This stage of the review of the literature of the madness of cognition and the Jia Yuehan contribution

The late Qing period is the Chinese society the concept of "madness" shift recognized the critical period of the the lunatic hospital system function as Michel Foucault said: "Crazy is not a natural phenomenon, but a product of civilization no such phenomenon as crazy and persecuted by every culture, history, there would be a crazy history ....... In fact, the same madness itself, change is the people know it. "[1] 29. will be the founder of China's first lunatic hospital - Guangzhou Hui love lunatic hospital process some historical research, analysis the madman understanding of modern psychiatry and health care system, the new ideas and the lunatic hospital that reveal "madman disease" system to enter the Chinese society unique cultural phenomenon. Scholars generally believe that this hospital is the founder of the Church in the United States is not clear, but the founder of the lunatic hospital, 1 [2] 437-440 In this paper, the United Presbyterian the files and lunatic hospital reports first-hand information, to sort out some of the historical facts, this piece of history to add specific sum.

"Madness" cognitive built lunatic hospital debate

Mental illness is still the medical profession a mystery nineteenth century the American missionaries Jia Yuehan, 2 [1] in the medical education activities in Guangzhou, lunatic illness encountered in the Central Standing Committee of the long-term medical practice he sympathized with the plight of the madman, To summarize this, the Chinese society to treat mental patients: the family unit to custody or in prison, never make satisfactory arrangements madman, the more common the fact that the presence of a madman with a chain imprisoned, subjected to day sun and rain, or throughout the year off in the dark, damp room, or in the barn, the the madman little care and attention rarely hear warm words, not to mention the health conditions more frightening is that only a few means to deal with this there is no hope of cure illnesses, often returned to his home country, where the clan forces the right to decide that this person is alive or dead. mortality in the poverty-stricken people, the madman is very high, because they are frequently subjected to rougher treatment and lack of care. [3]
In ancient China, said Maniac >> According to << Huang Di Nei Jing Xian pivot >> Kango << mania performance insomnia, loss of appetite, delusions of grandeur, self-esteem, and arguing, and even disposable clothing while walking, climbing song, or to not eat for several days, more than Ogaki on the house. "Chinese doctors generally understand the madness of the many forms of disorders of the body, they are used for the interpretation of the" insane "and" crazy "language and explain other disease there is no difference. [4] In the history of human disease, the treatment of mental illness is one of the most brutal chapter, until the 19th century, many countries do not yet know mental illness is how it is, so there can be no psychiatric care, in addition to very few exceptions, almost all psychiatric patients should be subjected to cruel ban lock. madness judgment and disposal are often out of the attitude of the administration of justice rather than medicine. [5]
From the 17th century, the development of science and culture in Western countries has changed the views of the people of witches' broom, anatomist reveal activities in the circulatory system and the coordination of limbs, spinal cord and cortical neural network, and began to explore the nervous system in the control of sensory and motor role. madman attitudes are beginning to change, "society as a whole is a free process of development, the madman is no longer an animal, or be deprived of all remnants of the human characteristics, on the contrary, he has a human nature. madman lack of self-control and sense of order, but a complete person, he lacks the essence perhaps after recovery, individuals can still become rational citizens to play a role. "[6] 18th century, 19th century, Europe and North America the eastern coastal areas of the school, the number of workhouse and the asylum surge to solve the problem of madness patients. madhouse control is isolated madman, to protect their safety, and increase the hope of a cure. part of the reformers the spirit of the new method of treatment using drugs and confinement control has become the primary means of treatment of mental illness, emphasis on spiritual healing and kindness, rational and humane ways. [7]
It is based on the theory of modern psychiatry in the West, the lunatic hospital admitted patient efficacy and the special situation of the madman, the Jia Yuehan convinced that China is necessary to establish a madhouse. Currently see is the first to call on Jia Yuehan madhouse construction, in 1872 China the report of the Medical Missionary Society in this report, Jia Yuehan mentioned group of helpless madman living conditions, call the church's attention and save this group. [8]
Western missionaries in China at that time, however, is also prevalent this idea that "China does not have a lot of patients with mania, there is no need to be like the United States and Europe as built lunatic asylum." Wei Luo Lin once said, such as the famous British missionary doctor However, he "8 years of medical practice experience only encountered two crazy patient", pursuant to which he concluded: "tranquil personality and modest habits of Chinese people, the Chinese people have a small number of this illness." [9] Therefore, there is no need to establish a madman sanctuary in China.

