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5-2020

Imperial Professionals: American Protestant Female Medical Missionaries to China, 1880-1930

Yutong Zhan William & Mary

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Recommended Citation Zhan, Yutong, "Imperial Professionals: American Protestant Female Medical Missionaries to China, 1880-1930" (2020). Undergraduate Honors Theses. Paper 1530. https://scholarworks.wm.edu/honorstheses/1530

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Imperial Professionals: American Protestant Female Medical Missionaries to China, 1880-1930

A thesis submitted in partial fulfillment of the requirement for the degree of Bachelor of Arts in History from The College of William and Mary

by

Yutong Zhan

Accepted for Highest Honors (Honors, High Honors, Highest Honors)

Adrienne Petty, Director

Joshua Hubbard

Leisa Meyer

Williamsburg, VA May 1, 2020 Table of Contents

Acknowledgements ……………………………………………………………………………...2

Illustrations ………………………………………………………………………………………3

Introduction………………………………………………………………………………………5

Chapter I. “The Benefit of [...] the Western World”: Female Medical Missionaries and the Motivations for Missions ……………………………...19

Chapter II. “Something That One Knows She Has Time and Ability to Do”: Professionalism in Female Medical Missionary Work ……………………………………...... 37

Chapter III. “The Chronic Discouragement of Trying, and Failing”: Cultural Negotiation and the Limits of Cultural Imperialism…………………………………. 64

Chapter IV. “A Physician Can Not Do It All”: Female Medical Missionaries and the Contradictions in Christian Missions ………………….89

Conclusion ………………………………………………………………………………….… 110

Bibliography…………………………………………………………………………………... 114

Acknowledgements

The guidance and support of my wonderful professors, friends, and family made the completion of this thesis possible. First, I would like to thank my thesis advisor, Professor Adrienne Petty, for her incredible dedication at every stage of the project. Her advice is instrumental for the development of this project and her constant encouragement helped me get through the long archival research and writing process. I would also like to thank Professor Joshua Hubbard and Professor Leisa Meyer for serving on my committee and offering their inspiring insights. My friends also helped me in many ways during the past year. Their kind offering of lodgings made it possible for me to have extended archival visits during the summer. Their keen interest in my project and constant inquiries also motivated me to work hard on my research and writing. I am also grateful for my parents’ unwavering support for my aspiration to be a historian. They made my archival search in Fuzhou go more smoothly by putting me in touch with professors and staff at the archives. My mother, who volunteered to join me during my archival research in Fuzhou, also contributed to the Chinese-language source base that my project drew from. Finally, I want to give credit to the global pandemic we are living through right now. All the moments of uncertainty and anxiety I experienced due to COVID-19 made me realize how precious it is to be able to sit down and write. The changes associated with this pandemic also pushed me to work on this project in a way that I would never have imagined being possible. So, I would like to acknowledge the new appreciation that COVID-19 brought me during the course of this project.

2

Figure 1 Map of the Foochow Mission, Province of Fuh-Kien, China (1905). From Rev. C. C. Baldwin, D. D., The Foochow Mission, 1847-1905: A Condensed Sketch (Boston: 1905). Courtesy of Yale University Divinity School Special Collections.

3

Figure 2 Methodist Episcopal Church in China (1939). From Seventieth Anniversary General Executive of the Woman’s Foreign Missionary Society Methodist (Episcopal) Church, 1869- 1939. Courtesy of the United Methodist Archives and History Center, Madison, New Jersey.

4 Introduction

“The medical profession offers many rewards to the young women of to-day,” Dr. Pauline

Root, an American Congregationalist missionary to India, wrote in the mission magazine, “not in money… but in love and esteem when they reap a hundred folds.”1 Offering a glimpse of the fulfillment female medical missionary work could bring, Root continued, “Beside the leper, they tell of a land where there will be no more sickness and no outcasts; tenderly dressing the sore aching body of the little child dying with smallpox, they win the love of the patient, sad-eyed mother.”2 She then appealed to readers to join the medical mission, asking, “What women are wanted for this work? Careless, materialistic, worldly doctors? No! But the cheerful, thoroughly in earnest Christian girl, trained mentally, and strong physically, with a courageous and sympathetic heart? Yes! We want her.”3 Root then added, “You need thorough medical training and a hospital year. And while you are studying—for you are not ignorant of Satan’s devices— you should know the missionary ladies.”4

Referring to both the spiritual influences and necessary medical qualifications, Root pointed to the two aspects that were intimately linked to female medical missionaries in the late nineteenth century—their role as ambassadors of cultural imperialism and as emissaries of medical professionalism. To examine the importance of female medical missionaries’ double-sided role, this thesis focuses on the transnational experiences of American female medical missionaries to

Foochow, China from the 1880s to the 1920s. By analyzing missionaries’ writings, this thesis

1 Pauline Root, “Young Women as Medical Missionaries,” Medical Missionary Record, 9:6 (June 1894), 133. The physical copy of this document is located at Archives and Special Collections, Drexel University College of Medicine, Philadelphia, Pennsylvania. 2 Ibid., 133, 134. 3 Ibid., 134. 4 Ibid.

5 argues that female medical missionaries played an equally important role in their capacity as medical professionals. Aiming to convert people in foreign lands to both evangelical culture and western medical approaches, female medical missionaries constituted a distinctive group of transnational professional women in the late nineteenth and early twentieth centuries.

More specifically, this thesis pays special attention to female medical missionaries’ professional role, that is, their role as physicians, and how professionalism impacted their work.

Few historians have systematically examined female medical missionaries and their role as medical professionals in an international context. However, historians have written quite extensively in two related topics: women in Christian missions and women in the medical profession in the United States. Since the 1970s, the call for situating women at the center of religious history has drawn scholarly attention to female missionaries and their role in the spread of Christianity and American culture. 5 In the expanding field of women in Christian world missions, historians have started to devote more attention to female medical missionaries as a distinctive group in woman’s missions. Among the earliest works is Sara Tucker’s article, “A

Mission for Change in China: The Hackett Women’s Medical Center of Canton, China, 1900-

1930,” in which she traces the development of Hackett Women’s Medical Center, a female medical educational institution for Chinese women.6 Tucker argues that the separate female institution

5 For a more comprehensive overview of American Protestant women in world mission, see Barbara Reeves- Ellington, “Woman, Protestant Missions, and American Cultural Expansion, 1800 to 1938: A Historiographical Sketch,” Social Sciences and Missions, 24, No.2-3 (2011): 190-206, DOI 10.1163/187489411X587070. For more details on American woman’s missionary movement, see, for example, Dana L. Robert, American Women in Mission: A Social History of the Thought and Practice (Macon.: Mercer University Press, 1998); Patricia R. Hill, The World Their Household: The American Woman’s Foreign Mission Movement and Cultural Transformation, 1870-1920 (Ann Arbor: University of Michigan Press, 1985); R. Pierce Beaver, American Protestant Women in World Mission: A History of the First Feminist Movement in North America, (Grand Rapids.: WB Eerdmans Publishing Company, 1980). 6 Sara W. Tucker, “A Mission for Chang in China: The Hackett Women’s Medical Center of Canton, China, 1900- 1930,”in Women’s Work for Women: Missionaries and Social Change in Asia, ed. Leslie A. Flemming (Boulder: Westview Press, 1989), 137-157.

6 offered both Chinese and Western women a chance to carry out the more public-oriented medical work within a traditionally acceptable framework in the early years of the institution’s establishment; growing unafraid of the mixed-sex world, these women obtained personal success in their work which contributed to the decline and the eventual disappearance of this institution.7

With a similar focus on the Hackett Medical Complex, Shing-ting Lin in her dissertation, “The

Female Hand: The Making of Western Medicine for Women in China, 1880s–1920s,” examines the transmission and professionalization of Western medicine in China.8 Lin argues that through

“the technical dimension of social practice of medicine daily practices” including textual materials, gendered clinical practice, female missionary doctors’ work facilitated the professionalization of

Western woman’s medicine in China.9

Other scholars have focused on Presbyterian female missionary physicians and their work overseas. Inspired by the section of Canadian Presbyterian women physicians in Ruth Brouwer’s work, Kristin Gleeson in her dissertation, “Healer’s Abroad: Presbyterian Woman Physicians in the Foreign Mission Field,” surveys Presbyterian woman doctors in foreign missions.10 She argues that female medical missionaries, due to their greater interactions with people in different societies and their cultural sensitivity, became the “cultural brokers” and contributed to the shaping of medical missions and the greater social mission effort.11 However, based on the assumption that female medical missionaries were more inclined to perceive themselves as “nurturing physicians

7 Ibid., 137, 154. 8 Shing-ting Lin, “The Female Hand: The Making of Western Medicine for Women in China, 1880s – 1920s” (PhD diss., Columbia University, 2015), https://doi.org/10.7916/D80864TG. 9 Ibid., “Abstract,” 203. 10 See Ruth C. Brouwer, New Women for God: Canadian Presbyterian Women and India Missions, 1876-1914 (Toronto: University of Buffalo Press, 1990); Kristin L. Gleeson, “Healer’s Abroad: Presbyterian Woman Physicians in the Foreign Mission Field” (PhD diss., Temple University, 1996), https://proxy.wm.edu/login?url=https://search.proquest.com/docview/304267793?accountid=15053. 11 Gleeson, “Healer’s Abroad,” xxii.

7 rather than feminist professionals,” Gleeson downplays these women’s role as professionals.12

Writing under the influence of post-colonial studies, Brouwer in her later book, Modern Women

Modernizing Men: The Changing Missions of Three Professional Women in Asia and Africa, 1902-

69, details the experiences of three professional Canadian Presbyterian women—two of them medical missionaries—and their changing views of gender in relation to their profession, indicating the liminality of interwar missionary enterprise.13 In her book, Brouwer focuses more on these women’s administrative responsibilities and contributions to the development of mission than on their medical work, which makes her work fall short in accessing the important implications of medical professionalism in Protestant missions.

A detailed analysis of various denominations’ female medical missions in China, Hsiu- yun Wang’s dissertation, “Stranger Bodies: Women, Gender, and Missionary Medicine in China,

1870s – 1930s,” examines the gender politics in medical encounters between female medical missionaries and Chinese people.14 Wang argues that health care and gender remained central in both Chinese and Westerners’ efforts to change China at the turn of the twentieth century.15 Wang shows how gender politics contingent upon class and social status played out in medical encounters, and illuminates the critical ways in which mission-trained Chinese female doctors elaborated on their own conceptualization of New Woman in modernizing China.16 While Wang discusses the professional identity of female medical missionaries and investigates the prospect of empowerment and professional opportunities, she does not examine this aspect beyond

12 Ibid., xxv. 13 Ruth C. Brouwer, Modern Women Modernizing Men: The Changing Missions of Three Professional Women in Asia and Africa, 1902-69 (Vancouver: UBC Press, 2002), 120. 14 Hsiu-yun Wang, “Stranger Bodies: Women, Gender, and Missionary Medicine in China, 1870s – 1930s” (PhD diss., University of Wisconsin-Madison, 2003), https://proxy.wm.edu/login?url=https://search.proquest.com/docview/305298305?accountid=15053. 15 Ibid., 1. 16 Ibid., 128-129, 161.

8 missionaries’ motivations and left these missionaries’ professional role in their day-to-day work unexplored. Therefore, as historians of Christian woman’s missions gradually turn their attention to female medical missionaries, the importance of professionalism in female medical missions remains understudied. Overlooking the professional aspect of the work, historians lose a valuable perspective to examine different forms of transnational experiences.

On the other hand, in the historiography of women in the medical profession, female medical missionaries occupy a rather marginal position. Historians of women’s history have been examining American women’s entry into the medical profession in the late nineteenth century and the gender barriers that they had faced in the process.17 One of the most significant works in this field is Regina Markell Morantz-Sanchez’s book, Sympathy and Science: Women Physicians and

American Medicine.18 In her work, Morantz-Sanchez traces American women’s struggles for obtaining medical education and career in the professionalizing field of medicine from the colonial era to the early twentieth century.19 Writing from a feminist perspective, Morantz-Sanchez argues that the tension between sympathy and science was an ongoing theme that structured medical women’s struggle; while most medical women in the late nineteenth and early twentieth centuries believed that they could achieve both, they had limited success in achieving their goals and later

17 For works on women and American medical profession, see Ellen Singer More, Restoring the Balance: Women Physicians and the Profession of Medicine, 1850-1995 (Cambridge.: Harvard University Press, 1999); Judith Walzer Leavitt, ed., Women and Health in America: Historical Readings (Madison: University of Wisconsin Press, 1999); History of Women in the United States: Historical Articles on Women’s Lives and Activities, ed., Nancy F. Cott, vol.11, History of Women in the United States: Historical Articles on Women’s Lives and Activities (Munich: KG Saur, 1993); Gloria Moldow, Women Doctors in Gilded-Age Washington: Race Gender, and Professionalization (Champaign: University of Illinois Press, 1987); Regina Markell Morantz-Sanchez, Sympathy and Science: Women Physicians and American Medicine (New York: Oxford University Press, 1985); Mary Roth Walsh, “Doctors Wanted: No Women Need Apply”: Sexual Barriers in the Medical Profession (New Haven: Yale University Press, 1977). 18 Regina Markell Morantz-Sanchez, Sympathy and Science: Women Physicians and American Medicine (New York: Oxford University Press, 1985). 19 Ibid., 3.

9 moved away from the “distinct female vision” in the male-dominant profession.20 While Morantz-

Sanchez presents a comprehensive analysis of the history of American women in the medical profession, she pays little attention to female medical missionaries. With only a brief discussion of Emmeline Cleveland, a medical missionary, and Mary T. Greene, a health reformer who endorsed Christian mission, as examples of medical women who pursued both a medical career and reform society, Morantz-Sanchez left the professional career of female medical missionaries unexplored.21 In other works about American women in the medical profession, historians rarely offer details about female medical missionaries and marginalize these missionaries in their analysis of professional women. This omission might be a result of the perceived incompatibility between religion and science that blinds historians from examining Christian missions. It might also result from the equally, if not more, important evangelical role of female medical missionaries that deflects historians’ attention from their professional roles. Marginalizing female medical missionaries in their analyses, historians overlook a group of historical actors whose experiences could contribute new understandings to the history of American women in the medical profession.

This thesis thus attempts to address this gap in scholarship by incorporating professionalism as a critical component of female medical missions. I define professionalism as the practice of exercising power based on competence in specialized knowledge.22 As physicians,

20 Ibid., 5-6. 21 Ibid., 102, 104. 22 Sociologists have not reached a consensus on the definition of professionalism. My definition draws insights from both Eliot Friedson’s and Terence Johnson’s analyses. As Friedson points out, professions can be “defined by reference to a particular kind of training and skill” and profession “constitutes the most useful source for identifying the agents of formal knowledge” (16,24). Johnson contends that professionalism is a “particular type of occupational control” which is one of the “institutionalized forms of control” that is partly in response to the changing power relations (45). For more discussion of defining professionalism, see, for example, Eliot L. Friedson, Professional Powers: A Study of the Institutionalization of Formal Knowledge (Chicago: University of Chicago Press, 1988); B. J. Bledstein, The Culture of Professionalism (New York: W. W. Norton & Co., 1976); Terence Johnson, Professions and Power (London and Basingstoke: The McMillan Press, 1972); Philip Elliott, The Sociology of the Professions (London and Basingstoke: The McMillan Press, 1972).

10 female medical missionaries drew their authority from their medical skills and their interaction with Chinese patients could be viewed in light of the power relation between trained physicians and their patients and the contention between different medical approaches. Focusing on female medical missionaries’ role as medical professionals contributes a transnational perspective to examining female physicians’ elaboration on professionalism and sheds light on professionalism as a critical aspect of the international dimension of women’s history.

Moreover, in their medical work, female medical missionaries channeled cultural influences through their medical expertise. The medical encounters between female medical missionaries and Chinese people constituted a site of cultural interaction and contributed unique insights to American cultural imperialism. Many scholars of Christian missions have discussed and questioned the concept of cultural imperialism.23 Arthur Schlesinger Jr. was first to draw attention to the relationship between Christian missions and cultural imperialism.24 He argues that the American Protestant missionary enterprise shared the expansionist impulse of the West and constituted an important element of the cultural interpretation of imperialism.25 Building upon

Schlesinger’s argument, Paul Harris distinguishes between the functional and structural ties between mission and imperialism, and further affirms the structurally imperialist nature of the

Christian mission and the usefulness of cultural imperialism as an analytical category.26 In contrast,

Ryan Dunch uses the examples of Protestant missions to China to demonstrate the deficiency of

23 For more detailed overview of the scholarly debates over cultural imperialism, see Connie Shemo, “Directions in Scholarship on American Women and Protestant Foreign Mission: Debates Over ‘Cultural Imperialism’,” History Compass 10/3 (March 2012): 270-283, DOI: 10.1111/j.1478-0542.2012.00831.x. 24 Arthur Schlesinger Jr. “The Missionary Enterprise and Theories of Imperialism,” in The Missionary Enterprise in China and America, ed. John K. Fairbank (Cambridge: Harvard University Press, 1974) 25 Ibid.,336, 337, 373. 26 Paul W. Harris, “Cultural Imperialism and American Protestant Missionaries: Collaboration and Dependency in Mid-Nineteenth-Century China,” Pacific Historical Review, vol.60, no. 3 (August 1991): 312, 316, DOI: 10.2307/364045.

11 the concept of cultural imperialism, which assumes a dichotomy between the “actor and the acted upon” and reduces the complexity in the interactions.27 Bringing women into the discussion of imperialism, Carol Chin characterizes American female missionaries as “beneficent imperialists” who imposed American culture on Chinese society and internalized their privileged position backed by American imperial expansion.28

Using the theoretical framework of empire and imperialism, a growing body of scholarship has focused on the experiences of American female missionaries abroad and their interactions with local politics and cultures. Jane Hunter, in her pioneering work, The Gospel of Gentility: American

Woman Missionaries in Turn-of-the-Century China, closely analyzes how the concept of evangelical woman’s sphere and the missionaries’ implicitly imperialist status played out in their interactions with Chinese people.29 Hunter argues that operating under the morally acceptable, conservative evangelical framework, foreign missions broadened the possibilities for American female missionaries, who exercised “unexpected authority” in creating and organizing the

“domestic empire.” 30 Scholars continue to employ diverse perspectives and methodology in exploring the wide-ranging activities and impact of American missionary women to Asia, Africa, and the Middle East.31 Capturing this development is the edited volume, Competing Kingdoms:

Women, Mission, Nation, and the American Protestant Empire, 1812-1960.32 This volume reflects

27 Ryan Dunch, “Beyond Cultural Imperialism: Cultural Theory, Christian Missions, and Global Modernity,” History and Theory, vol.41, no.3 (October 2002): 302, DOI: 10.1111/1468-2303.00208. 28 Carol C. Chin, “Beneficent Imperialists: American Women Missionaries in China at the Turn of The Twentieth Century," Diplomatic History, vol. 27, no. 3 (June 2003): 328, DOI: 10.1111/1467-7709.00356. 29 Jane Hunter, The Gospel of Gentility: American Women Missionaries in Turn-of-the-Century China (New Haven: Yale University Press, 1984). 30 Ibid., xvi, 128. 31 For works about Christian woman’s missions to China, see, for example, Connie A. Shemo, The Chinese Medical Ministries of Kang Cheng and Shi Meiyu, 1872-1937: On a Cross-Cultural Frontier of Gender, Race and Nation (Bethlehem: Lehigh University Press, 2011); Motoe Sasaki, Redemption and Revolution: American And Chinese New Women in The Early Twentieth Century (Ithaca: Cornell University Press, 2016). 32 Barbara Reeves-Ellington, Kathryn Kish Sklar, and Connie A. Shemo, eds., Competing Kingdoms: Women, Mission, Nation, and the American Protestant Empire, 1812-1960 (Durham: Duke University Press, 2010).

12 the transnational turn in American historiography and unites the articles about woman’s mission at home and abroad under the overarching framework of imperialism, offering an interdisciplinary perspective and a comprehensive synthesis of previous scholarship on American woman’s foreign mission. 33 Competing Kingdoms thus further illuminates the great potential in the study of

American women in foreign missions. In spite of these promising trends of development in the literature of women in missions, the relationship between female medical missionary work and

American cultural imperialism remains relatively understudied. While existing literature has sections about medical work as a component of female missionary work, few scholarly monographs have adequately addressed this relationship. Grouping female medical missionaries with other women missionaries makes us lose sight of the unique perspective that female medical missionary work contributed to the understandings of the non-unilateral trajectory of cultural imperialism.

Hence, this thesis uses female medical missionary work as a lens to explore the broader process of American cultural imperialism in China in the late nineteenth and early twentieth centuries. Using a transnational approach, this thesis also takes Chinese people’s responses into account and attempts to show the positive role of non-Westerners in cultural exchanges. I define cultural imperialism as the assertion and the attempted imposition of a perceived superior culture in conjunction with formal colonial aggression.34 As medical professionals, while female medical missionaries attempted to convert people to the western medical approach and Christianity, they were also converting people to a culture characterized by scientific rationality and evangelical

33 Ibid., 2. 34 Paul Harris defines cultural imperialism as “the active expression abroad of a culture that has been shaped by the experience of aggressive expansion and dominance.” My definition of cultural imperialism draws insights largely from Harris’s definition. At the same time, I consider the cultural hierarchy embedded in cultural imperialism and missionaries’ attempt to transform Chinese society important as well. I therefore modify Harris’s definition to incorporate these notions. See Paul Harris, “Cultural Imperialism and American Protestant Missionaries,” 311.

13 ideals. The rejections and negotiations that female medical missionaries experienced in their medical encounters with local people therefore helped reveal in a different yet concrete way of the non-unilateral trajectory of cultural imperialism.

Analyzing professionalism and cultural negotiations in female medical missionary work, this thesis addresses three main questions: What were the motivations of American female medical missionaries to join missions to China? How did they navigate through local cultures and channel their cultural influences through their medical work? How did the on-the-ground interactions, in turn, inform and challenge their original goals? To answer these questions, this thesis mainly relies on American missionaries’ writings including correspondence, reports, mission periodicals, and diaries. It should be noted that there are potential problems and advantages of using missionaries’ writings. Addressed mainly to the mission board with the mission’s expectations in mind, missionaries’ writings, especially their reports and published articles, might not be a fully truthful reflection of their day-to-day work; they might play up what the home audiences expected to read, that is, the successes of evangelical work, and downplay some of the obstacles and challenges they faced in the process. Although they might be biased in presenting their work, female medical missionaries included descriptions of the medical cases they treated, the challenges that they overcame, and the needs that they hoped the board could address. By reading against the grain, these sources still provide valuable insights into the life and work of female medical missionaries.

Looking at transnational cultural exchanges, this thesis also incorporates Chinese sources such as newspaper and mission board reports. However, the Chinese sources found in my research have very few references to medical missionary work, even fewer for female medical missionaries. As a result, Chinese sources are used, when possible, mainly for context. While Chinese sources are less fruitful in providing Chinese people’s perspectives on the missionary work, American female

14 medical missionaries’ writings indirectly offer Chinese responses through detailed descriptions of the medical encounters which, though with omission and biases, were helpful for reconstructing the two-way influences in missionaries’ interactions with local people.

In terms of the subject of the study, this thesis focuses on female medical missionaries from the Woman’s Board of Missions of American Board of Commissioners for Foreign Missions

(WBM), a Congregationalist mission, and Woman’s Foreign Missionary Society (WFMS), a

Methodist Episcopal mission, to Foochow (Fuzhou), China.35 As various American mission boards were operating in hundreds of different locations in China in the late nineteenth and early twentieth centuries and each mission had left a large volume of records, it is more reasonable to choose one region to examine in detail under the time constraint of this project. However, the choice of

Foochow is not simply for expediency. As historian Ryan Dunch points out, Foochow was “one of the earliest and in numerical terms more successful centers of Protestant missionary work in

China” but receives less scholarly attention than other regions in China.36 Foochow is located on the coast of southeastern China. It was, and continues to be, the “political, literary, and commercial center of the province.”37 In the late nineteenth century, Foochow was also significant for its interior, coastal, and foreign trade in “teas, opium, cotton and woolen goods, rice” and other commercial commodities.38 Foochow was most famous for its tea export, which, according to

ABCFM’s records, was four times that of Canton. 39 The Treaty of Nanjing in 1842 opened

35 A note to the names of places in the thesis: I retain the spellings that missionaries used in their writings instead of changing them to modern Pinyin to keep my quotes as close to the original forms of the sources as possible. 36 Ryan Dunch, Fuzhou Protestant and the Making of Modern China, 1857-1927 (New Haven: Yale University Press, 2001), xvii. 37 Rev. C. C. Baldwin, D. D., The Foochow Mission, 1847-1905: A Condensed Sketch (Boston: 1905), 4, Records of the American Board of Commissioners for Foreign Missions, Special Collections, Yale University Divinity School Library, New Haven, Connecticut (hereafter as YDS). 38 Ibid. 39 Ibid.

15 Foochow for foreign trade and Protestant missionaries started to reside in Foochow in January

1847.40 Due to Foochow’s status as a port city and its abundance of export, mission boards decided to set up mission stations in Foochow.41 There were three missions operated at the same time in the Foochow region: American Board of Commissioners for Foreign Missions, Methodist

Episcopal Church (North), and Church Missionary Society from London.42 A study of American missionaries, this thesis hence focuses on ABCFM and Methodist Episcopal Mission and their activities in Foochow and adjacent localities. This thesis also includes examples of missions other than Foochow to provide further context and points of comparison.

