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Reporting Error Revealed in Knee Pain Acupuncture Study, Catastrophe Avoided

June 2016 | by Jonathan Gilbert

http://thegilbertclinic.com/reporting-error-revealed-in-knee-pain-acupuncture-study

On October 1st, 2014, the prestigious Journal of the American Medical Association (JAMA) published a study entitled “Acupuncture for Chronic Knee Pain: A Randomized Clinical Trial”[1]. It was a major study whose results stated that neither acupuncture nor laser acupuncture was useful to patients aged 50 and older with moderate-to-severe knee pain. Enter Dr. Arthur Fan…

In March of 2016 Dr. Fan and associates published a reevaluation of this study. It found serious flaws in its methodology and analysis. Not only that, but when properly evaluated, it appears that the study actually showed significant improvement in patients undergoing acupuncture and laser acupuncture in the clinical trial.

Dr. Fan is a consultant and long term researcher in Traditional Chinese Medicine who has been published in many of the world’s foremost medical journals. He has received numerous awards and commendations including a letter of thanks from the President himself. And thanks to him a grave reporting error was averted and an catastrophe avoided.

What is of interest to this writer is how such a mistake could have been made by one of the most respected, peer reviewed, medical publications in the world? I leave that, along with the link to Dr. Fan’s paper, “Acupuncture is Effective for Chronic Knee Pain: A Reanalysis of the Australian Acupuncture Trial”[2] to your discerning minds. Be well. ♥

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Fan,Zheng,Yang-Evidence that dry needling the intention to practice acupuncture. JACM-2016 Last Version

Dry needling is a short form acupuncture, currently Physical Therapiests and other related professionals want to practice acupuncture under such a name with only 20-30 hours weekend training. This may cause big negative impact to public safety and acupuncture (both traditional and medical) profession.

We just published an article in a known SCI journal–Journal of Alternative and Complementary Medicine (JACM),  which treated this article as a High Impact Article. Please read at(I also attached a copy of Manuscript):

Evidence That Dry Needling Is the Intent to Bypass Regulation to Practice Acupuncture in the United States
Arthur Yin Fan, Ling Zheng, Guanhu Yang  Read Now

Fan,Zheng,Yang-Evidence that dry needling the intention to practice acupuncture. JACM-2016 Last Version

