The crowded manner in which the common people live together in small apartments in all the cities, the confined streets and, above all, the want of cleanliness in their persons, beget sometimes contagious diseases that sweep off whole families, similar to the plague. In Pekin incredible numbers perish in these contagious fevers, which more frequently happen there than in other parts of the empire, notwithstanding the moderate temperature of the climate. In the southern provinces they are neither so general, nor so fatal as might be expected, owing, I believe, in a very great degree, to the universal custom among the mass of the people of wearing vegetable substances next the skin which, being more cleanly, are consequently more wholesome than clothing made from animal matter. Thus, linen and cotton are preferable to silk and woollen next the skin, which should be worn only by persons of the most cleanly habits. Another antidote to the ill effects that might be expected from want of cleanliness in their houses and their persons, is the constant ventilation kept up in the former both by day and night: during warm weather, they have no other door but an open matted skreen, and the windows are either entirely open or of thin paper only. Notwithstanding their want of personal cleanliness, they are little troubled with leprous or cutaneous diseases, and they pretend to be totally ignorant of gout, stone, or gravel, which they ascribe to the preventive effects of tea. In favour of this opinion, it has been observed by some of our physicians, that since the introduction of tea into common use, cutaneous diseases have become much more rare in Great Britain than they were before that period, which others have ascribed, perhaps with more propriety, to the general use of linen; both, however, may have been instrumental in producing the happy effect.
The ravages of the small-pox, wherever they make their appearance, are attended with a general calamity. Of these they pretend to distinguish above forty different species, to each of which they have given a particular name. If a good sort breaks out, inoculation or, more properly speaking, infection by artificial means becomes general. The usual way of communicating the disease is by inserting the matter, contained in a little cotton wool, into the nostrils, or they put on the clothes of, or sleep in the same bed with, such as may have had a favourable kind; but they never introduce the matter by making any incision in the skin. This fatal disease, as appears from the records of the empire, was unknown before the tenth century, when it was perhaps introduced by the Mahomedans of Arabia who, at that period, carried on a considerable commerce with Canton from the Persian gulph, and who not long before had received it from the Saracens, when they invaded and conquered the Eastern Empire. The same disease was likewise one of those blessings which the mad crusades conferred upon Europe; since which time, to the close of the eighteenth century, not a hope had been held out of its extirpation when, happily, the invaluable discovery of the cow-pock, or rather the general application of that discovery, which had long been confined to a particular district, has furnished abundant grounds to hope, that this desirable event may now be accomplished.
In some of the provinces the lower orders of people are said to be dreadfully afflicted with sore eyes, and this endemic complaint has been supposed to proceed from the copious use of rice; a conjecture, apparently, without any kind of foundation, as the Hindus and other Indian nations, whose whole diet consists almost exclusively of this grain, are not particularly subject to the like disease: and in Egypt, both in ancient and modern times, the opthalmia and blindness were much more prevalent than in China; yet rice was neither cultivated nor known in that part of Africa until the reign of the caliphs, when it was introduced from the eastward. The disease in China, if prevalent there, may more probably be owing to their living in crowded and low habitations, wherein there is a perpetual smoke from the fire, from tapers made of sandal wood dust employed for marking the divisions of the day, from the general use of tobacco, and from the miasma or noxious vapours exhaling from the dirt and offals which are collected in or near their habitations. The organ of sight may also be relaxed, and rendered more susceptible of disease, by the constant practice of washing the face, even in the middle of summer, with warm water. I must observe, however, that in the course of our long journey, we saw very few blind people, or persons afflicted with sore eyes.
It will readily be inferred, from the short view which has been taken of the state of society, that the disease occasioned by an unrestrained and promiscuous intercourse of the sexes cannot be very common in China. In fact, it is scarcely known, and the treatment of it is so little understood, in the few cases which do occur, that it is allowed to work its way into the system, and is then considered by them as an incurable leprosy. On arriving at the northern extremity of the province of Canton, one of our conductors had imprudently passed the night in one of those houses where, by the license of government, females are allowed to prostitute their persons in order to gain a livelihood. Here, it seems, he had caught the infection, and after suffering a considerable degree of pain, and not less alarm, he communicated to our physician the symptoms of his complaint, of the nature and cause of which he was entirely ignorant. He was a man of forty years, of a vigorous constitution and a gay cheerful temper, and had served as an officer in several campaigns from the different provinces of northern Tartary to the frontiers of India, yet such a disease did not consist with his knowledge. From this circumstance, and many others of a similar kind, I conclude that, although it may sometimes make its appearance in the capital, and even here but very rarely, it has originally, and no long time ago, found its way thither through the ports of Chu-san, Canton, and Macao, where numbers of abandoned woman obtain their subsistence by selling their favours to such of every nation as may be disposed to purchase them. It is, in fact, sometimes called by the Chinese the Canton-ulcer.