The chronological framework of this study is thus based on the development of female medical missions of these two boards in Foochow. The first female medical missionary to

Foochow was Dr. Sigourney Trask of WFMS who arrived in Foochow in 1874 and established

Liang-au Women’s and Children’s Hospital in 1877.43 The first female medical missionary of

ABCFM to Foochow was Kate Cecilia Woodhull, who arrived in 1884 and started a small hospital in 1886.44 In 1928, ABCFM’s Foochow Missionary Hospital merged with WMFM’s Magaw

Memorial Hospital into Foochow Christian Union Hospital and became the woman’s section of the hospital effective in 1929.45 In 1934, Kate C. Woodhull Hospital, the woman’s hospital of

40 Ellsworth Carlson, The Foochow Missionaries, 1847-1880 (Cambridge: Harvard University Press, 1974), 2, 4. 41 Fuzhou meiyimeihui nianshi (History of Foochow Methodist Episcopal Mission) (Foochow: Methodist Episopal Mission Press, 1932), 4, Special Collections, Institute of the History of Sino-Foreign Relations, Fujian Normal University, Fuzhou, China. 42 Dunch, Fuzhou Protestants, 3, 4. 43 “Chronological History of the Willis F. Pierce Memorial Hospital, Foochow Fukien, China,” box 13, folder 23, series III: The ABCFM Mission in Foochow, American Board of Commissioners for Foreign Missions (ABCFM), China Records, c.1816-1967, Special Collections, Andover-Harvard Theological Library, Harvard University, Cambridge, Massachusetts (hereafter as ABCFM-Andover). 44 Ibid. 45 Ibid.; Mary Isham, Valorous Ventures: A Record of Sixty and Six Years of Woman’s Foreign missionary Society, Methodist Episcopal Church (Boston: Methodist Episcopal Church, 1936), 230, Center for the History of Medicine, Francis A. Countway Library, Harvard University, Boston, Massachusetts.

16 ABCFM, was recognized as a branch institution of the Foochow Christian Union Hospital.46 The unification and the disintegration of independent Woman’s Board in 1927 and WFMS in 1939 undermined the autonomy of woman’s missionary work of both boards.47 Therefore, this thesis mainly examines the period from the 1880s to the end of the 1920s, the overlapping period of the relatively flourished and independent female medical missionary work of the two missions.

Female medical missionaries shared other female missionaries’ goal of evangelizing people in foreign lands and bringing western culture to “heathen” women. However, as medical professionals, the mission field had another special appeal to some of them. Chapter 1 examines the motivations of female medical missionaries: Why did American medical women choose to go on foreign missions? Why did they choose to go to China? Motivated by their religious callings and professional opportunities in the mission field, female medical missionaries shared the imperial assumption of cultural superiority and joined Christian missions to China intending to improve Chinese women’s lives through Christian conversion and scientific medical treatment.

Carrying with them the double-sided goal of the medical mission, female medical missionaries organized their work based on professional principles and used their professional skills to attend to Chinese women’s health. The missiology of “Woman’s Work for Woman” and the flexible context also offered them the opportunities to develop a form of medical professionalism that differed from that of their fellow medical women in the United States. Chapter 2 will focus on this

46 “Chronological History of the Willis F. Pierce Memorial Hospital, Foochow Fukien, China,” box 13, folder 23, ABCFM-Andover. 47 Fifty-Ninth Annual Report of the Woman’s Board of Missions, November 10-12, 1926, 17, ABCFM Woman’s Board of Missions Annual Reports, 1869-1926, American Board of Commissioners for Foreign Missions Archives, 1810-1961, ABC 1-91, 91.6, Houghton Library, Harvard University, Cambridge, Massachusetts (hereafter as ABCFM-Houghton); Year Book: Woman’s Foreign Missionary Society of the Methodist Episcopal Church Being the Seventieth Annual Report of the Society, Nineteen Thirty Nine, 1939, 96, folder Woman’s Foreign Missionary Society: Annual Report 1939, Records of the Women’s Division of the General Board of Global Ministries, United Methodist Church Archives–GCAH, Madison, New Jersey (hereafter as GCAH).

17 elaboration of professionalism in the transnational context of female medical missionary work. Far from being able to implement their goal at will, female medical missionaries faced challenges and

Chinese people’s rejection of both their cultural messages and medical approaches. Chapter 3 illuminates the non-unilateral trajectory of cultural imperialism by examining the negotiations between female medical missionaries and their Chinese patients. Chapter 4 grapples with the contradictions of female medical missionary work. As agents of cultural change, female medical missionaries and Christian missions were also changed by the on-the-ground needs and challenges in China. The chapters are followed by a brief conclusion that discusses the impact of female medical missionary work on the modernization of Foochow especially in medicine and the historical importance of female medical missionaries.

18 Chapter I “The Benefit of […] the Western World”: Female Medical Missionaries and the Motivations for Missions

In the early years of her childhood, Kate Cecilia Woodhull, a girl from Wading River, New

York, sometimes heard a whisper while reciting her prayers: “If God should call you to go to the heathen, are you willing to go?”48 At that time, Woodhull had little idea what that meant to her.

Born on July 24, 1842, Woodhull grew up with her parents, an elder sister, and a younger sister,

Hannah.49 She spent the “halcyon days” at the Ingham College in Le Roy, New York, and attended activities in a small foreign missionary society there.50 Her uneventful life took a sharp turn after she graduated from college. Her father and her elder sister passed away within a week, and several years later, so did her mother, leaving Woodhull and her younger sister alone in the world.51 After all these incidents, Woodhull “eagerly [took] up” medical study.52 She attended the Medical

College of New York Infirmary and, after graduation, worked as a house-physician in the Chicago

Foundling’s Home, where she took care of fifty to seventy-five babies every day.53 Returning from her two-year of study abroad—one in the University of Zurich in Switzerland and the other in

Dresden, Germany—she was occupied with her private medical practice and the low whisper in her childhood was buried in her busy life.54 However, when she was “well established in practice,”

48 Kate C. Woodhull, “Report of Hospital for Women and Children, Foochow City, 1901-1904” in Pagoda Bells: Report of Hospital for Women and Children 1901-1904 and A Brief Summary of Work for Women During 20 Years, Foochow City, China, 1904, 3, Historical Collections-Pamphlets, Andover-Harvard Theological Library, Harvard University, Cambridge, Massachusetts (hereafter as Andover). 49 Ibid.; Kate C. Woodhull, Memoranda, 1884, v.9, 136, Memoranda Concerning Missionaries, 1830-1924, ABCFM-Houghton, 77.2. 50 Woodhull, Pagoda Bells, 3. 51 Ibid., 4. 52 Ibid. 53 Ibid., 5; Woodhull, Memoranda. 54 Woodhull, Pagoda Bells, 5.

19 she heard the Master’s call again: “Lovest thou more than all this?”55 At the same time, her sister,

Hannah, also received the same message from God.56 The sisters then decided to answer the divine calling and set out for the Christian mission in the foreign land in 1884.57

In participating in the Foochow Mission, the Woodhull sisters joined a missionary movement meant to reach “heathen women” in seclusion and to open doors for the gospel. Since the 1860s, mission boards of mainline American Protestant denominations started to send out female medical missionaries, and the first American female medical missionary to China arrived in 1873. 58 Motivated by religious calling and potential professional opportunities, female physicians set out for medical missions to China. Some medical women joined the mission out of an evangelical impulse. Internal callings, family influences, and missions’ publicity prompted many to become missionaries. Others participated in woman’s missions out of professional considerations. As the opportunities for women the United States medical profession continued to decrease, foreign missions attracted some female physicians who sought potential professional opportunities. Setting out for missions, female medical missionaries also adopted widespread cultural imperialistic assumptions and aimed to transform local cultures through their medical work. Therefore, an evangelical impulse and professional opportunities presented by mission work motivated American female physicians to go to China and implement their vision of improving

Chinese women’s life through Christian conversion and scientific medical treatment.

The evangelical impulse was one of the factors that motivated female medical missionaries to join missions. Personal religious callings, family influences, and the publicity of missionary

55 Ibid., 5. 56 Ibid., 5, 6. 57 Ibid. 58 Wang, “Stranger Bodies,” 5-6.

20 societies all helped cultivated am interest in evangelism. For instance, Gertrude Taft, a medical missionary to Chinkiang, China, explained on her application form that feeling “called of God to be a missionary” led her to apply.59 Similarly, when asked for her reason for going to the mission field, Lora Dyer responded that it was the “consideration of the ‘next steps’ for a surrendered will,” suggesting the importance of Christian piety in influencing her decision.60 Although not a lot of female medical missionaries explicitly referred to their spiritual experience, Woodhull, Taft, and

Dyer’s words show that their spiritual knowledge and religious piety played an important role in motivating female physicians to become medical missionaries.

Additionally, religious influences from family appears to have been a more common factor that led American female physicians to evangelistic endeavors abroad. For example, the roll call of the Woman’s Foreign Missionary Society mentioned that Julia Sparr, a medical missionary to

Foochow and the daughter of a Methodist clergyman, lived a “singularly devoted life” in her childhood and “grew up with the thought of becoming [...] a missionary,” which came to fruition in 1878.61 Likewise, the story of Adoniram Judson’s three wives, one of whom was an intimate friend of her grandmother, raised Mary E. Carleton’s interests in missions when she was still a child.62 Due to such inspiration, Carleton joined the WFMS and became a medical missionary to

Mintsing in 1887.63 Other missionaries also confirmed their early interests in missions. In her application form, WBM medical missionary Minnie Stryker briefly stated that she had been

59 Gertrude Taft, Application Form, 1895, reel 66, folder 2230, Microfilm Edition of the Mission Biographical Reference Files,1880s-1969, GCAH. 60 Lora G. Dyer, “Life Memoranda for Newly Appointed Missionaries,” 1916, folder 15, Memoranda Concerning Missionaries, 1830-1924, ABCFM-Houghton, 77.2. 61 “Roll Call,” reel 64, folder 2156, Microfilm Edition of the Mission Biographical Reference Files, 1880s-1969, GCAH. 62 “Mission Career Ended by Death,”1927, box 35, folder 7, China Records Project, YDS. 63 Ibid.

21 interested in missionary work “since childhood.”64 Another WFMS roll call also noted that Mary

Ketring, a medical missionary to Chunking, China, always “held herself in readiness” for the call to mission because of the “impression from childhood that she should be a missionary.”65 Similar references to their interests in foreign missions during their childhood constantly appeared female medical missionaries application forms. These references therefore suggest that female medical missionaries’ long-existing interests in evangelism that influenced their decision to go on missions.

Moreover, the publicity of church and mission-related societies attracted some female physicians to foreign missions. One of the main venues was the Student Volunteer Movement

(SVM) for Foreign Missions. Founded in 1886, the SVM was an organization for recruiting

American college students for foreign missions.66 As historian Ben Harder argues, the SVM kindled students’ missionary zeal and contributed a significant force to foreign missions before its decline in the 1920s.67 Indeed, many female medical missionaries, such as Lora Dyer and Clara

Shepherd of the Foochow Mission and Shaowu Mission, were student volunteers themselves.68

Other female medical missionaries also came to know about foreign missions through the SVM.

When attending an SVM meeting, Luella Masters’s thought “turned to the idea of becoming a medical missionary” and she eventually became a missionary to Foochow.69 For Rena Spathelf, besides her childhood longings for missionary work, student volunteer groups also brought her

64 Minnie Stryker, Application Form, 1908, reel 66, folder 2209, Microfilm Edition of the Mission Biographical Reference Files, 1880s-1969, GCAH. 65 Louise Manning Hodgkins, The Roll Call, 1896, reel 46, folder 1374, Microfilm Edition of the Mission Biographical Reference Files, 1880s-1969, GCAH. 66 Ben Harder, “The Student Volunteer Movement for Foreign Missions and Its Contribution to Overall Missionary Service,” Christian Higher Education v.10, no.2 (April-June 2011): 140, DOI: 10.1080/15363751003733026. 67 Ibid. 68 Lora G. Dyer, “Life Memoranda for Newly Appointed Missionaries,” 1916, folder 15, Memoranda Concerning Missionaries, 1830-1924, ABCFM-Houghton, 77.2.; Clara Sargent Shepherd and George W. Shepherd, “Yours in the Bond of Love,” 1965, 3, box 316, folder 1, China Records Project, YDS. 69 Roll Call, 1869-1896, reel 51, folder 1623, Microfilm Edition of the Mission Biographical Reference Files, 1880s- 1969, GCAH.

22 closer to foreign missions.70 In addition to the SVM, mission-related publicity such as the appeals from the returned medical missionaries, the accidental encounter with a missionary leaflet on the train, the conventions, all prompted to American female medical missionaries to participate evangelistic efforts abroad. 71 Female medical missionaries’ involvement in mission-related organizations and these organizations’ impact on them both indicated the importance of the religious impulse in influencing their decision to join foreign missions.

Some might question the sincerity of female medical missionaries in terms of their religious fervor, but this should not be of major concern. Admittedly, since female medical missionaries rarely discussed their motivations other than on the application forms, they might have written their evangelical zeal to please the mission board. However, the very fact that they chose to join the mission suggests that they at least acknowledged and accepted the basic evangelical underpinnings of the mission. Some female medical missionaries chose to study medicine, because of their hope to respond to the needs of foreign missions.72 The questions on the application forms ensured that candidates shared the missions’ evangelical impulse. For instance, WFMS’s application forms of 1916 inquired candidates’ faith by asking questions such as “Do you trust that you are inwardly moved by the Holy Ghost to take upon you the work of a foreign missionary?

70 Rena Spathelf, Application Form, 1922, reel 64, folder 2156, Microfilm Edition of the Mission Biographical Reference Files, 1880s-1969, GCAH. 71 Florence P. Gebhart, “Life Memoranda for Newly Appointed Missionaries,” 1920, folder 15, Memoranda Concerning Missionaries, 1830-1924, ABCFM-Houghton, 77.2; “Missionaries of the Des Moines Branch, Agnes Edmonds, M.D.,” 1902, 109, reel 33, folder 854, Microfilm Edition of the Mission Biographical Reference Files, 1880s-1969, GCAH; Rena Spathelf, Application Form, 1922, reel 64, folder 2156, Microfilm Edition of the Mission Biographical Reference Files, 1880s-1969, GCAH. 72 For instance, Clara Shepherd mentioned in her memoir that she always wanted to be a missionary, but she was too young to be one when she graduated from college. Therefore, upon the suggestion of her teacher, she took pre-med courses and later became a physician. See Shepherd and Shepherd, “Yours in the Bonds of Love,”1965, chapter 1, box 316, folder 1, China Records Project, YDS.

23 What reason have you for so believing?”73 The mission further required candidates to answer these questions in detail on a separate sheet.74 Moreover, it is hard to imagine anyone abandoning the relatively more comfortable life in the United States to live somewhere materially worse without any evangelical impulse. And, as Gleeson mentions, female medical missionaries on average served a longer term than other female missionaries, which also suggests the religious impulse that motivated them throughout their missionary career.75 Hence, an evangelical impulse, more or less, figured into female medical missionaries’ decision to join foreign missions.

On June 2, 1884, Woodhull received the appointment to the Foochow Station.76 “God grant that this action of the Board may result in labors which shall bear fruit to his honor and glory,”

Woodhull wrote in her letter to the American Board.77 The evangelical impulses brought some

American female physicians to the foreign mission enterprise, but the destination—China—was not in most of these women’s original consideration. Neither the WBM nor the WFMS inquired about the candidates’ intended stations on the application forms, which suggested that the destination was not the main consideration for missionary applicants.78 Even if one had a place in mind, the final destination was subject to the board’s decision. For example, Agnes Edmonds expressed an interest in joining medical missions because of the need for female physicians in

India, but eventually, she became a doctor in China.79

73 “Woman’s Foreign Missionary Society of the Methodist Episcopal Church, Candidate Blank: Application,” September 1916, reel 48, folder 1441, Microfilm Edition of the Mission Biographical Reference Files, 1880s-1969, GCAH. 74 Ibid. 75 Gleeson, “Healer’s Abroad,” 224. 76 Kate C. Woodhull to Dr.Clark, 2 June 1884, Foochow Mission v.4, reel 236, ABCFM-Houghton, 16.3.5. 77 Ibid. 78 See, for example, Memoranda Concerning Missionaries, 1830-1924, ABCFM-Houghton, 77.2 79 J. Gasser, Obituary of Dr. Agnes Edmonds, n.d., reel 33, folder 854, Microfilm Edition of the Mission Biographical Reference Files, 1880s-1969, GCAH.

24 Despite the lack of preference for a certain locality among most female medical missionaries, several female missionary physicians recalled that their early experiences had informed their decision to go to China. The encounter with Chinese people inspired Frances L.

Draper to join the Hinghwa Mission.80 When she was twenty, Draper fell ill and went to the Pacific

Coast for recovery.81 There, she became “interested in the Chinese people” and “made a covenant that if she recovered her health, she would devote her life to them.”82 Clara Shepherd also related her connections with China in her memoir. Shepherd entered the pre-med course at the University of Michigan and there she met a young Chinese girl.83 Being in the same medical sorority,

Shepherd built up her friendship with this girl, which “intensified [her] interest in China.”84 When the Young Women Christian Association asked Shepherd if she was willing to work with the

Christian National Council for Health Education in China, she gladly took it up and later joined the Shaowu Mission.85 Similarly, in the early twentieth century, Ruth V. Hemenway, a medical student then, ran into an evening study of a church in which a Chinese woman physician, Mary

Stone, told the audience about China’s needs of medical care.86 The terrible medical conditions in

China shocked Hemenway.87 “Before Dr. Stone was through talking,” Hemenway recalled, “I knew I would give my strength and knowledge to medical work in China.”88 She then joined

WFMS and devoted her life to the medical work in Mintsing and interior China through 1940.

80“In Memoriam,” in Official Reports for 1912 of the Hinghwa Conference of the Woman’s Foreign Missionary Society (Shanghai: Methodist Publishing House, 1912), i, Methodist Conference Journals, Drew University Methodist Library, Drew University, Madison, New Jersey (hereafter as Methodist Library). 81 Ibid. 82 Ibid. 83 Shepherd and Shepherd, “Yours in the Bonds of Love,”1965, 3, box 316, folder 1, China Records Project, YDS. 84 Ibid. 85 Ibid.,5. 86 Ruth V. Hemenway, A Memoir of Revolutionary China, 1924-1941, ed. Fred W. Drake (Amherst: University of Massachusetts Press, 1977), 9, 11, 14. 87 Ibid., 14. 88 Ibid.

25 Admittedly, written retrospectively, these writings might have over-stated the importance of some of these encounters. Nevertheless, these accounts reflected the impact of various encounters with

Chinese people on different occasions on some of the female physicians’ decision to go to China as missionaries.

Preparing for her work in Foochow, in 1884, Woodhull addressed her concerns about the medical practices at the Foochow Station. “This is not because I want to have my own way or am anxious to carry out any theories of my own,” Woodhull wrote, “It is because I want to do my best for those who look to me for the relief of suffering […].”89 She continued, “[I] think the Chinese should have the benefit of reformed medicine.”90 Woodhull’s words illustrate the importance of medicine in her sense of mission to Chinese people. Indeed, in addition to the evangelical impulse and for some, special interests in China and Chinese people, medical work figured significantly into female missionary physicians’ sense of mission and their decision to join the mission. In the late nineteenth century, the medical need of people in foreign lands motivated female physicians to join foreign missions. Ellen M. Lyon, being “continually impressed that it was the women of pagan lands whose need was the greatest,” eventually decided to go on the mission, despite being

“greatly interested in the educational and medical work of her own country.” 91 As Lyon’s experience suggested, the spiritual and physical well-being of Chinese people was central to female medical missionaries’ consideration for participating in medical missions.

However, with a closer look at the correspondence and mission publications, the potential professional opportunities also incentivized some American female physicians to become female

89 Kate C. Woodhull to Dr. Clark, 11 August 1884, Foochow Mission v.4, reel 236, ABCFM-Houghton, 16.3.5. 90 Ibid. 91 “Miss Ellen M. Lyon (M.D.),” in Roll Call, n.d., reel 49, folder 1541, Microfilm Edition of the Mission Biographical Reference Files, 1880s-1969, GCAH.

26 medical missionaries, especially in the early twentieth century. In the late nineteenth century, the majority of the female medical missionaries had established themselves as physicians or surgeons and practiced medicine in the United States before they set out for missions. Missionaries like

Woodhull had to give up the medical practice at home, for which she had a hard time securing a successor.92 At the end of the nineteenth century, this condition seemed to change. Although none of the candidates explicitly stated their motivations concerning the expanded professional opportunities in the mission field, missionaries’ writings provide some hints about this underlying incentive. The short biography of Lucy P. Bement, a medical missionary to Shaowu, showed this additional motivation. As the pamphlet described, after Bement graduated from the Medical

College at Baltimore, “Where should she practice? In this country, there is one doctor for every six hundred people.”93 And then the call for medical missionaries came—“What could she do but go?”94 Here, the question of where to practice implied the overcrowding in the medical profession in the United States and the opportunity for practicing medicine through medical missions. A later pamphlet about Bement also stated that “it is hard to realize in crowded America, […] where competition is so intense, and the contention for opportunity so fierce, that anyone could be quite so sorely needed as was Dr. Bement.”95 This pamphlet further revealed the increasing competition in the U.S. medical profession that might have prompted some women physicians to seek mission as an option for career advancement.

92 Kate C. Woodhull to Dr. Clark, 11 August 1884, Foochow Mission v.4, reel 236, ABCFM-Houghton, 16.3.5. 93 Lucy P. Bement: Medical Work, Shaowu, China, 1898, 1922, box 8, folder 5, Biographical Collection, ABCFM- Houghton, 77.1. 94 Ibid. 95 Mrs. Ozora S. Davis, Moving Pictures of the Doctor’s Compound: Dr. Lucy Bement, 1916, box 8, folder 5, Biographical Collection, ABCFM-Houghton, 77.1.

27 Similarly, when Minnie Stryker requested to put off her departure for China, Frances E.

Goddard, the WFM medical missionary in Foochow, voiced her concerns.96 Goddard was worried that if Stryker did not go out sooner, then “there is [a] danger of losing her altogether” because “if she gets into medical work here in the States, she will become so interested that it would be hard to give it up.”97 Goddard’s concerns suggested that some of the female medical missionaries might view medical missionary work as a back-up plan since professional opportunities were limited in the United States. Although Stryker was determined to and indeed had committed herself to missionary work, Goddard’s concerns suggest that some female medical missionaries went abroad in pursuit of professional opportunities.98

Due to changes in the American medical profession in the early twentieth century, professional opportunities in medical missions seemed to become an increasingly important factor that influenced female physicians to go on missions. In the early twentieth century, as Morantz-

Sanchez points out, the development in bacteriology and “professionalization and bureaucratization” had brought about structural changes in American medicine in the twentieth century.99 In this context, as historian Ellen More argues, due to factors such as the closing of women’s medical schools, the percentage of American female medical graduates declined from

3.4 percent to 2.6 percent.100 Women who succeeded in becoming physicians still had to cope with the “extremely limited opportunities for internships, residencies, hospital staff positions, medical

96 Frances E. Goddard to Miss Child, 15 January 1901, Foochow Mission Woman’s Board v.1, ABCFM-Houghton, 16.3.6. 97 Ibid. 98 Minnie Stryker to Dr. Barton, 24 June 1908, Foochow Mission v.14, reel 246, ABCFM-Houghton, 16.3.5. 99 Morantz-Sanchez, Sympathy and Science, 235. 100 More, Restoring the Balance, 96, 97.

28 school faculty appointments, specialty society memberships.” 101 Hence, American female physicians faced a rather unfavorable professional environment in the early twentieth century.

With their disadvantaged position in the United States, aspiring female physicians likely found the relative abundance of professional opportunities in foreign missions promising. Joining medical missions offered some women opportunities to pursue a medical education, which might have attracted potential candidates. At least one medical school, the Women’s Medical College of

Pennsylvania (WMCP), admitted four students each year at half-price if they “desire[d] to study medicine with a view to becoming missionary physicians.”102 In the case of WMCP, the affiliation with missionary societies helped reduced the cost of medical education for women significantly, which might thus enable some women to acquire a medical education that they might have otherwise eluded them. Moreover, missionary societies sometimes sponsored female medical students to pursue further medical education. For instance, writing to Miss Lamson in 1915, Lora

Dyer inquired about the possibilities of taking two additional medical courses in preparation for the mission.103 “Both of these courses appeal to me very strongly, and I shall be delighted with the chance to take them if there is any way of financing them, as I hope there is,” Dyer said.104 Dyer’s inquiry suggested the precedence of mission boards funding prospective medical missionaries for further studies. With the possible sponsorship of the mission boards, Dyer would be able to acquire additional training in Operative Surgery, which she could not afford.105 Similarly, H. M. Scudder also mentioned that the American Medical Missionary Society would “provide every worthy

101 Ibid., 98. 102 Woman’s Medical College of Pennsylvania, Philadelphia, Fortieth Annual Announcement, May 1889, 19, series V, box 8, Medicine Collection, Sophia Smith Collection of Women’s History, Young Library, Smith College, Northampton, Massachusetts (hereafter as SSCWH). 103 Lora Dyer to Miss Lamson, 11 October 1915, Foochow Mission Woman’s Board v.4, ABCFM-Houghton, 16.3.6. 104 Ibid. 105 Ibid.

