The Americans in Manila, the French in Saigon, and the republican Chinese, however, are listening to the dictates of hygiene rather than to the long sonorous trump of tradition. In the American cavalry in the tropics it is found that the imported white animals are immune to the heat, whereas the darker breeds soon die. Southern Tibet is coming nearer to the railhead with its wonderful climate for the enervated of the whole East. India, Tonquin and China are sending on their construction gangs, and the day is not so far off when the veil at the 8,000 feet passes, which has hid the last withheld land, will be rent in twain. The two men who have done the most to break down the forts of exclusion are Sir Francis, Colonel Younghusband, for the Indian government, and the Chinese general, Chao Ehr Feng, who in 1910 also broke up the Buddhist superstitious system by driving the Dalai Lama (their pope) for the first time into unholy foreign soil at Darjeeling. Twenty miles south of Chungking, in the sublime valley of Wen Tang, is a famous hot sulphur bath cut in the rock. The flow is generous, and the Buddhist priests have divided the bath so that men and women may use it. They make no charge for the use of the water, but they charge for inn service. Before many years many foreigners will resort here, as the bathing is beautifully clean.
A remarkable thing about China is the comparative absence of flies, because manure and refuse is so important as a fertilizer that it is immediately carried to the intensively farmed fields, which are expected to produce two to three harvests a year. Therefore typhoid and other diseases are not as prevalent as they otherwise would be. However, a whisper in your ear, reader: if China lacks in flies, she abounds in “bunkies,” which is the polite name for fleas! Nature abhors a vacuum and always provides for the deficiency in one field from the surplus in another! To have real safety in a Chinese inn, one needs to go to bed in a Peary suit, furnished with a diver’s helmet. This is never done, however, because of the heat. Cold weather only increases the torture, for the pauper “bunkie,” small as he is, successfully races to the heated kang faster than the paying guest! As the Chinese masses use no liquor, tobacco or drugs, and live an outdoor life on vegetable food mainly, their hearts are in splendid condition, and all the hospital surgeons report remarkable recoveries when an accident has made operations necessary. The race seems to have that old aboriginal fortitude of not fearing the knife or wincing under pain. They have no idea of the danger of infection by contact, the rich being as ill-informed as the poor. Wet towels, wrung out in the same hot water, are for refreshment rubbed over the hands, face and neck of every one at a feast. A governor’s pipe is first lighted and puffed for him by a miserable attendant, the governor merely wiping the mouthpiece dry with his hand or long sleeve, the custom being to cut out a soiled sleeve and substitute a new sleeve so as to save the splendid garment.
The Chinese are proving themselves to be adept in dental surgery. Many Chinese have graduated from the University of Pennsylvania dental school, and they have set up in business throughout the Chinese treaty ports. Others have graduated from Hongkong’s school, and still others, entering as apprentices under Chinese dentists, trained abroad, soon start out for themselves and pass the good work along. When customers are slow in coming, the Chinese dentist adds another shingle to his door. “Dentist and Photographer”; “Dentist and Printer”; “Dentist and Manufacturers’ Agent,” are common signs. A good many stories are printed that the old-fashioned Oriental dentist trained himself for tooth pulling by practising with his fingers on pulling pegs from soft and afterward from hardwood logs, but this is true only as far as loosened teeth are concerned. They always used forceps of some kind. Generals Roberts and Kitchener could not, by taking thought, add one cubit unto the stature of the British soldier, but they decreed that he must have as good teeth as he had a rifle when on foreign service, and so the dentists of Hongkong and other garrison ports flourish. The British call themselves “dental surgeons.” The Chinese put out a sign that they repair or extract molars “by best American methods.” The Philadelphia dentist, here as over the world, leads in his calling. One owns a leading newspaper of Hongkong. The prices of the American dentist are high, as the tourist and five-year indentured clerk discover. Apprentices are brought out under contract covering service, and it is rumored that some contracts prohibit independent practise in the same port at the end of the term; but common law has long ago exploded the legality of a man signing away his rights to make a living.