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46 reviews of McLean Center for Complementary and Alternative Medicine, about Dr.Arthur Yin Fan, from http://www.bookfresh.com
Simply Amazing
3/2/2016
Deborah L. says: Dr. Fan is simply amazing. Regular PT failed my daughter and both. Dr. Fan far exceeded expectations. Love the atmosphere in the office
Thankful
12/30/2015
Kay S. says: Dr Fan is a super amazing Acupuncturist.. His Chinese Herbs have helped to save my life.. Dr Fan’s acupuncture opened up my meridian to the point where I even got pregnant. I had a healthy baby girl. Dr Arthur Fan knows exactly what he is doing when it comes to treating his patients with Acupuncture . He not only listens , but he treats his patients according to their diagnosis w his super excellent Chinese Herbs💗
PERFECT
11/28/2015
Gwen D. says: Dr. Fan is wonderful. He listens and is very patient and understanding of your issues. I highly recommend him.
Amazing
10/19/2015
Abdou Y. says: I have just started a treatment for a knee pain that has been threatening my ability to work out. Just after 2 visits to Dr. Fan’s center, I can only say that I feel way better than before as I don’t feel anymore about 70% of the pain. I can’t wait for the next sessions as I now hope for a complete healing. I was skeptical at first since I was stranger to acupuncture but not I can say it works.
Excellent
9/1/2015
Lynn D. says: I saw Dr. Fan yesterday for the first time and already feel like I have some improvement in my mood and stress level. Wonderful.
Doctor who cares
8/26/2015
Kasandra M. says: I just started seeing Dr Fan and I appreciate that he is looking at finding the cause of medical issues rather than masking symptoms. I have seen countless doctors and this one finally gives me hope. I have started feeling some relief with my various conditions and I know I have a long road ahead but Dr Fan is very kind, explains things and really targets where the issues are. I am so happy to have found him.
Great insight
7/24/2015
Barbara B. says: Dr. Fan listens more than most conventional doctors and is more attuned with what is going on with your health. His treatments are specialized and individualized to you. He has addressed specific concerns ranging from back discomfort, swollen joints, headaches, and colds, to helping to guide you to an overall sense of quiet and calm. Regardless of what ails you, a cupping session is a must.
Dr Fan Is Amazing
7/3/2015
Yuuna K. says: Dr. Fan is an outstanding doctor. He is trained in both western medicine as well as Chinese traditional medicine. He brings years of experience practicing both disciplines. He is amazing with acupuncture, diagnosis, and treatment suggestions. My body responded very positively to his acupuncture treatment. I would recommend him to other patients considering Chinese Traditional Medicine.
Post-Stroke Dystonia
6/9/2015
Sameer Y. says: I have an odd condition, and Dr. Fan is handling it with patience and success.
Excellent Doctor
4/7/2015
Robin S. says: I am fortunate to have found Dr. Fan who has helped me with a variety of issues: poison ivy, arthritis and allergies among them. His medical expertise is evident as he explains what is happening in the body and how acupuncture can support healing. His knowledge is balanced with kindness and compassion supported by an office environment that provides positive energy. I highly recommend Dr. Fan, particularly if other approaches to a problem have not brought relief.
Incredible!
4/6/2015
Eileen W. says: I was diagnosed with dystonia which affects my neck movement ability. Specialists such as neurologists, rehabilitation doctors suggest Botox injections which has side affect and not a long term solution. I had acupuncture in nearby NYC area and not much improvement. I found Dr. Fan and had great improvement under his treatment. And Dr. Fan is extremely kind and patient. Many thanks to Dr. Fan! Eileen
Very Helpful
4/6/2015
Gwen D. says: Dr. Fan amazes me with his ability to help me with multiple things. I have seen him in the past on other issues, and he has helped me greatly. I tend to be very stressed out and when I am with Dr. Fan, I feel my anxiety level drop. He is kind, understanding and extremely knowledgeable. Dr. Fan his assistant, Sarah, are excellent.
Very astute in diagnosis and treatment
2/8/2015
Scott B. says: I daresay, Dr. Fan has added years to my life. Very early in my chronic lymphocytic leukemia Dr. Fan intervened with a combination of herbs and acupuncture that has kept my cell counts stabilized since 2009–and at a juncture where it is too early for western medicine to intervene. From my vantage, Dr. Fan is most astute for both his skills of diagnosis and week-by-week treatment. Incidentally, for anyone with an interest, I recommend the book “Between Heaven and Earth: A Guide to Chinese Medicine,” by Beinfield and Korngold.
Magical Doctor
1/23/2015
Deborah L. says: I have been going to Dr. Fan now for years when I have a medical issue I’m confident he can treat. When I experienced back issues years ago, I saw a orthopedic doctor, tried a chiropractor, physical therapy and pain medication. It was then I decided to give acupuncture a try. How fortunate that I found Dr. Fan. A very informed physician who was gentle and caring. After only a few treatments which included cupping, I was cured. To this day years later, I have not had any back issues. He is now treating me for acid reflux. I so recommend his treatment – just amazing.
Alternative medicine treatment for hypertension,insomnia and others
11/26/2014
May T. says: Dr Fan treated my hypertension and a myriad of other aches and pains. His knowledge of western and Chinese medicine blends a wholistic approach in his treatment. He is patient and gentle as a doctor. Determined to avoid getting on medication to treat hypertension, I started a diet and exercise regime but only to limited results. Only after I began accupuncture did my blood pressure begin to normalize. My husband also sees him for insomnia which has helped.
