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Patrick Manson, Father of Tropical Medicine
Otte--Missionary Doctor, Architect, Carpenter" "How
Ancient China Discovered (and lost!) Surgery"
is known to Western doctors as the “Cradle of Tropical Medicine”
because it was here that Sir Patrick Manson (1844–1922), “Father
of Tropical Medicine,” made discoveries that helped tackle leprosy,
malaria, and other diseases that 150 years ago made Xiamen a “white
In his 1873 report of the Amoy Missionary Hospital, Patrick Manson noted
that in 1871, it was rumored throughout Amoy that Western doctors gave
out magical, poisonous pills that created diseases only they could cure.
Pamphlets and posters accused Western doctors of using Chinese’
eyes and hearts for potions, and of drugging and raping Chinese women.
When patients died, doctors were accused of murdering them to harvest
body parts. When patients survived, doctors were accused of resorting
to magic to affect their miraculous cures. In the beginning, theirs
was a thankless occupation!
oldest of nine children, Manson gave up a lucrative career to study medicine.
After obtaining his medical degree in 1866 from the university at Aberdeen,
he spent 24 years in China, where he tackled not only mosquitoes but also
Amoy tigers (he was an avid hunter).
the Tiger Hunter “Life in Amoy in those days in
a mixed community of Europeans in China was far from dull. There was
a gay social life, and also from time to time sporting events, such
as pony races, and shooting expeditions into the surrounding countryside
where excellent snipe grounds were provided by the numerous paddyfields.
“Farther field were the wild highlands where every now and again
tigers were bagged. Manson was foremost in these adventures and soon
gained the reputation of being the best snipe-shot in China.
“But, as he became more familiar with the Chinese and their ways
and won their confidence, work began to accumulate.
“Sometimes he was too busy to sleep, as his services were in constant
demand.” Sir Philip Manson-Bahr
were slow to trust the sporting Scotsman. For centuries, Chinese had spread
tales of foreigners eating Chinese babies and using their eyeballs to
line mirrors, and many believed Western doctors’ medicines were
Manson gained their trust by opening his clinic to the street so everyone
could see that his surgeon’s scalpel didn’t come in a set,
with knife and fork.
Manson was dismayed by Western doctor’s ignorance about the tropical
dis-eases he faced. He estimated 1 in 450 people in Xiamen were lepers,
but Western medicine had no answers. When he asked the British Museum
for information on mosquitoes ; they wrote back six months later to say
they had nothing on mosquitoes but were sending a book on cockroaches
they hoped would help.
When Manson moved to Hong Kong in 1883 he found that Western doctors could
not discern typhoid from malaria, calling it “typho-malaria.”
Malaria had wiped out nearly an entire regiment right after Britain occupied
Hong Kong in 1841, and for years, 3% of British troops died from the dread
medicine was impotent in the face of tropical disease, and Chinese medicine
fared no better. In 1877, 2% of Xiamen’s population died of cholera,
and to Manson’s frustration, traditional Chinese doctors treated
the disease with alum, stimulants, hot poultices, shampooing, and “pinching.”
But Manson discovered that, in fact, some Chinese treatments did work.
Chinese cured a woman’s anemia with pills concocted from a black
chicken’s dried liver. Western
doctors did not learn to treat pernicious anemia with liver until 1926.
Perhaps Chinese medicine’s occasional successes helped spur the
Scotsman on to the research that gave birth to modern tropical medicine.
or Drunken Scotsman?
In his quest to conquer China’s diseases, Manson dissected everything
from mosquitoes to corpses (in the dead of night, in graveyards, because
Chinese frowned on carving up corpses). But it was a lonely life, and
in 1877 the discouraged young pioneer wrote to a friend in London,
“I live in
an out of the world place, away from libraries, out of the run of what
is going on, so I do not know very well the value of my work, or if it
has been done before, or better.”
In fact, Manson’s
work was so far ahead of his time that other doctors ridi-culed his discoveries.
One doctor said Manson’s claims represented “either the work
of a genius or, more likely, the emanations of a drunken Scots doctor
in far-off China, where, as everyone was aware, they drank too much whisky.”
Manson was first to connect mosquitoes with elephantiasis (1878) and malaria
(1894), and he discovered that only female mosquitoes suck blood (males
live on fruit juices). Manson also invented new surgical techniques and
instruments that even today bear his name (he had one elaborate device
made by a local Chinese metal worker). He also helped introduce modern
vaccination to China—ironically enough, since Taoists inoculated
against smallpox almost 1,000 years ago. Ancient Chinese almost created
surgery as well (see end of this chapter).
As news of Manson’s medical prowess spread, patients flooded in.
In 1871, Manson’s first year at the Baptist Missionary Hospital,
he treated 1,980 patients. His third year he treated 4,476 people. In
1877, he performed 237 elephantiasis surgeries alone. He removed over
one ton of tumors from 61 of the cases and lost only two patients. He
also got sued.