It is strongly hoped that a cure has now been found for incipient tubercular leprosy, hitherto supposed to be incurable. South China has more lepers than any country, and the necessary segregation is incomplete. Doctor J. T. Wayson, city physician of Honolulu, has used the “beauty pencil” (stick of carbon dioxide ice), which gives a temperature of one hundred degrees below zero, on the nodule sores, breaking down the affected tissues time after time, until no “bacilli leprae” are found in the tests of the cuttings from the surrounding parts. He has found that affected children of lepers seem to have been cured. The trial of this method will be made in the missionary and University of Pennsylvania hospitals at Canton, which is the center of the largest leprous district in the world, though it has had no Robert Louis Stevenson or Father Damien eloquently to make its wants known, as was done for the Molokai colony in Hawaii. If there is some unknown microbic diathesis or nervous tendency to it, this remedy, like quinine, strychnine, phosphate of iron, chaulmoogra oil, etc., may not be a permanent success. Long years of observation only can tell. I have gone through the leper camps and the leper boat colonies of the Heungshan Peninsula between Canton and Macao. The colonies do not seem to move up or down in numbers. There seems to be no danger of infection if the visitor does not eat or handle things among them.
As I have related in The Chinese, the scenes are piteous beyond words, and illustrate China’s old Spartan methods, that the sooner incompetents pass away the better for all. It is said that a fish diet encourages the diathesis, and certainly Heungshan is a remarkable fish center. Doctor G. A. Hansen, of Bergen, a Norwegian bacteriologist, and Doctors Brinckerhoff, Cumy and Hallman, of Honolulu, all discovered the leprosy bacillus, and Doctor Hansen broke down the belief that the disease was hereditary. By segregation, he reduced Norway’s cases from three thousand to four hundred. The American bacteriologists are experimenting on toxins. In 1902 an American named Conrardy established and lived in a model endowed lazaretto with five hundred lepers near Canton. He, of course, contracted the disease, which made slow headway because of his vitality, which was stronger than that of the vegetable-fed Chinese. He expected to live for fifteen years, but at the end of eight years he was slowly sinking. On beautiful Joao Island, which is in view from your hotel window at Macao, South China, Portugal long ago established a leper asylum.
A careful study of the newspapers for many years must lead one to the deduction that as the Chinese adopt foreign life in the treaty ports, suicides are increasing among married women and business men. Probably both religion and nerves are at fault, for they go somewhat together. As is well known, Chinese cities and dwelling-compounds are surrounded by walls. Unusual rains or quickly melting snows often undermine the walls of compounds, filling the street with débris. In August, 1911, at Mukden, Manchuria, particularly, the streets looked as though the Russians and Japanese had again just got through with bombarding the town! How differently everything is done in China and the Occident! The New Jersey cities are spending some $10,000,000 to take liquid sewage from their rivers and conduct it in a trunk sewer to New York Bay. In China so little sewage remains after the farmer is through with its manuring properties that British analysts concluded to take the water supply for the three cities of Hankau, Hanyang and Wuchang, in the center of populous China, directly from the Han River near the cities. The extensive plant consists of a deep intake protected from the heavy loess siltage; an air lift, which showers the water in rain into filter beds; reservoirs of five million gallons; three Worthington pumps of 300,000 gallons an hour and an electric plant to supply the cities. The company is Chinese, and Chinese did all the contracting by the favorite method of piecework. As the provincial parliament was not established when the company was chartered, the viceroy granted the franchise. American boilers were used.
Water gathering is easy in Hongkong, though it has no river. Many mountains of the island have been reserved and trenched at the bottom. The torrential rains strike these peaks, and a thousand trenches carry the water to dammed valleys at Taitam, Pokfulum and Wong Nei Chong, high enough up in the hills to give gravity pressure for the mains. The beautiful aqueducts on Bowen Road, far up on the mountain side, facing the famous harbor, are a sight no tourist approaching on his steamer will forget. When pianos are made for the humid south, loose keys and felt, fastened without gum, must be provided for, and even at that lamps are kept burning under the instrument to dry the atmosphere. A case of the Korean “earth disease,” or “tochil,” is rare in America, owing to the vigilance of our Marine Hospital Service, but one case got into Seattle from the Orient in September, 1910. The disease is incurable and infectious, and is much dreaded. Other races may have forgotten, but the Orient never forgets, and always can bring up something wonderful from the dispersion of Babel, and every camp gathering since, along the valley of the Tarim!