Dr. Fan has done wonders!
11/2/2014
Al P. says: Dr. Fan has done wonders for both my wife and me. My wife had lingering multiple small blood clots in her lower leg area. Her vascular surgeon had told she needed to be on blood thinners for the rest of her life. Plus, she would have to wait for the clots to reobsorb back into her blood. Inside two weeks of treatment from Dr. Fan, the clots were gone. After my knee replacement the swelling was not going down. I was told that at my age it would take a much longer time frame. Three weeks of visits to Dr. Fan the swelling was completely reversed. We both whole heartedly recommend Dr. Fan.
Larry A
9/12/2014
Larry A. says: I believe I am very fortunate to have found Dr. Fan. I could not be happier and I am a severe critic, so I believe Dr. Fan is tops. Dr. Fan took his time to explain the procedures before they happened and made sure I understood the message he was telling me. Thank you Dr. Fan
Feeling much better
9/4/2014
Phannee W. says: Having been a patient of Dr. Fan for a while, I am very grateful that he has cured most of my ailments and I would highly recommend him to other patients for acupuncture treatment..
Great Service and Very good doctor
9/2/2014
Maryam Z. says: I have really bad leg pain and I went to see Dr. Fan and explained him my situation. He took great interest in my leg pain and overall health issues and gave me a treatment plan which will help me to deal with my pain until its treated completely. He was not interested in money aspect of my treatment but was more keen to find a cure for my leg pain. I am very happy with his treatment strategy and after 3 sessions, I already to start feeling better.
Great!
8/13/2014
Gwen D. says: Dr. Fan is a wonderful doctor. He is interested in his patients, listens carefully to your issue, and proceeds with the treatment. I have seen Dr. Fan before and he was concerned about the symptoms I had experienced previously; making sure that was cleared up. His assistant is also very committed to the patients and practice. The office has a lovely peaceful aura, I felt good just walking in.
Good oriental medicine and doctor
7/23/2014
Eric T. says: I had went to see Dr. Fan because of pain and numbness in my hands, elbow, and wrist. The doctor at urgent care could not do anything but give my anti-inflammatory. But after seeing Dr. Fan and being treated with acupuncture and medicine he gave me, the symptoms have lighted and is decreasing daily. I would recommend that people with issues that most western medical doctors cannot treat to at least pay Dr. Fan a visit to see if anything can be done.
Five Star
4/27/2014
Al P. says: Both my wife and I have been seeing Dr. Fan for almost a year. He has been able to allow me to delay a total knee replacement for almost a year. And I am certain he will allow me to delay the operation until I am in a better position to have the operation on my terms. He also, in one treatment cleared my Carole tunnel node that was sticking out over an inch and stop the pain entirely. Dr. Fan has saved me from a repetitive operation on my wrist.
Professional and curteous
4/25/2014
Dr. Jerome W. says: Just started, so far everything is fine. I will have more to say when I an further into my treatment.
Made huge difference!
4/23/2014
Takeo Y. says: I had a great experience with Dr. Fan. Aggravated shoulder pain due to lifting heavy stuff on top of the old pain I had been suffering for a while was removed mostly after 3 sessions of acupuncture and cuppings. Will definitely go back to seek for his treatment if the needs arises.
Excited to finally experience alternative medicine
4/22/2014
Carmela & Brent B. says: For me and my husband, it was all positive energy and results. I can’t wait to complete the recommended treatment (2 times a week for 4 weeks), I know Dr. Fan will make a difference! My husband was satisfied after his first time treatment yesterday (4/21/14). After his 40 mins session, he felt like he slept for days and no pain all day.
Always awesome
2/7/2014
Diane H. says: Dr. Fan is wonderful. He has helped me overcome a paralyzed leg (skiing accident), increased the mobility of a surgically repaired shoulder, relieved migraines, and relieved vertigo induced by a concussion. He’s amazing!
Highly recommended!
1/16/2014
Meschelle L. says: I have been seeing Dr. Fan regularly for about 8 months. Acupuncture and Chinese herbs were new to me and I have greatly appreciated Dr. Fan’s knowledge, skills, and approach/demeanor. He and his office team are highly professional and organized as well. Dr. Fan has helped me tremendously with both benzodiazepine withdrawal and rheumatoid arthritis. I plan to make acupuncture and Chinese herbs a regular accompaniment to my healthcare from now on.
Outstanding
12/19/2013
Caron D. says: Dr. Fan has been successfully treating me for something western medicine hasn’t been able to achieve. He is very knowledgable, gentle, thorough and runs a very sanitary and organized office. I highly recommend Dr. Fan.
Outstanding !!!!
10/20/2013
Phil S. says: My wife and I have been going to Dr. Fan for years off and on for various treatments, proof is in the treatment when the pain associated with the condition, goes away. Dr. Fan is extremely helpful and knowledgeable about how to treat a problem. Very compassionate and takes the time to explain the his treatment plan.
Great Experience
10/19/2013
Gwen D. says: This was my first visit, I too was impressed with Dr. Fan’s compassion, understanding and patience with me. Both Dr. Fan and his assistant were wonderful. I am so glad that my friend recommended him.
The best doctor of Chinese medicine in the DC areas
10/9/2013
Jane C. says: I had shingles and the pain was awful. After a brief antivirus treatment my primary doctor at Kaiser Permanente could only give me strong pain killers (generic Percocet) to dull the pain. I was warned that the pain could last for months. So I turned to Dr. Fan for help. Within a week, my pain was gone under Dr. Fan’s care. I am very grateful to Dr. Fan!