Suing the Surgeon!
One patient had so much excess tissue that he could not move and he
was carted about town in a wheelbarrow. He made a living selling lemonade
and peanuts, and created a table by spreading a cloth over his massive
deformities. After Manson removed eighty pounds of tumors, allowing
him to move freely once again, he promptly sued Manson and sought compensation.
He com-plained that without his convenient table of deformed flesh he
had lost his livelihood! Sir Philip Manson-Bahr, “Patrick Manson”
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Manson, like Otte, knew that the way to combat disease was to multiply
the medical warriors through medical education. In 1886, Manson established
the Hong Kong College of Medicine, which boasted such alumni as Sun Yat-sen,
first president of the Chinese Republic. In September, 1898, he opened
the London School of Tropical Medicine, although he was adamantly opposed
not only by the government but also, ironically, by the medical establishment
(which perhaps still suspected his reams of insights were the work of
a drunken Scotsman). After writing his bestselling “Manual of Tropical
Diseases”, Manson retired in 1912 to fish in Ireland, but returned
to medicine at the beginning of World War I, and in spite of debilitating
gout, he pursued medical education until his death in 1922.
Ancient China Discovered (and lost!) Surgery
(From McGowan, 1913, pp.176-9)
was not a doctor in the Empire who knew anything of anatomy and for
any one of them to have performed a serious surgical operation would
have meant certain death to the patient. [But]…
“Tradition tells the story of one famous doctor [Huatuo], who
lived in the misty past, and whose prescriptions form part of the medical
library of every regular practitioner, that is intensely interesting.
He seems to stand out more prominently than any of the others who have
become conspicuous in the history of medicine, because he evidently
had the ambition and perhaps the genius to inaugurate a new system in
the treatment of diseases. He evidently felt there were occasions when
the knife ought to be used if life were to be saved.
“On one occasion a military officer had been severely wounded
in the arm by a poisoned arrow in a great battle in which he had taken
part. The doctor, who for long centuries has been a god, and shrines
and temples have been erected in which his image sits enshrined, was
summoned to his assistance. He saw at a glance that unless heroic measures
were at once adopted the man would die of blood-poisoning.
Contrary to the universal practice then in vogue, he cut down to the
very bone, extracted the arrow, and scraping away the poison that might
have been injected into the flesh, he bound up the gaping wound, using
certain soothing salves to assist Nature in her process of healing.
“The result proved a great success, and might have been the means
of introducing a new era in the treatment of diseases throughout China.
“Not long after a high mandarin [Caocao], who had heard of the
wonderful cure, summoned the same doctor to prescribe for him. He had
been greatly troubled with pains in his head, and no medical man that
had attended him had been able to give him any relief. His case having
been carefully diagnosed, the doctor proceeded to tell him what he thought
ought to be done.
“I find,” he said, “that what really is the matter
with you is that your brain is affected. There is a growth upon it,
which, unless it is removed, will cause your death.
Medicine in this case,” he continued, “will be of no avail.
An operation will have to be performed. Your skull must be opened, and
the growth that is endangering your life must be removed.
“The thing, I think, can be safely done, and your health will
be perfectly restored, and you may continue to live for a good many
“If you are pleased to confide in me, I have full confidence in
myself that I can do all that is needed to restore you to perfect health.
“Whilst he was talking a cloud had been slowly gathering over
the mandarin’s face. His eyes began to flash with excitement and
a look of anger to convulse his face. In a voice tremulous with passion,
he said: “You propose to split open my skull, do you? It is quite
evident to me that your object is to murder me. You wish for my death,
but I shall frustrate that purpose of yours by having you executed.”
Calling a policeman, he ordered him to drag the man to prison, whilst
he gave orders to an official who was standing by that in ten days hence
the doctor should be decapitated for the crime of conspiring against
“During the days he was in prison he so won the heart of the jailer
by his gentleness and patience that he showed him the utmost devotion
and attention. The evening before his execution, he handed over to him
some documents that he had been very carefully preserving, and said,
‘I am most grateful to you for the kindness you have shown me
during the last few days. You have helped to relieve the misery of my
prison. I wish I had something substantial to give you to prove to you
my appreciation of the sympathy and tender concern you have manifested
“’There is one thing, indeed, that I can bestow on you,
and that is the manuscripts of all the cases I have attended. These,”
he said, handing them to the jailer, “will raise your family to
wealth and honor for many generations yet to come. They explain the
methods I have employed in the treatment of disease. Never part with
them; neither let the secrets they contain be divulged by any of your
posterity, and so long as your descendants are faithful to them poverty
shall never shadow the homes of your sons and grandsons nor of their
children after them.’
“Next day this great medical genius was foully put to death merely
to satisfy the caprice of an ignorant official, and the first dawn of
surgical enterprise was eclipsed by his death, and many a tedious century
would have to drag its weary way along before the vision that had died
out in blood would again appear to deliver the suffering men and women
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