29 applicant with the medical education required to make her a powerful agency for good in heathen lands,” articulating the financial assistance that mission-related organizations provided.106 Thus, the possibility of acquiring medical education through affiliating with foreign missions might prompt some female students to become medical missionaries.

In response to the increasingly unfavorable professional environment for American female physicians, mission boards in the first decades of the twentieth century also became more vocal about the positive professional prospects offered by missions in their publicity. Beginning in the

1910s, references to the overcrowded American medical profession started to appear in the appeals to female medical missionaries. In her 1911 article, “Responsibility of Medical Women of the

United States to Women of Non-Christian Lands, and How We are Meeting It,” Mary H. McLean encouraged American female physicians to join Protestant missions. 107 Besides American women’s critical role of spreading the gospel to non-Christian lands, McLean pointed out that in the United States, “we are crowded; and envies and jealousies arise,” but in the non-Christian lands,

“there is work enough and to spare for all the medical women who could be educated within the next half century.”108 McLean continued to emphasize, “from a professional standpoint,” in the medical work abroad, “one can secure large and varied experience” in a variety of diseases and found opportunities for pathologists, sanitarians, and medical social workers. 109 The article illuminated the tightening professional opportunities for medical women in the United States in contrast with the conditions abroad, making medical missions professionally appealing. McLean’s

106 H.M. Scudder, A Great Field for Women, n.d., 5, series I, box 8, folder 39, Medicine Collection, SSCWH. 107 Mary H. McLean, “Responsibility of Medical Women of the United States to Women of Non-Christian Lands, and How We are Meeting It.” Woman’s Medical Journal, 21:11 (November 1911), 245-249. 108 Ibid., 248. 109 Ibid., 249.

30 use of the positive professional prospect as an appeal, therefore, suggested that for some female physicians, the pursuit of medical career might have motivated them to join the mission.

The professional opportunities in the mission field continued to be an important part of the mission board’s appeals to potential candidates in the 1920s. In the July to August 1920 issue of the Life and Light for Women, a WBM magazine, Dr. Josephine Lawney listed the opportunities in a variety of fields in medicine that the mission to China could offer.110 Lawney mentioned the need of orthopedic and general surgeons, specialists in pathology, bacteriology, and serology, and trained roentgenologist as well as the teaching opportunities in the new medical school for Chinese women, encouraging American medical women to work in China.111 Lawney’s exclusive focus on the professional aspects of medical missions and the mission magazine’s inclusion of this article both suggest that some American female physicians joined foreign missions for professional reasons. Some medical missionary’s experience affirmed the professional opportunities that the foreign mission offered. Clara A. Nutting, a WMB and later, a WFMS medical missionary, to

Foochow, completed her medical study at the University of Minnesota and sailed for China before receiving the M.D. title because the laws of Minnesota demanded a year’s intern work for getting the M.D. degree.112 Nutting then interned in the Margaret Williams Hospital of Shanghai from

1917 to 1918 and successfully acquired her M.D. after the internship.113 Acquiring internship opportunities through the mission, Nutting benefited from her medical missionary experience and secured her professional title through it. Although Nutting might not choose to go to China simply

110 Josephine Lawney, “An Appeal to the Medical Women of America” in Life and Light for Women, July-August 1920, 317-319, Life and Light 1869-1922, ABCFM-Houghton, 91.9. 111 Ibid., 317-318. 112 “Clara Adams Nutting,” folder Nutting, Clara A., Mission Biographical Reference Files, 1880s-1969, GCAH; Clara A. Nutting: Kate Ford Whitman Hospital, Fenchow, Shansi, China, 1917, 1922, box 54, folder 44, Biographical Collection, ABCFM-Houghton, 77.1. 113 “Clara Adams Nutting,” folder Nutting, Clara A., Mission Biographical Reference Files, 1880s-1969, GCAH.

31 because of the internship, her experiences reveal that foreign missions could contribute to professional advancement for some female physicians.

While professional opportunities might have attracted some career-seeking women to join

Christian missions, it should not be assumed that they were professionally incompetent medical students who took advantage of the mission. Female medical missionaries in the mission field had all acquired an M.D. and, in the case of trained nurses, an R.N. Indeed, over time, mission boards set up increasingly high standards for medical missionary candidates’ professional qualifications.

In 1853, the manual for missionary candidates of the American Board had already required that the missionary physicians should “have what would in this country be esteemed a competent medical education.”114 With the professionalization of medicine in the late nineteenth century, the requirements became more and more stringent. Pointing out that “the practice of medicine shows a highly specialized calling on the foreign field as at home,” the American Board in 1916 asked the candidates to “choose a medical school of the first rank,” and the coursework should be followed by “an internship in a large hospital, or by its equivalent in actual practice.”115 The Board also encouraged the candidates to take postgraduate study and sometimes provided sponsorship for these studies. 116 As the increasingly rigorous standards indicated, missionaries’ medical professional competence was critical to medical missions.

Arriving in Foochow on Thanksgiving Day in 1884, Woodhull and her sister settled down and prepared for their work in Foochow.117 “[O]h! [T]he superstition! [H]ow every inch of advance

114 American Board of Commissioners for Foreign Missions Manual for Missionary Candidates and for the Missionaries Before Entering their Fields, 1853, 6, Manual for Missionary Candidates, ABCFM-Houghton, 91.5. 115 Manual for Missionary Candidates, 1916, 10, Manual for Missionary Candidates, ABCFM-Houghton, 91.5. 116 Ibid. 117 Kate C. Woodhull, “Report of Hospital for Women and Children, Foochow City, 1901-1904” in Pagoda Bells: Report of Hospital for Women and Children 1901-1904 and A Brief Summary of Work for Women During 20 Years, Foochow City, China, 1904, 6, Andover.

32 has to be fought for and what long continued patience is required,” Woodhull exclaimed in her letter to Dr. Smith.118 “We can see that there is plenty of work for us here as soon as we can understand and talk with people,” she wrote, “So many ignorant ones waiting from someone to lead them to Him who is ‘the Way the Truth and the Life.’”119 The perception of Chinese people being ignorant and superstitious, as Woodhull described, was common among missionaries. What such perception reflected was missionaries’ culturally superior self-perception. Identifying with the goals of missions, female medical missionaries took up the cultural imperialistic project of spreading American evangelical cultures through their medical work. Historians Barbara Reeves-

Ellington, Kathryn Kish Skalar, and Connie Shemo argue that American female missionaries actively participated in the “American Protestant Empire” based on their shared beliefs in the superiority of “Protestant Christianity, American civilization, and the American form of government.”120 With their perceived privileged cultural identity, as historian Carol Chin argues, female missionaries viewed themselves as “representatives of the center” obligated to teach those

“on the periphery.”121

Similar to most female missionaries, female medical missionaries adopted the imperialist assumptions that influenced their understandings of medical missionary work. Female medical missionaries asserted a cultural hierarchy rooted in the superiority of evangelical Protestantism.

For instance, WBM physician Frances Goddard, in her plea to people at home, criticized the insufficiency of Confucianism, Buddhism, and Taoism for meeting the “real and pressing need in

China.”122 She argued, “[China] needs the light and fresh air of the blessed Gospel” and “that alone

118 Kate C. Woodhull to Dr. Smith 16 February 1885, Foochow Mission v.4, reel 236, ABCFM-Houghton, 16.3.5. 119 Ibid. 120 Reeves-Ellington, Sklar, and Shemo, eds., Competing Kingdoms, 4, 5. 121 Chin, “Beneficent Imperialists,”332. 122 Rev. Dwight Goddard and Frances E. Nieberg-Goddard, M.D., Ing-Hok: Eternal Happiness (The Presbyterian Mission Press, 1897), 30, box 8, folder 124, Willard Livingstone Beard Family Papers, YDS.

33 can dispel the darkness and miasma and break the bonds.”123 Demeaning the virtues of Chinese religions and addressing the paternalistic concerns about the needs of China, Goddard placed

Chinese cultures in a lower position. By emphasizing that the gospel “alone” could elevate China,

Goddard then established the superior position of evangelical Christianity and therefore reaffirmed the righteousness of her missionary endeavors.124

This religious hierarchy also informed female medical missionaries’ cultural observations of Chinese customs concerning women. In her article published on Life and Light for Woman,

Woodhull commented on foot-binding among Chinese women.125 Woodhull pitied that the “most favored women” were “nothing better than this deformity carried to the greatest extreme,” which created the stark contrast with the “enlightened” Christian Chinese women with unbound feet.126

She then appealed to the readers, “Surely when we pray for those who are oppressed, we should not forget the crippled women of China.”127 Using words such as “deformity,” Woodhull not only revealed the suffering of Chinese women but also implicitly condemned the oppression of local cultural customs. Meanwhile, Woodhull associated unbinding feet and conversion to Christianity with “enlightened” womanhood, reaffirming the superiority of evangelical Christian culture.

Moreover, characterizing Chinese women as the oppressed “other,” Woodhull assumed an air of cultural superiority and expressed a sense of responsibility for elevating Chinese women’s status.

Moreover, some female medical missionaries shared the racist perceptions of Chinese people prevalent in the United States and expressed the sentiment for racial uplift through their

123 Ibid., 30, 31. 124 Ibid., 31. 125 Kate C. Woodhull, “Golden Lilies,” in Life and Light for Woman, August 1896, 354, Life and Light 1869-1922, ABCFM-Houghton, 91.9. 126 Ibid. 127 Ibid.

34 missionary work. Upon her arrival in Shaowu, WBM medical missionary Josephine Kennedy considered it “mystifying” to be surrounded by the “queer wrinkled little yellow people” who were all “just children” and expressed her “big aching wish” to help them “grow up into the larger, richer life” that people had in “Christian America.” 128 Employing racist stereotypes in her descriptions of Chinese people, Kennedy carried with her the racist assumptions and established the racial and cultural superiority rooted in American evangelical Protestantism. Her language of racial uplift also signified her imperialist intentions to spread American culture through her missionary work to those whom she deemed racially inferior.

Adhering to a sense of cultural superiority, female medical missionaries viewed their work as integral to spreading western culture to Chinese people. In her letter, Woodhull mentioned an operation on a little boy for hare lip and used cocaine as an anesthetic.129 When she saw that cocaine helped reduce the boy’s pain, Woodhull was pleased that China could enjoy the fruit of modern medical discoveries and the benefits of “the Western world.” 130 Juxtaposing the advancement in medicine and the western culture, Woodhull identified medicine as a symbol of

Western culture and thus considered medical work critical in promoting such culture. Similarly, depicting the patients as “dirty, hair matted,” Ellen Lyon, a WFMS missionary doctor in Foochow, mentioned that while these patients were in the hospital, “a new world opens up before these poor women.”131 Lyon contrasted the living condition of Chinese women at home with that in the hospital and implied the perceived backwardness of the Chinese way of living. The association of the hospital with “a new world” to Chinese women further reflected female medical missionaries’

128 Josephine Kennedy to “Dear Friends,” 1 March 1921, Shaowu Mission v.2, ABCFM-Houghton, 16.3.18. 129 Kate C. Woodhull, 29 February 1888, Foochow Mission v.4, reel 236, ABCFM-Houghton, 16.3.5. 130 Ibid. 131 Ellen M. Lyon, “Liang-au Hospital,” in Official Minutes of the Eighteenth Session of the Foochow Woman’s Conference of the Methodist Episcopal Church, Foochow, November 13-18, 1902, 33, Day Missions Annual Reports, YDS, http://hdl.handle.net/10079/digcoll/4336746.

35 perception of the close tie between the western medical facilities and the spread of a culture that was superior to the local one.

Therefore, responding to their evangelistic impulses and the professional opportunities in the mission field, American female physicians embarked on medical missions to China.

Meanwhile, they took up the imperialistic assumptions and the vision of improving the lives of

Chinese women through Christian conversion and scientific medical treatment. With both evangelism and western medical treatment central to their sense of mission, female medical missionaries held motivations that were different from other female missionaries. This double- sided goal also made female medical missionary work a distinctive yet indispensable part of

Christian foreign missions.

In the spring of 1885, Woodhull was about to begin her work in Foochow. Months after her arrival, she had been diligently studying the language and started to “feel somewhat at home.”132 She was busy preparing for her new hospital in Foochow and received a few patients every day.133 In Foochow, Woodhull found herself having a “much wider range of practice.”134

Looking forward to the opening of the hospital, Woodhull was eager to carry out her “greatest desire of all”: to “tell these poor suffering women of Dear Savior who is able to save them.”135

After Woodhull secured the house, her work was about to begin.

132 Kate C. Woodhull, Letter, 23 January 1885, Foochow Mission Woman’s Board v.7, ABCFM-Houghton, 16.3.6. 133 Ibid. 134 Kate C. Woodhull to Mrs. Hill, 18 June 1885, Foochow Mission Woman’s Board v.7, ABCFM-Houghton, 16.3.6. 135 Ibid.

36 Chapter II “Something That One Knows She Has Time and Ability to Do”: Professionalism in Female Medical Missionary Work

In August 1885, Woodhull was ready to move into the house that she purchased the previous winter from a local family. Woodhull planned to turn the backroom, previously a “place of worship […] contain[ing] the household god” that “prescribed” cures for the patients, into an operating room. 136 In planning for the transformation, Woodhull also assigned a new meaning to the room: “the hands that in the future shall care for sick ones in that room, will be guided by

Him.”137 By contrasting the local custom of medical healing with medical care under the guidance of Christian God, she articulated the new operating rooms’ two-fold significance: the advancement of both Western medical treatment and the evangelical culture that assumed superiority over local culture. Woodhull’s view indeed encapsulated the complementary goal of the work of female medical missionaries: organizing professional medical treatment and spreading American culture through the teaching of Christianity.

Carrying with them the goal of healing the body and soul, female medical missionaries centered their work on their medical expertise. They managed the hospitals and dispensaries, visited patients at home, trained Chinese female medical students, and provided medical care for patients with different needs. In contrast with local medical practices, they strove to uphold professional standards and established their professional role. Drawing authority from their medical expertise, they put forth an agenda to subvert the cultural customs that they deemed backward and incorporated their special concerns about Chinese women’s well-being into their

136 Kate Woodhull to “Dear Friends”, 12 August 1885, Foochow Mission Woman’s Board v.7, ABCFM-Houghton, 16.3.6. 137 Ibid.

37 professional goals. Emerging out of their medical work in a transnational context was a distinct sense of gendered professionalism. While the missiology of “Woman’s Work for Woman” recognized their important gender role, the imperial context and the mission offered them opportunities for professional development. Therefore, professionalism was central to female medical missionaries’ work and their transnational experience created a sense of gendered professionalism that differed largely from that of their fellow female physicians in the United

States.

On January 1, 1886, the Hospital for Women and Children was ready to accept patients.138

During the first three months, Woodhull received thirteen in-patients and around two hundred dispensary patients.139 Woodhull was somewhat disappointed by the small number of patients who came to the hospital.140 “Foochow seems to be different from Shanghai and some other places in

China, where patients flock to the dispensaries,” Woodhull noted.141 “I am anxious that the number of patients should be increased.”142 Though disappointed, Woodhull faithfully carried out the daily work in the hospital and dispensary work.143 Woodhull and her fellow female medical missionaries’ work consisted of running the hospitals and dispensaries, making house calls, and traveling to remote regions. WBM and WFMS female medical missionaries established several hospitals and dispensaries for women and children in Foochow and its vicinity. As of 1928, the year before the merge of one of WFMS hospitals into Foochow Christian Union Hospital, there were six women’s

138 S.F. Woodin to Rev. Judson Smith D.D., Secretary of the A.B.C.F.M., 1 April 1886, Foochow Mission v.3, reel 235, ABCFM-Houghton, 16.3.5. 139 Ibid. 140 Kate Woodhull to Dr. Smith, 10 May 1886, Foochow Mission v.4, reel 236, ABCFM-Houghton, 16.3.5. 141 Ibid. 142 Ibid. 143 Ibid.

38 hospitals operated by the two mission boards in this region.144 Frances Goddard, a WBM physician in Foochow, related the routine of her work in her letter to the general board of Foochow mission.145 In the morning, she and her students visited the wards, compiled the reports for the patients, and ventilated the wards; after the visits, they went into the dispensary to treat patients in the waiting room.146 For female medical missionaries working in rural areas where there were only one or two hospitals, they had to make tours to remote regions. In addition to working in the dispensary and visiting patients’ homes in the vicinity, Lucy Bement, a doctor of WBM in Shaowu, reported that she “spent a number of weeks each year touring.” 147 Touring in the mountainous areas of Shaowu, Bement traveled “almost daily from daylight to dark” to reach people in the outstations of the mission.148 These tasks constituted the majority of the work of female medical missionaries.

As Woodhull established herself in the local community, her medical work for women and children continued to grow.149 She found herself busy dealing with medical calls from distant parts of the city and country.150 Compared to male medical missionaries’ work, Woodhull noted, the burden of work of women physicians was heavier because of midwifery and outside calls.151 In contrast, patients rarely called male doctors for home visits or midwifery cases. 152 Besides

144 “Chronological History of the Willis F. Pierce Memorial Hospital, Foochow Fukien, China,” box 13, folder 23, ABCFM-Andover; Woman’s Work: Foochow Conference, Foochow, 1928, Day Missions Annual Reports, YDS, http://hdl.handle.net/10079/digcoll/4336651. 145 Frances Goddard to Dr. Smith 15 April 1897, Foochow Mission v.5, reel 237, ABCFM-Houghton., 16.3.5 146 Ibid. 147 Ethel D. Hubbard, Missions on the Min: Story of the Shao-Wu Station, Foochow Mission, China (Boston: American Board of Commissioners for Foreign Missions Congregational House, 1905), 26, box 122, folder 12, Chinese Records Project, YDS. 148 Ibid. 149 Kate Woodhull to Mrs. Hill, 9 November 1887, Foochow Mission Woman’s Board v.6, ABCFM-Houghton, 16.3.6. 150 Ibid. 151 Kate Woodhull to Miss Lamson, 15 January 1910, Foochow Mission Woman’s Board v.3, ABCFM-Houghton, 16.3.6. 152 Ibid.

39 maternal cases, Woodhull’s outside calls consisted of visits to “the very sick” in their homes as well as weeks of regular visits to several well-to-do families.153

Another line of work that Woodhull was particularly proud of was training Chinese women medical students. Indeed, teaching Chinese women medical students was a critical component of the work of WBM and WFMS medical missionaries. The medical education shared the same rationale of uplift, as Woodhull reasoned, “nothing will do more to elevate [Chinese women] than a medical education.” 154 Although the curriculum of the Chinese women medical students incorporated evangelical teaching, it included standard medical subfields.155 Woodhull designed a set of medical courses for her Chinese women students.156 The course consisted of six years of studies and covered seventeen subjects such as anatomy, physiology, obstetrics, gynecology, pharmacology, and surgery.157 Covering a variety of key subjects that helped equip Chinese women with skills important in both the mission field and beyond, Woodhull’s curriculum reflected the centrality of professionalism in medical education for Chinese women students.

Besides covering important medical theories, female medical missionaries valued practical training. WFMS missionaries Ellen Lyon and Luella Masters mentioned in their report to Foochow

Woman’s Conference that the serious cases in the hospital served as an opportunity “to give our students practical instruction in the treatment of fevers and other acute diseases.” 158 Missionary

153 “Kate C. Woodhull M.D. writes,” 22 August 1887, Foochow Mission Woman’s Board v.6, ABCFM-Houghton, 16.3.6. 154 Kate C. Woodhull, “Some Results from Hospital Work in Foochow,” Life and Light for Woman, 1893, 71, Life and Light 1869-1922, ABCFM-Houghton, 91.9. 155 Mrs. S. Brainard Pratt, Annual Report of the Woman’s Board of Missions, 1892, 11 January 1893, 16, ABCFM Woman’s Board of Missions Annual Reports, 1869-1926, ABCFM-Houghton, 91.6. 156 Kate C. Woodhull, Report of the Work for Women and Children, Foochow City, China, A.B.C.F.M. (Romanized Press, 1898), 2, box 3, 1232, 18.6.6 China, Congregational Library & Archives, Boston, Masachusetts. 157 Ibid. 158 Ellen M. Lyon and Luella M. Masters, “Woman and Children’s Hospital, Foochow,” in Minutes of the Tenth Sessions of the Foochow Woman’s Conference of the Methodist Episcopal Church, Foochow, November 23-28, 1894, 13, Day Missions Annual Reports, YDS, http://hdl.handle.net/10079/digcoll/4336694.

40 physicians also evaluated Chinese women students in examinations, such as the ones Woodhull had administered in the field of physiology and anatomy. 159 Graduates received diplomas affirming that they “studied diligently the medical theories, strictly followed the rules of the hospital, and were accomplished in their studies that they were able to prescribe for patients, carry out obstetrical work, and cure serious cases.”160 Proud of her students, Woodhull praised one of the graduates for having “developed great proficiency in surgical midwifery,” and her assistance in the hospital was “invaluable,” indicating the importance of professional skills in the medical education for Chinese women. 161

In addition to carrying out everyday tasks, female medical missionaries situated their professional role as doctors at the core of their identity and developed a sense of professionalism.

They were keenly aware of their role as medical professionals and made a distinction between medical work and other fields of work in the mission. For instance, Minnie Stryker reported her home visits to the patients.162 Stryker mentioned, when practical, “Miss [Hannah] Woodhull has followed our professional visits with social calls.”163 Using the designations of “professional visits” and “social calls,” Stryker consciously distinguished her medical work from Hannah Woodhull’s evangelical work. This conscious distinction further reflected Stryker’s self-perceived role as a medical professional. Besides their awareness of their professional role, female medical missionaries also considered their medical expertise a key component of their role in the mission.

159 Kate C. Woodhull to Ms. Child and Friends, 4 February 1895, Foochow Mission Woman’s Board v.7, ABCFM- Houghton, 16.3.6. 160 “Meibuhui nüyiguan zhizhao (Medical Diploma of American Board of Commissioners of Foreign Missions Hospital for Women and Children, Foochow, China),” 1906, private collection of Weiwei Wu. 161 Ibid. 162 C. Hartwell, Foochow City Mission 1903-1904, 1904, Foochow Mission v.10, reel 242, ABCFM-Houghton, 16.3.5. 163 Ibid.; In mission records, missionaries would use the title “Dr.” when referring to medical missionaries. Since Hannah Woodhull was doing evangelical work alongside Kate Woodhull during the same period of time, it can be inferred with confidence that here Stryker was referring to Hannah.

41 Due to the lack of personnel in the field, WFMS appointed Mary Carleton to supervise the Bible women in addition to her medical obligations.164 Carleton expressed her disappointment with the appointment and stated, “One cannot put as much heart into a thing that she knows she will not do well as into something that one knows she has time and ability to do.”165 Although Carleton did not spell out the distinction, her words showed the centrality of medical expertise in her understanding of her role in the mission. Suggesting that medical work was something that she had “time and ability” to do well, Carleton viewed herself as a capable physician and considered the medical work, rather than the evangelical work, her main contribution to the mission.

With professionalism being central to their sense of mission, female medical missionaries continued to uphold their professional status through contrasting with local medical practices.

Sociologist Terence Johnson views professionalism as a form of occupational control where it

“creates occupations with a high degree of self-consciousness” and the occupational skills are considered “non-transferable.”166 Johnson also points out that the impulse to stop charlatanism or quackery often arises when an occupation is “attempting to establish or struggling to maintain a monopolistic position.”167 In their work, by delegitimizing the practices of traditional Chinese doctors and midwives, female medical missionaries distinguished their professional position from other practices that they deemed unprofessional. One of the most salient examples was their criticism against the evils of local midwives. As Wang notes, both female and male medical missionaries frequently condemned practices of Chinese midwives.168 For instance, Lora Dyer, a

164 M.E. Carleton, “The Good Shepherd Hospital,” in Report of the Thirtieth Annual Session of the Foochow Woman’s Conference of the Methodist Episcopal Church, Foochow, October 14-16, 1914, 67, Day Missions Annual Reports, YDS, http://hdl.handle.net/10079/digcoll/4336536. 165 Ibid. 166 Johnson, Professions and Power, 57. 167 Ibid. 168 Wang, “Stranger Bodies,” 84.

42 doctor of WBM in Foochow, reported that foreign physicians were called to help the patient after

“the native midwife [had] been doing her worst job for two or three days,” condemning the suffering that the local midwives had brought to women patients.169

While female medical missionaries condemned the practices of local midwives, they also upheld their professionalism through contrast with the Chinese way of dealing with childbirth. In her diary, Ruth V. Hemenway related an obstetrical case in WFMS’s Mintsing Good Shepherd

Hospital in 1924. Describing the conditions of the patient, Hemenway mentioned that the midwives had “worked over her for two days” and injured the woman “shamefully.”170 When Dr.

