IV Pioneer Work in Nanchang
In the first year of the young physicians’ practice in China, a launch had been sent to Kiukiang by one of the high officials of Nanchang, the capital of Kiangsi province, with the request that one of the physicians should return to Nanchang in it and treat his wife, who was very ill. Dr. Kahn went, and brought the woman back to Kiukiang with her. After a few weeks under the doctors’ care she returned to Nanchang completely recovered, and gave such glowing accounts of the benefit she had received that many of the wealthy ladies of the city followed her example and went to the Kiukiang hospital for treatment.
At that time no American missionary work was being done in Nanchang; but the successful treatment of the wife of the official is said to have “opened the gates to Protestant missionaries.” The Methodist Mission soon established a station there, and the work grew rapidly in spite of the fact that Nanchang was not an altogether easy place in which to work. As it was in the interior and off the highway of travel, little was known of foreigners. Moreover, there was a rowdyish element of the population which was very hostile to them and everything connected with them, as Dr. Kahn had good cause to know. Soon after the work in Nanchang had been begun by their mission, she and Miss Stanton made a trip there, the latter to do evangelistic work, Dr. Kahn for medical work. Dr. Kahn shall tell the story of their experiences:
“One afternoon, Miss Stanton and myself went to call on some ladies of the Plymouth Brethren Mission, the only other Christian mission besides our own in the city. The day being warm Miss Stanton had the rain cover of her sedan chair removed. Unfortunately it was a hired chair and there were no side curtains, neither was there an upper curtain in front. When we had gotten fairly started boys began to follow us, and by the time we had reached our destination quite a crowd was with us, and rushed into the compound ahead of us. Once in, we planned to cover the chair; and also waited till dark for our return, hoping that by that time the crowd would have dispersed.”
“However, when we got ready to start, there was a large crowd still clustered around the court and door. They allowed Miss Stanton to get into her chair first and start off, but when I followed, then the fun began. The coolies would take a step or two, then the chair would be pulled almost down. Yelling at them was of no avail. Finally a stone was thrown and one of the windows broken, so I thought it was time to walk. The crowd called out, ‘A foreigner! a foreigner!’ I was almost ready to cry with vexation, and could not help telling the people that they were cowards and barbarians. One or two of the bystanders now began to take my part, and administered a blow or two to those who seemed to be too obstreperous, telling me at the same time not to be afraid. I started to enter the largest residence near me, but the gatekeeper slammed the door in my face so I went on ahead. One of my volunteer helpers said, ‘There is the residence of the official Yang, where you can find shelter.’ So he led me into a house where a couple of women were sitting in the great room. Rather abruptly I told them that I was pursued by a crowd, and asked if I could find shelter there until I could send word to my people. My guides also explained that the people took me to be a foreigner. To my surprise the ladies welcomed me cordially, and ordered the doors to be shut on the crowd. Now all my friends will be ashamed to know that I could not repress my tears, but after a good cry I felt relieved. The people in the house urged me not to be afraid. I told them I was not afraid; I was disgusted that my people could be so mean. My hostess related several instances where ladies coming home alone in their chairs had been pulled about, and deplored the fact that there were so many rowdies everywhere.”
“Very soon the church members heard of my trouble and came to escort me home. As we wended our way homeward fresh members joined us till we formed quite a procession with lights flashing everywhere. Indignation was felt by all, so some of the party went back to demand the arrest of the ringleaders. How thankful I was to get back safely to our mission compound. Miss Stanton’s chair coolies had assured her that I was following behind, and she thought everything was secure. The church members were at prayer meeting and did not notice my non-arrival. The delay I think must have been providential, for had the members rushed there and found a crowd, I fear more trouble must have resulted.”
“Very soon the husband of a wealthy patient came and offered many apologies for the bad conduct of the people. How do you suppose he found out about the matter? He was returning home from a feast, and seeing so many Methodist lanterns (please do not smile, for the lanterns have ‘Methodist Church’ written on one side, and ‘Gospel Hall’ on the other) asked what it meant, and learned of the trouble.... Certainly the devious ways of my own countrymen never struck me so forcibly before. How much we do need the truth to shine in upon us and change us completely.”
Yet it was to this city that the Christian physician’s heart went out in such compassion that, for its sake, she was not only willing, but glad to leave her home in Kiukiang, the prosperous work which she had been doing in fellowship with her lifelong friend, Dr. Stone, and the beautiful new hospital to which she had long looked forward with so much eagerness.
“This old city of Nanchang with about three hundred thousand inhabitants, and surrounded by a thickly settled country, has not a single educated physician,” one of her letters reads. “Do you know what that means? The people realize their need and asked us to go and live among them. One of the church members offered to give us, free of charge, a piece of land situated in a fine part of the city, for either a hospital or a school lot. The pastor said he could raise $1,000 among the people if we would only begin medical work there. Do you think we ought to refuse that offer, which is a wonderful one, because the church has only just been established there? ‘And when they came to Jesus they besought Him instantly, saying that he was worthy for whom He should do this.’”
