First Aid in China

The American Bureau for Medical Aid to China this week releases for its first Manhattan showing a Key Scott film on the bombing of Chungking. The film has the shortcomings of most camera-eye reports: it does not stink, like gangrene, nor scream, like a child shot through the stomach.

When the Japanese attacked the old Chinese capital of Peking in 1937, swarms of Chinese limped to the city wall, dazed, half-naked, riddled with wounds. Hidden under the wall was the only first-aid station in the city. Their case was typical. For the 450,000,000 souls of swarming, near-defenseless China, there were only 9,000 adequately trained doctors. Most of them were trained in Britain, Europe or the U. S. Their colleague-competitors were native medicine men, who used such ancient practices as "acupuncture"--sticking patients with scores of hot & cold needles to let out evil spirits.*

In the summer of 1938, Physiologist Robert Kho-seng Lim, who had served in World War I with the British Royal Army Medical Corps, left his laboratory in Peiping Union Medical College to organize the Chinese Red Cross Medical Relief Corps (to train doctors, nurses and orderlies). Driven from one town to another by the Japanese invasion, the medical workers finally settled in the hills of Kweiyang, Kweichow, in thatched huts of log and plaster. Kweiyang, more than a thousand miles southwest of Peking, is now the medical centre of Free China: there are the refugee remains of famed National Hsiangya Medical College, formerly known as Yale-in-China./-

In its first six months, the Red Cross Corps trained 1,432 medical workers, gave special courses to 32 surgeons, 161 physicians. Dr. Lim also organized mobile ambulance and stretcher units to travel vith the armies, for sometimes wounded soldiers had to be carried 100 miles to base hospitals.

Practically all Dr. Lim's equipment and supplies from the U. S. come through the American Bureau for Medical Aid to China, which has some 70 chapters throughout the U. S. Executive chairman of the bureau is Professor Frank Co Tui of New York University's College of Medicine. Last year Dr. Co sent $500,000 worth of supplies to China. Included was a lathe for making wooden legs.

Supplies are sometimes a long time coming, in China. Last month Dr. Lim received equipment and materials for a vaccine plant which the American Bureau had sent a year ago. Dr. Lim now plans to pasture a herd of ponies for serums, manufacture 200,000 doses a day of vaccine for typhoid, cholera, bubonic plague and tetanus toxoid.

From Scratch. The Red Cross Corps had to start literally from scratch, for the entire army was infested with lice, and lice carry typhus and relapsing fever. Bamboo delousing stations have been set up all over China. Many hospitals have no sterilizers, so the doctors use clay pots; surgical instruments are beaten out of old knives. Modern operating tables cost at least $200, but Chinese doctors now build useful tables out of bamboo for ten cents. Only the most essential drugs are used, and often surgeons must operate without anesthetics. But they try to practice 1941 medicine. At present they are using sulfapyridine for pneumonia, will soon experiment with sulfathiazole for bubonic plague, may try brand-new sulfaguanidine for dysentery. They are planning to establish blood banks and to start manufacture of vitamins.

Red Cross workers labor day & night killing plague-infested rats, purifying water supplies with chlorine, operating delousing stations. In 1938 Dr. Co shipped over a million doses of cholera vaccine to China, thus preventing an epidemic. Last year there was an outbreak of plague in Chekiang, and the bureau rushed vaccines and fumigants to kill germ-bearing rats.

In Caves and Huts. In Nationalist China there are now about 650 base and front hospitals, many of them in caves and peasant huts, where patients sleep on k'angs (brick ledges). Chungking now contains the National Shanghai Medical College and six first-aid stations built by the American Bureau.

Perhaps the most brilliant foreign hospital organizer in China was the late Dr. Norman Bethune. A noted Canadian chest surgeon, Dr. Bethune established the first wartime blood transfusion system in Spain. In 1938 he went to China. He established a 300-bed base hospital in Wutai, which is the surgical centre serving 12,000,000 people. A 150-bed hospital in North Shensi, named after him, winds through 30 caves. In the fall of 1939, while operating with bare hands (rubber gloves are scarce in China) Dr. Bethune infected his finger, died of blood poisoning.

New Order in Asia. Although he and the Red Cross are constantly on the move, Dr. Lim takes lengthy clinical notes on diseases of the army. Samples:

>Some 90 to 100% of the troops have scabies, which, when scratched, often result in leg ulcers. Treatment: delousing, bathing, rubbing the affected parts with sulfur preparations.

> In some areas every third soldier has malaria.

> Nutritional diseases are widespread. "The lack of protein," says Dr. Lim, "is particularly important. . . . Healing of wounds is slow and infections of all kinds are frequent in the undernourished soldier. The lack of fat ... is responsible for the frequency of hemeralopia [blindness under bright lights]." Beriberi, a disease caused by vitamin B deficiency, is common in Southern China, where the main food is polished rice.

> Pneumonia and tuberculosis can be overcome, says Dr. Lim, only if troops are provided with adequate clothing and food. "One of the most serious of venereal diseases is gonorrheal ophthalmia [inflammation of the eyes]" due to lack of water, neglect of elementary personal hygiene (and vitamin A deficiency).

*Dr. Edward Hicks Hume, founder of the Yale-n-China Medical College, recently published a fascinating little book on old Chinese remedies The Chinese Way in Medicine; Johns Hopkins Press, $2.25). Dr. Hume points out that ancient Chinese doctors, dusty as they may seem, were he first in history to use: 1) liver as an antidote for anemia; 2) iron-bearing seaweed for thyroid disease; 3) ephedrine for colds.

/- There are ten medical schools in Nationalist China. Held by the Japanese are Peiping Union Medical College ("The Johns Hopkins of the Orient"), St. John's and Aurora in Shanghai.

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