Jia Yuehan foreign doctors do not agree on the madman's assertion ", he argued madman did not stand out because, first, they were chained to bundle home, they are likely to commit suicide Third, relatives abuse, their life usually very short, fourth, they are arbitrary exile. mania patients always tried to commit suicide, Boji Hospital a patient who hanged himself with his belt several times, Jia Yuehan The doctor promptly cut off with a knife under the ropes to save. [8] 17
1881 the Jia Yuehan << Western Daily News >> 1 published << The medical mania disorder >> article, he called on the Chinese people should be concerned about this issue, "mortal disease weird special for most Kulie refractory by elucidating the madness of the disease, slow anxious, or since the beginning of the surgeon murder or illness and raved delirium, or cry or laugh, its shape is difficult to try to describe "He introduced the United States established a madman hospital" the provinces in the United States has the special mania hospital several small provinces will be set up a lunatic hospital (this does not include the various cities set up according to the different funding lunatic hospital), as well as doctors set up their own museum professionals medical disease. Britain, Russia, France and other countries have their own system, set up in accordance with such method the madness hospital. the Jia Yuehan further explanation, "the treatment of this disease must be an experienced doctor to competent, set up more sturdy ward in the hospital treated patients with mania, and then take the appropriate medical approach slowly mediation, will achieve better results. "Chinese medicine or the patient's tribe widespread use of chains the handcuffs locked madman hand, foot, and this means the madman is not then murderer Branch, but suffering from mania I had no big benefits. "see mania patients or to to plunge himself or committed suicide by hanging," as a doctor but can not rescue ", Jia Yuehan feel very sorry" [10] Jia Yuehan >> << Wan Guo has published << established gone mad home On >> << the British adoption madness >> << governance crazy early >> announcement India construction madhouse news, Jia Yuehan hope that through the promotion of the missionaries and Chinese scholars understand the necessary construction madhouse. ③
1886 to commemorate the 50th anniversary of the establishment of the Guangzhou Boji Hospital some effort After Jia Yuehan of, China Medical Missionary Council passed a resolution, decided to establish a madhouse. [11] Two years later, they withdrew their resolution. In addition to the economic burden considerations, they reply: "This is not currently working an important goal, although the Jia Yuehan character optimist, always diligent and willing to take on this responsibility, but If Jia Yuehan successor reluctant to assume this class work, the prospects of this institution is not to be optimistic. "recommendations the Jia Yuehan to set up an independent committee to promote this work. [12] they do not want to intervene in this charity, refused to do anything crazy people.

In the U.S., Jia Yuehan get some peer support of the medical profession, especially the president of the Hospital of Brooklyn (Brooklyn) EP Thwing Professor He actively support the Jia Yuehan China to build first madhouse, and to report thereon with Jia Yuehan to maintain communication. out of interest in missionary work, charity and scientific research, a Thwing decided to visit China. Jia Yuehan and he the "the these mental confusion madman should enjoy the social welfare, suggested that consideration be given to public institutions and social welfare agencies to solution to this problem plagued China for thousands of years. they get a lot of Catholics in the United States to support and encourage their commitment to China will build its first funding madhouse.