The people of Nanchang, both Christian and non-Christian, pleaded so eagerly for medical work, and promised to do so much toward its support, that the missionaries agreed with Dr. Kahn in feeling that a door to great opportunity was open before her, which it would be a serious mistake not to enter. Accordingly, early in 1903, she responded to what Dr. Stone termed “the Macedonian call,” and began work in Nanchang.
The Woman’s Foreign Missionary Society did not feel able to assume any responsibility for the financial support of the medical work in the new field, beyond that of the doctor’s salary. But Dr. Kahn firmly believed that missionary work should be just as nearly self-supporting as possible; and since many of the urgent invitations from Nanchang had come from homes of wealth, she was very willing to attempt to carry on medical work there on a self-supporting basis. In an article on the subject of self-supporting medical missionary work, written for the China Medical Missionary Journal, she gave some of her reasons for believing in self-support, and her theories as to how it might be carried out.
“To the many of us, no doubt, the thought naturally arises that we have enough problems to deal with in our work without having to take up the irksome question of self-support. Yet at the present time, when every strenuous effort is being made to evangelize the world in this generation, any plan which can help forward such a movement at once assumes an aspect of vital importance in our eyes. Let it not be presumed that self-support is to be recommended as possible to every medical missionary. On the contrary, I fear, only by those fortunate enough to be located in large cities could the effort be attempted with any hope of success. Yet in a measure the question concerns every one of us, because in its different phases self-support is sure to be pressed upon all of us with more or less force. Personally, my work was undertaken in Nanchang partly from faith in the principle, partly because there were no funds available to institute medical work on any other basis. My faith in the principle is founded upon the belief that anything of value is more appreciated when something has been asked in exchange for its worth, from those perfectly able to effect the exchange.... The ordinary people who seek help from the missionary will retain a higher measure of self-respect, and also suspect less the motives of the benefactor. The rich will appreciate more highly the services received, besides having the added glow of satisfaction in helping forward a worthy charity....”
“There should be no ironclad rules, however; each case must be counted on its own merits. Generally speaking, it might be well for the physician in charge to state plainly that the very poor are to be treated free of charge and have medicines, and occasionally food supplies, gratis. Those a little better off may help a little in paying for the medicines. The next step above that is to pay partly for the treatment as well; while the highest grade is to pay in proportion to the amount of help received. All this means a good deal of thought on the part of the physician and assistant, but gradually it will become routine work and so demand less labour.”
“Is self-supporting work a missionary work? Assuredly yes; for is not the money thus gained used in giving relief to the poor?... And if all money received goes again into the work, to increase its efficiency, why may it not be counted missionary? Part of it is given as thank-offering by those who are not Christian, and all is given for value received from Christian effort. Our Lord healed diseases without money and without price. If we ask, ‘What would Jesus do?’ under our existing circumstances, the suggestion comes to my mind that it would be something different in form, but not in principle, from what He did in a different land, under far different circumstances, nineteen hundred and more years ago. Someone says we are to follow Jesus, not to copy Him; and the principal thing, it seems to me, would be always to abide in the Spirit of the Christ, by whatever method we feel constrained to render our little service.”
Although the new step was taken so bravely, it was not an easy one. Some idea of the courage it required is shown by the doctor’s report of her first year in Nanchang; “The very thought of making a report causes many poignant memories to rush upon us. With what hesitancy and timidity did we begin our work in the new field! Knowing our own limitations, it was not with a light heart that we began the new year. Yet,” she was able to add, “as we toiled on, we could but acknowledge that we were wonderfully led along ‘The Pathway of Faith.’”
Enough money was contributed by the Nanchang people to enable Dr. Kahn to rent a house in the centre of the city, in which dispensary work could be carried on, and in which she lived. They also supplied her with a small stock of drugs with which to begin work, and she treated something over two thousand patients during the first eight months. The number seemed small after the work to which she had been accustomed in Kiukiang; but she was becoming known in the city, and in addition to her patients several of the women of the city had called on her in a purely social way, many of them educated women of the official class. Dr. Kahn says of them:
“As the wives and daughters of expectant officials they are representative of the better class of the whole country, for they are assembled from every province. It is pleasing to note that dignity and modesty are often combined with real accomplishment among them. It is amongst these that there is a marked eagerness to learn something better. They talk about their country incessantly, and deplore with real sincerity her present condition, of which many of them have a fairly good knowledge. To these we tell over and over again that the only hope of China’s regeneration is in her becoming a Christian nation, and that only the love of Christ can bring out the best qualities of any people....”
