Medical Mission Series 
 
 
 HOSPITALS IN SIAM 
 
 1. Southern Siam 
 
 2. The Laos 
 
 New Hospital, Nakawn 
 
 Woman’s Board of Foreign Missions 
 of the Presbyterian Church 
 156 Fifth Avenue, Room 813, New York 
 
 1905 
 
HOSPITALS AND DISPENSARIES 
 1905 
 
 Southern Siam. 
 
 Bangkok. —Medical itineration. 
 
 Lucius C. Bulkley, M. D. 
 Petchaburi. —Hospital; dispensary. 
 
 E. B. McDaniels, M. D. 
 Rajaburi. —Hospital; dispensary. 
 
 Rev. Egon Wachter, M. D. 
 Nakawn. —Hospital; dispensary. 
 
 W. J. Swart, M. D. 
 Pitsanuloke. —Hospital; dispensary. 
 Carl J. Shellman, M. D. 
 
 Laos. 
 
 Chieng Mai. —Hospital; dispensary. 
 
 Lampoon (sub-station).—Dispensary. 
 
 James W. McKean, M. D.;. Claude W. Mason, M. D. 
 Lakawn. —Hospital; dispensary. 
 
 C. C. Hansen, M. D. 
 
 Nan. —Hospital; dispensary. 
 
 Rev. S. C. Peoples, M. D. 
 
 Pre. —Hospital; dispensary. 
 
 Chieng Rai. —Hospital; dispensary; twenty branch dispen 
 saries in villages. 
 
 Rev. W. A. Briggs, M. D. ; Charles H. Crooks, M. D. 
 Total number of patients treated (1907) 57,062. 
 
 We are indebted to the kindness of W. A. Briggs, M. D. 
 for much of the information contained in this leaflet. 
 
HOSPITALS IN SIAM 
 
 EDICAL MISSION work in Siam began in 1835 
 with the arrival of Dr. Daniel B. Bradley, a 
 missionary of the American Board. Dr. Bradley 
 was a man of remarkable skill and ability, and 
 remained in Siam after his Board’s work there 
 was given up, devoting himself to the welfare 
 of the Siamese until his death in 1873. Rev. S. E. House, 
 M. D., the first physician sent by the Presbyterian Churchy 
 arrived in 1847. 
 
 During the first critical years of the Mission, the medical' 
 work was the chief means of allaying the natural prejudice 
 felt against the foreigners and gaining toleration from the 
 old king. Since the accession of King Chulalongkorn in 1868, 
 American missionary physicians have been the trusted ad¬ 
 visers of the government in its efforts to introduce scientific 
 medical practice. With the gradual increase of intelligence 
 the new generation has come to recognize to some extent the 
 efficiency of modern methods and especially the benefits of 
 surgical skill. The king has established in Bangkok army and 
 navy hospitals, two hospitals for citizens, an insane asylum 
 and a Royal School of Medicine. All these, with one or two 
 exceptions, are in charge of medical missionaries, or of those 
 who have at some time been connected with the missionary 
 work. The crown prince, who w r as educated in England, has 
 asked several missionary physicians to write theses on hygiene 
 and the most prevalent diseases to serve as a basis for sani¬ 
 tary measures to be brought before the government. But 
 
 3 
 
the spread of western ideas is confined as yet to a very 
 narrow circle, and the masses of the people, both in city and 
 country, are content to live and die in the unsanitary tra¬ 
 ditions of their forefathers. 
 
 We have no organized medical work in Bangkok. Rev. 
 Eugene P. Dunlap, D. D., though not a professional physician, 
 has relieved much suffering in his itinerating trips by land 
 and sea along the shores of the Gulf of Siam and through 
 the peninsular provinces. In such tours recently made by Dr 
 Dunlap and Lucius C. Bulkley, M. D., over one thousand 
 patients were treated and many operations performed, be¬ 
 sides thousands of vaccinations. Dr. Bulkley says: 
 
 The high commissioner of Pooket, grateful for his own recovery 
 from serious illness, offered to build hospitals at two places if 
 missionaries could be sent. “I want a missionary doctor,” he said, 
 “because I know how much deeper interest he will take in the sick 
 than an ordinary doctor. Come start hospitals and schools and I will 
 see that money is secured to help support them, and I will also aid 
 you in going about to preach to the people.” His excellency has since 
 purchased land and drawn up plans for the first hospital at Tap 
 Tiang, an important market town. 
 
 At Panga, for a cripple who had been bitten by a crocodile, 
 we made a pair of crutches, the first ever seen in that region. What 
 a change it made in his life! From lying helpless on his back for 
 seven years he was now an active and independent member of the 
 community—even his name was changed from “Dog” to “Happy.” 
 He was baptized, with his mother, on Dr. Dunlap’s arrival. 
 