Professional and attentive
9/25/2013
Dianna P. says: I have seen Dr. Fan only once so far, but can report that my experience was very good. I had acupuncture and felt better afterwards. I will continue to see him as I believe in the holistic approach to staying well.
More than accupuncture…
9/3/2013
Bill S. says: I have been seeing Dr. Fan for amost 2 years. The accupuncture has helped in so many ways. But, Dr. Fan will talk to you and get to know you. He has recommended teas, herbs and lifestyle changes that have been so benefitial to me. He is a wonderful wholistic healer. WRS
Chinese Medicine works
7/21/2013
Ruth B. says: Dr. Fan’s thoughtful analysis of our conditions each week help us with everything from swollen ankles to allergies to getting greater function in a hip replacement area to blood abnormalities. He and his office staff are pleasant, welcoming, and reassuring.
Dr. Fan is the best!
6/8/2013
Karen D. says: I feel very fortunate to have met Dr. Fan; he is very knowledgeable and skilled in his art. I sought Dr. Fan’s care for what a previous doctor diagnosed as facial nerve damage. Dr. Fan assessed the situation as chronic inflammation, and I have had a remarkable reversal. I couldn’t be more pleased with my transformation, and I highly recommend Dr. Fan. His staff is awesome too; thank you so much, Dr. Fan!
A Real Treasure
4/17/2013
George L. says: I have been a patient of Dr. Fan’s for some time now, and consider him to be a real treasure. Based on the effectiveness of his treatment, he is obviously a master acupuncturist and herbalist. He takes care to explain the nature of the treatment and to answer any questions related to it. I can wholeheartedly recommend Dr. Fan to anyone interested in acupuncture.
Great, compassionate doctor
3/30/2013
Anastasia C. says: Dr. Fan understood my problem and approached it with the utmost care. I’m very appreciative of the wonderful experience being his patient has been.
Mike B says:
3/5/2013
Michael B. says: I have seen Dr. Fan but one time, received accupuncture and something new to me, cupping. The cupping seems to have made my lower back pain, that I have been experiencing 24/7 for about four months, disappear. I have no fantasies about this being a forever thing, but I am optimistic that future visits will have nothing but positive effects on the many trouble spots of my body. Thank you Dr, Fan!
Keeps me balanced
3/1/2013
Jan Y. says: Dr. Fan keeps me balanced and when I have congestion he opens up my sinuses. Doesn’t matter what I go in for, he always seems to have a solution.
Great Dr of alternative medicine
12/22/2012
Sarah T. says: Sarah T. says: Dr Fan is very professional and extreamly knowledgeable about alternative and conventional medicine. He takes time to fully interview me each time I see him, regarding my symptoms and progress. Dr Fan fully understands herbal medicines and I trust his recommendations. I am seeing some success for my balance issues and expect to see additional progress. Thank you Dr Fan.
Thank You Dr. Fan !!
12/3/2012
William S. says: Both I and my wife have been seeing Dr. Fan for most of 2012. We are thoroughly satisfied with Dr. Fan’s kindness, awareness and manner in which he works with us. We could not think of a better environment in which to receive this kind of help. I have recommended Dr. Fan to others and, they are very well satisfied as well. Thank you Dr. Fan!!!
Richard & Arlene
10/16/2012
Arlene R. says: Dr. Fan was recommended to us and my husband went first. Richard came home relieved of his pain so he than he took me in to see Dr. Fan. I been having back and hip pain for 20 years and now after 3 sessions I can sleep on my right hip with no pain. The best customer service to both of us, he gives us great advice on health care. I don’t know why I waited so long to see him!! I highly recommend Dr. Fan and my husband and I always feel very relaxed while getting our treatment together and we love the music that just soothes our whole being!!!
Great !
5/29/2012
Bill S. says: WRS – I am a new patient. I have seen Dr. Fan twice. My initial evaluation was very informative. Dr. Fan discussed alternatives and diet. My first few days were much better. On the second visit, I was complaining of back pain. When I wakled to my car after the accupuncture treatment I realized… “hey!! no more pain!!”. I recommend McLean Center for Complementary & Alternative Medicine and Dr. Yin Fan.
THE BEST DOCTOR IN ALEXANDRIA
4/17/2012
Simara C. says: I have severe back pain and I have to say that everytime I come to see Dr. Fan, he really takes care of me and makes the pain go away. I usually get spasms where sometimes I can’t even move and/or walk straight. He is always concerned, he gives very good advice and is extremely skilled and helpful. His technique is amazing and I never feel whenever he puts the needles in. The cupping is also amazing- which most of the time are done by his great assisstant, April. Dr. Fan along with April give the best customer service and the best treatment. His office is very pleasant, always clean and organized and I always feel very relaxed while I’m getting my treatment with the chinese music he has in every patient room. I feel very lucky to be his patient and I plan to keep going to him as long as I need to.
Wonderful!
3/19/2012
Susan G. says: I am very happy to have found Dr. Fan over a year ago. He is very patient, gentle and understanding and uses his knowledge to help with various issues, like neck and back pain. His assistant is also kind and skilled.
Sarah & Scott
2/8/2012
Sarah L. says: I was very impressed at Dr. Fan’s level of organization and ability to handle multiple clients. He conducted a thorough interview of both my husband and myself and provided treatment. Dr. Fan was very knowledgeable and the things he suggested made sense. He and his assistant are very compassionate and thoughtful individuals and we feel fortunate to have found him.

