Horace N. Allen: Treating the masses

A pharmacy in Seoul in 1884 Robert Neff Collection

By Robert Neff

In the summer of 1884, Korea was not a place for casual tourists or globetrotters seeking to impress their peers. It was especially not for missionaries lacking conviction and courage. Commonly referred to as "The Hermit Kingdom," the peninsula was in the vortex of change. Christianity was still barely tolerated; there was animosity and mistrust towards foreigners fueled by the brief and violent encounters with foreign nations ― France in 1866, the USA in 1871 and Japan in 1875. The peninsula was also gripped with a degree of political instability as evidenced by a bloody coup in 1882.

Horace N. Allen, a missionary physician, was more than aware of the dangers he and his family faced but he felt compelled to answer his calling. He came to Korea not so much as a missionary to save immortal souls but as a physician to save mortal lives ― and perhaps make a buck or two.

His arrival in Korea was well-timed. American Minister to Korea Lucius Foote (a "handsome old politician … in his declining years") was impressed with the 26-year-old Allen who, unlike an earlier missionary, did not impose upon the legation for accommodation but instead "ate 'dog meat and rice' at a native inn." In his diary, Allen described Lucius Foote and his wife Rose as "a handsome and elegant elderly couple" who were in "great need" of a doctor residing near them. He was promptly appointed as "physician to the legation with no salary." But Allen was convinced he would be able to make ends meet by tending to the handful of foreign diplomats, advisers and merchants.

A view of the East Gate of Seoul in the late 19th or early 20th century Robert Neff Collection

One can imagine Allen's appearance in the streets of Seoul generated a great deal of interest. He was a giant ― standing over six feet tall ― with a bushy red beard and receding hairline. More striking than his appearance were his notorious impatience and quick temper. Allen was not shy about using physical coercion to achieve his goals. His diary is peppered with examples of him violently losing his temper and the remorseful expressions afterward.

In late February 1885, Allen established Gwanghyewon, the first Western hospital, in the house once occupied by Hong Yong-sik ― one of the victims of the Gapsin Coup attempt the previous December. Allen's description of the building's state was horrific:

"In one of his rooms, the floor is all gory and thick with blood probably from his family who were murdered there. The building has been entirely looted even to the doors, window, stoves, paper, and parts of the walls."

The hospital was to be supported not just by the Korean government, but also influential Koreans and the small number of foreigners residing in Seoul and Jemulpo (modern Incheon). It is interesting to note this annotation in Allen's diary in which he states that foreign contributions were "limited in amount so as not to shame the poor but sensitive Coreans."

A water carrier and his product in the early 20th century Courtesy of Diane Nars Collection

By mid-April, the hospital, newly named Chejungwon, was completed. Allen and his small staff found themselves inundated with people seeking medical relief. Allen boasted that his hospital "speedily became popular" and he normally treated between 60 and 100 patients daily.

Unsurprisingly, his diaries have only occasional references to his patients, but his medical reports to the Customs Department provide a wealth of information ― not all of it positive and most of it very heavily opinionated.

"The [Korean] women dress much after European style, with loose gowns and a waist. They are carefully secluded, have but little exercise in the open air, suffer greatly from nervousness, venereal troubles, rheumatism and confinement. The children of the upper classes are usually pasty, scrofulous little creatures, with delicate features, long eyelashes and clammy hands. Some of the nobility seem to appreciate the fact that by marriage with the secluded daughters of their own rank their families are becoming continually weaker, and their second wives or concubines are usually taken from more robust classes. These sons of second wives, though not entitled to full power, are said to be the strongest men in the Government service."

Throughout his report, Allen was brutally undiplomatic with his descriptions of Korean food, hygiene and the medical complaints he was presented with. He declared:

"Skin diseases revel in unmolested glory, those of a parasitic nature being in the ascendant … Tapeworm is so common as to be frequently seen in the stools along the streets. It does not alarm the possessor. Roundworms are so widely distributed that they are seldom complained of, and patients seem surprised at being asked if they have them."

Blind people were "met continually in the streets." Many of them were blinded by smallpox. Others suffered from cataracts. Allen could not do much for those blinded by smallpox but in six months Allen treated and possibly cured 31 cataract patients.