Carleton “chloroformed,” Hemenway “delivered by low forceps” a dead baby and later “gave strychnine 1/30 twice” to the mother.171 Hemenway used medical jargon to describe her treatment but used the phrase “worked over” and the word “shamefully” to characterize Chinese midwives’ work. Through this contrast in word choice, Hemenway distinguished between missionary physician’s practice and the local practices, marking the social distance between two types of medical practices—professional and non-professional. This contrast then indicated Hemenway’s self-identification as a medical professional in contrast to local medical practices. Similarly, Clara

Nutting, physician of WBM who worked in Foochow in the late 1920s, denounced local midwives’

“torture” of Chinese women and pointed out that the “untrained Chinese midwives [did] not know what surgical cleanliness means.” 172 Nutting’s emphasis on training and surgical cleanliness suggested her status as a trained physician. It implied her adherence to a commonly affirmed

“professional code of conduct,” which, as Johnson summarizes, is a characteristic of

169 Lora Dyer, “Needs of China's Women as Seen by One Doctor,” Life and Light for Woman, September 1919, 13, Life and Light 1869-1922, ABCFM-Houghton, 91.9. 170 Ruth V. Hemenway, Diary, 20 March 1924, box 1, v.1, book 1, Ruth Hemenway Papers, SSCWH. 171 Ibid. 172 Clara A. Nutting, M.D.: Kate Ford Whiteman Hospital, Fenchow, Shansi, China, 1917, box 54, folder 49, Biographical Collection, ABCFM-Houghton, 77.1.

43 professionalism. 173 In this way, Nutting established herself as the medical professional and differentiated herself from local practitioners.

Establishing themselves as medical professionals, female medical missionaries also aimed to keep up with the professional standards for medical practices and facilities in the United States.

For instance, in her diary entry, Hemenway described an operation in which she cut out the ulcers in a patient’s leg due to bone infection.174 Reflecting upon the operation, Hemenway stated, “I used to shudder at handling these things with bare hands but am getting a little hardened.”175 She then added immediately, “however I have no intention of so doing after the gloves which were ordered shall arrive,” and mentioned that she “cleaned out every incision with pure carbolic followed by alcohol and then packed with iodoform gauze.”176 Hemenway’s disclaimer reflected her anticipation of the reader’s questioning of her practice and thus suggested her recognition of a commonly perceived professional standard, that is, proper disinfection and sterilization in surgical operations. The reference to the incoming gloves and their use of alcohol and iodoform gauze reflected the limited medical supplies that the hospital had and her best efforts to keep up with the medical practices that were deemed professionally acceptable.

Not only did female medical missionaries try to stick to the professional standards despite the lack of proper supplies, but they also strived to improve the hospital’s facilities to keep up with modern hospitals in the United States. As the medical work progressed, Woodhull was hoping to enlarge the current hospital to accommodate the expanded work.177 What she had in mind was a

173 Johnson, Professions and Power, 23. 174 Ruth V. Hemenway, Diary, 17 October 1924, box 1, v.1, Book 2, Ruth Hemenway Papers, SSCWH. 175 Ibid. 176 Ibid. 177 Kate C. Woodhull to Mrs. Cook, 28 August 1902, Foochow Mission Woman’s Board v.1, ABCFM-Houghton, 16.3.6.

44 well-equipped modern hospital. In her appeal for people in the United States to make donations for a new women’s hospital in Foochow, Woodhull referred to the Sim’s Memorial Surgical Ward in New York which had “every provision for cleanliness, isolation, and the proper separation of different diseases.”178 Woodhull then argued that missionary physicians faced similarly severe cases in their work, and a well-built hospital “in heathen lands” would be “a monument to Christian benevolence” and an important part of the “plan for uplifting the people.” 179 Woodhull’s comparison and argument indicated her understanding of the importance of establishing modern medical facilities to offer better treatment and to exert greater Christian influences.

Female medical missionaries of the WFMS also aimed to improve their hospital facilities.

Ellen Lyon, Lena Hatfield, and Cora Simpson envisioned the new plant of Liang-au Magaw

Memorial Hospital in Foochow to have “medical, surgical, obstetrical, operating, dressing, medicine, reception and private rooms, wards, halls, kitchens, laundry, laboratory, offices and classrooms” and “electric lights, steam heat, elevators and sun parlors.”180 The physical space of the new plant of the hospital bore a great resemblance to modern American hospitals and these female missionary physicians’ eagerness to follow the model of hospitals in the United States further revealed that concerns for professionalism laid at the heart of their vision of medical missionary work.

As they aimed to meet the professional standards, female medical missionaries actively engaged in studies and meetings that helped improve their medical skills and knowledge. Most

178 Kate C. Woodhull, Pagoda Bell: Report of Hospital for Women and Children 1901-1904 and A Brief Summary of Work for Women During 20 Years, Foochow City, China, 1904, 53, Historical Collections-Pamphlets, Andover. 179 Ibid., 55, 57. 180 Ellen M. Lyon, Lena Hatfield, and Cora E. Simpson, “Liang-au Magaw Memorial Hospital,” in Report of the Twenty-Eighth of the Foochow Woman’s Conference of the Methodist Episcopal Church, Foochow, December 4-6, 1912, 35, Day Missions Annual Reports, YDS, http://hdl.handle.net/10079/digcoll/4336511.

45 female missionary physicians continued to study medical theories in their spare time after work and during their furlough in the United States. For instance, Hemenway frequently mentioned studying anatomy, surgery, gynecology, and many other medical topics with her fellow doctors in the evening.181 She expressed her eagerness to study medicine and exclaimed, “How I wish I could put all my language time into medicine.” 182 Hemenway’s persistent study of medicine thus indicated her efforts to acquire new professional knowledge continuously. More often, female medical missionaries enrolled in postgraduate medical studies during their furloughs in the United

States to learn new medical skills useful for their work in China. As Stryker reflected, she undertook postgraduate studies in a variety of institutions during her furlough, spending her time

“in hospital work and observation” and “in taking courses of study preparatory service on the mission field.”183 Similarly, asking to be excused from a meeting when she was on furlough,

Woodhull had mentioned that she overworked herself by constantly visiting different places and studying medicine.184 Stryker’s and Woodhull’s activities during their furloughs hence indicated female medical missionaries’ persistent efforts in enhancing their professional skills and knowledge to carry out medical missionary work in China better.

In addition to personal professional development, female medical missionaries organized meetings to share experiences and discuss the future development of medical missionary work. In her diary, Hemenway mentioned having afternoon tea with fellow physicians of WFMS and WBM in Foochow.185 During tea time, they discussed topics closely related to their medical work and

181 Ruth V. Hemenway, Diary, 30 October 1924, box 1, v.1 Book 2, Ruth Hemenway Papers, SSCWH. 182 Ibid. 183 Minnie Stryker to Dr. Bertha Van Hoosen, 1935, box 11, folder Stryker, Minnie, 1898, Alumnae Files, 1897- 1898, Archives and Special Collections, Drexel University College of Medicine. 184 Kate C. Woodhull to Miss Stanwood, 25 March 1893, Foochow Mission Woman’s Board v.7, ABCFM- Houghton, 16.3.6. 185 Ruth V. Hemenway, Diary, 24 July 1924, box 1, v.1 Book 2, Ruth Hemenway Papers, SSCWH.

46 strategies in missionary work, such as “organization of a hospital here,” “medical education for

Chinese girls,” and “publicity to interest people” in their medical work.186 Though an informal meeting, the subjects discussed were closely related to their professional work. Centering on medical work and cutting across denominations, these meetings indicated female medical missionaries’ active involvement in activities that helped improve their work. Thus, by keeping up with professional standards and strengthening their professional competence, female medical missionaries integrated the sense of professionalism into their day-to-day medical missionary work.

Identifying with the goal of woman’s mission, female medical missionaries incorporated the special concerns for Chinese women into their professional goals and wielded cultural influence through their medical expertise. A comparison of female and male medical missionaries’ writings reveals female physicians’ special interests in the conditions of Chinese women. In addition to reporting the cases treated, and the operation of hospitals and dispensaries, the reports of female medical missionaries devoted attention to women patients’ social relations. The reports contextualized these cases with the conditions of the patients’ families and the patients’ personal experiences. Missionaries’ emphasis on developing certain medical subfields also reflected the centrality of Chinese women’s well-being in female medical missionary work. As Wang argues, recognizing the harm done by local midwives, female medical missionaries devoted more effort to developing obstetrical work.187 Woodhull once pointed out that since there were two physicians at work, she had “more time to work up the department of Hospital Obstetrical Work,” which she considered to be “of the greatest importance.”188 Woodhull’s words indicated the weight that female medical missionaries put on the obstetrical work. Female physicians’ intention to develop

186 Ibid. 187 Wang, “Stranger Bodies,” 87. 188 Kate C. Woodhull, Pagoda Bells,1904, 24, Historical Collections-Pamphlets, Andover.

47 obstetrical work, a field of work that was closely related to Chinese women’s health, illustrated their special professional concerns about Chinese women. The annual report for the Foochow mission also noted that the “numerous out visits” and “obstetrical cases” were where “the lady physicians’ strength [was] largely expended,” indicating that caring for Chinese women was one of the crucial professional goals of female medical missionaries.189

Moreover, to improve the well-being of Chinese women and girls, female medical missionaries actively incorporated a cultural agenda into their day-to-day medical work to subvert harmful cultural practices such as foot-binding. As Chin points out, foot-binding was one of the social practices that female missionaries targeted for reform.190 Female missionary physicians also considered foot-binding a social ill that limited Chinese women’s “means of communication and travel” and made them “involuntary prisoners, shut away from all hope of proper care.”191 They were also ready to combat foot-binding through their medical work. For instance, Woodhull met two parents who brought their girl with “weak hand and arm” for treatment.192 Instead of treating the girl immediately, Woodhull asked the parents to unbind the girl’s feet as a condition for treatment.193 The parents hesitated but eventually yielded, agreeing to unbind their daughter’s feet and let her attend school.194 As her demand to unbind the feet before the treatment indicated,

Woodhull considered changing social practice equally important as providing medical treatment.

By withholding medical treatment to push the parents to unbind the girl’s feet, Woodhull assumed

189 H.T. Whitney, Annual Report of the Foochow Mission, April 2st 1896 to March 31st1897, 1897, 40-41, Foochow Mission v.5, reel 237, ABCFM-Houghton, 16.3.5. 190 Chin, “Beneficent Imperialists” 336. 191 Edward H. Smith, Around the White Pagoda: Typical Work in a China Mission the Foochow Mission (American Board and Woman’s Boards, n.d.), 7, box 11, folder 1, ABCFM-Andover. 192 Caroline E. Chittenden, Dr. Kate Woodhull: Pioneer Doctor for Women in Foochow, 1917, 7, box 79, folder 14, Biographical Collection, ABCFM-Houghton, 77.1. 193 Ibid. 194 Ibid.

48 an active role to promote the social goals of the mission. As the father agreed to unbind the girl’s feet and “left the child receiving treatment and attending school,” Woodhull’s insistence helped improve the physical well-being of the girl and created potential educational opportunities for the girl.195 Moreover, according to Caroline Chittenden, a missionary and the author of Woodhull’s short biography, Woodhull and other missionaries’ efforts in combating foot-binding contributed to the official ban of foot-binding in China, further illustrating female medical missionaries’ active involvement in promoting social change through medical work.196

In addition to promoting the cultural agenda, female medical missionaries carried out their gendered professional goals by mediating the household gender dynamics of their women patients.

Female medical missionary work was intimately linked to the gender dynamics of Chinese households. Goddard related a story about a partially blind woman in her 1897 report.197 The woman sought medical help from the missionary, entreating missionaries to cure her and promising to stay longer “if her sight could be restored.”198 Goddard mentioned, the woman “dared not return home, fearing ill-treatment from her husband, who told her if she could not be cured, so that she could see to work, she had better tie a rope around her neck and hang herself, that he would get another wife.”199 In this case, Goddard’s medical treatment had special social implications and was closely connected to the gender dynamics within the woman’s family. The woman turned to

Goddard to avoid the abuse of her husband who threatened to let her kill herself if she remained blind. What was at stake was not simply to cure the disease; the success of Goddard’s treatment or not had an immediate and long-lasting impact upon the life of this woman. This case therefore

195 Ibid. 196 Ibid. 197 Frances Goddard, Report of the Work for Women and Children: Hospital for Women and Children, Kindergarten, Woman’s School, 1897, 9, box 8, folder 125, Willard Livingstone Beard Family Papers, YDS. 198 Ibid. 199 Ibid.

49 illustrated the complicated gender dynamics entailed in female medical missionaries’ medical treatment.

Aware of the social influences of their medical treatment, female medical missionaries took advantage of their professional work to mediate gender dynamics in their women patients’ families.

For instance, Hemenway wrote in her diary about two medical cases she encountered.200 First was a five-year-old slave girl who was poorly dressed, malnourished, and badly treated by the family that owned her.201 The missionaries “kept her as long as there was any excuse for denying her return to her cruel home” and gave her “good food and warm clothing.”202 By employing her medical authority to retain the girl in the hospital, Hemenway used her professional skills to intervene in the mistreatment of the girl at home and attempted to optimize as much as possible the girl’s well-being. Moreover, Hemenway used her medical skills to mend family relationships.

A woman patient came for the treatment of breast cancer because she was rejected by her daughter- in-law, who, due to the “unpleasantness” of the presence of the tumor, made clear that her mother- in-law was “unwelcome in the house until surgery should remove the unpleasantness.”203 Although

Hemenway determined that the cancer was incurable, she still proceeded to operate on the tumor so that the woman could be accepted back to her home. Here, Hemenway used her professional skills not to eradicate the disease but to facilitate positive changes in the woman’s relationship with her family, indicating the special social impact of female medical missionaries’ professional work. In these ways, missionaries carried out their professional goals of improving Chinese women’s well-being through medical treatment. They subtly exerted their intervention in the

200 Ruth V. Hemenway, “In China … (The Story of a Medical Missionary),” Medical Woman’s Journal 52:2 (February 1945), 34-38, 40. Material is located at Archives and Special Collections, Drexel University College of Medicine. The accounts published in 1945 came from Hemenway’s diaries during her time in Mintsing in the 1920s. 201 Ibid., 38. 202 Ibid. 203 Ibid.

50 internal household dynamic through their medical work, influencing the lives of Chinese women in a professional context.

Moreover, female medical missionaries carved out a space in which the pre-existing gender power dynamics were, to some extent, altered. In 1903, Carleton reported that a woman who “was badly crippled” and suffered from “rheumatoid arthritis” came to her.204 The woman had “a most sad expression” because she had a “haunting fear” that she might have leprosy.205 Carleton assured her that her problem was not leprosy but still so serious that it was uncurable; Carleton then made efforts to stop the progress of the disease, alleviating much pain for the woman.206 However, according to Carleton, who got the information from others, after the woman left the hospital for

Lunar New Year, her husband mistreated her.207 He refused to let her go back to the hospital for further treatment regardless of her entreaties.208 As indicated in this example, in the space of the hospital, Carleton was able to exercise her professional power to help lessen the pain of the woman even though her disease was incurable, a condition which the woman’s husband deemed unworthy of treatment. This woman’s contrasting experiences inside and outside of the hospital thus suggested the unique quality of the hospital as a professional space where the gender power dynamics were somewhat altered. Although female medical missionaries were unable to remake the gender relations at large, in the hospital, Chinese women were able to obtain medical care, which otherwise might be unattainable under the local social and cultural structure. The combination of medical healing and the influences on gender relations based on medical authority

204 Mary E. Carleton, “Medical Work,” in Official Minutes of the Nineteenth Session of the Foochow Woman’s Conference of the Methodist Episcopal Church, Foochow, October 6-9, 1903, Day Missions Annual Reports, YDS, http://hdl.handle.net/10079/digcoll/4336504. 205 Ibid. 206 Ibid. 207 Ibid., 76. 208 Ibid.

51 also further illuminated the gendered professional goal that female medical missionaries were actively promoting.

Chinese women patients’ reactions and responses, on the other hand, also corroborated this gendered professional goal; Chinese women perceived female medical missionaries as people to whom they could address their special problems. Woodhull mentioned a woman who came to the hospital, “weeping and sobbing in great distress.”209 Not explicitly stating the exact problem,

Woodhull described the women’s experience as “the same old story of one sin followed by another to hide her disgrace until health and hope and self-respect were wrecked” and did her best to relieve the woman’s pain.210 “Sin,” “disgrace,” and the wrecked “self-respect” implied unspeakable issues unique to women. Although the woman might go to the missionaries because of missionaries’ outsider status in the local community, her choice to seek help instead of keeping it to herself indicated her understanding of female missionary physician’s ability to address both the medical and gendered concerns. Woodhull also reflected that in her daily rounds to patients’ rooms, some women patients “[told] their real sorrow to [her] alone sometimes,” sentiments that these patients did not express to other Chinese women students.211 Women patients’ willingness to share their troubles with Woodhull, on the one hand, demonstrated the trust that these patients had in

Woodhull and, on the other hand, suggested the patients’ perception of Woodhull’s ability to cope with their concerns. As Woodhull commented, “the sick and suffering have always found comfort in pouring out the story of their woe on a sympathetic ear.”212 Chinese women patients’ responses hence, from another perspective, reflected the gendered concerns that female medical missionaries

209 Kate C. Woodhull, Report of Foochow City Woman's Hospital for year ending Dec 31, 1900, 1901, v.5 Foochow Mission v.5, reel 237, ABCFM-Houghton 16.3.5. 210 Ibid. 211 Kate C. Woodhull and Hannah C. Woodhull, Pagoda Bells, 1884-1909: Report of Work for Women and Children, 1909, 32, box 8, folder 125, Willard Livingstone Beard Family Papers, YDS. 212 Ibid.

52 had incorporated into their work. Therefore, taking up special concerns for women in their professional work, female medical missionaries offered medical care for mothers, promoted a cultural agenda for social change, and acted as mediators of Chinese women’s household gender relations.

When female medical missionaries treated patients and attempted to exert cultural influences, they also participated in a distinct culture of professionalism that was different from that in the United States. In the transnational spaces created by the mission, female medical missionaries were in a different professional position. As historian Carolyn Skinner argues, in the nineteenth-century debate over woman’s suitability as doctors, the supporting and opposing arguments “intertwined with constructions of the character of woman physician” and the compatibility of the role of physicians with femininity was “crucial to women’s success in the medical field.” 213 At the end of the nineteenth century, the discovery and development of bacteriology further challenged the holistic approach to medicine that emphasized the moral influences and raised new questions for the relationship between womanhood and medical professionalism.214 Femininity continued to be the focal point of tension over the inclusion and exclusion of women physicians and their self-understanding. As Morantz-Sanchez summarizes, one of the major themes of women in medicine in the United States was the “tension between

‘femininity,’ ‘feminism,’ and ‘morality’ on the one hand and ‘masculinity,’ ‘professionalism,’ and

‘science’ on the other.”215

213 Carolyn Skinner, Women Physicians and Professional Ethos in Nineteenth-Century America (Carbondale, IL.: South Illinois University Press, 2014), 13, 38. 214 Morantz-Sanchez, Sympathy and Science, 185-187. 215 Ibid., 200.

53 In contrast to the hostility medical women faced in the United States, in the missions, both male and female missionaries recognized the importance of female physicians and considered their work indispensable. In the mid-nineteenth century, missionaries in the field were increasingly aware of the potential role that female physicians could play in evangelical work. The seclusion of women in some Asian countries made it impossible for male medical missionaries to reach these women, the limitation that gave rise to the need for female medical missionaries.216 Though sending out female medical missionaries raised controversies, the success of WFMS missionary

Clara Swain in India set up a positive example, and later female medical missions became, as historian Dana Robert argues, “the most universally-acclaimed aspect of woman’s missionary work in the late nineteenth century.”217 Dauphin W. Osgood, the physician-in-charge of Foochow

Medical Missionary Hospital of the American Board, reported that Dr. Sigourney Trask already had “quite an extensive practice among Chinese women and children” within a year of her arrival in 1876.218 “Whatever difference of opinion may exist as to the expediency of ladies engaging in medical practice in England or America,” Osgood contended, “there is no question that a lady physician has a wide field of usefulness and much hard work awaiting her in China or Japan.”219

Osgood’s words thus indicated male missionaries’ recognition of female physicians’ importance to the mission.

Indeed, mission boards and societies continued to praise the critical role of female missionary physicians in the mission. H.M. Scudder argued in her article for the American Medical

Missionary Society that female medical missionaries cleared out the suspicion of women in the

216 Robert, American Women in Mission, 163. 217 Ibid.,162. 218 Dauphin W. Osgood, Fifth Report of the Foochow Medical Missionary Hospital in Connection with the A.B.C.F.M Mission under the care of Dauphin W. Osgood, M.D. (Foochow Printing Press, 1876), 1-2, box 4, 18.6.6 China, Congregational Library & Archives, Boston, Massachusetts. 219 Ibid.

54 zenana and harem by treating their diseases, and there was “an impressive harmony between preaching and healing,” illustrating female medical missionaries’ contributions to the evangelizing endeavors.220 Similarly, in the summary of the American Board’s medical work, Enoch F. Bell gave special credits to female missionary physicians’ work. 221 Bell mentioned that female physicians’ work was one of the “distinctive methods of the Board’s medical work.”222 He argued that female medical missionaries were “changing the conceptions of Oriental society respecting women’s rights and privilege” by raising the awareness that “women and girls are worth any sacrifice or effort to relieve suffering, or even to save from death;” the changing notions of womanhood “[laid] the foundation for the true Christian home and prepares the way for a well- balanced Christian society.”223 Bell’s words reflected missionaries’ common perception of female medical missionaries’ positive influences on women in foreign lands and their significant contribution to the overall goal of the mission. Therefore, differing from their counterpart in the

United States, female medical missionaries operated in a professional environment in which their gender was not a point of contention but an advantage that was integral to their professional identity and widely acknowledged by the missionary community.

With the acknowledgment of their gender and professional identity, female medical missionaries participated in a culture of professionalism that cut across conventional boundaries such as gender and nationality. Female medical missionaries joined fellow missionary physicians in organizing conferences to discuss medical work, forming professional associations that were similar to those in the United States among physicians. For instance, Woodhull mentioned the

220 H.M. Scudder, A Great Field for Women, n.d., 4, series I, box 8, folder 39, Medicine Collection, SSCWH. 221 Enoch F. Bell, Envelope Series: Your Doctor Abroad, July 1915, box 6, folder Medical Work, Special Topic, ABCFM-Houghton, 85.9. 222 Ibid., 13. 223 Ibid., 13-14.

55 medical meetings she attended during the summer. 224 The meeting consisted of eighteen missionary doctors in the province from different denominations, and there were subjects for special study.225 Woodhull praised that doctors from Amoy were very “progressive” and remarked,

“it was quite an inspiration to study with them.”226 Likewise, Hemenway also mentioned that she attended a medical meeting where half of the twenty-two doctors present were women.227 During the meeting, missionary physicians discussed the case reports from different doctors, which

Hemenway found “very interesting.” 228 Organized for professional purposes, the meetings, therefore, shed light on the culture of professionalism in the medical missionary community.

Aside from the meetings, missionary physicians in China organized their own professional association. Introducing “our Medical Association in China,” Lyon, Hatfield, and Simpson mentioned that it consisted of “a fine band of men and women” and “many of them not so far behind the times as one might think.” 229 Members of this association received advanced postgraduate training in medical institutions around the world.230 Lyon, Hatfield, and Simpson also proudly claimed, “we have a very good Medical Journal published at Shanghai and biennially a

Meeting of the Association at some center.”231 The Association, as described by Lyon, Hatfield, and Simpson represented a medical professional organization that included both male and female foreign physicians. The reference to these physicians’ advanced training indicated the cohesion of this Association was established upon their shared expertise. By using the word “we,” Lyon,

224 Kate C. Woodhull to Dr. Smith, 16 October 1899, v.8 Foochow Mission v.8, reel 240, ABCFM-Houghton, 16.3.5. 225 Ibid. 226 Ibid. 227 Ruth V. Hemenway, Diary, 12 August 1924, box 1, v.1, book 2, Ruth Hemenway Papers, SSCWH. 228 Ibid. 229 Ellen Lyon, Lena Hatfield, and Cora E. Simpson, “The Liang Au Women’s and Children’s Hospital,” in Report of the Twenty-Fifth Session of the Foochow Woman’s Conference of the Methodist Episcopal Church, Foochow, November 17-19, 1909, 48, Day Missions Annual Reports, YDS, http://hdl.handle.net/10079/digcoll/4336510. 230 Ibid. 231 Ibid.