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Acupuncture treatment for chronic knee pain: study by Hinman et al underestimates acupuncture efficacy.

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Dr.Fan’s new article about Miriam Lee published recently. 

“Dr. Miriam Lee: A heroine for the start of acupuncture
as a profession in the State of California.
You could read the detail at:

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Fan’s new article “The beginning of acupuncture in Washington, D.C. and Maryland: an interview with Dr. Yeh-chong Chan” was published todayon Journal of Integrative Medicine http://www.jcimjournal.com/articles/publishArticles/pdf/jintegrmed2013028.pdf.

Dr. Yeh-chong Chan (Y.C. Chan) is one of the earliest acupuncturists in the United States (US). He served for seven years in the first acupuncture center in the US, which was established in Washington, D.C. in 1972. In 1979, he moved the clinic to Rockville, Maryland and continued to practice acupuncture there for over 30 years. He is a well-known licensed acupuncturist (LAc), one of the developers of the acupuncture profession, and a scholar of acupuncture and traditional Chinese medicine (TCM). He has treated two US Governors (In the US, the title Governor refers to the chief executive of each state or insular territory and the political and ceremonial head of  the state.) and many sports stars. He is the author of books entitled Acupuncture Practice in the United States [1], Dr. Chan’s Cancer Healing, Prevention and Self-healing and others. To record the early history of acupuncture in the US, on September 30, 2012, the author, Dr. Arthur Fan interviewed Dr. Chan, 70 years old, who is still in practice.

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19th Century Medical Self-Help

 Historical Essay by Dr. Joan B. Trauner
Dr. Trauner is a research specialist at the University of California, San Francisco, Medical Center in the History of Health Science Department. Excerpted from the version which appeared in California History, Spring 1978, Vol. LVII, No. 1, courtesy of the California Historical Society.

