David Duncan Main (1856–1934) was a British doctor, best known for his medical missionary work in Hangzhou, the capital of the south-eastern Chinese Province Zhejiang, during the late 1800s and early 1900s. He was superintendent of the Church Missionary Society (CMS) Medical Mission from his arrival in 1881 until 1927, and principal of the Hangzhou Medical Training College. He was also involved in the formation of the Young Men's Christian Association (YMCA) in Hangzhou, which focused on preaching the Gospel to non-Christians. Main and his wife, Florence Nightingale Smith, opened over thirty medical buildings during their time in China, as well as a centre for industrial work training.
He was characterised by his cheerful and trustworthy nature, and was one of Hangzhou's best-known missionaries, referred to as "Dr. Apricot." His contributions included the Hospital of Universal Benevolence and the Hangzhou Medical Training College. The college was one of the first medical training schools in Zhejiang, and in 1926 was given provisional registration by the China Medical Association. When he retired in 1926, the hospital was dealing with 3,000 inpatients and 60,000 outpatients per year. The hospital is now The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU) and was ranked as one of the top 100 hospitals in China in 1999.
Early life and education (1856–1873)
David Duncan Main was born on 10 June 1856 in Ayrshire in western Scotland, southern Scotland.(8) He grew up the village of Kirkmichael. Throughout childhood he lived by his signature phrase, "Be good and do good." He left school at the age of 16 as head boy and medalist of his class.
In 1873, he began studying business at the University of Glasgow. Following graduation he found work at a shipping agency in Glasgow.
Early medical influences In the spring of 1873, after a conversation with a friend about living life as a Christian, Main decided to pursue medicine. He associated himself in Glasgow with Pastor Findlay's work at the St. George's Tent Mission in early 1874. Here, he met Dwight L. Moody, the American evangelist, and his friend Ira D. Sankey the gospel singer. After attending one of Moody's speeches, Main join the revival movement, which put him in touch with medical missionaries. During his time with Findlay, he met the medical missionary Donald Morrison, and himself entered medical missionary work.
Medical training and early career (1874–1881)
Main finished his business education at Glasgow University, and then pursued medical training with support from the Edinburgh Medical Missionary Society, at the University of Edinburgh.. He also studied medicine in Glasgow, and took the Triple Qualification of the Scottish Corporations in 1881. He graduated medical school that year. During his training (1877—1881) Main with fellow students worked in the slums of Edinburgh and preached at open air meetings. With his friend Dr. Arthur Neve, Main at this period formed the Church Missionary Society (CMS) Medical Auxiliary, to interest other students in foreign service missions.
In Hangzhou, Main and his wife studied Mandarin Chinese.
Work abroad Main married Florence Nightingale Smith in 1881; she had also worked in the slums of Edinburgh, as a service woman in the Free Breakfast Mission and the Cowgate Medical Mission. Main had initially requested to be assigned work in India, but was asked to choose China, and was assigned to the Mid-China mission. Main and his wife sailed for China in September 1881, where they stayed for 46 years, returning to the United Kingdom in 1890, 1899, and 1910.
They were welcomed by Dr. James Galt and his wife, and Rev. Arthur Elwin and his wife, at Hangzhou. Upon their arrival, Hangzhou was in a poor state, the aftermath of the Taiping Rebellion of 1861. The streets were full of debris, opium was widely used, period, and some areas of the city were filled with addicts.
Buildings and hospitals
The Central Hospital and Opium Refuge (1881)
The central hospital was the first western hospital in Zhejiang, consisting of a small building with two floors and four wards, containing the capacity to treat 20 inpatients and about two hundred outpatients in the lower floor dispensary each month. It had been created in 1869 by Christian Missionary Society member Dr. Meadows. Upon Main's arrival, he was appointed as the superintendent of Hangzhou's Church Missionary Medical Mission and thus took charge of the hospital.
During his first year in Central Hospital, he treated opium addiction, performed cataract removals, treated leprosy, and prescribed medicine.
As the opium epidemic continued in China, Main maintained the original goal of the first Central Hospital, and thus continued to allot time to treating opium addicts and included space for a male and female Opium Refuge.
The Hospital of Universal Benevolence (1884)
The Hospital of Universal Benevolence, also known as Kwang-Chi (or Guangji in Pinyin), was founded after increasing numbers of patients lined up at the dispensary each morning, and more in-patient space was needed. To fund this expansion operation, Main saw private patients, who paid him small fees for his service. Main reported that he had been "sent out here to glorify God by our lives work, and we must do it as far as possible under the healthiest conditions," thus implying the existing hospital conditions to be unfit.