56 Hatfield, and Simpson identified themselves as members of this professional community and, therefore, actively engaged in a culture of professionalism that moved beyond the strict gender boundary. While women physicians in the United States faced obstacles in joining general professional medical associations, female missionary physicians’ participation in such meetings reflected the more flexible gender relations among medical professionals on the mission field.232

Moreover, some female medical missionaries’ sense of profession moved them beyond the boundary of nationality. Although mission boards advocated for the notion of Christian universalism, the missionary community, as historian Connie Shemo argues, in reality, practiced racial segregation.233 In their missionary life, female medical missionaries also witnessed such segregation. For instance, Hemenway mentioned that while the foreign missionaries lived “upstairs in the hospital,” Dr. Dang, a Chinese physician working in Good Shepherd’s Hospital, lived in the nurses home because “she can thus have Chinese food with them, while Miss Loland can have

American food with us.” 234 The separate residence seemed to suggest the segregation along cultural lines that was present in the mission. Hemenway then commented on this different arrangement: “Personally, I do not think it right for Dr. Dang to be left out that way— professionally.”235 Here, the shared identity of Hemenway and Dr. Dang as doctors working alongside each other transcended the prescribed cultural difference between foreigners and

Americans, creating a sense of cohesion based on their professional identity. Hemenway’s thought

232 For more on American medical women’s difficulties in joining professional associations, see for example, More, Restoring the Balance: Women Physicians and the Profession of Medicine, 1850-1995 (Cambridge, MA.: Harvard University Press, 1999); Gloria Moldow, Women Doctors in Gilded-Age Washington: Race Gender, and Professionalization (Urbana and Chicago: University of Illinois Press 1987). 233 Connie Shemo, “So Thoroughly American: Gertrude Howe, Kang Cheng and Cultural Imperialism in the Woman’s Foreign Missionary Society, 1872-1931,” in Competing Kingdoms, eds. Reeves-Ellington, Sklar, and Shemo, 123. 234 Ruth V. Hemenway, Diary, 4 February 1924, box 1, v.1, book 1, Ruth Hemenway Papers, SSCWH. 235 Ibid.

57 hence suggested the multifaceted meaning of the sense of professionalism forged in close connection with the reality of mission.

As female medical missionaries participated in a different culture of professionalism, the imperial context also brought about different, if not broadened, professional opportunities for them.

Due to the demand for medical care in the mission, female medical missionaries needed to carry out medical tasks that they might not have ample experience with. One of the immediate impressions of female medical missionaries upon the beginning of the work was the wide array of responsibilities they assumed. As Woodhull reflected in her report during her first year in Foochow, she had “a much wider range of practice here and medical appliances.”236 The cases that Woodhull took in were also difficult. “A physician’s work here is very hard because nearly everything that comes to us is serious and important,” Woodhull stated, “while the busy physician at home has many calls that involve little or no anxiety,” articulating the disparate working conditions in mission. 237 Although female medical missionaries intended to develop medical specialties concerning the health of women, such as obstetrics and maternity work, the variety of cases that they faced daily pushed them to develop a wider range of medical skills. Female medical missionaries treated cases of indigestion, chronic bronchitis, rheumatism, stiff limbs, ulcers, wounds, and bruises and constantly performed cataract operations, amputations, removing tumors, and so on.238 Minnie Stryker also mentioned that it would be easy to “build up a large eye practice” in Foochow as “refractive error and inflammatory disease are extremely common, and eye

236 Kate C. Woodhull to Mrs. Hill, 18 June 1885, Foochow Mission Woman’s Board v.7, ABCFM-Houghton, 16.3.6. 237 Kate C. Woodhull to Mrs. Hill, 9 November 1887, Foochow Mission Woman’s Board v.6, ABCFM-Houghton, 16.3.6. 238 Annual Report of the Woman’s Board of Missions, 1901, November 1901, 36, ABCFM Woman’s Board of Missions Annual Reports, 1869-1926, ABCFM-Houghton, 91.6.

58 examinations and treatments are greatly appreciated.”239 She also looked forward to having “more space and better equipment for carrying on the specialty.”240 The development of eye-related work in Foochow then illuminated the missionaries’ branching out of the feminine area of disease to a more general practice due to the practical needs in the field. While American medical women concentrated on obstetrics, gynecology, and pediatrics in the late nineteenth century partly due to limited training opportunities and social acceptance of their role in these fields, the diverse lines of work that female medical missionaries carried out illustrated a different trajectory of professionalism that was playing out in the mission field.241

Moreover, working in China also offered some female medical missionaries the opportunity to carry out their work according to their own will. In addition to medical treatment, female medical missionaries shouldered the responsibilities of managing the hospital. As

Woodhull mentioned, in her management of the hospital, she had to “look after and plan with carpenter, mason, and painter […] the discipline, settling quarrels, paying the helpers &c.,” indicating the multi-sided work of female medical missionaries.242 This was common among female medical missionaries from both WFMS and the American Board, and due to the heavy burden of the work, the calls for additional female physicians constantly appeared in their reports and letters. Although the lack of assistance in managing the hospitals created certain difficulties for them, for some, this work gave them greater agency in determining how the work should develop. For instance, after several months of work in the Good Shepherd Hospital in Mintsing in

1924, Hemenway commented that “It is going to be a great pleasure to work here for I can try out

239 Minnie Stryker, Outpractice for 1903, Woman’s Hospital, Foochow City, 1904, Foochow Mission v.10, reel 242, ABCFM-Houghton, 16.3.5. 240 Ibid. 241 More, Restoring the Balance, 54, 55. 242 Kate C. Woodhull to Miss Lamson, 18 June 1908, Foochow Mission Woman’s Board v.2, ABCFM-Houghton, 16.3.6.

59 new things and at least endeavor to help some cases.”243 When she was in the state hospital in the

United States, Hemenway recalled, “I was being held down constantly by old-fashioned men who were afraid of anything new,” and her fellow female doctor was also constrained by “the powers that be.” 244 Additionally, planning for the “charts and history sheets and nurses records,”

Hemenway was “very pleased indeed at the prospect of them made according to my own idea.”245

As indicated in Hemenway’s comparison with the limits in the state hospital and liberty to plan according to her will in her medical work, the missionary experience gave some female medical missionaries greater agency in professional work that they might not otherwise have in the United

States.

The widened range of medical practices also created opportunities for female medical missionaries to improve their practical skills in surgery, which some found hard to obtain in the

United States. Woodhull constantly mentioned the importance of the surgical skills that incoming female missionary physicians should possess, and “no lady who has not made up her mind to do surgical work should come to China.”246 She was also aware of her limitations in general surgical skills because when she was in medical schools, “ladies had very hard work to get opportunities for surgical training.” 247 She admitted, “many things I have had to learn from the hard experiences of performing operations for the first time alone with my medical students.”248 Her way of acquiring medical skills—trying surgical operations on Chinese people—on the one hand, showed the lack of female surgeons in the missions and the limited training opportunities in the United

243 Ruth V. Hemenway, Diary, 4 March 1924, box 1, v.1, book 1, Ruth Hemenway Papers, SSCWH. 244 Ibid. 245 Ruth V. Hemenway, Diary, 9 November 1924, box 1, v.1, book 2, Ruth Hemenway Papers, SSCWH. 246 Kate C. Woodhull to Miss Child, 10 November 1898, Foochow Mission Woman’s Board v.7, ABCFM- Houghton, 16.3.6. 247 Kate C. Woodhull to Dr. Smith, 16 October 1899, Foochow Mission v.8, reel 240, ABCFM-Houghton, 16.3.5. 248 Ibid.

60 States, and, on the other hand, illuminated the imperial context that enabled her to do so. It is problematic for a physician to carry out surgical operations without sufficient training. However, in the context of mission in China, where the social and professional constraints were less stringent,

Woodhull was able to perform general surgical operations both as medical treatment and as a way of learning, which would be largely unattainable in the United States.

Not only did medical missions help create a different meaning of professionalism on the ground, but it was also mobilized by supporters of female physicians in the United States to advocate for their cause. Although female medical missions did not have a substantial impact on the medical profession in the United States, female medical missions provided rhetoric for domestic proponents of the advancement of women in the medical profession, especially in the rally for women’s medical education. For instance, as the article, “A Century of Medical Education for Women,” argued, the success of Dr. Clara Swain in India not only broke down the prejudice in the mission against sending out women as missionaries but also was “a first step in gaining world recognition of the struggle that a small but determined group of men and women in

Pennsylvania was waging to establish the right of women to study and practice medicine.”249

Similarly, when Mary H. McLean emphasized the contributions of female medical missions to people in the foreign lands, she also pointed out the importance of supporting Woman’s Medical

College of Pennsylvania, the only woman’s medical college in the United States in 1911.250

McLean argued that it would be opportune to rally for the college and to make sure “it shall have adequate equipment, befitting the standards of the present day in new of the great responsibility

249 “A century of medical education for Women,” Independent Woman, April 1950, 105, reel 66, folder 2222, Microfilm Edition of the Mission Biographical Reference Files,1880s-1969, GCAH. 250 McLean, Mary H. “Responsibility of Medical Women of the United States to Women of Non-Christian Lands, and How We are Meeting It,” Woman’s Medical Journal, 21:11 (November 1911). Material is located at Archives and Special Collections, Drexel University College of Medicine.

61 resting upon it for preparing workers” for evangelizing endeavors in the world.251 As these two examples indicate, the consensus on the importance of female medical missionary work in

Christian missions rendered the training of female physicians critical as well. Female missionaries, as historian Jane Hunter argues, “shared the genteel vision and extolled the virtues of the evangelical woman’s sphere.” 252 With this prescribed conception, female missionaries’ role conformed to the general perception of women’s role in society, thus making female medical missionaries effective advocates to appeal for support for women in medicine. Moreover, professionalism established the tie between the domestic development and mission abroad, and as medical expertise figured significantly into female medical missionary work, missionaries’ success to some degree also affirmed women’s suitability in the medical profession in general.

In short, professionalism animated the work of female medical missionaries in Foochow.

They organized their daily life to follow professional expectations and established themselves as medical professionals in the mission. They drew authority from their medical expertise and carried out their gendered professional goals to promote the well-being of Chinese women. In the transnational context, female medical missionaries participated in a different culture of professionalism from that in the United States, and their success also contributed to the rally for the advancement of American women in the medical profession.

As Woodhull was busy running her hospital and carrying out her medical work in the local community, more and more people turned to her for medical help. In 1895, her medical work for women in Foochow was “never more prosperous than it has been during the year,” and Woodhull

251 Ibid., 247. 252 Hunter, The Gospel of Gentility, 265.

62 also opened four new dispensaries which she visited regularly.253 However, under this image of prosperity were constant contentions and negotiations with local cultures. To Woodhull, as well as many female missionary physicians in the region, medical missionary work was never an easy task.

253 Annual Report of the Woman’s Board of Missions, 1895, November 1895, 26, ABCFM Woman’s Board of Missions Annual Reports, 1869-1926, ABCFM-Houghton, 91.6.

63 Chapter III “The Chronic Discouragement of Trying, and Failing”: Cultural Negotiation and the Limits of Cultural Imperialism

In 1901, a Chinese woman brought her little boy with a curvature of the spine to the

Woman’s Hospital in the city.254 After days of waiting for the missionaries to prepare the child and “secure the materials for applying a plaster of Paris jacket,” the woman grew more and more impatient.255 Just as Woodhull was ready to put the jacket on the boy, the woman “concluded that

[they] were too slow” and “watched her chance when the door was not guarded and carried the child away.”256 The woman’s impatience demonstrates her conception that medical care should be delivered swiftly. Her agency in leaving and Woodhull’s inability to compel the woman and her boy to stay reflects the limits that female medical missionaries faced in carrying out their medical work and achieving their goals.

Far from being able to carry out their work at will, female medical missionaries faced various constraints on their ability to convert people to both the western medical approach and evangelical Protestantism. They were subject to the cultural constraints in the local community and susceptible to the disruptions of political unrest. In their day-to-day work, they also encountered obstacles in achieving their goals. While perceiving themselves as medical professionals whose treatment was superior to local practices, female medical missionaries nonetheless had to compete with local medical practitioners to win patients and establish their reputation in the community. At the same time, aiming to exert cultural influences through medical

254 Kate C. Woodhull, Woman’s Hospital, Foochow City, 1901, 1901, Foochow Mission Woman’s Mission v.1, ABCFM-Houghton, 16.3.6. 255 Ibid. 256 Ibid.

64 treatment, female medical missionaries faced challenges to convert people to evangelical culture.

Moreover, gender relations and Chinese people’s different conception of how medical care should be delivered sometimes prevented female missionary physicians from carrying out medical treatment as they expected. Facing these limitations, female medical missionaries had to adapt to local cultural understandings and made constant compromises. Female medical missionaries’ negotiations and adaptations in their medical encounters with Chinese people, therefore, reveal, in a more concrete way, the limits of missionaries’ cultural influence and illuminate the non- unilateral nature of American cultural imperialism.

In 1886, months after the opening of Woodhull’s small hospital in Foochow, the physical conditions of the hospital building concerned her. Transformed into a hospital from a local residence, the house had “no ceiling” to prevent dust.257 Woodhull hence considered constructing a new hospital.258 However, to build a new hospital was not easy. Woodhull first had trouble getting enough land for the new hospital, which she found “very wearisome.”259 In 1890, when she eventually secured a piece of land, the hospital almost did not come to fruition because of local people’s cultural perceptions.260 People believed that the land for the hospital was “situated on one of the veins of the Earth Dragon.” 261 They insisted that the hospital could not be built two stories high for the fear of “obstructing the view from a temple nearby,” and “pressing too heavily on the dragon’s vein supposed to pass under the side, lest his circulation be impeded, for on this the

257 Kate C. Woodhull to Miss Child, 16 August 1886, Foochow Mission Woman’s Mission v.7, ABCFM-Houghton, 16.3.6. 258 Ibid. 259 Kate C. Woodhull to Dr. Smith, 29 February 1888, Foochow Mission v.4, reel 236, ABCFM-Houghton, 16.3.5. 260 Caroline E. Chittenden, Dr. Kate Woodhull: Pioneer Doctor for Women in Foochow, 1917, 7, box 79, folder 14, Biographical Collection, ABCFM-Houghton, 77.1. 261 Ibid.; Twenty-Third Annual Report of the Woman’s Board of Missions, 1890, January 1891, 10, ABCFM Woman’s Board of Missions Annual Reports, 1869-1926, ABCFM-Houghton, 91.6.

65 prosperity of the city is believed to depend.”262 These obstacles in land purchasing illuminated

Woodhull’s inability to wield absolute power over the local community. Moreover, despite

Woodhull’s intention to upgrade the hospital, the local community’s cultural beliefs in the underlying dragon limited the height and size of the new hospital, compromising Woodhull’s original plan for a two-story building. Female medical missionaries hence had to cope with substantial constraints and adapt to cultural beliefs and perceptions in their work.

Indeed, similar to Woodhull’s experience, female medical missionaries were subject to the constraints created by local people’s cultural beliefs, which the success of missionary work was contingent upon. When Li Bi Cu, a WFMS medical missionary in Futsing, moved into the new building of Lucie F. Harrison Hospital in 1926, the progress of her work was closely tied to people’s cultural perceptions.263 In Futsing, the majority of people preferred boys, and there was no son “ever born in the home which formerly occupied this site.”264 Therefore, “the whole community waited anxiously the arrival of the first baby” after the opening of the hospital.265

When eighteen out of the first twenty-one babies delivered were boys, “[the hospital’s] fame spread abroad” and 190 maternity patients came to the hospital in six months.266 The community’s cultural understanding of the site as a somewhat cursed place where no boy was born, and people’s close attention to the new hospital made the sex of the first babies delivered critical. It was Li’s ability, as perceived by local people, to break the “spell” and deliver boys that made these people believe in the efficacy of missionaries’ medical skills. 267 Had Li been less lucky in this respect,

262 Ibid. 263 Li Bi Cu, “Lucie F. Harrison Hospital Report,” in Woman’s Work: Foochow Conference, Foochow, 1926, Day Missions Annual Reports, YDS, http://hdl.handle.net/10079/digcoll/4336628. 264 Ibid., 48. 265 Ibid. 266 Ibid. 267 Ibid.

66 she might have had a more challenging time gaining people’s confidence in the hospital and western medical treatment. Local people’s cultural perceptions—a factor that was out of missionaries’ control—therefore had an important impact on the success of female medical missionaries’ work.

In addition, political conditions added greater uncertainty and interruptions to medical missionary work. In the wake of the Boxer Rebellion, one of the major anti-foreign uprisings in

China at the turn of the twentieth century, political unrest in various parts of China had brought about attacks on the missionary community. In 1900, Woodhull was deeply concerned about the political situations around her. “Things look very serious and we do not know what a day will bring,” Woodhull wrote.268 “Hearts are sick when we read of the sufferings of the missionaries coming from the interior,” Woodhull exclaimed.269 Woodhull’s fear was not groundless. Female medical missionaries worked within the context of American imperial activities, and their work, as were other branches of missionary work, was susceptible to the impact of the constantly changing political conditions in China. Furthermore, these social and political conditions could sometimes bring major disruption to their medical work. For instance, missionaries in Shaowu, an interior region of the province, mentioned their loss due to anti-Christian attacks.270 Missionaries reported that the raiders “plundered the Christian druggist and gutted his establishment,” damaged several buildings, and destroyed the personal property of missionaries and Chinese Christians, seriously interrupting the medical work.271

268Kate C. Woodhull to Miss Child, 28 June 1900, Foochow Mission Woman’s Board v.7, ABCFM-Houghton, 16.3.6. 269 Kate C. Woodhull to Miss Child, 15 August 1900, Foochow Mission Woman’s Board v.7, ABCFM-Houghton, 16.3.6. 270 Rev. Geo. W. Hinman, The Fifty-Fourth Year of the Foochow Mission of the American Board (Foochow: Romanized Press, 1901), box 8, folder 123, Willard Livingstone Beard Family Papers, YDS. 271 Ibid., 52.

67 In addition to the loss of property, missionaries’ lives also received threats to their lives in some cases. Emma Betow, a WFMS missionary physician in Hinghwa, related an escape from the mob.272 “We saw a mob of over a thousand men standing near the city gate snatching bundles away from people as they came over the city wall,” Betow wrote.273 She recalled, “Our lives as well as our compound were in danger; even the Chinese Government sent a gunboat for us to come into Port.”274 As a result of the serious situations, Betow and other missionaries had to “stay at

Foochow the greater part of two years,” compelling her to suspend the medical work in

Hinghwa.275 They left behind “[a]ll [their] clothing, books, instruments, and everything else dear to one’s heart, including the building which [they] had built.”276 As Betow’s words reflected, the unsettling political conditions in China created further difficulties for female medical missionary work.

Besides the impact of the cultural constraints and unsettled political circumstances, local people’s different understanding of medical healing also challenged female medical missionaries’ goal to convert people to the western medical approach. Rooted in a different system of medicine, local people held different conception of disease and medical efficacy, which sometimes made it hard for them to adopt missionaries’ treatment. “The people [have] strange ideas about diseases and medicine,” Woodhull wrote to people back home, “they consider all as divided into two classes, hot & cold.”277 Woodhull constantly had patients coming to the dispensary and asked her, “with

272 Emma Betow to “Dear Friends,” 6 September 1913, reel 20, folder 405, Microfilm Edition of the Mission Biographical Reference Files,1880s-1969, GCAH. 273 Ibid. 274 Ibid. 275 Forty-Fifth Annual Report, Woman’s Foreign Missionary Society of the Methodist Episcopal Church, 1914, 188, Records of the Women’s Division of the General Board of Global Ministries, GCAH. 276 Emma Betow to “Dear Friends,” 6 September 1913, reel 20, folder 405, Microfilm Edition of the Mission Biographical Reference Files,1880s-1969, GCAH. 277 “Miss Kate C. Woodhull writes,” 23 July 1888, Foochow Mission Woman’s Board v. 7, ABCFM-Houghton, 16.3.6.

68 the greatest concern,” whether the disease was hot or cold.278 This different conception of diseases and medicine had led to some confusion for female medical missionaries who were new to the community. Emily Smith, an American Board medical missionary to Ing Hok, was puzzled when she first encountered this new idea. In 1904, only two years after her first arrival, Smith mentioned that when people came to see her, they usually asked her whether the medicine was hot or cold.279

“As I do not understand the Chinese theories of ‘hot and cold’,” she reflected, “I cannot give a satisfactory answer.”280 The vocabulary in describing diseases and medicine, therefore, indicated a disparate system of cultural understanding.

Moreover, Chinese people’s perception of effective medicine further indicated the difference. As historian Yi-li Wu argues in discussing medical efficacy in late imperial China, for people to believe the medicine was effective, they had to “perceive a significant, positive change in the patient’s condition following the treatment,” and they had to be “predisposed to credit these changes” to the medicine given.281 This perception also had an important influence when it came to missionaries’ medical treatment. In 1893, a woman came back to Woodhull a short time after receiving the treatment.282 She said “in a very impatient voice” that she had used the medicine, and she was “no better” and “no worse” and therefore brought it back, placing the ointment on the table “with an air of great disgust.”283 As this woman’s words suggested, she determined the efficacy of medicine based on the swift improvement; the lack of such perceived efficacy of the

278 Ibid. 279 Emily D. Smith, Report of Medical Work, Ing Hok, 1903-1904, 27 June 1904, Foochow Mission v.10, reel 242, ABCFM-Houghton, 16.3.5. 280 Ibid. 281 Yi-li Wu, "The Bamboo Grove Monastery and Popular Gynecology in Qing China," Late Imperial China 21, no. 1 (2000): 48, doi:10.1353/late.2000.0005. 282 Kate C. Woodhull and Frances E. Nieberg, Report of Hospital for Women and Children, Foochow City, for Year Ending Dec 31, 1893, April 1894, Foochow Mission v.5, reel 237, ABCFM-Houghton 16.3.5. 283 Ibid.

69 medicine that Woodhull gave her led her to abandon it. Male medical missionaries also encountered similar challenges. H. N. Kinnear, physician-in-charge of American Board’s

Ponasang Missionary Hospital, reported that there were “frequent instances of impatience & lack of confidence in the foreign physicians & his appliance.” 284 One man returned the medicine after two days of use because “he did not see any improvement.”285 These instances thus showed local people’s different conceptualization of medical efficacy, which posed challenges to medical missionary work.

The cultural understanding was so deeply ingrained that even when people accepted the evangelical teachings, they still adhered to Chinese approaches of medical care. Admittedly, compared to non-Christians, Chinese Christians were relatively more open to missionaries’ treatment.286 However, this was not always the case. In 1924, the child of Chinese Methodist

Presiding Elder, Mr. Ding, got sick, and Mr. Ding went to Dr. Ruth Hemenway for help in

Mintsing.287 While there, the couple was “frantic” and were “feeding [the baby] an awful mixture

[of] cooked rice and water.”288 Despite being a Christian and receiving Christian education, Mr.

Ding “[did] not trust foreign medicine and firmly believe[d] that their centuries of custom in bringing up babies [was] superior” to missionaries’ treatment. 289 Using the word “awful,”

Hemenway assumed a hierarchy where the western way of child care was better than the Chinese way. Mr. Ding’s lack of trust in Hemenway’s treatment and his insistence on the Chinese way of

284 The Annual Report of the Foochow Mission for Year Ending March 31, 1893, April 1893, Foochow Mission v.5, reel 237, ABCFM-Houghton, 16.3.5. 285 Ibid. 286 For example, as the annual report for 1896 of Foochow Mission mentioned, female medical missionaries were received to Chinese Christian homes with “great warm welcome and confidence.” See, Twenty-Ninth Annual Report of the Woman’s Board of Missions (Boston: Frank Wood, Printer, 1896), 5, ABCFM Woman’s Board of Missions Annual Reports, 1869-1926, ABCFM-Houghton, 91.6. 287 Ruth V. Hemenway, Diary, 26 October 1924, Ruth Hemenway Papers, SSCWH. 288 Ibid. 289 Ibid.

70 caring for the child challenged such an assumption. It reflected his adherence to the traditional approach despite his Christian identity. Female medical missionaries tended to view healing the body and the soul as mutually constituting their work. Because Chinese patients adhered to their medical understanding and practices, however, female medical were not always able to achieve both goals. Thus, the difference in medical healing and Chinese people’s different conceptualization of effectiveness might have made Chinese people trust less in western medical treatment and further complicated female medical missionaries’ work.

Apart from the conceptual differences, other factors also dissuaded some patients from accepting medical missionaries’ treatment. While female medical missionaries assumed that the concerns for physical health should take priority, some patients, largely due to their economic constraints, held a different view. For instance, Woodhull mentioned that a poor woman who was blind due to the cataract came to the hospital.290 Upon hearing that she had to remain in the hospital for a while to have an operation, the woman and her husband “said over and over again ‘We are too poor—she cannot stay,” and eventually went home without receiving the treatment despite missionaries’ promise that “it should be no expense to her” during her stay.291 Even though the woman was willing to seek western medical care, her financial situation prevented her from doing so. As Woodhull remarked, “when the family is very poor, even what a blind person can do is missed.”292 A pamphlet about American Board’s Women’s Hospital in Foochow also related Lora

Dyer’s encounter with a poor woman who had “a growth on the breast.”293 Dyer urged the woman to stay in the hospital for treatment, but the woman refused. As the author of the pamphlet

290 Report of Foochow City Hospital for Women and Children for Year Ending Dec.31, 1896, 1897, Foochow Mission v.5, reel 237, ABCFM-Houghton, 16.3.5. 291 Ibid. 292 Ibid. 293 The Hospital on Peace Street, Foochow China, n.d., 6, box 13, folder 21, ABCFM-Andover.

71 described, “Oh no! that was impossible, for she had two little pigs at home that some one had just given to her and if she was not there to watch them they would run away or be stolen and she was too poor to hire any one to look after them.”294 Despite her suffering from the disease, the woman prioritized taking care of the pigs; for her, the pigs were important because they might help lessen her financial difficulties. In comparison to the imperative of maintaining a basic living, the woman might have considered seeking medical relief less of a priority. As the mocking tone of the description suggests, while missionaries were unable to understand this woman’s choice, economic factors and practical concerns, in reality, did prevent some people from adopting female medical missionaries’ treatment.

