“You Cuttee — Me Stand It”: Chinese Patients and Pain in Nineteenth-Century Surgery

March 2020

As a historian of medicine, it is fascinating as well as depressing to watch in real-time as anti-Chinese feeling is whipped up in the context of the current coronavirus epidemic.

The insistence in some circles of calling it “the Chinese Virus” to distract attention from potential major domestic public health policy failures is a remarkably transparent tactic, one with echoes of earlier “Yellow Peril” campaigns and of previous attacks on scapegoats in outbreak situations.[i] It reminds me of the kind of crude racist paranoia that one sees in the form of the diabolic Dr Fu Manchu, the most famous fictional embodiment of the Yellow Peril, who plotted with the “Red powers” to spread contagion and put the blame on the Americans in a 1956 TV episode entitled The Death Ships of Fu Manchu. My work is not on contagious disease but on the history of surgery. Fu Manchu was sometimes depicted as a surgeon, indeed, as “Satan’s surgeon,” as he was called in a 1940 American TV series, but in this context my research has focused on how Chinese patients were understood to respond to the pain of surgery. In this blog, I will just give a brief outline of the nineteenth-century debate on whether “Oriental” patients really felt the agony of surgery in the same way as their European counterparts, and what its significance was.

Dr Fu Manchu, the sinister “arch-murderer” and hater of the white race, was created by the English writer Arthur Ward under the pseudonym Sax Rohmer. Many of his dastardly plans had medical themes.
Dr Fu Manchu, the sinister “arch-murderer” and hater of the white race, was created by the English writer Arthur Ward under the pseudonym Sax Rohmer. Many of his dastardly plans had medical themes.

Little was written about any supposed physiological differences between Europeans and the Chinese before the middle decades of the nineteenth century. When a Chinese peasant called Hoo Loo travelled all the way to London in the 1830s to seek treatment for an enormous 65-pound tumour, many were convinced that Asians would be less tough than Westerners, surely “no human being, and least of all an Asiatic, would survive the removal of such a tumour,” the hospital’s house journal suggested. Hoo Loo in fact displayed “fortitude, patience, and heroic courage” during the doomed operation, having “firmly set his teeth, and resignedly strung every nerve in obedience to the determination with which he had first submitted to the knife.” However, in the context of expanding European colonial power elsewhere and quasi-colonial control in China itself, thinking on the Chinese in pain began to reflect the developing “racial science” of the period, and the kind of composure shown by Hoo Loo was increasingly seen as typical of the Chinese in general. Drawing on clichés of “Orientals” as docile, weak-willed opium smokers or as natural victims broken by centuries of mistreatment and cruelty, the notion that the Chinese were generally impassive in the face of pain became a commonplace.

“Poor Hoo Loo and his Tumour.” The Lancet (April 16, 1831), 89.
“Poor Hoo Loo and his Tumour.” The Lancet (April 16, 1831), 89.

From the 1840s onwards, there are innumerable examples of Western observers arguing that Chinese patients literally do not feel the pain of surgery in the same way. To give just a couple of instances, the British historian and travel writer Edward Barrington de Fonblanque, (who himself would lose a leg to amputation) wrote in 1863 that, “The fortitude of the Chinese, under the most severe operations, was the wonder of all. Not only men, but women and children would submit themselves to the knife without flinching, and undergo even the amputation of a limb without a cry or complaint.” And Arthur H. Smith, in his 1894 Chinese Characteristics suggested that the “Chinese endurance of physical pain,” exemplified in the “almost universal” phenomenon of hospital patients bearing pain “without flinching a degree of pain from which the stoutest of us would shrink in terror” was because they did not have “an outfit of Anglo-Saxon nerves.”

Sometimes this apparent national trait was discussed with admiration, sometimes with contempt or mockery. For instance, in an 1888 article entitled “The Callousness to Pain of Orientals to Pain,” Waldo Briggs of St. Louis recounted the apparent fortitude of a Chinese laundryman called Lee Gee who came to his hospital as a racist joke. Lee Gee refused all forms of pain relief, supposedly saying “‘me not gettee dlunk dis time. You cuttee—me stand it,’” which he did “without a groan or shiver” as “he sat and laughed and chatted continuously.” “No one who was present had ever before seen such a specimen of nerve and stoicism. What would have been insufferably painful to a European or American was borne not only without complaint, but with smiles, chatting and laughter.”

However, such ideas of Chinese insensibility were rarely uncontested. For example, in 1910, the medical missionaries William Hamilton Jefferys and James Laidlaw Maxwell rejected the ideas common among “laymen” and “physicians” that “the Mongolian races” had a less “highly developed” sense of pain than Europeans. This was, they wrote, an essentially “superficial observation.” Science, in the form of “Physico-psychological experiments” on the “sensory nerves of the skin and so forth” had shown that the Chinese were just like the “white races” in this regard, whatever anecdotal impressions might have been picked up by foreign observers. It was really a matter of class and of the life experiences of the “coolie classes… inured to lives of want, hard conditions, struggle, and cheerful submissions.” On the basis of these observations, they put forward a humanitarian and anti-racist argument that surgeons should not “economise on local and general anaesthetics” or “harden the conscience” with Chinese patients. They went on to condemn an unnamed foreign surgeon at a Chinese clinic who had “opened so many abscesses, even amputated fingers, without using any anaesthetic, ‘because the patients seemed to suffer so little pain,’” suggesting that in his next life he should return as a “pincusion [sic].”

 

[i] As Samuel Cohn has pointed out, epidemics do not necessarily lead to attacks on marginalised groups. Samuel K. Cohn, Epidemics: Hate and Compassion from the Plague of Athens to AIDS (OUP, 2018).