Image:chinatwn$chinese-medical-clinic-1890s.jpg

Chinese Medical Clinic in Chinatown, c. 1890s

Photo: California Historical Society

Another aspect of the story of the Chinese as medical scapegoats in San Francisco is the effect of public health policy upon the Chinese community itself. Throughout the nineteenth century, city officials were reluctant to finance any health services for the Chinese population even though Chinatown was popularly viewed as “a laboratory of infection.” Early Chinese immigrants realized the necessity of banding together and providing for their own health care needs. In the 1850’s they first grouped together into associations based upon loyalty to dan (family associations) or place of origin (district associations). In the 1860’s, the district associations federated into the Chung Wah Kung Saw, which later became known as the Chinese Consolidated Benevolent Association, or the Chinese Six Companies. During this period, each of the district associations maintained a small “hospital” in San Francisco for use by their aged or ailing members, a facility usually consisting of little more than a few bare rooms furnished with straw mats.[55] The existence of these hospitals was in direct violation of city health codes, but local officials allowed them to operate. In fact, during the leprosy scare of the 1870’s, health officers ruled that lepers should be “debarred from hospital maintenance” at city expense and that “the Chinese companies should be compelled to maintain them and send them back to China.”[56] Thus, from August, 1876, to October, 1878, known lepers were housed in the so-called Chinese “hospitals”; thereafter, health authorities ruled that all lepers were to be isolated in the Twenty-Sixth Street hospital.

Not only were local authorities ambivalent about admitting Chinese patients to municipal facilities, but they also were hesitant about providing sanitary services within the Chinatown area. Dr. A. B. Stout, a prominent physician and member of the California Board of Health, testified before a congressional investigating committee in 1877 that “the city authorities undertake to clean the city in other parts, but the Chinese are left to take care of themselves and clean their own quarter at their own expense.”[57]

Whenever a major epidemic threatened San Francisco, however, health officials descended upon Chinatown with a vengeance. During the smallpox epidemic of 1876-1877, for instance, city health officer J. L. Meares bragged that not only had he ordered every house in Chinatown thoroughly fumigated, “but the whole of the Chinese quarter was put in a sanitary condition that it had not enjoyed for ten years.”[58] Similar comments were made at the time of the bubonic plague in 1900-1901 when nearly every house in the district was disinfected and fumigated.

In the nineteenth century medical care in Chinatown was largely provided by herbalists and pharmacies in the classic tradition of Chinese medicine. As late as 1900, no Chinese physicians appear to have been licensed to practice medicine in the state of California; in fact, not until 1908 was the Medical Department of the University of California in San Francisco to graduate a physician of Chinese origin.[59] Some Chinese of the merchant class did seek treatment from Caucasian physicians, usually for surgical care not available from Chinese practitioners.[60] In the I880’s a few church missions in Chinatown also began offering the services of white female physicians for pediatric and obstetrical care. Throughout the nineteenth century, however, the vast majority of Chinese were unwilling to consult Caucasian doctors because, as one historian has noted, “the language barriers, the higher fees, and strange medications and methods were too much to assimilate.”[61]

The reluctance on the part of the Chinese to seek medical attention outside of Chinatown accounted in part for their low admission rate to the San Francisco City and County Hospital and to the Almshouse during the last century. An examination of the statistics on admissions to the city and county hospital for the years 1870-1897 reveals that less than .1 percent of the hospital inpatients were of Chinese origin, whereas the Chinese population in the city varied from 5 to 11 percent of the total population. Statistics on admissions to the Almshouse disclose an even lower admission rate: of 14,402 admissions from 1871 to 1886, only 14 cases were of Chinese origin.