Having to cope with these different factors, female medical missionaries constantly faced limits in extending their medical reach to Chinese people. Chinese patients’ refusal to undergo surgical operations was a challenge to many female medical missionaries. As doctors Ellen Lyon and Ella Johnson mentioned in 1891, their hospital in Foochow had only a few operations as they found “Chinese averse to being cut.”295 Chinese people’s aversion to operation continued to create obstacles for medical missionary work in the twentieth century. When Dyer told a woman patient that she needed an operation, the woman refused and said, “It does not matter. I have eaten fifty years already and I’m an old woman. I’ll just die. It does not matter.”296 The woman’s rejection of an operation thus indicated the limited ability of female medical missionaries to convince Chinese patients to accept western medical treatment. Even when the patients yielded to surgery, they did

294 Ibid., 6,7. 295 Minutes of the Fifteenth Session of the Foochow Annual Conference of the Methodist Episcopal Church, Foochow, November 18-24, 1891, 45, Methodist Conference Journals, Methodist Library. 296 The Hospital on Peace Street, n.d., 6, box 13, folder 21, ABCFM-Andover.

72 not adopt western treatment whole-heartedly. Mrs. Ding Ko’s eye was distended with pus. 297 She received an operation in which H.N. Kinnear and Ella Kinnear removed her eyeball.298 When Dr.

Kinnear prescribed “a mild analgesic” for her, Mrs. Ding Ko refused to take it because western medicine “did not agree with her” and “she had taken it once with unpleasant results.”299 “The same patient may thus trust us with her life for an operation, but put his, or her, own judgment above ours in the matter of the simplest remedies,” the Kinnears remarked.300 “The inconsistencies of the Chinese mind in its ordinary state are not easily fathomed.”301 These patients’ total rejection or partial acceptance thus reflects medical missionaries’ inability to convert Chinese people fully to the western medical approach.

Not only did female medical missionaries face difficulties in persuading patients to undergo surgery, but they also encountered setbacks in making people adopt hygienic practices and ensuring that people followed the medical instruction properly. How to make patients aware of the importance of hygiene was a problem for many missionaries. “The lack of cleanliness among the Chinese is very trying,” Woodhull complained, “when with us, they conform in a certain measure to our habits, but when they go back to their homes, seem to think that for the Chinese the old way is as well.” 302 Decades later, Dyer was also frustrated about the “chronic discouragement of trying, and failing” to make people aware of “the value of hygiene and plain ordinary hygiene in the care of children, as weighed against the worth of charms and ceremonies,

297 H.N. Kinnear and Ella Kinnear, Winning by Serving: The Annual Report of Foochow Missionary Hospital for the Two Years ending December 31, 1925 (Stewart Peet Memorial Press, 1926), 14, box 361, folder 11, China Records Project, YDS. 298 Ibid. 299 Ibid. 300 Ibid. 301 Ibid. 302 “Miss Kate C. Woodhull writes,” 16 Feb 1891, Foochow Mission Woman’s Board v.7, ABCFM-Houghton, 16.3.6.

73 tightly closed windows and impossible concoctions as medicines.”303 Woodhull and Dyer thought of Chinese people as being unclean, and considered western practices clean and, hence, better.

Chinese people’s insistence on their way of practice, however, illustrates their rejection of

Woodhull and Dyer’s assumption and thus missionaries’ inability to change Chinese people’s understanding of hygiene and other health-related ideas. Moreover, outside of the space of the hospital and the direct supervision of missionaries, patients did not necessarily comply with missionaries’ instructions. Cases such as overdosing for a speedy recovery and swallowing externally-use-only ointment happened despite missionaries’ instructions. 304 These patients’

“disobedience” further reflected female medical missionaries’ limited ability to convert people fully to western medical ideas and practices.

Additionally, female medical missionaries faced constraints in extending medical treatment to more people outside of the hospitals and dispensaries. One of the advantages of female medical missionaries over male missionaries, as the mission boards perceived, was their ability to reach women in seclusion and bring medical treatment and the gospel to these women. However, with a few exceptions, they were unable to attend to women patients at home continuously.

Woodhull mentioned in her letter in 1886 that she and her students did not “feel free to make visits

[after the delivery of the child] unless [people] ask us to do so, for we are not welcome unless specially invited.”305 Allowed to continue visiting only upon invitation, Woodhull could not treat the patients as she deemed fit. In these cases, it was local people, rather than Woodhull, who determined whether to receive medical care. WFMS missionary physicians also confirmed that as

303 Lora G. Dyer, “Woman’s Hospital, January-December, 1923,” in Another Fight at Foochow and the Work it Made for Us: The Annual Report of Foochow Missionary Hospital, Foochow, China, for the Two Year ending December 31, 1923 (Stewart Peet Press, 1924), 22, Historical Collections (Pamph. Foochow), Andover. 304 “Report of the Hospital for Women and Children in Foochow,” in Life and Light for Woman, October 1897, 450, Life and Light 1869-1922, ABCFM-Houghton, 91.9. 305 Kate C. Woodhull to Dr. Smith, 10 May 1886, Foochow Mission v.4, reel 236, ABCFM-Houghton, 16.3.5.

74 a rule, they could not “continue to go to the same home long,” which impeded them to exert greater influences on people from higher classes.306 Female medical missionaries continued to encounter this problem. As Minnie Stryker reported in 1902, she could “go to the same house but once or twice.”307 The limitations on female medical missionaries to freely attend to the patients in their house demonstrates the limits of missionaries’ efforts to extend their medical reach.

Moreover, in some cases, local people prioritized certain practices over missionaries’ treatment, which obstructed missionaries’ efforts to treat the patient. In her 1889 report, Woodhull recorded a visit to a woman who was in critical condition after cutting her tongue. Calling for

Woodhull, the family also sent for a conjurer to perform rituals and “invited [Woodhull] to sit and wait until he had finished.”308 Woodhull lamented, “[W]e found there was no hope of their allowing us to do anything until it was too late, so we retired from the scene.”309 Despite being called for in the first place, Woodhull was not able to carry out the treatment. While Woodhull viewed her treatment critical to saving the woman, the woman’s family prioritized the conjurer’s rituals, which made it hard for Woodhull to treat the woman. The impediment she faced further illustrated the constraint that female medical missionaries faced in delivering medical care to the patients.

While female medical missionaries coped with obstacles in extending their medical reach, they also had to compete with local medical practitioners. As the previous chapter shows, female medical missionaries established themselves as medical professionals and discredited traditional

306 Ellen M. Lyon and Luella M. Masters, “Women & Children’s Hospital, Foochow,” in Minutes of the Tenth Sessions of the Foochow Woman’s Conference of the Methodist Episcopal Church, Foochow, November 23-28, 1894, 13, Day Missions Annual Reports, YDS, http://hdl.handle.net/10079/digcoll/4336694. 307 “Minnie Stryker writes,” 2 May 1902, Foochow Mission Woman’s Board v.1, ABCFM-Houghton, 16.3.6. 308 Kate C. Woodhull, Report of Hospital for Women and Children in Foochow City, 1888-1889, 31 March 1889, 4, Foochow Mission v. 3, reel 235, ABCFM-Houghton, 16.3.5. 309 Ibid.

75 Chinese medical practices. Despite having this self-perception, they faced constant competition with Chinese doctors, and they did not always win the patients over. Female medical missionaries first needed to compete with Chinese people’s preexisting preferences to Chinese medical practices. Both male and female medical missionaries frequently mentioned that patients called for foreign doctors as the last resort. As Woodhull pointed out, people “delay[ed] sending for

[missionaries] until all help from native sources [had] been given up.”310 Intuitively, when ill, people tend to turn first to medical treatment with which they are familiar. Chinese people’s last- minute call for missionaries thus reflected such preference, which made it harder for missionaries to convert people to western medical treatment. The concerns of female medical missionaries, as

Hemenway stated, that “native doctor [would] beguile [the patients]” from them further affirmed the competition with traditional Chinese medical practices that missionaries had to confront.311

Additionally, female medical missionaries were subject to the selection of patients, and patients had greater agency in determining what treatment they would receive. As sociologist

Arthur Kleinman points out, the popular sphere of health care operates as “the chief source and most immediate determinant of care.” 312 Laypeople decide “when and whom to consult, whether or not to comply, when to switch between treatment alternatives, whether care is effective, and whether they are satisfied with its quality.”313 This was also the case for Chinese patients. Chinese patients’ agency in selecting treatments further added to missionaries’ difficulties in securing patients and subjected missionaries to competition with other Chinese medical practitioners.

WFMS physician Mary Carleton in her 1903 report described the Chinese manner of

310 Report of Foochow City Hospital for 1895, 1896, Foochow Mission v.5, reel 237, ABCFM-Houghton, 16.3.5. 311 Ruth V. Hemenway, Diary, 7 November 1924, box 1, v.1, book 2, Ruth Hemenway Papers, SSCWH. 312 Arthur Kleinman, Patients and Healers in the Context of Culture: An Exploration of the Borderland between Anthropology, Medicine, and Psychology (Berkeley and Los Angeles: University of California Press, 1980), 51. 313 Ibid.

76 prescribing. 314 In seeking prescription, Chinese people “call[ed] a physician, receive[d] and administer[ed] his prescription which usually consist[ed] of one dose only, then to wait a half hour or so, and if the patient [was] no better, to call another.”315 In this case, patients choose medical treatment as they deemed it. Due to this special doctor-patient relation, missionaries’ medical treatments were in constant competition with other Chinese medical practices.

Such competition was most salient at Kienning Hospital. This American Board hospital had a special arrangement where the hospital was divided into western and Chinese sides; foreign and Chinese doctors carried out their medical practices respectively in the same hospital. 316

Missionary physician Clara Shepherd related an incident to show “some of the limitations of the arrangement.”317 A patient with a serious infection came to the western side of the hospital.318 To save the patient, Shepherd used “drastic intra-venous treatment” and bone injection, but the patient only improved a little. Believing in that “a man’s spirit must not depart while he is absent from the ancestral home,” his family members quietly called for a Chinese doctor who could “read the approach of death in the state of the pulse.”319 As the Chinese doctor informed the family that the patient was about to die, the family insisted on going home though Shepherd believed other methods might work.320 Shepherd attributed this incident to the “premature admixture of the old and the new” and hoped to practice in a hospital that was “independent of all other influences.”321

In this case, witnessing the little improvement in the patient after western treatment, the patient’s

314 Mary Eline Carleton, “Medical Work,” in Official Minutes of the Nineteenth Session of the Foochow Woman’s Conference of the Methodist Episcopal Church, Foochow, October 6-9, 1903, 73, Day Missions Annual Reports, YDS, http://hdl.handle.net/10079/digcoll/4336504. 315 Ibid. 316 Clara Sargent Shepherd, Report of Kienning Hospital for 1927, Shaowu Mission v.1, ABCFM-Houghton, 16.3.18. 317 Ibid. 318 Ibid. 319 Ibid. 320 Ibid. 321 Ibid.

77 family decided to follow the Chinese doctor’s judgment and abandoned missionaries’ treatment.

Despite viewing the western side as carrying out “new scientific ideas,” Shepherd was unable to change the Chinese patient’s perception and eventually failed to persuade the patient to remain for further treatment.322 The patient’s agency in selecting medical treatment therefore reflected the competition of medical practices that missionaries were subject to.

Facing the competition from other Chinese doctors, female medical missionaries made a great effort to establish their reputation and they had some success in this respect. Both male and female medical missionaries recognized the effectiveness of surgical operations in increasing local people’s confidence in western medicine. As we have seen, Chinese people sometimes refused to have surgeries. When missionaries were able to carry out operations successfully, however, their surgical skills helped missionaries establish their reputation. As H.N Kinnear, commented, “in any but surgical or obstetrical cases superior skill can not be demonstrated at one visit,” indicating surgery’s effectiveness in demonstrating the advantage of western medicine.323

Female medical missionaries recognized the importance of surgical work in attracting people to missionary hospitals. The 1909 report of Hinghwa Woman’s Conference of WFMS recorded the story of Dr. Emma Betow’s successful surgery. Betow removed a thirty-eight-pound ovarian tumor and a forty-eight-pound ovarian tumor from two women.324 The operations caused a great sensation among local people as the news spread, and “before long [the missionaries] were besieged by men, women and children who wanted their abdomens cut open no matter what their

322 Ibid. 323 Rev. C. Hartwell, Rev. W.L. Beard, H. N. Kinnear, and Mrs. W. L. Beard, The Fifty-Third Annual Report of the Foochow Mission of the American Board (Foochow: Romanized Press, 1900), 13, box 11, folder 1, ABCFM- Andover. 324 Official Minutes of the Eleventh Session of the Hinghwa Woman’s Conference of the Methodist Episcopal Church held at Hinghwa City, China, November 25th to 27th, 1909 (Shanghai and Foochow: Methodist Publishing House, 1909), 15, Methodist Conference Journals, Methodist Library.

78 disease happened to be.”325 “Laparotomy was the fashion,” the report commented.326 As the enthusiasm of local people reflected, Betow’s surgery demonstrated her professional ability to effectively treat disease and establish her professional reputation among local people. Medical missionaries sometimes also enjoyed certain privileges that other missionaries did not have.

WFMS missionary physicians at Liang-au Women’s and Children’s Hospital pointed out that “the

Doctor’s chair, known by its two lanterns, [was] given right of way through any crowd day or night and [went] unmolested,” reflecting the success that missionaries had in establishing themselves as doctors in the local community.327

However, the reputation of female medical missionaries and the confidence built up still needed to be maintained carefully. In her diary, Hemenway mentioned an operation on a baby who had a large swelling under his jaw.328 Hemenway believed it was a caseous mass before the operation, but when she started to dissect the capsule, she found it “extended in between and behind various muscles,” and it would be risky to take that out.329 Ambivalent about whether to proceed,

Hemenway eventually decided to leave the capsule in its original place because “an accident here would prejudice people so that the hospital might remain empty for years.”330 Hemenway’s fear of negative consequences indicated that a mistake could easily break down missionaries’ medical reputation and her decision to avoid risk also reflected missionaries’ efforts in preserving such a reputation.

325 Ibid. 326 Ibid. 327 Ellen Lyon, Lena Hatfield, Cora E. Simpson, “The Liang Au Woman’s and Children’s Hospital, Foochow, China: Medical and Evangelistic,” in Report of the Twenty-Fifth Session of the Foochow Woman’s Conference of the Methodist Episcopal Church, Foochow, November 17-19, 1909, 46, Day Missions Annual Reports, YDS, http://hdl.handle.net/10079/digcoll/4336510. 328 Ruth V. Hemenway, Diary, 15 March 1924, box 1, v. 1, book 1, Ruth Hemenway Papers, SSCWH. 4 329 Ibid. 330 Ibid.

79 Moreover, missionary physicians did not have the absolute monopoly over surgery, either.

Kinnear mentioned in 1925 a patient who came to the hospital after serious injury in an explosion.331 While staying in the hospital, the patient frequently inquired about other cases in the hospital and the remedies.332 Years after the patient left the hospital, Kinnear heard that “[the previous patient] was making a great name for himself practicing medicine, and more especially surgery!” 333 Besides learning surgery, Chinese doctors also sought to reform Chinese medicine following the model of western hospitals. Considering Chinese doctors’ inability to reach each patient quickly when needed, Shuyu Lin, in a 1925 newspaper article, proposed establishing more

Chinese hospitals that provided Chinese medical treatment, setting up departments and drug stores, and referring to the rules of foreign hospitals when making the rules for Chinese hospitals.334 As these instances suggest, despite being able to establish themselves in the community through certain medical skills, female medical missionaries still needed to respond to new changes and development in Chinese medicine. Hence, working in a local society, female medical missionaries were in constant competition with local medical practitioners and had to work hard to establish themselves professionally.

Not only did female medical missionaries encounter challenges in converting people to the western medical approach, but they also experienced setbacks in their efforts to change people’s day-to-day cultural practices through medical work. The goal of healing the body and saving the

331 H.N. Kinnear and Ella J. Kinnear, “Oriental Reflexes,” in Winning by Serving: The Annual Report of Foochow Missionary Hospital, Foochow, China, for the Two Years Ending December 31, 1925 (Stewart Peet Memorial Press, 1926), 20, box 361, folder 11, China Records Project, YDS. 332 Ibid. 333 Ibid. 334 Shuyu Lin, “Wo dui zhongyi zenmeyang gailiang de guanjian (How I See Chinese Medicine Can Improve),” Qiushi ribao, March 19, 1925, Microfilm Department, Fujian Provincial Library.

80 soul was central in the rationale of sending out medical missionaries.335 Mission board members understood well the effectiveness of medical work in opening avenues for the spread of evangelical messages. As the 1916 ABCFM Manual for Missionaries Candidates described, “few workers have more opportunities for exerting a favorable influence upon individuals or for the breaking down of the prejudices of multitudes” than medical missionaries. 336 Expecting medical missionaries to exert religious and cultural influences on people abroad, the mission boards, as well as missionaries themselves, considered their medical work as a means to achieve this goal.

Though having this expectation, female medical missionaries found difficulties in changing Chinese people’s cultural practices and converting them to Christianity. While female medical missionaries made an important contribution to the abolition of foot-binding, they were not so successful in changing other cultural practices; Chinese people took advantage of missionaries’ medical treatment when it suited their purposes while rejecting missionaries’ many efforts to change their day-to-day practices. In 1894, a Chinese woman suffered from an extensive burn, leading her to receive care at the Hospital for Women and Children. 337 “Just as she was beginning to improve,” noted Woodhull, “[the woman] announced that she was going home” to engage in “idol worship” so that she could “get well faster.”338 Woodhull was able to improve

Chinese women’s physical conditions, but she made little impact on these women’s cultural understanding of medical healing. For this woman, the ultimate recovery was still at the mercy of an “idol.” The woman thus flexibly gained benefits from the medical treatment without adopting the intended cultural message. Similarly, in 1896, Woodhull and Frances Goddard were called to

335 Rosemary Fitzgerald, “A ‘Peculiar and Exceptional Measure’: The Call for Women Medical Missionaries for India in the Late Nineteenth Century,” Missionary Encounters: Sources and Issues (1996), 194. 336 Manual for Missionary Candidates, 1916, 4, Manual for Missionary Candidates, ABCFM-Houghton, 91.5. 337 Kate C. Woodhull, Report of Hospital for Women and Children, Foochow City, 1894, 1895, Foochow Mission v.5, reel 237, ABCFM-Houghton, 16.3.5. 338 Ibid.

81 a family. When they arrived, “to prevent the foreigner’s ‘evil influence,’” the family “burned straw in front of the patient’s room, and while it was blazing invited [the missionaries] to enter.”339

Woodhull and Goddard declined to walk through the fire and pitied “[these people’s] weakness and superstition.”340 Pitying that the family was superstitious, Woodhull and Goddard implied that western medical treatment, by contrast, was rational and scientific and expected local people to adopt such values when they received western medical treatment. The very act of setting fire to cast out “evil influences,” however, suggested that local people had no intention to conform to female medical missionaries’ cultural expectations and they viewed missionaries’ treatment mainly in a practical light.

Likewise, female medical missionaries’ evangelizing endeavors also yielded rather ambiguous results despite missionaries’ optimism in their reports. In some cases, female missionary physicians were successful in converting people or introducing people to the gospel and church life. However, most of the time, missionaries faced mixed responses from people to evangelical messages. As Woodhull mentioned, “It is such a joy to see those we are trying to help go on to know the Lord, such a sorrow to see them turn back,” illuminating the setbacks that medical missionaries experienced in their evangelistic work.341 Goddard also pointed out that it was challenging for a physician to “gain the attention of the people for anything aside from their diseases.”342 Goddard’s words therefore further showed missionary doctors’ limited evangelical and cultural influences. Female medical missionaries seemed to remain rather unsuccessful in

339 Kate C. Woodhull, “Woman’s Hospital,” in Report of the Foochow Mission of the American Board, 1895-6 (Foochow: Romanized Press, 1896), 48, box 8, folder 123, Willard Livingstone Beard Family Papers, YDS. 340 Ibid. 341 Kate C. Woodhull to Mrs. Cook, 11 July 1899, Foochow Mission Woman’s Board v.7, ABCFM-Houghton, 16.3.6. 342 Frances E. Nieberg-Goddard, “China: Foochow, May 22, 1896,” in Life and Light for Woman, October 1896, 470, Life and Light 1869-1922, ABCFM-Houghton, 91.9.

82 converting people to Christianity through medical work. In 1919, reflecting on her evangelistic work, Dyer said, “it is hard to tell how much the Kingdom has been advanced by this hospital.”343

As these instances suggested, increasing the interactions with Chinese people, medical work fell short in bringing people to Christianity.

Besides the challenges female medical missionaries encountered in converting people to evangelism and western cultural values, they did not always achieve their special goal of promoting Chinese women’s well-being as they wanted to. They were unable to subvert the gender relations that structured the community. As the previous chapter shows, female medical missionaries used their professional work to mediate gender relations for patients in the hospitals.

These mediations, however, had their limits, and female medical missionaries sometimes still had to yield to preexisting power dynamics. For example, Woodhull mentioned a “pitiful case” concerning a young woman in her report in 1894.344 The young woman had cancer of the foot.345

When Woodhull proposed amputation as “the only hope of relief,” her husband said “indignantly,”

“What could she do with only one foot.”346 From the husband’s attitude and the word “pitiful,” it may be inferred that the young woman did not get the treatment in the end. The woman’s husband rejected the amputation out of his consideration of women’s central role in the household, that is, to do chores for the family. Due to the husband’s opposition, Woodhull was not able to amputate the woman’s foot and gave her relief. Instead of proceeding to operate regardless of the husband’s objection, Woodhull did not attempt to confront this man and thus did not intend to challenge the commonly accepted gender relations in the local community.

343 Lora Dyer, Annual Report, 1919, Foochow Mission Woman’s Board v. 4, ABCFM-Houghton, 16.3.6. 344 Kate C. Woodhull, Report of Hospital for Women and Children, Foochow City, 1894, 1895, Foochow Mission v.5, reel 237, ABCFM-Houghton, 16.3.5. 345 Ibid. 346 Ibid.

83 Hemenway also experienced the constraint of gender relations in her work. In 1924,

Hemenway accepted a “poor little girl of seven” in the clinic.347 The girl’s father, who had sold her as a child-wife, took her in because she was “so ill that she [was] of no use” and “ her father- in-law gave permission for the father to take her” for treatment.348 Hemenway saw that the girl had

“at least five diseases” and urged him to leave the girl in the hospital.349 The father hesitated, and he said that he had to acquire permission from the father-in-law first.350 Despite that Hemenway told him to “hurry and to bring her back at once as she needed treatment,” the father did not return;

Hemenway feared that “the father-in-law decided that she was not worth the trouble.” 351

Hemenway then exclaimed, “Poor little girl—and only one of so many in this country.” 352

Although the doctors considered it necessary for the girl to receive treatment as soon as possible,

Hemenway was unable to keep the girl in the hospital without the father-in-law’s permission.

Neither could she challenge the gender power relations in which the father-in-law was to determine the life of the child-wife. Hemenway could only pity that this girl and many other girls would suffer. Therefore, female medical missionaries, though sometimes succeeding in mediating household relationships for their woman patients, were not able to challenge the gender relations structuring local society. Behind the optimistic statements that “medical missionaries […] are changing the conceptions of Oriental society respecting women’s rights and privileges,” and that

“the general sentiment of all classes is undergoing a change wherein the value, dignity, and glory

347 Ruth V. Hemenway, Diary, 30 October 1924, box 1, v. 1, book 2, Ruth Hemenway Papers, SSCWH. 348 Ibid. 349 Ibid. 350 Ibid. 351 Ibid. 352 Ibid.

84 of womanhood are increasingly appreciated” was a set of more complex interactions between female medical missionaries and their patients in missionaries’ quest to uplift Chinese women.353

To cope with these limits and obstacles, female medical missionaries adapted to local conditions and developed strategies to advance their work. Being aware of the cultural constraints,

Woodhull actively participated in local cultural events to familiarize herself with people’s cultural views. “It is so important that we know what [Chinese people] do, so we may be wise and tactful to know how we can suggest better ways,” Woodhull remarked after she went to a Chinese wedding.354 Not only did Woodhull attempt to learn more about local culture, but she also adapted to people’s cultural views of medical healing. As she continued to work among Chinese people,

Woodhull got a better sense of how to explain western medicine to people. In 1902, a patient was brought in and the family members emphasized that “only cold medicine agreed with her.”355

Woodhull explained to them that western medicine had no such division, and she “would be very careful to give just the right medicine that her disease required.”356 Woodhull’s words reflected her understanding of the key distinction between Chinese and Western concepts of diseases and medicine. Using the vocabulary of hot and cold, Woodhull pointed out the difference between two types of medicine. Furthermore, by articulating that she would use the “right medicine,” Woodhull understood the culturally coded message and got at the root of the problem—the family’s fear of wrong medicine, therefore clearing out the family’s concerns.

353 Enoch F. Bell, Envelope Series: Your Doctor Abroad, July 1915,13, 14, box 6, folder Medical Work, Special Topic, ABCFM-Houghton, 85.9. 354 Kate C. Woodhull to Dr. Smith, 22 August 1891, Foochow Mission v.8, reel 240, ABCFM-Houghton, 16.3.5. 355 Kate C. Woodhull, “Pagoda Bells or Medical Work in Foochow,” in Life and Light for Woman, January 1902, 24, Life and Light 1869-1922, ABCFM-Houghton, 91.9. 356 Ibid.