An account of the quarantine practise at Hongkong and other Oriental tropical ports may be of interest. Manila, Saigon, Singapore, Shanghai or Nagasaki may hear or believe that there is plague or cholera at Hongkong, and they quarantine vessels from the latter port. There is always certain feeling between the port doctors, and Hongkong retaliates. A vessel loaded with steerage and cabin passengers arrives at Hongkong from one of these other ports. The yellow flag is hoisted on the main topmast and no one is allowed to board the ship, which lies in the stream, until the port doctor and his assistants come off in a launch, which flies a yellow flag, and allows the ship’s yellow flag to be hauled down. Quartermasters man the gangway and rail until the doctor frees the vessel. He holds a conference with the ship’s doctor, and woe betide the latter’s vessel, or its future calls up and down the coast, if untruths are told or concealments made. The cabin passengers are carefully watched as they march by the cabin table, and the temperature of suspicious cases is taken. Any one who shows over ninety-nine degrees Fahrenheit is examined further for corroborative symptoms. The temperature of every one of the steerage is taken and the glass thermometer is not always cleaned as it is passed from mouth to mouth here in these crowded regions! A suspicious case is stripped of clothes then and there in the line. Despite satisfactory examinations, vessels are sometimes held up forty-eight hours, and every one in the steerage, as well as his baggage and quarters, is sulphur-smoked, steamed and washed. A fumigation hulk is used for this purpose, and it is the most hated vessel anchored in the harbor. I have known a ship’s white officers, afflicted with plague, cholera, etc., to be taken off to the plague hulk Hygeia, and their vessels to be detained fourteen days for observation and cleansing before being released by the British and American doctors of the port. The detention anchorage ranges on the northwest of the usual fairway, and though a beautiful spot under the heathen hills of old China, it is naturally considered by many as a most melancholy one.
There is always a smouldering fire of conflict burning in the hearts of ships’ agents, port doctors and United States Marine hospital surgeons on duty abroad. The agents are inclined to imperfect care and quicker despatch of vessels. The United States doctors who, abroad, splendidly and incorruptibly guard the health of America, are likely to injure competitive business for the sake of making safety doubly sure. The proper course is “in medio tutissimus ibis.” I have known these doctors to examine the earth around lily roots and prohibit their export to America during many months of the year. Ships’ captains, doctors and agents, ever pressed by the management for increased earnings, take every bit of risk they can, even in the case of west-bound Chinese suffering from phthisis, and the check of the United States Marine Hospital Service is salutary, and will continue to be necessary. When a vessel is homeward bound the United States Marine doctor at Hongkong will not give a clean bill of health for America until all steerage passengers and their effects have been washed and steamed in disinfecting waters. Often the emigrants are stripped and America thus saved from loathsome hidden diseases being imported. The scene is sometimes enough to make the doctors as sagacious as Solomon, or as compassionate as Florence Nightingale.
What a work is opening up in China for the labors of the medical missionary, first with the touch and then with the voice of the Angel of Salvation. The rigid medical examination of returning Chinese at Hongkong and San Francisco is disliked by Chinese consuls, firms and the steerage passengers themselves, but the best friend of China, if he is enlightened as to the unsanitary conditions yet obtaining there, could not ask America to lighten her severity, which is no more onerous than Japan’s, until China cleans up her land, sanitizes her houses, and supplies herself with a modern medical system. The inspection at San Francisco sometimes calls for lancing of the ear at night to see if the patient is suffering from filariasis, and at Hongkong and sometimes at San Francisco the immigrant is required to disrobe, bathe and have his effects fumigated. The Hongkong inspection can not obviate the wisdom of a new inspection at San Francisco to ward against hookworm, elephantiasis, plague, cholera and the unmentionable disease.