Obviously, the low admission rate of the Chinese to municipal facilities cannot be attributed entirely to reluctance to seek Western-style care. An 1881 article in the San Francisco Chronicle, headlined “No Room for Chinese: They are Denied Admission to the County Hospital,” referred to a resolution of the Board of Health, adopted several years earlier, that had essentially closed City and County Hospital to Chinese patients.[62]

The article pointed out that in the fall of 1881 the Chinese consul had petitioned the Board of Health on behalf of an ailing Chinese immigrant who desired to gain admission to the city and county facility. Fearing an influx of Chinese patients with chronic diseases, the board passed a resolution that all Chinese patients who thereafter requested care were to be assigned to a separate building on the Twenty-Sixth Street hospital lot.[63] Apparently, this policy remained in effect throughout the remainder of the nineteenth century. A document dated 1899 noted that the City and County Hospital only opens its doors to a limited number of [Chinese] patients. The remainder of the patients are taken to the small, dismal Charnel-house established by the Chinese Companies, and known as the “Hall of Great Peace,” or else to the Leper Asylum or Pest-House.[64]

Although the ban on Chinese patients at both the City and County Hospital and the Almshouse was common knowledge, city officials continued to claim that San Francisco opened its municipal facilities to the sick and poor of any nationality.[65]

Because of the difficulties inherent in obtaining care at municipal expense, the Chinese community sought from an early date to fund a well-equipped hospital within the Chinatown area. Dr. Stout, in his congressional testimony in 1877, mentioned that the Chinese desired very much to establish a general hospital and a smallpox hospital, similar to those built by the French and German communities. Reportedly, the Chinese were willing “to pay liberally and freely” to establish a hospital, with patient care to be provided by both white and Chinese physicians.[66] (In order to secure approval from the Board of Supervisors for the erection of such a hospital, the Chinese community recognized that their Physicians would have to work in conjunction with state-licensed Caucasian physicians.)

Nothing more is heard of any hospital plans until the early 1890’s when land was purchased in the southern outskirts of San Francisco in the name of the Chinese consul general of San Francisco. Plans were drawn up for a hospital, and funds were collected both locally and from foreign sources. When construction of the hospital was about to begin, “city authorities forbade further proceedings on the ground that the promoters only intended to use objectionable Chinese systems of medical treatment.”[67] It can be surmised that the real objections were to the proposed location of the hospital outside the perimeter of Chinatown.

In 1899, the community planned to rent a house in a “suitable locality” to be fitted up as a hospital and dispensary where only practitioners with American or European diplomas were to be allowed to visit the patients. The dispensary was to give free advice and medicine to indigent clinic patients; the hospital was to consist of twenty-five beds for use by both clinic and paying patients. The Chinese Hospital (Yan-Chai-i-yn) was incorporated under California law in March, 1899. At that time, twenty-one persons (including twelve Caucasians) pledged to become members of the hospital by payment of an annual subscription of $5. Except for the Chinese consul general, the officers of the hospital’s first governing board were to be prominent members of the white community.[68] This project, too, must have been shelved because no further trace of this hospital can be found.

Image:chinatwn$tung-wah-dispensary.jpg

Tung Wah Dispensary, opened in 1900 by the Chinese Six Companies at 828 Sacramento St.

Shortly thereafter bubonic plague was discovered in Chinatown; public officials suddenly were faced with the fact that no health facilities existed in Chinatown for the care of plague victims. As early as May, 1900, the surgeon general of the Marine Hospital Service, Dr. Walter Wyman, suggested that one of the more “substantial” buildings in the area should be converted into a pest hospital.[69] The War Department, on the other hand, preferred to see the Chinese quarantined on Angel Island. Neither plan went into effect, and in April, 1901, the San Francisco Board of Supervisors appropriated funds for the erection of a hospital in Chinatown. The city auditor immediately declared that the appropriation was illegal, and accordingly, the hospital was never constructed.[70]

About the time that plague was discovered in Chinatown, the Chinese Six Companies realized that it was imperative for the Chinese community to organize its own health care system. The result was the Tung Wah Dispensary which opened in 1900 at 828 Sacramento Street. The dispensary, which employed both Western trained physicians and Chinese herbalists, was funded entirely by the Chinese Six Companies, and this dispensary was to be the forerunner of the present-day Chinese Hospital which opened its doors in April, 1925.[71]

In 1900, in addition to financing the dispensary, the Chinese Six Companies instituted legal action to prevent local, state, and national officials from enforcing discriminatory measures aimed at the Chinese. In court, their attorneys won the right for non-licensed Chinese physicians to attend autopsies conducted under the jurisdiction of the San Francisco Board of Health. Similarly, their lawyers forced the courts to end the quarantine of Chinatown as ordered by the Board of Health. In May, 1900, when the U.S. Marine Hospital Service imposed a ban on interstate travel by Asiatics, the secretary of the Chinese Six Companies obtained a restraining order from the U.S. circuit court, arguing that such a ban was unfair class legislation.[72]