85 Similar to Woodhull, other female medical missionaries also adapted to Chinese people’s cultural views and developed strategies in response to these views. As Wu argues, among Chinese of all classes, religious practices were an integral component of traditional medical healing, and the distinction between the two was often unclear.357 Female medical missionaries were aware of the spiritual components in Chinese medical healing. Quoting the word of the “great traveler” Mrs.

Bishop, a WFMS pamphlet explained that “every system of Medicine prevailing in the east is connected with sorcery, demonolatry, and witchcraft” and there was “ a close connection between medicine and extraordinary, superstition, and wickedness,” which rendered medical mission important.358 This comment suggested that female medical missionaries had noticed the overlap.

From their observations, many missionaries also noted that people would constantly go to the

“idols” for medical advice.

Knowing about this feature of Chinese medical healing, female medical missionaries adapted to people’s cultural views and tried to persuade them to take western medicine. Goddard’s encounter with a group of Chinese women illustrated such flexible adaptation. Goddard met a group of women who had just gone for idol worship in Ing Hok in 1898. 359 The daughter of one of these women was ill, and the women went to the “idol” for the cure.360 Asking the woman what the “idol” had said, Goddard told her that “the idols were not able to help her and to follow their directions would only be injurious.”361 The woman asked for medicine before she left.362 “In this

357 Wu, "The Bamboo Grove Monastery and Popular Gynecology in Qing China," 49. 358 Medical Missionary Work for Chinese Women& Children in Fukien Province China by The Woman’s Foreign Missionary Society of the Methodist Episcopal Church, 1874-1897 (Foochow: The Foochow Printing Press, 1897), 11, folder Foochow Conference Willis F. Pierce Memorial Hospital Foochow China through 1935, Mission Geographical Reference File (sub-series: U.S.A.), GCAH. 359 “Ing Hok” in “Happy Valley: The Fifty-Second Annual Report of the Foochow Mission of the American Board (Foochow: Romanized Press, 1898), 44, box 8, folder 123, Willard Livingstone Beard Family Papers, YDS. 4 360 Ibid. 361 Ibid. 362 Ibid.

86 way foreign medicine is slowly being introduced,” Goddard explained.363 Although it is unclear what additional persuasions Goddard had employed to make the woman want to try foreign medicine, her words here illuminated her strategy to promote western medicine. First, asking about what the “idol” advised then centering her persuasion on the ineffectiveness of this approach,

Goddard established her argument from these women’s perspective; by discrediting the “idol,”

Goddard also indirectly challenged the effectiveness of the prescription given by the “idol.” In this way, Goddard adapted her strategy to the local cultural view of medicine and attempted to establish confidence in western medicine among local people.

Besides adopting the culturally coded language that Chinese people understood to explain western medicine, female medical missionaries were willing to make compromises in order to give patients as much western treatment as possible. Lucy Bement, a WBM medical missionary in

Shaowu, treated a little boy who was burned by a kettle of boiling water and came in with layers of Chinese medicine covering his body.364 As Bement learned from her previous experience,

Chinese people were only to come to the hospital once or twice because “[i]f the patient was improving they thought he would get well, and if he was not improving he surely need not come again.”365 Bement told the father that it would take a long time for the boy to heal, but she could help the boy if he could “come once or twice, and then go back to his Chinese drugs again.”366

Knowing the habits of Chinese people, instead of insisting on having the boy coming for treatment until fully recovered, Bement compromised by asking them to come once or twice and agreed on their use of Chinese medicine later. Although Bement compromised her original goal of converting

363 Ibid. 364 Lucy P. Bement and Frances K. Bement, Work for Women and Children, Shaowu, China, 1900, 1900, 6, box 20, folder 2, ABCFM-Andover. 365 Ibid. 366 Ibid.

87 people to western medical treatment, Bement made it easier for the patient to accept the treatment, which he might otherwise be unwilling to adopt by requesting that they make a minimum number of visits. As it turned out, the father promised to bring the child as long as Bement was able to cure him, and the child healed quickly. Bement’s experience further reveals female medical missionaries’ flexible use of their cultural understanding to develop strategies to win over patients.

Female medical missionaries faced various constraints in achieving their goal of converting people to the western medical approach and evangelical culture. Local cultural beliefs and the unsettled political situations interrupted their work. Chinese people’s different conceptualization of medicine created obstacles for missionaries to convert them to western medical treatment, within or outside hospitals. They were also in competition with other Chinese medical practitioners, striving to carve out their own space in the community. Female medical missionaries faced further difficulties in changing people’s cultural practices and converting them to Christianity. Their negotiations revealed the complicated dynamics of cultural imperialism. In promoting western medical treatment and evangelical Protestantism, female medical missionaries were promoting a western culture characterized by a modern scientific ethos and evangelical ideals. Chinese people’s flexible use of missionaries’ medical treatment was, therefore, also a challenge to medical missionaries’ imperialistic endeavors. Through the direct responses of Chinese people, female medical missions revealed more concretely than other lines of missionary work that the process of imperial cultural expansion was not unilateral but fraught with negotiations and contingencies.

While on-the-ground medical encounters with local people complicated the broader cultural imperialist project, medical work among Chinese people also engendered contradictions and unexpected outcomes within the missions, which would eventually contribute to a major reconceptualization of Christian foreign mission.

88 Chapter IV “A Physician Can Not Do It All”: Female Medical Missionaries and the Contradictions in Christian Missions

When Woodhull started her work in 1885, she looked forward to improving the lives of

Chinese women through her medical treatment and evangelical messages. “My greatest desire of all is to be able to tell these poor suffering women of Dear Savior who is able to save them,”

Woodhull wrote.367 As she organized her professional work, Woodhull also continued to promote evangelicalism by instructing the patients, carrying out prayer meetings and morning worships, and distributing hymn cards in the hospital.368 However, as the burden of the medical work continued to increase, Woodhull found it hard to keep up with the evangelical work. She wrote to the Executive Committee of the Woman’s Board in 1893 and requested to have a hospital evangelist so that the evangelistic teaching could be better done.369 Affirming the importance of evangelical work, Woodhull lamented, “the work of teaching the heathen who have never heard of God is great labor and a physician can not do it all.”370 Unable to take care of both the evangelical and the medical work, Woodhull faced the conflict between the two aspects of the medical mission. Her request for an additional evangelist reflects her prioritization of the medical work, and her deviation from the expected obligations of medical missionaries to undertake both medical and evangelizing work.

367 Kate C. Woodhull to Mrs. Hill, 18 June 1885, Foochow Mission Woman’s Mission v. 7, ABCFM-Houghton, 16.3.6. 368 S. F. Woodin to Rev. Judson Smith, 1 April 1886, Foochow Mission v.3, reel 235, ABCFM-Houghton, 16.3.5; Kate C. Woodhull, “Medical Work for Women in Foochow,” Medical Missionary Record, 6:7 (July 1891), 16. Material is located at Archives and Special Collections, Drexel University College of Medicine. 369 Kate C. Woodhull to Ladies of the Executive Committee, 31 January 1893, box 3, folder 28, Mission Field Papers: Correspondence with Missionaries, 1883-1993, ABCFM-Houghton, 9.5.1. 370 Ibid.

89 The changes in Woodhull’s relationship with evangelical work was one example of the many contradictions and unexpected outcomes that female medical missionaries’ work engendered.

Due to the practical needs that arose in their day-to-day work, female medical missionaries gradually deviated from their original goals of the mission, creating changes and contradictions in the mission. On the one hand, female medical missionary work complicated the expectations and ideology of woman’s mission. The lack of female physicians in the field, coupled with the heavy burden of the medical work, took up their time for evangelistic work and prompted them to seek new ways to channel evangelical influences. Additionally, obligated to address the medical needs of both male and female patients out of professional considerations, they moved away from the limits of “Woman’s Work for Woman” to take in male patients as well. On the other hand, female medical missionary work also contradicted the original imperialist intentions of the mission. While upholding the ideal of evangelical domesticity and aiming to cultivate Chinese Christian households, female medical missionaries trained Chinese women as physicians. They thus brought up a group of Chinese working women whose presence challenged the ideal of domesticity.

Moreover, in their medical encounters with patients, some missionaries adopted a more sympathetic view toward Chinese people and cultural values. Therefore, as agents of cultural transformation, female medical missionaries were also changed by their on-the-ground experiences in China.

Viewing medical work as a means to the end of evangelizing Chinese people, female medical missionaries were occupied with medical work. They sometimes fell short in carrying out the evangelical work. In the view of the mission boards, evangelization, naturally, was of utmost importance in medical missionary work. Historian David Hardiman points out that late-nineteenth- century missionaries viewed medical missionary work as not being done solely for medical

90 purposes but as “a beneficent means to spread Christianity.” 371 Until the 1920s, medical missionaries were expected to “devote a substantial part of their time to evangelical work.”372

Sending out female medical missionaries in the latter half of the nineteenth century, woman’s boards of mainline Protestant denominations also expected that medical missionary work could help further the evangelical influences. In the appeal of the American Missionary Society, H.M.

Scudder articulated that medical women’s “benefactions” helped “[open] the way, not only for her, but also for her message.”373 Scudder argued that medical women could speak to the “benighted souls” of women in the “harems and zenanas” and there was “an impressive harmony between preaching and healing.”374 Scudder’s emphasis on how female medical missionaries contributed to the spread of evangelical influences thus illustrated the centrality of evangelism in female medical missionary work. In their daily work, female medical missionaries also attempted to exert evangelical influences through various means. Gladly mentioning that people remained in the hospital for a longer time than in previous years, Woodhull, in her 1891 report, pointed out that longer stays in the hospital “[gave] a better opportunity for religious instructions.”375 In fact, most of the female medical missionaries related detailed cases of patients’ conversion after successful medical treatment in their reports, further indicating evangelical work was expected to be an integral element of their work.

While female medical missionaries affirmed the importance of evangelical work, many, however, were unable to carry out this line of work to the fullest extent. One of the major reasons

371 David Hardiman, ed., Healing Bodies, Saving Souls: Medical Missions in Asia and Africa (Amsterdam-New York: Editions Rodopi B.V., 2006), 25. 372 Ibid., 18. 373H.M. Scudder, A Great Field for Women, n.d., 4, series I, box 8, folder 39, Medicine Collection, SSCWH. 374 Ibid. 375 Twenty-Fourth Annual Report of the Woman’s Board of Missions, 1891 (Boston: Frank Wood, Printer, 1892), 16, ABCFM Woman’s Board of Missions Annual Reports, 1869-1926, ABCFM-Houghton, 91.6.

91 was the lack of personnel for medical work. Requests for an additional female physician constantly appeared in missionaries’ correspondence with the board. Since 1889, Woodhull had been continuously asking for another female doctor to share the burden of her work. Considering the prospect of her vacation, Woodhull, in 1889, inquired about the possibility of sending out another female physician “[i]n order that the work shall go on without interruption.”376 It turned out that this request was a hard one to fulfill. In 1891, Woodhull was anxious, “Where are the medical ladies that were coming? Do they all vanish into thin air? It is so desirable that some one comes

[…].” 377 The need for additional female physicians was prevalent among American Board’s stations. Grace A. Funk, a missionary in Shaowu, relating the busy work of Dr. Lucy Bement, exclaimed that “I do not see how [Dr. Bement] keeps up under her very heavy work.”378 Funk then concluded, “We certainly need another woman doctor more than anything else,” indicating the lack of female doctors in the mission field.379 Missionaries from WFMS also encountered the same problem. Mary Carleton ended her report for the 1920 Foochow Woman’s Conference with a note that she “earnestly desire[d] that a younger woman may come to help in this most delightful work.”380

Several factors might have brought about this lack of new female medical missionaries.

The educational opportunities for women in medicine decreased, especially starting in the early twentieth century.381 The decreased number of newly trained female medical professionals might

376 “Miss Kate C. Woodhull, M.D. writes,” 16 October 1889, Foochow Mission Woman’s Board v.7, ABCFM- Houghton, 16.3.6. 377 Kate C. Woodhull to Dr. Smith, 22 August 1891, Foochow Mission v.8, reel 240, ABCFM-Houghton, 16.3.5. 378 Grace A. Funk, “Miss Grace A. Funk writes from Shaowu, China, October 26, 1907,” in Life and Light for Woman, March 1908, 142, Life and Light 1869-1922, ABCFM-Houghton, 91.9. 7 379 Ibid. 380 Mary Eline Carleton, “Mintsing Hospital,” Women’s Work: Foochow Conference, Foochow, 1920, 20, Day Missions Annual Reports, YDS, http://hdl.handle.net/10079/digcoll/4336650. 381 More, Restoring the Balance, 97.

92 have resulted in an even smaller number of female medical missionary candidates. Moreover, as historian Patricia Hill argues, the increasing professionalization of Christian mission and the secularization of American culture in the early twentieth century contributed to a declining interest in Christian mission in general.382 The increasing indifference toward Christian mission might also have made women physicians more inclined to look for jobs in the United States than to join foreign missions. These factors thus might have contributed to the mission boards’ difficulties in securing enough female physicians for missionary work.

As a result, female medical missionaries found themselves occupied with medical work and unable to carry out the evangelistic work fully. Besides Woodhull, several other missionaries also hinted at the insufficiency on their part in evangelizing. “Although in dispensaries we heal many ills and relieve much suffering, we do not feel that there is where our best work for Christ is done,” Ellen Lyon, a WFMS missionary, commented. She then added that “[w]e feel that the real work for Him is at the bed-side and in the daily teach by Miss Johnson and the Deaconess […].”383

By emphasizing the “real work” of evangelical instructions, Lyon articulated the centrality of the evangelism and the ultimate goal of medical work. Mentioning that her work was not the “best work for Christ” and that she was not involved in the evangelical work, Lyon implied that her work fell short in bringing about the goal expected by the mission. Similarly, in 1904, Emily Smith, an American Board doctor in Ing Hok, stated that “we talk to the patients a little, but one longs for a Hospital where daily teaching may be given.”384 Smith’s hope for more evangelical teaching in

382 Hill, The World Their Household, 173. 383 Ellen M. Lyon and Ella Johnson, “Medical Work,” in Minutes of the Fifteenth Session of the Foochow Annual Conference of Methodist Episcopal Church (Foochow: M. E. Mission Press, 1891), 45, Methodist Conference Journal, Methodist Library. 384 Emily D. Smith, Report of Medical Work, Ing Hok, 1903-1904, June 27, 1904, Foochow Mission v.10, reel 242, ABCFM-Houghton, 16.3.5.

93 the hospital implied the current lack of it. It thus indicated that while she was able to give effective medical treatments, she considered her evangelical work insufficient.

In addition to missionaries’ inability to take care of both evangelical and medical work, the instruction on personal health assumed greater importance in medical missionary work over time.

Some female medical missionaries had flexibly combined religious and public health instructions to teach patients scientific knowledge and hygiene. Among the female medical missionaries in

Foochow, Woodhull worked hard to teach patients about how to maintain personal health.

Woodhull mentioned, during the early worship, “after singing, repetition of Scripture texts and prayer,” she would sometimes “give a short lecture on Hygiene, the importance of cleanliness, fresh air, etc.”385 These lectures were rather effective as Woodhull was pleased to hear people repeat some of the “health maxims” she taught.386 Woodhull also made use of catechism to instruct patients on subjects, such as the importance of the circulation of fresh air and not expectorating on the floor.387 In addition to these oral instructions, Woodhull composed health tracts in Romanized

Foochow dialect and emphasized the proper maintenance of personal health in conjunction with complying with God’s will.388 With her flexible uses of catechism and the occasions of religious gathering, Woodhull delivered public health knowledge to more Chinese people. Rather than using medical work to convey evangelical messages, Woodhull used the opportunities of evangelical teaching to help advance the knowledge of health care.

385 Kate C. Woodhull, Woman’s Hospital, Foochow City, 1901, Foochow Mission Woman’s Board v.1, ABCFM- Houghton, 16.3.6. 386 Ibid. 387 Kate C. Woodhull and Hannah C. Woodhull, Pagoda Bells, 1884-1909: Report of Work for Women and Children, 1909, 30-31, box 8, folder 125, Willard Livingstone Beard Family Papers, YDS. 388 See Kate C. Woodhull, Wei Shen Cuo Wen (Health Questions Digest), 1902, Harvard-Yenching Library, Harvard University, Cambridge, Massachusetts, http://nrs.harvard.edu/urn-3:FHCL:33057494.

94 Moreover, while missionary hospitals remained to missions’ evangelizing efforts, in the early twentieth century, instructions on health became an equally important, if not more important, endeavor in the hospital. As Hardiman points out, missionaries considered hospitals helpful in evangelizing people as patients were “confined and thus amenable to preaching other ‘Christian’ influences.”389 Female medical missionaries also constantly referred in their report that the longer stay in the hospital made some patients receive the evangelical message.390 In the twentieth century, however, new rhetoric appeared. In her article about the “interesting cases” in Foochow Women’s

Hospital, Lora Dyer mentioned that she was “especially glad” when patients were willing to stay in the hospital because she could then “really have a chance to teach them the proper care of infants.”391 Instead of emphasizing the evangelical influences that she was able to exert through the patients’ stay in the hospital, Dyer stressed the important opportunity for teaching child care.

Dyer’s rationale differed from earlier missionaries’ rhetoric and thus illustrated the new focus of female medical missions in addition to evangelical teaching.

Indeed, the inability of male and female medical missionaries to accomplish the goal of evangelical conversion raised domestic audiences’ concerns. For instance, the American Board published a pamphlet in 1898 concerning the medical branch of the mission. The pamphlet collected “testimony” from medical missionaries in the mission field to address inquiries such as

“What is the place appropriately occupied by the medical work as a missionary agency?” and “Has

389 Hardiman, ed., Healing Bodies, Saving Souls, 17. 390 For example, the 1891 report of the Woman’s Board of Missions mentioned that “the average time of remaining in the hospital has been longer than in previous years, which gives a better opportunity for religious instruction.” Twenty-Fourth Annual Report of the Woman’s Board of Missions, 1891 (Boston: Frank Wood, Printer, 1892), 16, ABCFM Woman’s Board of Missions Annual Reports, 1869-1926, ABCFM-Houghton, 91.6. 391 Lora G. Dyer, “Some Interesting Cases in Our Woman’s Hospital,” in Life and Light for Woman, November 1920, 491, Life and Light 1869-1922, ABCFM-Houghton, 91.9.

95 it any perils in the spiritual side, as related to the secularizing of the missionary work?”392 The concerns of the secularizing tendencies in the medical missions suggests that some medical missionaries might have compromised the evangelical aspect of the work. In their responses, medical missionaries also recognized the potential problems of medical missions. H. T. Whitney, a medical missionary to Foochow, pointed out the “dangers” that “the press of secular duties will cause the neglect of the religious part of the work” and that “the exceptional opportunities of surgical work may create an ambition to develop a professional reputation at the expense of the society supporting him.” 393 Whitney’s views on these “dangers” implicitly affirmed medical missionaries’ possible deviation from the expectations of Christian missions and pointed to the tension between professional and evangelistic work.

Facing the tension between the two aspects of their work, female medical missionaries sought new approaches to channel their evangelical influences. Some of them concentrated their efforts on training Chinese medical students, aiming to further the gospel through these students.

Recognizing the changes after the expansion of medical missionary work, Woodhull “decided that the most efficient way for a missionary physician to do evangelistic work was to work with and through their medical students” and “that most of the time we could spend in strictly spiritual teaching should be devoted to them.”394 Woodhull further explained, if she could “strengthen and stimulate [the medical students] to become zealous, earnest, and consecrated workers,” then the

“efficiency of medical missionary work as an evangelistic agency” would increase.395 Woodhull’s move away from directly engaging in evangelizing patients to instilling evangelical spirits into

392 The Medical Arm of the Missionary Service: Testimonies from the Field,” 1898, 1, box 6, folder Medical Work, Special Topic, ABCFM-Houghton, 85.9. 393 Ibid., 31. 394 Kate C. Woodhull, “Pagoda Bells or Medical Work in Foochow,” in Life and Light for Woman, February 1902, 73, Life and Light 1869-1922, ABCFM-Houghton, 91.9. 395 Ibid.

96 Chinese medical students reflected missionaries’ adjusted approach to evangelistic work in response to their heavier burden of medical treatment. Other female medical missionaries chose to rely on the Bible women to maintain the evangelical atmosphere in the hospitals and dispensaries.

In Lucy Bement’s dispensary, while Bement was occupied with the medical work, a Bible woman

“talk[ed] informally to the waiting women,” assisting the evangelistic work that Bement was not able to do.396 Similarly, in summarizing the work of medical missionaries abroad, Enoch F. Bell mentioned that “[m]uch should be said in praise of the work done by the Bible women in the wards and clinics in bringing comfort to the suffering and discouraged.”397 Bell’s compliment reflected that Bible women’s work was complementary to that of medical missionaries who were busy with their treatment. Hence, the practical conditions in the mission field somewhat compromised female medical missionaries’ evangelistic work and prompted them to seek new approaches to exert evangelical influences.

In addition to the deviations from evangelizing endeavors, female medical missionaries further complicated the missiology of woman’s foreign missions in their work. Driven by the professional obligations to care for all patients, female medical missionaries gradually moved away from the limited focus on women delineated by the notion of “Woman’s Work for Woman.”

As Robert argues, the nineteenth-century missiology of “Woman’s Work for Woman” emphasized

“the conversion of the soul and the transformation of the role of women, evangelization, and civilization.” 398 It worked as a way of “legitimating and extending women’s special mission work.”399 Following this missiology, female medical missions functioned as an important agency

396 Ethel D. Hubbard, Missions on the Min: Story of the Shao-Wu Station, Foochow Mission, China, 1905, 26, box 122, folder 12, China Records Project, YDS. 397 Enoch F. Bell, Envelope Series: Your Doctor Abroad, July 1915, 16, box 6, folder Medical Work, Special Topic, ABCFM-Houghton, 85.9. 398 Robert, American Women in Mission, 137. 399 Ibid.

97 to address the medical need of secluded women and further the gospel.400 With the premise that

Chinese women were unwilling to seek medical help from male doctors, female medical missionaries established hospitals to provide medical treatment exclusively for women and children. As H.N. Kinnear, physician-in-charge of Foochow Missionary Hospital, mentioned, a woman brought in her baby and requested a transfer of her baby into his hospital.401 The doctors treated the baby in the women’s hospital for a week, but the woman had to return to work before her child was fully cured and needed to transfer the baby to a men’s hospital so that her husband could take care of it.402 The woman’s request reflects the challenges presented by the female- exclusive medical services, and the strict sex segregation practiced in women’s hospitals.

While women’s hospitals in the city continued to limit their services to women patients, dispensaries, and hospitals in smaller localities deviated from the gender-specific services and accepted male patients as well. Differing from the city where there were both women’s and men’s hospitals, in some smaller towns, there was only one hospital providing medical care for people in the region. 403 This lack of medical facilities prompted some female medical missionaries to consider treating male patients as well. In the report for her work in the Min Chiang district, Mary

Carleton mentioned that “men in considerable number wanted to remain near the Hospital for treatment but there was no place for them.” 404 As a result, she considered it important to “have a

400 Ibid., 163. 401 H.N. Kinnear and Ella J. Kinnear, “Oriental Reflexes,” in Winning by Serving: The Annual Report of Foochow Missionary Hospital, Foochow, China, for the Two Years Ending December 31, 1925 (Stewart Peet Memorial Press, 1926), 19, box 361, folder 11, China Records Project, YDS. 402 Ibid. 403 For the distribution of hospitals in the Foochow region of the American Board and Methodist Episcopal Mission, see “Chronological History of the Willis F. Pierce Memorial Hospital, Foochow Fukien, China,” box 13, folder 23, ABCFM-Andover. 404 M. E. Carleton, “Medical Work,” in Official Minutes of the Twentieth Session of the Foochow Woman’s Conference of the Methodist Episcopal Church, Foochow, October 26-29, 1904, 51, 52, Day Missions Annual Reports, YDS, http://hdl.handle.net/10079/digcoll/4336505.

98 place where men may be housed during their stay for treatment.405 Expecting opposition, Carleton argued that “it may be said that this is not women’s work but I am convinced that any missionary physicians whose work is in the country districts must be willing and equipped to do any work that comes to her.”406 Carleton eventually figured out a plan for a separate room from the hospital. 407

Although male patients could not be admitted as inpatients, they could stay in that room and come to the hospital for daily treatment.408 Out of obligations as a physician, Carleton did not want to decline male patients for treatment. As Carleton’s anticipation of the potential criticism suggests, her professional consideration challenged the premise of woman’s work and deviated from the gendered expectations of the mission.

Similar to Carleton, though recognizing the main goal of treating women patients, other female medical missionaries also attempted to accommodate the medical need of male patients.