 Each of the four provincial mission stations in Siam, 
 Petchaburi, Rajaburi, Pitsanuloke and Nakawn, has now a 
 good hospital and dispensary, wdth a resident physician. In 
 all these places land was given by the king or rented at a 
 nominal price, and generous gifts made for the buildings. 
 The women’s ward at Petchaburi -was given by the queen. 
 These stations are all centers for wide itinerating work. 
 Rajaburi and Petchaburi are now connected with Bangkok by 
 rail, which makes it easier to obtain supplies and saves much 
 time in travel. 
 
 The beautiful hospital at Pitsanuloke, 255 miles north 
 of Bangkok, is the only one in that region. It was given 
 by the high commissioner as a memorial to his mother, and 
 
 4 
 
built and equipped with modern apparatus by Dr. Toy’s 
 energetic efforts. Though only three years old, this hospital 
 of fourteen beds is already too small. The physician in 
 charge rejoices in an excellent Siamese assistant, thoroughly 
 sympathetic and useful. On a recent tour over one thousand 
 six hundred children were vaccinated. The governor of the 
 province was so pleased with this service that he offered to 
 pay all expenses of the trip. 
 
 Nakawn, five hundred miles south of Bangkok, occupies 
 a field of its own as the center of influence in its province. 
 In 1883 an invalid gentleman of Nakawn started in a sailboat 
 with his wife to consult the ‘ ‘ foreign doctor ’ ’ at Bangkok. 
 The little boat was driven by the wind into the harbor of 
 Petchaburi. “Why go to Bangkok?” said the people. “Here 
 at Petchaburi is a foreign doctor who can almost make the 
 dead to live! ’ ’ The strangers made their way to the hospital; 
 the man was cured of his illness and both he and his wife 
 became Christians before returning home. Through their in¬ 
 fluence missionaries -were sent to Nakawn and a church organ¬ 
 ized in 1895. The medical work has always been important, 
 and in 1907 a beautiful hospital was completed and opened 
 through Dr. Swart’s exertions. The entire cost was twenty- 
 four thousand ticals ($8,000 gold), of which three fourths was 
 given in Siam. 
 
 All these hospitals are self-supporting, except for the 
 salaries of the physicians in charge. 
 
 The prevalent diseases in Siam are cholera, dysentery and 
 malarial fevers—all transmitted by infected water or abundant 
 insect life. In Bangkok, while the climate is not more un¬ 
 wholesome than that of other tropical cities, the question of 
 water is a very serious one. There is practically no rain 
 for six months of the year; there are no wells or springs; 
 the only natural supply comes from the filthy river and 
 canals, 'which serve as bath tubs, wash tubs and sewers for the 
 city. The masses drink the river water, with the natural 
 
 5 
 
results. The only alternative is that adopted by most of 
 the well-to-do people—to gather and store the rain water that 
 falls in the wet season. This has to be done with the greatest 
 care and the supply kept in covered earthen jars or some¬ 
 
 times in great iron tanks, which are carefully locked for fear 
 of robbers. The stored water must be further purified by 
 boiling or filtering before it is safe for drinking. A small 
 family requires a store of about eight hundred gallons. One 
 may imagine the expense and vigilance needed to provide 
 an adequate six months’ supply for a large school or hospital. 
 
 The natives have a great dread of cholera, which they call 
 
 “the hurricane,” from its sudden coming and swift fatality, and fear 
 to mention its name. A great spirit, they say, sits with his feet 
 
 in the fire and needs many servants to bring him water. All those whose 
 bodies are not burned are forced to serve him. Cremation is the 
 
 general custom in Siam, but is forbidden in the case of cholera 
 victims until after some months. Thus the spirit has all those that 
 die of this disorder. After a time many of these bodies will be 
 taken up and burned, and their spirits thus delivered from their hard 
 master. When his retinue becomes too small, he sends another 
 epidemic of cholera to keep up the number. 
 
 In times of epidemic a tall bamboo pole stands in front of 
 each house, from which float gay-colored flags of odd shapes. When 
 the ' first cholera patient dies in Bangkok his hands are examined 
 and the shapes formed by the intersecting lines on the palms are 
 carefully traced. From these the Buddhist priests make these flags, 
 which the people buy as charms. Upon one of the flags the names 
 of the household are written, and at night a lantern is hung from 
 each pole so that the evil spirit may see the names and pass by the 
 house. 
 