As to the financial side of the work, Dr. Kahn reported: “The outlook is most promising. During the eight months I have received over $700 from the work, and as much more has been subscribed.”
During the succeeding two years the work developed steadily. The number of patients treated at the close of 1905 was almost three times the number reported in 1903, and Dr. Kahn wrote, “We have tried to check the number of patients, simply because we did not feel financially able to treat so many.” The rent which she had been obliged to pay for her building in the city had been a heavy burden financially. Great was her delight therefore to be able to report, at the end of this year, a new $2,000 building for dispensary purposes, the money for which had been secured partly from fees, partly from subscriptions. “With the incubus of a heavy rent off our shoulders we may be able to relieve more patients, as we would wish,” she wrote.
The dispensary building was not the sole cause for rejoicing that year; for in addition to it a fine, centrally located piece of land, worth $3,600, was given for a hospital site. “All the assistance received has been from the gentry and not the officials, and therefore it really represents the people and we feel much encouraged by the fact,” reads Dr. Kahn’s report. The gentry wanted to make over the deeds of the property to the doctor. This, however, she would not permit, but insisted that they be made in the name of the Woman’s Foreign Missionary Society of the Methodist Church, assuring the donors that the work would then be on a permanent basis, as it could not be if the deeds were made out in her name.
It would not have been just cause for discouragement had the work dropped off the next year; for a dispute between some French Catholic priests and the Nanchang magistrates led to such serious disturbances and bloodshed that the missionaries were obliged to flee for their lives. Dr. Kahn refused to leave her work until the last possible moment, and returned just as soon as it was at all safe to do so. At the end of the year she was able to report that although it had been necessary to close the dispensary for three months, fully as many patients had been treated in the nine months as in the twelve months of the year previous. Another gift had also been received from the gentry, a piece of land near the hospital site, on which a home for the physician was already in process of building.
During 1907 the work continued to grow steadily in scope and favour. Dr. Kahn’s annual report for that year shows something of its development: “My practice has increased steadily among the foreigners and Chinese, until now we have patients come to us from all the large interior cities, even to the borders of Fuhkien. You would be surprised to know how many foreigners I treat in this out-of-the-way place. During the year we have treated over eight thousand patients. The evangelistic work among them has been better undertaken than ever before, and I am sure we shall see results in the near future. Several inquirers have been accepted, and seven women have been taken in as probationers.”
Although the demands of her work in Nanchang are constant and absorbing, Dr. Kahn has never become provincial in her interest; while working with whole-hearted devotion in her own corner, she still keeps the needs of the entire field in mind. At the fifth triennial meeting of the Educational Association of China, held in Shanghai in the spring of 1905, she gave an address on “Medical Education,” in which she said in part:
“Turn the mind for a moment to the contemplation of China’s four hundred millions, with the view of inaugurating effectual modern medical practice in their midst. How many physicians are there to minister to this vast mass of humanity? Barely two hundred! Such a ratio makes the clientele of each physician about two million. What would the English-speaking world think if there were only one physician available for the cities of New York and Brooklyn! Yet the people of these cities would not be so badly off, because of the steam and electrical connections at their command.”
“We as missionary physicians recognize our own inadequacy and the imperative demand for native schools. How can we undertake to help spread medical education in China with the limited means at our command? Shall we simply take unto ourselves a few students as assistants, and after training them for a few years turn them out as doctors? By all means, no! Take us as we are generally situated, one or two workers in charge of a large hospital or dispensary, is not the stress of our professional work almost as much as we can bear? Then there are the people to whom we ought to give the bread of life as diligently as we minister to their bodily needs. Add to this the urgent need of keeping up a little study. Where comes the time and strength to teach the students as they should be taught? Certainly to the average missionary such work as the turning out of full-fledged doctors ought to be debarred. It seems to me that what can and ought to be done is to single out promising students who possess good Christian characters as well as physical and mental abilities, and send them to large centres such as Peking, Canton, Shanghai, and Hankow, where they might take a thorough course in medicine and surgery. In these large cities the case is altered; for hospitals and physicians are comparatively numerous, and much could be done in a union effort. I am glad one or two such schools have been inaugurated.”
“As stiff a course as possible ought to be arranged and if it is thought best the whole thing might be outlined by the China Medical Missionary Association. For entrance requirements there should be presented a solid amount of Chinese and English, with some Latin and perhaps one other modern language. That may seem a great deal to ask at present, but our higher schools of learning ought soon to be able to supply such a demand, as well as the necessary training in mathematics, physics, chemistry, etc. In other words the student must be equipped in the very best manner for his lifework.”