But the Jia Yuehan build the Cuckoo's Nest appeal has not been the response of the Chinese officials, businessmen and foreign communities in China. The Professor a Thwing arrived in Guangzhou, Jia Yuehan doctor accompanied Guangzhou love Yuk Sin Tong Benevolent Society, you, Director, Hong Kong Tung Wah Group of Hospitals of you director of meeting these elites are Guangzhou and Hong Kong's business tycoons, they admit it is very necessary to the establishment of such a body, but refused to invest in. Jia Yuehan doctors tried to submit a development plan to fight border province Zhidong support, Zhang Zhidong aides back a letter to the effect that: "The one with the letter returned to this plan shelters Sorry to say, Governor adults are not interested." [13 ] letter to Jia Yuehan also handed Panyu county magistrate Department officials are "weak" sponsorship rejected his request. [14] 102-108 Although there is no local officials and business people also should support, but Jia Yuehan Thwing still patiently insisted that called for a medical missionary in China concerned about this issue.

1890 Professors Jia Yuehan Thwing attended Bo Chinese Medical Association General Assembly held in Shanghai, he read out at the meeting papers >> << Western treatment and mental patients, issued << up a madhouse on the need to >> promotional materials. adopted by the General Assembly by Dr. Jia Yuehan and Professor Thwing plans to build the Guangzhou madhouse participating doctors were very interested in this project and hope that the the Jia Yuehan can accomplish this is of great cultural significance and social reality sense arduous task for voting recommendations have to work hard to establish the appropriate madman shelter in other parts of China. [15] reposted elsewhere in the Research Papers Download
But things are not smooth sailing, Foshan London doctors Wenyon in 1892 >> << BrainLAB will be reported on the different views expressed, he said: "An American gentleman with the organizations of the Church of England, to discuss working together to establish a lunatic hospital in Guangzhou, and this project in the UK to raise models as senior medical missionaries in the United Kingdom, has the responsibility on the matter to express different opinions. "he once again asks whether it is necessary to build a madhouse, and said," unlike the United States and Europe in the incidence of mental patients as universal, Hong Kong and Foshan madhouse is simply no patients. "he does not agree to the establishment of such a body, it is expected that" the establishment of a madhouse be subject to abuse by missionary agencies. (4)
Jia Yuehan >> << BrainLAB will be reported in a subsequent response, he asked Dr. Wenyon "can you give statistical data to prove that China madman, unlike Europe and the United States as universal? China has no madman." He stressed the madman must take appropriate treatment measures, answered madhouse feasibility questions he is not fair to criticize the doctor Wenyon random speculation and misleading remarks on China's encephalopathy in patients ⑤ the Jia Yuehan sigh, China madman behavior is striking, but the foreigners living in China did not pay attention to this group, they are a relatively small number of group madman, not worth it to do for them. Jia Yuehan old friend Ji good Bute doctors worried his situation, to console him not asking for trouble, "Chinese society does not want to see huge changes, more reluctant to anatomical thigh or built lunatic hospital." He suggested that Jia Yuehan go to work in Hong Kong, Do not Yinjiayuehan of undermine to other missionaries normal life. [16]
Visible during this period, not only the traditional Chinese society, even if the foreign communities, treat madman there is not clear identification and understanding of the instability of two main problems: First and madman treatment madman space, the other is how to treat the madness of the ideological issues. [1] 55 people on the madman the closed completely departure from the medical point of view, the madman non social membership also added inhuman treatment. Jia Yuehan advocate lunatic hospital run, the starting point is the madness classified as a mental illness, which is the evolution of socially significant, despite the sense of community has to be raised.

American Presbyterian blocked plans to build lunatic hospital

In 1892, Jia Yuehan own pension purchased a located in Fangcun White Swan Pond dockside nearly 4 acres of land, to be built madhouse very advantageous geographic location, across the Pearl River facing Shamian concession area, beheld Boji hospital not far from the north shore of the Pearl River where the land price is relatively cheap, and avoid the hustle and bustle of the city of Guangzhou, is an ideal place for the patient's convalescence. [17] for the harmony of the surrounding neighborhood relations, Jia Yuehan first use The land opened a free clinic, by the preparation of the madhouse members of the Interim Committee Yinwen Kai (Yin end mode) doctors the main reason.