WFMS physicians Emma Betow and Frances Draper mentioned a story about a male patient whose arm was crushed in a cane mill in Hinghwa. 409 “We do not receive men,” the missionaries contended, “but something had to be done for this one.”410 They proceeded to amputate the patient’s arm above the elbow the next day.411 Despite being aware that in principle, they should not receive male patients, out of their professional concerns, Betow and Draper crossed the boundary and operated on the male patient. Their decision thus indicated some missionaries’ deviation from the gender-exclusive when new conditions arose in their medical work. In some

405 Ibid., 52. 406 Ibid. 407 M. E. Carleton, “The Dr. Sites Memorial Good Shepherd Hospital,” in Official Minutes of the Twenty-Third Session of the Foochow Woman’s Conference of the Methodist Episcopal Church, Foochow, October 16-19, 1907, 86, Day Missions Annual Reports, YDS, http://hdl.handle.net/10079/digcoll/4336507. 408 Ibid. 409 Emma J. Betow and Frances L. Draper, “Margaret Eliza Nast Memorial Hospital,” in Official Minutes of the Tenth Session of the Hinghwa Woman’s Conference of the Methodist Episcopal Church Held at Hinghwa City, China (Shanghai: Methodist Publishing House, 1908), 44, Methodist Conference Journals, Methodist Library. 410 Ibid., 45. 411 Ibid.

99 cases, even in the city, missionaries also made such accommodation. Ellen Lyon, Lena Hatfield, and Cora Simpson reported that even though the presence of men in the wards and clinics would keep Chinese women away, “this spring [they] had to take some as patients,” undermining the delineation of “Woman’s Work for Woman.”412

In fact, in the 1920s, the scope of missionary social services continued to expand, and the mission boards were moving toward organizing general hospitals. These changes might be a result of the missiological shift following the end of World War One. Robert mentions the ideological changes from “Woman’s Work for Woman” to “world friendship” after WWI.413 Robert argues that with the passage of woman’s suffrage and the improved status of women in the United States after WWI, “an optimistic younger generation of women began to question gender-based thinking” and the earlier ideology of woman’s mission “began to seem old-fashioned.”414 The new idea of

“World Friendship” emerged out of the context of “increased ecumenical relationships and optimism about the achievement of equality between the sexes.” 415 While woman’s mission continued to address the need of women and children, female missionaries were ready to “work through civic organizations, legislations, and through ecumenical initiatives with men to achieve its goal.”416 Under the logic of this new missiology, Robert argues, “the demand of the mission field seemed to support the integration of woman’s and general mission boards.” 417 This ideological shift might have paved the way for the transition into Foochow Union General Hospital

412 Ellen Lyon, Lena Hatfield, and Cora E. Simpson, “The Liang Au Women’s and Children’s Hospital, Foochow, China,” Report of the Twenty-Fifth Session of the Foochow Woman’s Conference of the Methodist Episcopal Church, Foochow, November 17-19, 1909, 47, Day Missions Annual Reports, YDS, http://hdl.handle.net/10079/digcoll/4336510. 413 Robert, American Women in Mission, 313. 414 Ibid. 415 Ibid. 416 Ibid., 273. 417 Ibid., 314.

100 in 1929 in which the WFMS’s Magaw Memorial Hospital and American Board’s Kate C.

Woodhull Hospital became two branches of the hospital.418 In light of these later developments,

Carleton’s and others’ decisions to accommodate both female and male patients seemed to suggest the change toward a similar direction even before this major ideological shift. Because of this early transition, Carleton’s hospital, which Hemenway took over, had already become a “general hospital” when the calls for unifying men’s and women’s hospitals appeared more frequently in the 1930s.419

Not only did the on-the-ground conditions of medical missionary work complicate evangelistic work and the ideology of woman’s mission, but female medical missionaries also inadvertently challenged the cultural imperialistic underpinning of the mission. Upholding the notion of evangelical womanhood, female medical missionaries trained Chinese women to be physicians and nurses, which, under the influences of the changing social atmosphere, yielded unexpected outcomes. In the late nineteenth century, Victorian ideals of womanhood were central to woman’s mission and, as Robert argues, the conversion of mother and through them, the society remained a justification for woman’s mission movement.420 In China, as Shemo points out, female missionaries expected Chinese Christian girls to “become Christian wives and mothers” who would “produc[e] the Christian families that would be the bedrock of a Christian China.”421

To a large extent, female medical missionaries adopted such rationale and trained Chinese women medical students along this line. In commenting on the graduation of the first class of

418 Foochow Mission Letter June 1923-June 1929, 12 August 1929, Foochow Mission v.18, ABCFM-Houghton, 16.3.5. 419 “Medical Work,” in Year Book: Woman’s Foreign Missionary Society of the Methodist Episcopal Church Being the Sixty-Seventh Annual Report of the Society, 1936, 32, folder Woman’s Foreign Missionary Society: Annual Report 1936, Records of the Women’s Division of the General Board of Global Ministries, GCAH. 420 Robert, American Women in Mission, 135. 421 Shemo, “So Thoroughly American,” in Competing Kingdoms, eds. Reeves-Ellington, Sklar, and Shemo, 125.

101 Chinese medical students, Woodhull pointed out that “we can all feel that it is no small thing to have a part in lifting these young women out of the depths of heathenism.”422 Woodhull’s language of uplifting young Chinese women through medical education reflected her identification with the imperialistic undertaking of woman’s missions. Additionally, female medical missionaries upheld the ideal of domesticity and prioritized Chinese women medical students’ family obligations. For instance, Woodhull mentioned that she released a student from a year of post-graduate work in the hospitals because Woodhull “felt that [the student’s] first duty was to her little family,” illustrating the greater weight that she placed on the student’s domestic responsibilities. 423 Similarly, explaining her proposal of offering nurse’s training to some women graduates from mission schools, Carleton argued that this training would help these students “[acquire] a useful means of livelihood without obliging them to go away from home to get it.”424 Even though these girls might

“never practice their profession outside of their own homes,” Carleton still deemed it beneficial because “Chinese mothers in particular [needed] this training.”425 Carleton’s emphasis on the benefits of nurse training to Chinese households in particular hence indicated her commitment to the ideal of domesticity in her training of Chinese women students.

At the same time, however, some of the female medical missionaries’ discourse seemed to imply their ambivalence toward the ideal of domesticity. When Woodhull referred to the current conditions of the medical graduates, she mentioned that the four graduates who practiced in

Foochow were “all married and have children, so they do not have much time to give to outside

422 1900, Graduation of Medical Class of Foochow City Hospital in charge of Dr. Woodhull, 1900; to Light and Life 423 Kate C. Woodhull, “Chinese Women Doctors,” in Life and Light for Woman, June 1909, 246, Life and Light 1869-1922, ABCFM-Houghton, 91.9. 424 Mary E. Carleton, “The Good Shepherd Hospital,” in Report of the Thirty-First Annual Session of the Foochow Woman’s Conference of the Methodist Episcopal Church, Foochow, October 27-30, 1915, 68, Day Missions Annual Reports, YDS, http://hdl.handle.net/10079/digcoll/4336561. 425 Ibid.

102 work.”426 Praising these women, Woodhull remarked, “They give the same testimony that married women in the profession do in America—that what they are able to do for their families, repays them for all their toil in studying medicine.”427 Woodhull was also expecting that they would “have time for outside work” when they were “not so much occupied with maternal duties.” 428

Woodhull’s comparison between missionary-trained Chinese women physicians and American professional women pointed to their shared capability of doing professional work while taking good care of their family. Though Woodhull conceded that carrying out “maternal duties” should take precedence, the comparison to American professional women and her expectation of these students to do more outside work both suggested Woodhull’s hope for them to develop their professional role further. Woodhull’s remarks therefore reflected her ambivalence toward the ideal of domesticity.429

In fact, despite missionaries’ consensus on the goal of transforming Chinese women according to the ideal of evangelical womanhood, missionary medical education in reality sometimes yielded unexpected outcomes. Because of the missions’ increasing need for medial missionaries, some Chinese women medical students acquired greater geographical mobility within the missionary network. Hu King Eng, a WFMS Chinese missionary doctor trained in the

United States, mentioned that the graduates of her hospitals were working in North China, Tientsin,

Shanghai, and many other places in China.430 The report of Chunking Gamble Memorial Hospital,

426 Kate C. Woodhull and Hannah C. Woodhull, Pagoda Bells, 1884-1909: Report of Work for Women and Children, 1909, 26, box 8, folder 125, Willard Livingstone Beard Family Papers, YDS. 427 Ibid. 428 Ibid., 27. 429 Woodhull’s ambivalence about domesticity might be not only be professional but also personal. With the exception of only a few, all female medical missionaries were unmarried professional women. Their personal marital status might also make them ambivalent toward upholding the ideal of domesticity. 430 Hu King Eng, “Woolston Memorial Hospital,” in Report of the Thirty-First Annual Session of the Foochow Woman’s Conference of the Methodist Episcopal Church, Foochow, October 27-30, 1915, 27, Day Missions Annual Reports, YDS, http://hdl.handle.net/10079/digcoll/4336561.

103 a WFMS hospital in West China, also mentioned that a Foochow woman, Dr. Ch’en, who studied at Woman’s Medical College in Peking and interned at Magaw Hospital would soon be working in West China. 431 These instances of Foochow women working away from their hometown illuminated the increased geographical mobility that their work for medical missions had offered them, which they might not otherwise enjoy if they lived a normal family life. Instead of staying at home and taking care of their family, these Chinese medical women worked as medical professionals and, to a certain extent, developed their own careers, which was an outcome that the woman’s missions did not intend to bring about.

Moreover, the opportunities offered by the mission enabled some Chinese women to have greater agency in determining their life trajectory. Dyer mentioned an incident where the missionary network offered unintended assistance to a woman student.432 A second-year woman medical student’s fiancé had turned bandit and threatened to kidnap her if she did not come home and married him immediately. 433 As Dyer reported, the woman was uneasy and eventually

“disappeared” from Kate C. Woodhull Hospital in Foochow.434 The woman “reappear[ed] sadly in our hospital in Tehchow by arrangement with Miss Sawyer.”435 After the woman arrived, “her family merely [was] told that she was safe.”436 Through the arrangement with medical missionaries in other parts of China, this woman medical student made full use of the missionary network and was able to escape from the marriage that she did not want to commit herself to. In this case, being

431 “CHUNKING-Gamble Memorial Hospital,” in Year Book: Woman’s Foreign Missionary Society of the Methodist Episcopal Church Being the Fiftieth Annual Report of the Society,”1919, 84, folder Woman’s Foreign Missionary Society: Annual Report 1919, Records of the Women’s Division of the General Board of Global Ministries, GCAH. 432 Lora G. Dyer, “Kate C. Woodhull Hospital, Foochow China,” 1937, box 22, folder 15, Biographical Collection, ABCFM-Houghton, 77.1. 433 Ibid. 434 Ibid. 435 Ibid. 436 Ibid.

104 a medical student for the mission indeed enabled this woman to have greater agency and effectively challenge the gender power dynamics that she would otherwise succumb to.

Additionally, the medical training that female medical missionaries offered raised a sense of professionalism among some Chinese women medical students. For instance, when Carleton was working in Mintsing, she related the story of a student who graduated with honors in 1912.437

The student “decided that her official name could no longer be her husband’s surname as he was not a doctor” and “that being a doctor in her own right, she must be known by her own surname.”438

The graduate became “Dr. Ciong I Seng,” and, by this name, “she was known during many years of efficient service in the Hospital of the Good Shepherd.”439 By declaring her intent to use her own surname and be “a doctor in her own right,” Ciong not only viewed herself as a medical professional but also—based on this identity—challenged the pre-existing gendered cultural custom of women taking their husbands’ surnames. The medical training in this case engendered a sense of professionalism, which challenged both the ideals of domesticity and the traditional

Chinese cultural customs. Although these experiences of mission-trained Chinese medical women were by no means a common phenomenon, the very existence of such instances illustrated the unexpected outcomes and contradictions that female medical missionary work might create on the ground.440

437 “Miss Mary Eline Carleton, M.D.,” The Bulletin of New York Branch Woman’s Foreign Missionary Society, May-June 1927, 2, reel 27, folder 574, Microfilm Edition of the Mission Biographical Reference Files,1880s-1969, GCAH. 438 Ibid. 439 Ibid. 440 The relationship between female medical missionary work and the development of Chinese professionalism and feminism is a topic worthy of further investigation. Conditions in China, such as the embracing of Western science and medicine by May-Fourth activists and later the Nationalist state and the ideal of “New Woman,” might also have enabled these Chinese women medical students to become independent career women. Due to the limited number of sources concerning Chinese women that I have found in my research, I am not able to address this topic in detail in this thesis.

105 As the on-the-ground conditions of female medical missionary work brought contradictions and unexpected outcomes to the mission, female medical missionaries themselves were also changed in this process. While assuming a culturally superior position, some female medical missionaries in their interactions with Chinese people became more sympathetic to

Chinese cultures and practices. Hemenway’s experiences offered a good example of the changes in cultural views that medical missionary work had contributed to. When Hemenway started her work in Mintsing, she adopted the culturally superior mindset that was common among female medical missionaries. Hemenway recorded that she called each female patient up in front of her,

“just like calling naughty pupils up in front of the class!”441 She also gladly remarked that “my presence lends moral support and cheer to the patients” and that “we foreigners are supposed to be such wise aristocrats that they felt great confidence in us, when they once know us.” 442

Hemenway’s use of “pupils” entailed the paternalistic implications, and the phrases such as

“supposed to be” and “wise” also reflected her assumed superior position over Chinese people.

Her description therefore demonstrated her imperialistic assumptions and perceptions.

However, Hemenway’s attitude underwent a gradual change as she interacted more with the patients in her medical work. In 1926, Hemenway related a case in her report to the Foochow

Woman’s Conference. The neighbors brought a fifteen-year-old girl to the hospital because of the abuse of the girl’s mother-in-law.443 “Her legs had been pounded to pulp by a stone hammer, her neck burned with a red hot iron, her back puncture with many knife wounds, her breasts black from pickings, both arms rendered useless, and her mind utterly confused by her suffering,”

441 Ruth V. Hemenway, Diary, 25 February 1924, box 1, v.1, book 1, Ruth Hemenway Papers, SSCWH. 442 Ibid. 443 Ruth V. Hemenway, “Nathan Sites Memorial Hospital,” in Woman’s Work: Foochow Conference, Foochow, 1926, 68, Day Missions Annual Reports, YDS, http://hdl.handle.net/10079/digcoll/4336628.

106 Hemenway wrote. 444 Witnessing the terrible mistreatment that the girl received, Hemenway exclaimed, “For the first time I recognized the truth of one Chinese man’s remark that it is better to drown the girl babies than to sell them.”445 The medical encounter with the girl here provided a different perspective for Hemenway to evaluate some of Chinese values and practices. In her medical work, Hemenway came to know the abuse of women in its concrete form, that is, the physical injuries that the girl suffered. Although Hemenway did not condone the idea of infanticide, the sheer injuries of the girl complicated her perception of female infanticide by expressing more sympathy toward the rationale behind it. Therefore, when she saw another little child-wife later,

Hemenway remarked, “Is it much wonder that mothers are not always happy to bring little girls into the world to suffer?”446

With the interactions with and observations of Chinese people, Hemenway also had a more positive view of Chinese people and their characters. For instance, in discussing the Chinese manner of handling a subject, Hemenway commented that “[i]t is a great, and often pleasing contrast to our abrupt American way of dealing with a subject” as the Chinese approach “show[ed] the most delicate tact, courtesy, and graciousness with a subtleness of intuition and suggestion which would be wholly lost on many at home.”447 Hemenway’s special word choice in her contrast between “abrupt American way” and the Chinese manner of “courtesy, graciousness” implied her compliment of Chinese manners. Similarly, Hemenway praised the “persistence and patience” of

Chinese people and their “willingness to endure hardship if it came their way,” which gave

Hemenway “high respect for all of them.”448 Explicitly expressing her respect, Hemenway here

444 Ibid.,68, 69. 445 Ibid., 69. 446 Ruth V. Hemenway, Diary, 21 April 1924, box 1, v.1, book 1, Ruth Hemenway Papers, SSCWH. 447 Ruth V. Hemenway, Diary, 3 April 1924, box 1, v.1, book 1, Ruth Hemenway Papers, SSCWH. 448 Ruth V. Hemenway, “In China … (The Story of a Medical Missionary),” Medical Woman’s Journal, 52:3 (March 1945): 46.

107 moved away from a culturally superior position and cast a more sympathetic eye towards Chinese people and their virtues. Hemenway went back to the United States in the 1940s and she wrote in

1974 in her memoir that “[o]ne mistake of too many Western missionaries to China was the conviction that they bore to the East all the good tidings and all the knowledge of a better way of life. Now many of us realize that abilities and defects are equally shared in the midst of our diversities.” 449 Her comments here indicated her awareness of the limitations of female missionaries’ imperialistic attitudes and the changes in her and other missionaries’ cultural views after the foreign missions. Admittedly, not all missionaries abandoned their perceptions of a cultural hierarchy, and missionaries who shared Hemenway’s views might as well be a minority, but Hemenway’s transformation illustrated what medical missionary experiences might have done to undermine the imperialistic understanding of some female medical missionaries.

Hence, as agents of cultural change, female medical missionaries were also changed by their missionary experiences. Due to the shifting practical conditions in the mission field, female medical missionaries in their work brought about contradictions to the goals of the mission. They were unable to fully carry out the evangelistic work and moved their work beyond the missiological delineation of “Woman’s Work for Woman.” Meanwhile, carrying with them the goal of cultural transformation, female medical missionaries trained Chinese women as physicians; the training brought some Chinese women greater mobilities and enabled them to challenge some of the gender norms. In their medical encounters with Chinese people, female medical missionaries also gained a more sympathetic perspective toward Chinese culture, undermining their culturally superior perceptions. These contradictions and unexpected outcomes all illuminated the fluidity of

449 Hemenway, A Memoir of Revolutionary China, 1924-1941, ed. Drake, 219.

108 cultures within the transnational space and the reciprocity of American cultural expansion in the late nineteenth and early twentieth centuries.

Preparing to leave China, Woodhull wrote, “There is a good deal of heartache connected with tearing ourselves away from this place where our interests have become so deeply rooted. I shall feel like a stranger in America. But if we are well enough, we shall find …the same work of comforting and uplifting others there as here.”450 For years, Woodhull had been trying to find her successor for the female medical missionary work in Foochow, but these efforts were of no avail.

Therefore, after establishing her hospitals, experiencing the unsettled political conditions, treating thousands of patients, and training many Chinese women medical students, Woodhull left

Foochow with her sister for the United States in 1912.451 And here concluded her twenty-eight years of missionary service to people in Foochow.

450 Kate C. Woodhull to Miss Calder, 13 April 1912, Foochow Missions Woman’s Board v.3, ABCFM-Houghton, 16.3.6. 451 “Chronological History of the Willis F. Pierce Memorial Hospital, Foochow Fukien, China,” box 13, folder 23, ABCFM-Andover.

109 Conclusion

In 1933, Lora Dyer pondered the relationship between medical work and evangelical work in a pamphlet in response to Re-Thinking Missions: A Laymen’s Inquiry after One Hundred

Years.452 Initiated by John D. Rockefeller Jr. and surveyed by an appraisal committee independent of mission boards, Re-Thinking Missions presented a reevaluation of Christian foreign missions and offered recommendations for future mission work.453 Dyer agreed with the suggestion of the

“clear-minded experimentation in the religious phases of hospital work” and concurred that “where evangelical work is causal and perfunctory and stupid, it is unworthy and would best be omitted, since it gives a wrong idea of the Christian faith.”454 Facing the critique of the coercive use of

“medical or other professional services as a direct means of making converts,” Dyer remarked,

“this criticism…is a stimulating challenge to the missionary physician to think more often and clearly on fundamental motives and the real goal in medical mission.”455

Dyer’s words reflected the new challenges that missionaries faced during the 1920s and

1930s. Situated at the forefront of modernizing endeavors, female medical missionaries were nonetheless caught up in the changes in Christian missions brought by modernization. As female medical missionaries’ commitment to their professional work gradually drifted away from the original goals of evangelism, after WWI, a new generation of mainline missionaries embraced the liberal Protestant theology, questioning the missions’ goal of conversion and favoring social

452 Lora G. Dyer, “Medical Work of Missions” in Comments on “Re-Thinking Missions” from Fukien, China,1933, 14, box 9, folder 131, Willard Livingstone Beard Family Papers, YDS; William Ernest Hocking, Re-Thinking Missions: A Laymen’s Inquiry after One Hundred Years (New York and London: Harper & Brothers Publishers, 1932). 453 James Alan Patterson, “Robert E. Speer and the Crisis of the American Protestant Missionary Movement, 1920- 1937,” (Ph.D. diss., Princeton Theological Seminary, 1980), 80, 81, https://proxy.wm.edu/login?url=https://search.proquest.com/docview/303086392?accountid=15053; Hocking, Re- Thinking Mission, xi. 454 Dyer, “Medical Work of Missions,”14; Hocking, Re-Thinking Mission, 201. 455 Dyer, “Medical Work of Missions,”15.

110 services over evangelism.456 These shifts then fueled the Fundamentalist attacks on the Protestant missionary enterprise later in the 1920s.457 Amidst these changes, woman’s missionary movement also moved toward its decline. As Robert argues, with the quest for efficiency and the fundamentalist-modernist controversy that “struck at the heart of the woman’s missionary movement by pitting the Bible against the ministry of women,” by the end of WWII, woman’s missionary movements disappeared in majority of the mainline Protestant denominations. 458

While female medical missionaries were still working in Foochow and its vicinity in the 1930s, after unification, several previous women’s hospitals in Foochow became branches of the

Foochow Christian Union Hospital. The investment of non-Christian institutions, such as the

Rockefeller Foundation, in the development of medicine in China, also gradually marginalized medical missionary work in the following decades.

Nevertheless, from the 1880s to the 1920s, female medical missionaries played a distinctive role as medical professionals and cultural ambassadors. Motivated by evangelical impulses and professional opportunities, female medical missionaries set out to China, aiming to improve the lives of Chinese women. Intending to convert people in foreign lands to both evangelical Protestantism and western medical approaches, they drew authority from, and channeled cultural influences through, their medical expertise, formulating gendered professionalism. Their experiences illuminate the usefulness and limits of cultural imperialism as a framework for interpreting female medical missionaries. As agents of significant cultural institutions in American life, medical missionaries contributed to the United States’ ambition of

456 Robert, American Women in Mission, 299; A. Scott Moreau, Gary R. Corwin, and Gary B. McGee, eds., Introducing World Missions: A Biblical, Historical, and Practical Survey (Grand Rapids, Michigan: Baker Academic, 2015), 143. 457 Moreau, Corwin, and McGee, Introducing World Missions,143. 458 Robert, American Women in Mission, 302, 307, 315.

111 spreading Christianity and western cultures throughout the world. However, as the experience of medical missionaries in Foochow demonstrates, they never completely managed to achieve cultural hegemony. Female medical missionaries often had to adapt to social and political crises beyond their control. Moreover, Chinese people accepted those practices that suited them while rejecting those that did not comport with their own worldview. At the same time, the practical needs in female medical missionary work sometimes engendered contradictions to their goals, and their medical encounters with Chinese people, in turn, changed their views toward Chinese people as well.

On March 25, 1926, Kate Woodhull, American Board’s first female doctor to China, passed away in Riverhead, Long Island.459 Years after she concluded her missionary service in 1912, as

The Missionary Herald mentioned, Woodhull was “still warmly remembered among a circle of friends in China” and “all who have come in touch with her life of service have found inspiration.” 460 To people in Foochow, while Woodhull and her fellow female medical missionaries might have been so successful in establishing the “bedrock of a Christian China” through the uplift of Chinese women, their medical work left an important mark on Foochow, the

Fukien Province, and even China.461 As one historian argues, medical missionary men and women introduced western medical science and modern managerial method of hospitals to Chinese people, laying the solid foundation for the rise of modern medicine in Fukien Province; missionaries’ treatment, to a certain extent, made health care available to people and their public health lectures brought people closer into contact with the western scientific ethos, contributing to social and

459 “The Passing of Dr. Woodhull” in The Missionary Herald, 1926, 197, Andover-Harvard Theological Library, Harvard University, Cambridge, Massachusetts. 460 Ibid. 461 Shemo, “So Thoroughly American,” in Competing Kingdoms, eds. Reeves-Ellington, Sklar, and Shemo, 125.

112 cultural changes in Fukien.462 To Chinese women specifically, the medical education offered by female medical missionaries brought up a group of Chinese professional women who pursued a

“profoundly distinct” path from that of most Chinese women and were intimately bound up with the project of reforming China.463

As important as the impact of their medical work on Chinese people, linking religious callings with professional competence, Woodhull and her fellow female medical missionaries represent another way in which American women pursued a medical career. In their work for the mission, striving for professionalism went hand in hand with their intention to spread evangelical culture. Their professionalism was integral to their sense of mission, and their professional work ran as a central thread throughout their career, in which their medical skills were constantly challenged as were their cultural assumptions. In the flexible transnational space created by the mission, they formulated a distinct form of gendered professionalism that differed from that of medical women in the United States. Female medical missionaries, therefore, formed a group of transnational professional women who played a distinct cultural role in American imperial expansion. Successful or not, their experiences presented the overlooked story of women as professionals working on an international stage before the rise of international organizations, the meaning of which awaits further exploration.

462 Dian‘en Zhou, “Fujian jidujiaoxinjiao Jiaohuiyiyuan geyan zhi chutan (A Brief Survey of the Development of Protestant Missionary Hospitals in Fujian),” Haijiaoshi yanjiu, no.1 (2015): 100. 463 Wang, “Stranger Bodies,” 100,101.

113 Bibliography

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