 The chief dependence of the native practitioners for all ail¬ 
 ments is upon incantations and charms. They know nothing of 
 surgery, but use various preparations of medicinal herbs and roots, 
 and curious medieval compounds, of which the following popular cure 
 for all kinds of fever may serve as an example: Take equal parts 
 of elephant’s tusk, tiger’s teeth, crocodile’s teeth and bear’s teeth; 
 equal parts of buffalo horn, rhinoceros horn, stag’s horn and 
 sandalwood; equal parts of the bones of a vulture, a crow and a 
 goose. All these to be pulverized and mixed on a stone with pure 
 water, one half the resulting paste swallowed at one dose, the other 
 half rubbed on the outside of the body. 
 
 Dried rhinoceros skin is sold in the markets in hard, black 
 slabs about a foot square, at one dollar a pound. A tea made from 
 the parings is supposed to be useful in cases of malaria. For wounds, 
 one remedy is a young mouse burnt to a cinder and tightly bound on. 
 
 There is crying necessity everywhere for sanitary and 
 medical reforms. It is said that seventy-five per cent of the 
 children born die in childhood from disease or lack of care, 
 
 6 
 
and in some districts the population is actually decreasing. 
 Smallpox destroys many thousands every year. Vaccination 
 was introduced by Dr. Bradley, who had to hire men to 
 undergo it. The government now offers it free to all, but 
 it is yet far from general. 
 
 The Laos people, occupying the northern provinces of 
 Siam, are largely spirit-worshipers and ascribe all diseases 
 to the agency of demons. The pioneer missionaries, coming 
 in 1867, brought with them the blessings of healing as well 
 as teaching. Dr. McGilvary, though without a physician’s 
 title, did a physician’s work from the beginning. He intro¬ 
 duced the use of quinine for the prevalent malarial fevers, 
 even hiring people at first to take it and prove its value. 
 To-day quinine is iu general use, and has saved many lives. 
 Dr. McGilvary also introduced vaccination, until then unheard 
 of. Dr. M. A. Cheek, Dr. Vrooman and Dr. Peoples were 
 the earliest physicians commissioned. Others have followed 
 them and through their ministrations prejudice has been 
 broken down and a hearing gained for the gospel. 
 
 Five stations—Chieng Mai, Lakawn, Nan, Chieng Rai, and 
 Pre—now have hospitals and dispensaries, all self-supporting. 
 At Lampoon a dispensary is maintained, though there is no 
 resident physician. Thirty-five thousand patients are treated 
 annually by these hospitals. Problems in this region are in¬ 
 tensified by the great distance from the base of supplies. 
 When deficiencies can only be made up by a journey of three 
 weeks down the river and six weeks back, it behooves the 
 doctor to take long looks ahead. 
 
 Chieng Mai, the capital of the province, has an excellent 
 hospital in a spacious compound, with a separate pavilion for 
 foreigners. One unique feature here is a vaccine laboratory, 
 established by Dr. McKean on account of the impossibility 
 of obtaining satisfactory virus. The lymph is supplied to 
 
VACCINATING STAFF, CHIENG MAI HOSPITAL 
 
 These Christian men have vaccinated more than ten thousand persons and have carried the good news into 
 
 many villages never yet reached by a missionary. 
 
the government employes as well as to the staff of the hospital. 
 A corps of 140 Christian men are employed to travel through 
 the province vaccinating the people and preaching the gospel. 
 They carry with them quinine and simple remedies, and also 
 distribute gospels and tracts. Ten thousand persons were 
 recently vaccinated in six months. A small charge is made, 
 of which the operators get half, which supplies their expenses; 
 the rest goes to the hospital. These men are required to spend 
 three days each month at the hospital for instruction, and 
 some of them become quite skillful. Even with this partial 
 training they are infinitely superior to the native spirit 
 doctors. 
 
 Dr. McKean says: 
 
 “Among many reasons for gratitude to God, 1 must not fail to 
 mention our three long-tried and faithful hospital assistants. Especially 
 should we mention our head nurse, Dr. Kao, who is unwearied in 
 service to the poor and distressed.” 
 
 For many years past it has been felt that there was 
 urgent need for some organized work for lepers, of whom 
 there are many in Siam. Buddhism has done nothing for 
 them and never will. According to Buddhist belief, lepers 
 are suffering for sins committed in some previous existence, 
 and the decrees of fate must not be thwarted. As the loss 
 of parts of the hands and feet makes any kind of work im¬ 
 possible, begging is the leper’s only resource. Hence these 
 unfortunate creatures, who are a menace to the community, 
 wander about in all public places, begging for food to keep 
 life in their poor deformed bodies. 
 