Washing produce in a stream in the early 20th century Robert Neff Collection

In the streets, he also encountered those suffering from mental diseases. Allen explained that "if the patient is poor and harmless he is allowed to wander about the streets, to the great amusement of the children." One of Allen's six mental patients was a married man whose father, a very wealthy individual, wanted his son cured "regardless of expense."

This was not the only married patient who surprised Allen. "Epilepsy is surprisingly common … (but) is considered no bar to matrimony, which may account for its prevalence." In his first six months at the hospital, Allen treated 184 epileptic patients ― the worst case suffered only two seizures daily. Allen used potassium bromide to treat them and it became so popular that one of his patients tried to purchase 13.5 kilograms of the salt.

One of his patients was a eunuch suffering from a sexually transmitted disease. According to Allen, eunuchs were very commonly met and served in the palace but usually had their own homes and women (wives/concubines). The residence of a eunuch was easily distinguishable as it had only one entrance gate instead of two ― "a necessary precaution for keeping the women in, as they do not like their masters and are apt to run away."

While venereal diseases may not have caused much social stigma, leprosy (Hansen's Disease) did. Many of Allen's patients suffering from this disease were beggars who had already lost fingers and toes and had ulcers on various parts of their bodies. Allen was able to provide some relief to their complaints, which generated great hope amongst the sufferers and rumors began to circulate that his foreign medicines could cure the disease. Sufferers from distant provinces appeared "with large certificates bearing the stamp of the various governors through whose territory they (had) passed, to the effect that the patient (was) worthy" of a cure. Even a few patients from the "high life" of society appeared and beseeched the doctor for a cure. Allen wrote, "It was very hard to convince the (patients) that nothing could be done."

Doing laundry in Cheonggye Stream in Seoul in the early 20th century Robert Neff Collection

Allen was surprised that Korea did not suffer much from typhoid ― especially considering the typical living conditions of the poor classes. He explained that the small houses were "often filled with smoke from the leaky kang, and always thick with tobacco smoke, for men, women and children smoke constantly." As many as eight people would "pack themselves on the floor, head to foot, so that not a bit of standing room is left." The rooms became even stuffier by their heavy breathing, sweat, and the heat of the floor. A more suitable incubator for the disease "could not well be imagined."

"Asthma is the burden of life with many Coreans," declared Allen, and added that his patients "beg for medicine that will stop the cough and give them sleep." It is unclear if he was able to assist them but did note that there were many cases of people spitting blood ― the cause of this troubling symptom was unknown as "postmortems are as yet out of the question here" and he did not have a microscope to examine the saliva.

Speaking of sleep, I found it somewhat amusing that Allen treated one patient for snoring ― one must wonder how loud the sufferer's snoring was to compel them to seek medical assistance from a foreigner.

Other entries are not amusing but rather horrifying. Allen was summoned to aid a woman who had "been delivered of a living child, and for four days and nights, a company of midwives had been tugging at the cord of a retained placenta. (Allen) found an old straw shoe attached to the cord, and on making inquiries found that it was so fixed to facilitate the walking out of the after-birth." Allen could do nothing for her.

One of Allen's first patients was a man suffering from Bright's disease. He was hospitalized and medicated. "The first night and second day he made marked improvements, but on the second night he decided to hasten matters, and got the bottle of medicine, which he drank down at once and died promptly."

Allen's report is horrifically eye-opening. How much of it is tinged with his personal biases, self-perceived moral superiority and exaggerations are open to interpretation. Some subjects ― such as sexuality ― he was willing only to provide a brief but tantalizing description of, "declaring the details of which will hardly be appropriate in a general article of this nature." Yet the details he did provide were often conflicting and clearly influenced by his own religious beliefs.

Much of his account stressed his opinion of the backwardness of Korean traditional medical practices and the superiority of Western medicine except for in one area ― glasses. He equivalently declared Koreans "to really excel in the manufacture of eye-glasses." He was "ashamed when trying to fit a superior lens, from a good trial case of glasses, in place of a stone lens" ― it could not be done. The Korean lens, made from transparent glass, was much better ― but very expensive.

Diseases rarely discriminated between classes but treatments did, as we shall see in our next article when we examine Horace Allen's role as the royal physician.

Robert Neff has authored and co-authored several books, including Letters from Joseon, Korea Through Western Eyes and Brief Encounters.