120th Anniversary of Yale-China: Pioneering Equal Partnership in Medicine

AURELIA DOCHNAL chronicles medical partnerships pioneered by the Yale-China Association, as part of a feature series on the organization.

Two figures in the history of the Yale-China Association, Dr. Edward Hume M.D. and Dr. Yan Fuqing M.D., exemplify the organization’s long-time spirit of equal Chinese-American partnership. These two medical doctors, both Yale-educated, worked together to establish a modern medical practice in Changsha, the first of its kind in central China. 

Yale-China’s early medical work was led by Edward Hume, M.D., Yale class of 1897. Dr. Hume came to Changsha with dreams of opening a modern medical college and hospital in China. The early stages posed numerous challenges: the hospital formally opened its doors in 1906 in a renovated inn in the center of the city. One of the greatest challenges lay in many of the clinic’s patients’ deeply held beliefs about traditional healing practices. Hume, acutely aware of the importance of the Chinese medical tradition, wrote in his memoir documenting 20 years of his experiences establishing western medicine in China, about the various superstitions he worked to overcome and the trust he built with locals, often through his excellent command of the Chinese language. He vividly described the elation his clinic felt when a high-ranking official decided to visit, only to have him promptly burst into a rage because Hume had taken his pulse on only one wrist instead of the traditional Chinese practice of taking both wrists’ pulses. Anxious not to lose even more credibility, Hume had to reluctantly send seriously ill patients home in case complications were further blamed on the “foreign clinic.”

Nina Gage, Yale graduate and pioneer of nursing in China, and Edward Hume (second and third from left) conducting their first surgical operation. Source: Centennial History

In 1910, an immensely important figure for the progression and history of the hospital and medical college arrived at the clinic: Dr. Yan Fuqing M.D., also known as Fu-chun Yen, the first Chinese graduate of the Yale School of Medicine. Yan’s medical expertise and diplomatic skills proved crucial for the acceptance of the clinic in Changsha. In a notable break from customary practice at foreign institutions in China, Yan was hired on equal terms with his American counterparts, an early affirmation of Yale-in-China’s commitment to equal Chinese-American partnership, and Yan and Hume became close friends and colleagues. 

Dr. Yan Fuqing (1882-1970). Source: Xiangya website (https://www.xiangya.com.cn/english/Content.aspx?chn=2327&id=24112)

Surgery and public health were at the time the greatest innovations that western medicine could bring to China, but it could not compete with traditional Chinese practices in every area, as Hume soon discovered. For instance, in one diagnosis, Hume had concluded that a pregnant woman would die unless she ended the pregnancy, but a famous Chinese doctor was able to save both her and her child; Hume never did learn what herbal remedy the doctor had prescribed.

Setting out to build a fully modern hospital, Hume managed to secure funding from the millionaire and Yale benefactor Edward Harkness in 1912. With the dream in reach, Yan’s diplomatic skills proved essential to brokering the “Xiang-Ya (or Hunan-Yale) Agreement” in 1914. This important agreement secured official government support for the Xiangya Hospital, Medical College, and the new School of Nursing (founded in 1911), including land and construction. One innovation agreed to was that leadership of the venture would in time shift to local Chinese control, a landmark achievement that was completed by the 1920s. 

Representatives of the two parties to the innovative Xiang-Ya Agreement (1914): Drs. Yan and Hume (first and second from right) representing Yale-in-China, with officials from the Hunan government.

The Xiangya Medical College was inaugurated in 1914, and Dr. Yan served as its first Dean. The 180-bed Xiangya Hospital’s construction was completed in 1918. In the 1920s, enormous political unrest caused by growing nationalism and anger with foreign “cultural imperialism,” and other antiforeign movements made it increasingly difficult for foreign institutions to continue teaching. As strikes became more violent, in 1926 the Yale-in-China institutions closed down. While many feared the violence might mark the end of Yale-in-China, the organization survived the 1926-1927 crisis and resumed work the next year.

Dr. Yan Fuqing departed for his birthplace Shanghai, where he went on to found the National Shanghai Medical College, now known as the Medical College at Fudan University, one of the top medical schools in China. He also served as Minister of Health in the 1930s under the Nationalist government. 

Dr. Hume and Dr. Yan’s “partnership as co-equals” was very unusual for its day. Hume was ahead of his time in respecting Chinese partners as equals and valued professionals and contributors to the “Yale-China experiment.” Dr. Yan’s expertise and unique background proved invaluable to the creation of the Xiangya Hospital, School of Nursing, and Medical College, institutions still renowned in China to this day. 

In collaboration with the Yale-China Association, China Hands Magazine is returning to our Yale roots to explore the complex, impressive, and often dramatic history of the organization. In this second article we have looked back on Yale-China’s pioneering of equal partnerships in medicine. This year marks its 120th anniversary, and we will be sharing weekly articles largely sourced from Nancy E. Chapman and Jessica C. Plumb’s The Yale-China Association: A Centennial History and books by Yale-China authors like Dr. Edward Hume’s Doctor’s East, Doctors West, about notable themes, figures, and events from the organization’s rich past. We invite you to follow along via Yale-China’s Instagram page

Aurelia Dochnal can be contacted at aurelia.dochnal@yale.edu. Aurelia is a student at Yale and history researcher at the Yale-China Association. She is an editor at China Hands, and is leading the Yale-China History Project to examine Yale’s long history of collaboration with China and to celebrate the organization’s 120th anniversary this year.

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