No male physician is ever allowed to prescribe for pregnant women; and they consider it so great a breach of delicacy for a man to be in the same room with a woman when in labour that, whatever difficulties may occur, the case is left entirely to the woman who attends her. There is not a man-midwife in all China, and yet the want of them does not appear to be injurious to population. They could scarcely believe it possible that, in Europe, men should be allowed to practice a profession which, in their minds, belonged exclusively to the other sex.
As a due knowledge of the organization of the human body, of the powers and functions of the several parts, is attainable only by the study of practical anatomy, a study that would shock the weak nerves of a timid Chinese, it will not be expected that their surgical operations should either be numerous or neatly performed. The law indeed which I have had occasion to notice, and the effects produced by it in two or three instances that occurred to our knowledge, will sufficiently explain the very low ebb of chirurgical skill. No one will readily undertake to perform the most simple operation, where not only all the direct consequences, but the contingencies for forty days must lie at his door. They sometimes succeed in reducing a dislocation, and in setting a simple fracture; but in difficult and complicated cases, the patient is generally abandoned to chance. Amputation is never practised. In the course of our whole journey, wherein we passed through millions of people, I do not recollect to have seen a single individual that had sustained the loss of a limb, and but very few in any way maimed; from whence I conclude, that accidents are uncommon, or that serious ones usually terminate in the loss of life. A Chinese is so dreadfully afraid of a sharp cutting instrument, that he has not even submitted to the operation of blood-letting; though the principle is admitted, as they are in the practice of drawing blood by scarifying the skin, and applying cupping vessels. In certain complaints they burn the skin with small pointed irons made hot, and sometimes, after puncturing the part with silver needles, they set fire to the leaves of a species of Artemisia upon it, in the same manner as the Moxa in Japan is made use of to cure and even prevent a number of diseases, but especially the gout and rheumatism, the former of which is said to be unknown in China. Cleansing the ears, cutting corns, pulling the joints till they crack, twitching the nose, thumping on the back, and such like operations, are annexed to the shaving profession, by which thousands in every city gain a livelihood. In short, the whole medical skill of the Chinese may be summed up in the words of the ingenious Doctor Gregory from the information he obtained from his friend Doctor Gillan. "In the greatest, most ancient, and most civilized empire on the face of the earth, an empire that was great, populous, and highly civilized two thousand years ago, when this country was as savage as New Zealand is at present, no such good medical aid can be obtained among the people of it, as a smart boy of sixteen, who had been but twelve months apprentice to a good and well employed Edinburgh Surgeon, might reasonably be expected to afford." "If," continues the Doctor, "the Emperor of China, the absolute monarch of three hundred and thirty-three millions of people, more than twice as many as all Europe contains, were attacked with a pleurisy, or got his leg broken, it would be happy for him to get such a boy for his first physician and serjeant-surgeon. The boy (if he had seen his master's practice in but one or two similar cases) would certainly know how to set his Imperial Majesty's leg, and would probably cure him of his pleurisy, which none of his own subjects could do."
Having thus given a slight sketch of the state of some of the leading branches in science, arts, and manufactures, omitting purposely that of agriculture, which will be noticed among the subjects of a future section, I think, upon the whole, it may fairly be concluded, that the Chinese have been among the first nations, now existing in the world, to arrive at a certain pitch of perfection, where, from the policy of the government, or some other cause, they have remained stationary: that they were civilized, fully to the same extent they now are, more than two thousand years ago, at a period when all Europe might be considered, comparatively, as barbarous; but that they have since made little progress in any thing, and been retrograde in many things: that, at this moment, compared with Europe, they can only be said to be great in trifles, whilst they are really trifling in every thing that is great. I cannot however exactly subscribe to an opinion pronounced on them by a learned and elegant writer[22], who was well versed in oriental literature, as being rather too unqualified; but he was less acquainted with their character than that of any other Asiatic nation, and totally ignorant of their language. "Their letters," says he, "if we may so call them, are merely the symbols of ideas; their philosophy seems yet in so rude a state, as hardly to deserve the appellation; they have no ancient monuments from which their origin can be traced, even by plausible conjecture; their sciences are wholly exotic; and their mechanical arts have nothing in them characteristic of a particular family; nothing which any set of men, in a country so highly favoured by nature, might not have discovered and improved."