isoniazid and rifampin and the extensive popularization of BCG vaccine, the epidemic situation of tuberculosis has undergone a significant change: the Prevalence and Mortality have fallen dramatically.1 The history of ideas of Tuberculosis: the introduction into China of western ideas of Tuberculosis In 1882, Koch isolated and identified Mycobacterium Tuberculosis successfully in the laboratory; In 1901, you could find the concept of"Mycobacterium Tuberculosis"in Health Science Q&A(《卫生学问答》)written by Ding Fu Bao, however, the"Mycobacterium Tuberculosis"was called"pulmonary phthisis worm"(肺痨虫). From the late Qing Dynasty to the Initial Period of Liberation, the Western Tuberculosis concepts based on bateriology were accepted gradually by Intellectual Circles. During the Republic of China, a large number of popular books had been published which introduced the Western Kowledge about etiology, transmission, diagnosis, treatment, prevention of Tuberculosis.2 The history of treatment of Tuberculosis: the introduction into China of western therapies of Tuberculosis In 1854, the German Hermann Brehman founded the world's first Tuberculosis Sanatorium at Gobersdorf in the mountains of silesian. Thereafter, sanatorium care was the bedrock of the treatment of tuberculosis in the West for nearly one hundred years. Undoubtedly, sanatorium therapy spreaded to China; In the 1930s there were at least 10 sanatoriums in Peking, such as Pa Ta Chu(八大处)sanatorium, Chung Hua (中华)Hospital. During the Republic of China there were at least 9 sanatoriums in Shanghai. In the late 19th century, Western doctors began to use surgery to treat pulmonary tuberculosis patients. Artificial Pneumothorax (AP), which was invented by Italian physician Carlo Forlanini around 1894, had become the primary therapy of pulmonary tuberculosis in Europe and America in 1920s. In China AP was used earlist in 1928-1930; In 1930s, AP was routine treatment for Pulmonary Tuberculosis patients in Peking Union Medical College Hospital; The operation was used more widely after 1940s; After the advent of chemotherapy in 1950s, AP was not used in clinic any more.3 The history of technology of Tuberculosis: the introduction into China of western technology of diagnosis, treatment, prevention of Tuberculosis To diagnose, treat and prevent Tuberculosis, Western Medicine must rely on a variety of specialized"technology"which were introduced to China one after another and had been widely used: Tuberculin, Artificial Pneumothorax, BCG, and antibacterial drugs. In 1890, Koch announced the invention of Tuberculin, in the same year, the Qing Dynasty official Xue Fu Cheng sent Zhao Yuan Yi to Koch's laboratory to learn the"therapy of phthisis". AP had become the primary therapy of pulmonary tuberculosis in Europe and America in 1920s, the therapy was introduced into China in 1928-1930. BCG invented by French Scientists Calmette and Guérin, was used in the human body for the first time in 1921; in 1927, French Authorities institued a program of vaccination with BCG; just the next year, Chinese Authorities introduced the strain of BCG. After the World WarⅡ, Europe began a large-scale BCG vaccination; in 1947, the World Health Organization began to extend BCG to the world; From 1949, China also institued a large-scale campaign of BCG vaccination. Streptomycin was first used in clinic in 1945, while after 1948 the drug was widely used in China.4 The history of personages of Tuberculosis: the two ways of the introduction of Western Medicine into China Lung Disease Guide(《肺病指南》) written by Ding Fu Bao and Theory of Phthisis(《痨病论》) by Lu Yong Chun, were classic popular books about Tuberculosis during the Republic of China. Ding and Lu, two men just embody the two ways of the introduction of Western Medicine into China: the one from Japan, another from Europe and America. Ding Fu Bao learned Western Medicine by translating Japanese books; Lu Yong Chun graduated from Hunan-Yale Medical College, receiving American medical education. Western Medicine was introduced into China from Japan mainly by the way of translating Japanese medical books. In the Republic of China, many popular books about Tuberculosis translated from Japanese have been published and reprinted, and by this way Western Kowledge was desseminated widely. Western medicine was introduced into China from Europe and America mainly by the way of medical education founded by the Churches or the Rockefeller Foundation, which is the most far-reaching way of introduction of Western Medicine into China, because it is in the Medical Schools where Chinese Youngsters were trained to become doctors of western medicine, thus the group of Tuberculosis specialists gradually came into being in China. The author makes a statistical analysis of senior TB specialists born before 1915, showing that the vast majority of Tuberculosis specialists graduated from domestic Medical Colleges with European or American background.5 The history of Public Health of Tuberculosis: anti-Tuberculosis Health promoted the wider dissemination and application of Western Medicine In 1915, Wu Lien-teh published article in the first issue of Chinese Medical Journal, appealing to the Chinese government to develop anti-Tuberculosis Health. In 1933, anti-Tuberculosis Association was launched in Shanghai. In 1935, Peking First Health Station established"Tuberculosis clinic"to carry out TB prevention and control work. In 1945, the national government began to develop anti-Tuberculosis Health in the major cities. After Liberation, under the leadership of the Communist Party, the Republic established top-down anti-Tuberculosis institutions; anti-Tuberculosis Health was implemented throughout the country with unprecedented speed and intensity. To implement anti-Tuberculosis Health, it was necessary to adopt Western technology and train a large number of doctors of Western Medicine; thus, anti-Tuberculosis Health promoted the wider dissemination and application of Western Medicine.