Main obtained the necessary funds through letter requests to the Chinese provincial government and through money from the William Charles Jones Fund. He designed the hospital, and in May 1884, the Hospital of Universal Benevolence was opened. It contained two stories and a basement, four general wards, ten private wards, a dispensary, a waiting room, and chapel. The patients were initially primarily male, with few wards allotted to women. Preaching occurred in each ward; all patients had the Gospel presented to them and many patients were baptised. It was mandated that those who could afford to pay for their board did so, but medical attendance was free to all. In 1894, due to space constraints and Chinese customary preferences, a separate women's hospital was constructed.
Dr. and Mrs. Kember, a European doctor and his wife, oversaw all of the operations and provided help, especially during the Mains' holidays. By the end of 1885, 7,931 outpatients and 374 inpatients had been treated, as well as 180 private patients and 1460 country patients. 79 cases of suicide by opium were brought to the hospital and 60 were saved.
Female and male rest homes were added in 1922 for the workers associated with the various hospitals and institutions. A Pastor's Rest Home was also built for the native clergy and their wives.
1909 renovations Throughout the hospital's existence, the number of patients and facilities increased. As the private practice grew, more fees poured into the hospital, which helped fund the working expenses of the institution. The chapel was renovated and a large public hall (Lecture Hall) was added to the other buildings in the compound. Each morning before work began in the outpatient department, Main and his workers held morning service and gave an address; all patients were able to attend.
New buildings were built on newly purchased land, in which the patients were able to live in the open air. In 1905, the hospital opened dermatitis wards, female wards, and obstetrical wards. Six years later, the hospital was fully equipped with electrical lamps, water pipes, and X-ray machine equipment.
The hospital exchanged hands and names multiple times as the political situations in China varied, however in 1960 it was given its present name "Second Affiliated Hospital, Zhejiang Medical University." In the 1980s it set up the area's first Emergency Intensive Care unit. In 1999 the hospital was ranked in the top 100 hospitals in China. It is now in touch with numerous hospitals and universities, including UCLA, Johns Hopkins, and the Mayo Clinic.
The Men and Women's Leper Hospitals (1889, 1892)
Main wrote to the Mission to Lepers in Edinburgh, asking for funds to open a leprosy apartment because the number of lepers in China was very high. His requests were met, enabling him to purchase land containing two buildings beside the compound of medical buildings. These were converted into male and female quarters, with a kitchen and attendants. They were later relocated to include renovations.
The Home for Untainted Children (1906)
Dr. and Mrs. Main built a home for the children whose parents were residing in either the Men's or Women's Hospital. There was shelter, care, and Christian influence; many were baptised after being brought in. A school was opened later. A matron and a nurse tended to the children, many of whom went on to be of service to the main hospital.
Fresh Air House Dr. Main established this home as a place of healthy living, in which patients were to "eat fresh air," along with fresh vegetables, fruits, and meat. Patients were weighed weekly, in order to document growth and progression. One patient remarked, "I feel all made new since I came up here."
Schools
The Hangzhou Medical Training College (1885)
In 1882, Main began training a few young men, teaching them surgery and medicine. They received practical training in the dispensary as well as bedside lectures, then formed their own diagnoses, which were later compared with Main's diagnoses. He continued the expansion of his preaching and teaching quarters in order to accommodate more practitioners and students. His lectures covered health, feeding, sanitation, education, chemistry, and Gospel studies.
Main opened this school to train natives as well as Europeans. About one hundred students were trained at the college in conjunction with the Hospital of Universal Benevolence while he was in China. Initially, the teaching staff consisted of two professors, and because of this, new students could only enter every five years. The first three batches of students were Christians, however the demand for Western medical training had increased so much since the Boxer Rebellion that a few "heathen" (non-Christian) students were admitted. The college contained a lecture hall, a pathological laboratory, and a chemical laboratory. Many of the men trained by Main remained to work either directly or indirectly in the Mission, if not in the hospitals.
The college was renovated after the Young Men's Christian Association (YMCA) came together in Hangzhou in 1916, in which large meetings were held to teach about hygienic rules of life and conduct. This included the Gospel as salvation for the soul and body. The meeting was met with success, and Yuan Shikai sent 2,000 dollars to fund the work. 10,000 dollars were donated by Lord and Lady Maclay in memory of their son. At the stone laying event, a casket was buried beneath the foundation containing a Bible, reports of the five years work of the YMCA, rules of the YMCA, badges, lists of subscribers and their subscriptions, a map of Hangzhou, a photograph of the building plan, calendars, and copies of the paper inviting people to the stone laying event.
The hospital was opened in 1924. The ground and first floors were devoted to teaching, and the second to a hostel for students. There were also six laboratories for physics, organic and physiological chemistry, general chemistry, elementary biology, histology, and pharmacology. The building also contained a library and was equipped with new apparatus, including two X-Ray machines, a UV light lamp, two high frequency systems for violet ray treatment, a pantostat, a carbonic acid snow generator, massage apparatus, a localizer for foreign objects in the body, fluoroscopic screens, and minor devices for galvanism, faradism, and ionization.