Urological Papers and Issues Arising from the Early Years of the Chinese Medical Journal

In 1932 the Medical Missionary Journal and the National Medical Journal merged to create the Chinese Medical Journal (CMJ) which was officially described at the time as the “official organ of the Chinese Medical Association” (CMA) . For the medical historian this journal provides a rich seam of clinical reportage chronicling the introduction of western medicine into China, and the personal and professional issues faced and dealt with by western and Chinese medical practitioners during China’s tumultuous but relentless march towards modernity and internationalisation. During the wartime period of Japanese occupation from 1937 to 1945, western medical personnel found themselves practising under difficult conditions being designated firstly as third party nationals and secondly, post-Pearl Harbour, as non-combatant enemy nationals. Those that were not repatriated were interned under the Japanese where they continued, with limited resources and equipment, to provide medical service. Methods We have analysed urological articles in the CMJ from its creation to the close of the Sino-Japanese War in August 1945 and will document the topics presented for publication and comment upon the issues and questions that arise. Results In total, 53 articles relevant to urology were identified. These covered a wide variety of topics: 17 genitourinary infections; 11 stone disease; 10 benign conditions; 4 malignant conditions; 3 foreign body insertion; 8 miscellaneous. Notable topics include: incidence of venereal disease throughout China; antischistomiasis campaign; complications of suprapubic bladder drainage; traumatic injury of the kidney; 30 cases of urine extravasation; stone formation; bladder calculi including geographical distribution and litholopaxy; experiments with diet and stone formation; incidence of tumours amongst 248,000 patients from 28 hospitals (159 cases of penile cancer - 7.4% of male cancers - this was thought to be due to hygiene but also caustic treatments for syphilis); traumatic and self-inflicted foreign body insertion (including garlic stem, wax, chopstick and carving knife!). Photographs of foreign bodies and extraordinary pathology findings are included. Conclusion As we trace this historical period, the gradual, but persistent rise of Chinese medical practitioners within the CMA’s ranks is noted as the indigenous medical personnel demanded and achieved greater autonomy. Despite this being a historical period of extreme change and uncertainty, high quality medical reports and analysis of disease prevalence demonstrates that the medical workers continued to maintain high