Public health officials were infuriated by the legal tactics of the Chinese Six Companies. Dr. J. J. Kinyoun, federal quarantine officer for San Francisco, expressed his indignation in the following statement:

The various injunctions which have been entertained by both state and federal courts … have all conspired to convince the Chinese Six Companies that they in nowise consider the Chinamen amenable to observe or comply with the health laws of the city, state, or United States. The attitude assumed by this powerful corporation forms a good excuse for the individual Chinaman to follow suit and set at naught and defiance any or all rules and regulations which are considered necessary for the sanitary protection of the citizens of this state and country.[73]

Although the Chinese were extremely hostile to the official anti-plague measures, this lack of cooperation stemmed in part from their unfamiliarity with public health procedures. When quarantine of Chinatown was first instituted, the Chinese attempted to prevent door-to-door inspection by locking up their homes and shops.[74] When health officials attempted to vaccinate the Chinese with Haffkine prophylactic serum, riots broke out in Chinatown.[75] Finally, when health officials came into the area to search for victims of the plague, the sick were reportedly hidden in the cellars and “subterranean passages” of Chinatown.[76] Health officials despaired, neither understanding nor sympathizing with the motives of the Chinese. In the words of J. J. Kinyoun: “We never can expect to accomplish in our dealings with this race what we intend to do.”[77] Accordingly, in 1905 after the first episode of the plague had ended, public health officials retreated from Chinatown, unofficially delegating the Chinese Six Companies with the responsibility of caring for the health needs of the Chinese community.

In the years to come, the overcrowded living conditions in Chinatown were to result in a high incidence of tuberculosis. For instance, the average yearly death rate from tuberculosis for the years 1912-1914 was 622 deaths per 100,000 as compared to a citywide average of 174.[78] In 1929, after the introduction of tuberculin testing of cattle and pasteurization of milk, the Chinese mortality rate was 276 deaths per 100,000 as compared to a citywide average of 8 3.[79] Yet, until 1933 no public health facilities existed within Chinatown for the diagnosis or treatment of tuberculosis. One 1915 health report noted the absence of clinics in the Chinatown area and stated as follows: “The Six Companies is probably in a better position than any other group to cooperate with the Board of Health in instituting curative and preventative measures among their own people.”[80] In other words, the city had adopted a “hands off” policy with regards to health care among the Chinese. Not until March 1933, when the Chinese Health Center was established in the nurses’ room at the Commodore Stockton School, would the city attempt to cope even half-heartedly with the tuberculosis problem in Chinatown.[81]

Today, the outright discrimination against the Chinese has ceased. Nevertheless, a continuing phenomenon is the reluctance of many Chinese–particularly among the aged or non-English speaking immigrant groups–to seek health services outside of the Chinatown area. Thus, while members of the Chinese community routinely seek medical care in hospitals, offices, and clinics throughout San Francisco, Chinatown itself continues to present a unique situation for the organization of health services. In one sense, the Chinese ceased being medical scapegoats by 1905; after that date, advances in medical science made obsolete the nineteenth-century policy of condemning the Chinese as “carriers of alien disease.” However, the failure of the City and County of San Francisco to provide health services within Chinatown was to have a more enduring effect. As late as 1967, the only outpatient facility furnishing acute medical services to the Chinese indigent in Health District IV (Chinatown-North Beach) was the Telegraph Hill Neighborhood Clinic, located in North Beach and funded in part by the United Crusade and by the San Francisco Department of Public Health.[82] The city facility–the Northeast Health Center–was housed during this period in the basement of the Ping Yuen Housing complex; a tuberculosis clinic, a well-baby clinic, dental services, an immunization center, and a public health nursing service were all provided in 1200 square feet of converted laundry space.[83] In other words, a paucity of medical services existed in Chinatown as late as the 1960’s; not until the 1970’s was the situation finally remedied.

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