In order to speed up the pace of the lunatic hospital, the Jia Yuehan first thought is to get the support of the American Presbyterian face of all the skepticism and doubts, Jia Yuehan specifically written more than a dozen reasons explain why to the poor lunatic hospital built in China For example, he pointed out that the Chinese Empire has five times the population of the United States, but not a lunatic hospitals in China and its neighboring countries, the madman even in their own homes are not given appropriate treatment and care, the madman particularity not revenue Church hospital, get treatment, run the madman hospital missionary doctor to follow the example of Jesus Christ, "cure all symptoms of the disease and pathological behavior, [15] and requires difference would be authorized in the United States raised $ 50,000 donation for the establishment of the Guangzhou lunatic hospital.

Despite the Jia Yuehan a very good reason, but his appeal did not get support of the poor. Presbyterian Overseas Secretary-General of the Ministry of Ellinwood persuade Jia Yuehan to give up the idea to build a madman hospital, "income, poor will also invested in newly opened areas, far better investment in the finality of the target, training a strong, healthy boy revenue is far better than the training blind or the like lepers. "[18] and in 1892 Nov. 9 formal notice the Jia Yuehan things on madman hospital in Guangzhou, the difference will decide not to participate. "[19] on the 10th difference will give missionary station official documents said," Jia Yuehan to build Guangzhou madman. hospital fund-raising matters ...... view of the activities of its raised will directly or indirectly affect the work of the Church, so the difference will not agree to the license the Jia Yuehan to carry out fund-raising activities. [20] On November 16 Ellinwood letter to Jia Yuehan, the The tone is full of threats, the letter said "the Jia Yuehan should obey the decision of the poor. to his raising activities has nothing to do with the Church's mission project. [21]
Differential will begin to continue to give the missionary station in Guangzhou to do the job While acknowledging that "build a madhouse, of course, is a good thing, but too far away and the distance to the missionary missionary station goal is to strive to improve the number of people to be saved" recommended "Boji another doctor of the hospital off John and Guangzhou missionary station not to get involved. "they think the missionary efforts probation goal is the eyes of the able-bodied people, people can learn and pray, instead of the blind, the deaf and the madman "medical missionary responsibility is not only to cure diseases of the body, is more important is to open the way for the spread of the gospel. [22] other missionaries missionary station in Guangzhou, if John (SWAN) and Hong will be in (Henry) does not support The Jia Yuehan built madhouse move.

The difference will then conclude against the build Guangzhou madhouse three reasons: First of all, this matter should be recognized by the Guangzhou missionary station, but do not agree with missionary station in Guangzhou, second, the current conditions missionaries should follow in order to spread the spirit of Christ the work of the Lord, do not encourage directly engaged in humanitarian work this tendency will lose the main areas of missionary work, is very risky, the third part of the feelings of the doctors working in China, can be understood to sympathize with these madmen and willing to providing services to them, but this is missionary work benefits or injury, or stir up suspicion and contempt of the residents can not conclusive. [23]
The face of poor and obstruction of the missionary station in Guangzhou, the Jia Yuehan and did not give up, In the following years, he continued to the Church to the United States appeals and protests of the General Assembly, to explain the reasons for his letter to every overseas missionaries. Presbyterian senior Jia Yuehan, continue to petitions complain practice quite offensive, said "Jia Yuehan practice their difference will fall into a hostile state." In their view Jia Yuehan continuous protests "will affect the poor the normal work. "difference will come back to criticize the missionary station in Guangzhou, asking them to further clarify the overall humanitarian relief work should not include built madhouse, does not encourage any of the activities associated with this, in particular, personnel and expenditure spent not associated with this command missionary station in Guangzhou leave no stone unturned to make the Jia Yuehan plan there is no possibility of realization, "the poor and the mission station of Guangzhou will have to bear the cost of the madhouse".

