Medical Missionaries
Except for the addition of cholera, the diseases of Korea of the nineteenth century and the first half of the twentieth century differed little from the ones prevailing in earlier times.
In fact, Westerners who came to Korea in the 1880s and 1890s thought that the illnesses found in Korea were generally the same as those in North America. George W. Woods, for example, a surgeon aboard the U.S.S. Juniata of America’s Asiatic Squadron, reported that he knew of no diseases peculiar to Korea, but he was struck by the almost universal presence of smallpox and malaria. Woods, who spent almost 3 months of 1884 in Korea, was one of the first Americans to visit the peninsula (Bohm and Swartout, Jr. 1984).Medical missionaries, upon whose observations we rely for much of this essay, tended to believe that Korean medical knowledge was entirely borrowed from China and that the history of real medical work in Korea began in September 1884, when Horace N. Allen of the Presbyterian Mission came to Seoul. Medical missionaries soon realized that foreign doctors could best establish a claim to medical superiority through surgery. Among the operations Allen performed were excision of the ankle, knee, shoulder, and wrist; amputation of fingers, arms, legs, cancers, and tumors; dissection of scrofulous glands; enucleation of the eyeball; treatment of cataract and pterygium; and closure of harelip. One of the most frequently performed minor surgical operations was for fistula. One Western physician, Oliver R. Avison, blamed this apparently common condition on the Korean custom of sitting on the floor instead of on chairs (Avison 1897).
After a little more than 3 years of medical work in Korea, Avison concluded that the kinds of diseases seen in Seoul were about the same as those seen in Canada, but also that the relative frequency was different. Avison, founder of Severance Union Medical College and Hospital, had come to Korea in 1893 in response to H.
G. Underwood’s call for medical missionaries. His Korean patients suffered from all the usual diseases of the major organs, eye diseases, Conjimctivitis, ulceration of the cornea, hernias, various forms of heart disease, hysteria, epilepsy, paralysis, Bright’s disease, asthma, bronchitis, tuberculosis, whooping cough, diphtheria, ulcerative tonsillitis, skin diseases, scabies, diarrhea, dysentery, intestinal worms, leprosy, syphilis, smallpox, malaria, typhus, and fevers of various sorts. Although he usually wrote with immense confidence in his own opinions, Avison admitted that “as we do not have the privilege of making autopsies to correct our diagnoses in case of death, many of our suppositions... may not be correct” (Avison 1897).Among the cases seen in the 1920s by Sherwood Hall were the following: gangrene, enlarged spleen due to chronic malaria, enlarged liver due to liver abscess, ascites, pleural effusion, edema, distomiasis due to lung flukes, and many forms of tuberculosis, often advanced cases. Hall thought that the use of unsterilized needles in acupuncture and moxa often led to infection and painful inflammation. Among women patients, Marian Hall encountered abdomens swollen from enlarged uterine fibroids, tumors, and ovarian cysts (Hall 1978).
The early missionaries often fell victim themselves to endemic diseases such as malaria, typhus, and dysentery. Some of these deaths were obviously unnecessary even with nineteenth-century medical techniques, such as the missionary from Australia who contracted smallpox after only a few months in Pusan, apparently because he had placed his faith in Providence instead of vaccination.
Despite the obvious effectiveness of quinine, vaccination, and various surgical operations, the medical missionaries found that Western medicine was quite powerless before “continued fevers” or, put another way, that the τnudang (Korean shaman) was equally as effective as they were. Indeed, the missionaries admitted that in the treatment of many ailments, the results obtained by Korean doctors were comparable to those of the Western doctor (Busteed 1895).
Studies of Korean village life in the 1940s found that although people died from many different diseases, no adequate accounts of morbidity and mortality patterns were available. Practitioners noted that many children died of tuberculosis, whereas many adults died of uncertain maladies of the stomach or intestines, which probably included bacillary dysentery. Among the diseases common in the villages were smallpox, typhoid, typhus, cholera, malaria, and parasitic worms. Quinine and preventive vaccines did make inroads on malaria, and some of the other diseases and health examinations were conducted in the schools where inoculations were given to students if infectious diseases were found (Osgood 1951).