“During the present generation at least, if not longer, the women of China will continue to seek medical advice from women physicians, and to meet the demand we must confront and solve another problem. Co-education is impracticable just at this juncture. We must have either an annex to the men’s college, or a separate one entirely. Whichever plan is adopted it matters not, barring the ’lest we forget’ that it is just as important to establish medical schools for women as for men.”
“In the golden future when schools abound we shall have to think of state examinations; but at that time we shall expect to be ready to greet the blaze of day in this wonderful country of ours, when she has wakened from the long sleep we often hear about, and taken her place among the nations of the world, and God and man shall see ‘that it is good.’”
At the close of 1907 Dr. Kahn had been back in China for twelve years, years of arduous, almost unremitting labour; and her fellow missionaries felt that before the work on the new hospital building began she ought to have a vacation. Certainly she had earned it. Not only had she worked faithfully for seven years in Kiukiang, but she had, within the five succeeding years, established medical work in a large city, where she was the first and only physician trained in Western sciences. Assisted only by two nurses whom she herself had trained, she had kept her dispensary running the year around, all day and every day. Moreover, she had kept the work practically self-supporting, in spite of the fact that she had refused to economize by using inferior medicines, or bottles of rough glass which could not be thoroughly cleansed. She had insisted that her drugs be of the purest, and dispensed in clean, carefully labelled bottles, and had often furnished besides the food needed to build up strength. In addition to all this, she so commended herself and her work to the people of the city that in 1906 she was enabled to hand over to the Woman’s Foreign Missionary Society, a dispensary building and two fine building lots, to be used for a hospital and physician’s home.
She was finally persuaded to go to America for a period of change and rest. “Rest” for Dr. Kahn evidently means a change of work; for she went at once to Northwestern University to take the literary course which she felt would fit her for broader usefulness among her countrywomen. Eager to get back to China she did three years’ work in two, studying in the summer quarter at the University of Chicago, when Northwestern closed its doors for the vacation. In addition to her University studies, she undertook, for the sake of her loved country, a work which is peculiarly hard for her, and almost every Sunday found her at some church, telling of the present unprecedented opportunities in China.
The question may perhaps be raised as to whether days could be crowded so full and yet work be done thoroughly. But Prof. J. Scott Clark of Northwestern University said of her, at this time: “Dr. Kahn is one of the most accurate and effective students in a class of eighty-four members, most of them sophomores, although the class includes many seniors. The subject is the study of the style and diction of prominent prose authors, with some theme work. Last year Miss Kahn attained a very high rank in the study of the principles of good English style during the first semester, and in that of synonyms during the second semester. In the latter difficult subject she ranked among the very best students in a class of over three hundred members. She is very accurate, very earnest, and very quick to catch an idea. In fact she is nothing less than an inspiration to her classmates.”
In the spring of 1910 Dr. Kahn was a delegate to the Conference of the World’s Young Women’s Christian Association held in Berlin, and from there went to London for six months of study in the School of Tropical Diseases. She had planned to return to Northwestern University to complete the work interrupted by her trip to Europe, and to receive her degree. Her work had been of so unusually high a standard, however, that she was permitted to finish her course by correspondence, and was granted her degree in January, 1911. She completed her course in the School of Tropical Diseases with high honour, and in February, 1911, she reached Nanchang, where one of her fellow-workers declares, “she is magnificent from the officials’ houses to the mud huts.”
The new hospital was still in process of building, but the doctor began work at once in her old dispensary, and the news of her return soon spread. In a short time she was having an average of sixty patients a day, and several operations were booked some time before the hospital could be opened. It was ready for use in the autumn and in October Dr. Kahn wrote: “The work has gone on well, and patients have come to us even from distant cities clear on the other side of Poyang Lake. The new building is such a comfort. It looks nice and is really so well adapted for the work. I would be the happiest person possible if I did not have to worry about drug bills, etc.... It is impossible to drag any more money out of the poor people. Our rich patients are very small in number when compared with the poor. Yesterday I had to refuse medicines to several people, though my heart ached at having to do so. You see I had no idea that the work would develop so fast, and things have risen in prices very much the last few years.”
At the time that this letter was written the Revolution was in progress, and Nanchang, with all the rest of Central China, was in a turmoil. Because of the disturbed conditions most of the missionaries left the city, but Dr. Kahn refused to leave her work. With the help of her nurses she kept the hospital open, giving a refuge to many sufferers from famine and flood, and caring for the wounded soldiers. None of the forty beds was ever empty, and many had to be turned away.
The close of the Revolution did not, however, bring a cessation of work for the doctor. She already needs larger hospital accommodation, three times as much as she now has, one of her friends writes. But Dr. Kahn delights in all the opportunities for work that are crowding upon her; for she says, “When I think what my life might have been, and what, through God’s grace, it is, I think there is nothing that God has given me that I would not gladly use in His service.”