The point of view of the American Presbyterian church-based resources directly used to spread the gospel of work yet to make ends meet, so the work of the church can only be qualified to win more direct the activities of the believers, not counting the humanitarian relief work will be poor dispersion will be of limited financial resources, is not desirable. poor day-to-day affairs of the purposes and policies "When you have a conflict, a missionary can only obey the interests of the overall situation of the Church" that host such agencies will also be involved missionaries too much energy, like the start-up the Guangzhou Christian Church (Lingnan University), many missionaries are trapped, alienated supposed to be engaged in church sermons. [24] at the same time, the Presbyterian Church USA to discuss the worst intend, if, Jia Yuehan successful, then the difference will be bound to take certain measures to force the Jia Yuehan give up the work of the missionary station in Guangzhou Boji Hospital, he has put a lot of time and effort to be responsible for management lunatic hospital. American Presbyterian be very afraid to start this project, they just exposed the tip of the iceberg, but for future missionary work placed a huge obstacle, the funds will be more and more obvious difference will be consumed. [25]
Differential will oppose the Jia Yuehan build the Cuckoo's Nest, fundamental reasons, first, the fear of the start-up and operation of the madhouse will spend large sums of money of the poor, the second from a utilitarian perspective, the same amount of money spent in the normal human body, the gain far more than teach the madman, and the third, the the contradictions exposed to preach and practice of medicine. church-run hospitals starting point is the use of medical means to spread Christianity spread of Christianity is the fundamental goal of poor will not pay a high as a means of implementation the cost of Ellinwood, madhouse Once started, the next job may all fall into the head of the mission station. He expects the "Jia Yuehan may take at least 1-5 years to raise funds even if he to raise the money, he will have another year to build the flats, the work program of the organization hospitals employ some casuals, etc., these work to take up all his time. madhouse work, the Guangzhou foreign community and the Chinese people will think the Guangzhou missionary station and the difference will be bound to this agency is responsible for the poor how could encourage China do not have any hope of spending $ 50,000 on a group of people who do? "So bad will try their very best prevent the Jia Yuehan build madhouse. [26] reposted elsewhere in the Research Papers Download

three lunatic hospital: humanitarian medical care

Resolutely oppose and obstruct the American Presbyterian, Jia Yuehan the lunatic hospital or built in 1897 .1898 February, a lower bleak light rain in the morning, the Jia Yuehan to hire a labor back patients, to bring his father to Pearl River arrived aboard a boat to spend Fangcun the new building. door opened, marking the establishment of China's first lunatic hospital, began to accept the madman groups as a medical object.

In However, Jia Yuehan also forced to January 1899 from the of Boji Hospital and Medical Missionary will resign, stationed with his male students the Fangcun VEAYE lunatic hospital, living together with the patient on the first floor.

The Jia Yuehan students Yefang garden chronicles the lunatic hospital in Guangzhou to build after, he said, passing a medical missionary in the Far East missionary in 1895 and Guangzhou, to visit the famous Bo Ji Hospital, of Jia Yuehan the dedication and professionalism admire over more than two years, he sent to Jia Yuehan to a letter, accompanied by 3,000 yuan, sound and Mingjiayuehan can freely dispose of the funds for medical charities in Guangdong. the Jia Yuehan very pleased, and immediately wrote back asking whether lunatic hospital in Guangzhou with the money to build the first building of the missionaries Reply "agreed to use the funds for the funding of the construction of the madhouse", and Jia Yuehan the act has to be praised. [14] 102-108 Ka John documented in the report, in 1897 built the first houses are $ 2,091.53 in Fangcun this person donated $ 3,576.66 for hospital operating costs which began, Jia Yuehan, and other avenues to raise funds, built second building of the room. [27] the Jia Yuehan and did not write the name of the missionary contributions, there is no description donations after the missionaries did not want to leave your name, may the missionary is the Presbyterian Church USA members, leave the name may for himself and Jia Yuehan bring some trouble because of poor reiterated Presbyterian personnel and property can not have any contact with this organization.