 Dr. McKean says: 
 
 “Ten years ago we began to represent the case to the Bangkok 
 government and have often asked for land on which to erect a refuge. 
 Now his excellency the governor of Chieng Mai has kindly given us 
 for the purpose half of an island in the river near Chieng Mai, and 
 his gift has been ratified by royal authority. The tract of land is 
 ideal in every way. It comprises 160 acres, most of it suitable for 
 the culture of rice, which is the chief food here. It has lain fallow 
 for years because it was the forage ground for the governor’s pet 
 elephant, which was so vicious that no one dared to live near his 
 haunts. When the elephant died we begged earnestly for the ground 
 
 9 
 
and the governor turned it over to us. At the upper end stands 
 a spreading banyan tree, under whose branches Dr. and Mrs. Me- 
 Gilvary moored their boats and spent their first Sunday when they 
 came as pioneers to Chieng Mai, forty-one years ago. 
 
 “We fervently hope and believe that the 'governor’s gift marks 
 the beginning of the end of leprosy in Siam. Careful and loving 
 treatment of those now afflicted, a practical demonstration of the 
 benefits of segregation, and the growth of education and Christian 
 sentiment will, we _ trust, bring about compulsory segregation, which 
 in the course of time will stamp out the disease in Siam as it did 
 in Europe centuries ago. In the meantime the Christian church should 
 care for the outcasts and also give them the gospel. . . . Our 
 present crying need is for money to erect suitable buildings where 
 we may house and feed our outcast friends—men and women for 
 whom Christ died, and for whom he seems to have felt an especial 
 compassion.” 
 
 At Lakawn (1885) is the Van Santvoorcl Memorial 
 Hospital, to which a new ward for women and children was 
 added in 1906. Not a few of the church members were 
 brought to Christ in the hospital. Among these was a young 
 man of intellect and fine character, who is now one of the 
 best teachers in the boys’ school. All the assistants in both 
 hospital and dispensary are Christians, so that a Christian 
 influence pervades the place. 
 
 Four days’ journey southeast of Lakawn is the station 
 of Pre (1894) in a fertile and beautiful valley. Here the 
 hospital work has been done in temporary structures of bam¬ 
 boo, without any adequate equipment. There is just now no 
 resident physician. 
 
 Nan (1895) is a beautiful walled city embowered in trees, 
 eight days’ journey northeast of Lakawn. The mission 
 property is situated between the city wall and the Nan River. 
 A new dispensary recently erected is admirably adapted to 
 its purpose. There are three large, airy rooms, with clinic 
 and storerooms, and a wide veranda. Dr. Peoples has done 
 much for the Laos people in his twenty-five years of de¬ 
 voted service, amid all the anxieties and discouragements of 
 pioneer medical work with very imperfect appliances. It is 
 hoped that the new dispensary may be followed some day by 
 a hospital of sufficient capacity and equipment for the 
 growing needs. 
 
 10 
 
Chieng Rai (1897), our most isolated station among 
 the Laos, is nine days by jungle trail northeast of Chieng 
 Mai. The American mail is nearly three months old when it 
 reaches the lonely mission there. The city lies on the main 
 route of trade, drawing custom from Indo-China (French), 
 the South Shan States (English), and Southern China. Dr. C. A. 
 Denman and his successor, Dr. W. A. Briggs, have built up 
 an important medical work at Chieng Rai under great diffi¬ 
 culties. Twenty branch dispensaries are maintained in the 
 country districts, and the civil and police departments of the 
 local government draw their supplies through our dispensary. 
 
 The great need for new buildings will be relieved on the 
 return of Dr. Briggs from his furlough, by the erection of a 
 memorial hospital, for the building and equipment of which 
 $10,000 gold has been given. This generous provision will 
 relieve the physician of the anxious struggle to care for the 
 suffering with no adequate means. 
 
 The remarkable progress of Siam in civilization during 
 the last fifty years is second only to that of Japan. The 
 responsibilities laid upon those who have stimulated and 
 guided this progress are well stated in the weighty words 
 of the Hon. Hamilton King, United States Minister to Siam, 
 in an address recently delivered at Bangkok: 
 
 “The missionaries came to Siam to help her people. They found 
 multitudes dying of disease; they fought cholera with cleanliness, fevers 
 with quinine, smallpox with vaccination. . . . Now Siam has changed. 
 She has taken long steps forward in fifty years. Things are no 
 longer in their "beginnings. From the introduction of quinine and 
 vaccination have developed questions of national sanitation and organ¬ 
 ized medical work. Are you missionaries who planted for this growth 
 ready to help develop the crop? 
 
 “Siam asks you to do your part in shaping the medical work 
 of the nation; to stamp it with the best known to Christian medical 
 science. Anything less than the best will not avail. Medical men 
 are needed who shall come from the best schools and conduct the 
 best hospitals in the best way.” 
 
 Price, 3 cents; 30 cents a dozen. 
 11 
 

 
 
 
 ' 
 
 
 
 
 
 
 *