The Jia Yuehan require treatment of mental patients have to follow three principles: First, Where a hospital by key patient, if they say show the irrational characteristics, that is not their fault, hospitals, not prisons, entirely out of madness, but they are still men and women, rather than a beast. [28] With these three principles as a guide, the Jia Yuehan proposed quite flexible treatment program: First, as far as possible the use of the means of persuasion, if necessary the case of minimum use of power management, the second is to give the patient freedom, imprisonment bundle of the implementation of the minimum necessary, a third of patients with moderate attitude to rest, hot water bath, outdoor activities , physical exercise and professional labor, in the case of the necessary minimum to implement drug treatment. [2] 441
Name of "madman" is not a happy choice, the madhouse not just the lunatic asylum, protected place, Jia Yuehan goal is to use rational means of direct treatment of these diseases. To Jia Yuehan died, the hospital has diagnosis and treatment received more than 150 patients, who come from all walks of life, bureaucratic officials, from the street to retrieve the ordinary people, some from far away, patients sent from Shanghai, Zhejiang, furthest from the northern Jilin [29] of Jia Yuehan doctors treat patients with crazy, and to heal their disease gradually recovered their health, restore the senses, able to lead a normal life.

Dr. Jia Yuehan life time engaged in medical work of the Chinese people, whether in the minds of the civilian population or government officials, he has a very high reputation, he is a well-known doctor, also a distinguished philanthropist his efforts to help helpless mental patients, access to widespread acclaim. fact that this hospital did not cause trouble to the people and officials, Jia Yuehan hospital open, and accept the supervision of the patient's family and officials, allowing relatives at any time to visit the sick through a variety of initiatives, Guangzhou has such a view, Jia Yuehan, and other doctors with patients is very good, and nothing is confidential.

Cuckoo's Nest of Jia Yuehan founder of Chinese mental patients a place of love and care, professional treatment of the madman in the summer of 1900, due to the rise in the North "Boxer" caused a riot in Guangzhou, it was out of the missionaries head the price tag, but also the city of Guangzhou held a rally, to discuss the development of the situation, but the officials and all the people of Guangzhou has repeatedly stated that adhere to, regardless of the other missionaries and missionary places what will happen unrest, must ensure that not destroy the Cuckoo's Nest, which is the only between the Cuckoo's Nest, only only Jia Yuehan of doctors can take care of them, so be sure to protect Jia Yuehan doctors from interruptions. This indicates that the work carried out for the madman to get the recognition and support of the people of Guangzhou.

Preferential love lunatic hospital established in Guangzhou, China's first professional nature of the mental hospital, it has broken the traditional Chinese practice of regulatory madman, change the treatment of the mentally ill, the Chinese medical community started to pay attention to the research and treatment of encephalopathy, local people are surprised to promote the development of China's psychiatric hospital to rapid development in such a short time, some patients were cured also makes them feel incredible, they say: "the cause of all foreign missionaries offered , this work is the best! "Jia Yuehan unheeded patient to the the humanitarian medical world, be kind to them and do not allow other people discourteous treatment of the patient when his condition is very dangerous when Rating: still the patient as their own children, extremely worried about. as Jia Yuehan the students his lover's heart is so great, is that people can not DD ". [30]
① see Mabo Ying, Gao Xi, Hong Zhongli: << foreign medical history of cultural exchange - China Medical cross-cultural Chuan >> Wenhui Publishing House, 1993 edition, Gu sound the: << missionaries and Modern China >> Shanghai People's Press, 1981 edition, Stuart >> << Morrison, Shanghai People's Publishing House, 1985 edition, care for the people: << Christianity and modern Chinese society >> Shanghai People's Publishing House, 1996 edition.

② Jia Yuehan, (John G.Kerr ,1824-1901), American Presbyterian Medical Missionary ,1853-1901 missionary to practice medicine in Guangzhou, is a pioneer in the spread of Western medicine in China.

(3) See << Wan Guo >> vol.383, 1876,4,15, vol.577, 1880,5,15, vol.611, 1880,10,23,1890,9 Taiwan Chinese Book copy of the 1968.

④ Wenyon. China Medical Missionary Journal, Dec, 1891, p. 225; April 20th, 1892, p. 135 reposted elsewhere in the Research Papers Download

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