COMMUNIST CHINA'S CAPABILITIES AND POTENTIALITIES IN MEDICAL SCIENCES

• Document Type: FOIA
• Collection: FOIA Collection
• Document Number (FOIA) /ESDN (CREST): 0005310540
• Release Decision: RIPPUB
• Original Classification: U
• Document Page Count: 43
• Document Creation Date: June 23, 2015
• Document Release Date: September 11, 2009
• Case Number: F-2008-01303
• Publication Date: July 20, 1959

(b)(1)
(b)(3)
E il ? 174
SCIENTIFIC INTELLIGENCE REPORT
COMMUNIST CHINA'S CAPABILITIES AND
POTENTIALITIES 'IN MEDICAL SCIENCES
STATES OF
CIA/SI 27-59
20 July 1959
CENTRAL INTELLIGENCE AGENCY
OFFICE OF SCIENTIFIC INTELLIGENCE
APPROVED FOR
RELEASE DATE:
05-Sep-2009
1'~ 71J)6j
 Scientific Intelligence Report
COMMUNIST CHINA'S CAPABILITIES AND POTENTIALITIES
IN MEDICAL SCIENCES
NOTICE
The conclusions, judgments, and opinions
contained in this finished intelligence report
are based on extensive scientific intelligence
research and represent the final and consid-
ered views of the Office of Scientific Intelli-
gence.
CIA/SI 27-59
20 July 1959
CENTRAL INTELLIGENCE AGENCY
OFFICE OF SCIENTIFIC INTELLIGENCE
 CONTENTS
Page
PREFACE . . . . . . . . . . . . . . . . . . iii
PROBLEM . . . . .. . . . . . . . . . . . 1
CONCLUSIONS . . . . . . . . . . . . . . . 1
SUMMARY . . . . . . . . . . . . . . 2
DISCUSSION . . . . . . . . . . . . 5
Introduction . . . . . . . . . . . . . . . 5
Organization and Planning of Chinese Communist Medi-
cal Research . . . . . . . . . . . . . 5
Organization . . . . . . . . . . . . . . . 5
Academia Sinica . . . . . . . . . . . 5
Chinese Academy of Medical Sciences . . . . 6
Chinese People's Liberation Army Academy of Medi-
cal Sciences . . . . . . . . . . . . 6
Research Laboratories Associated with Medical Col-
leges . . . . . . . . . . . . 7
Planning . . . . . . . . . . . . . . . . . 7
Chinese Communists' Objectives, Major Achievements,
and. Trends in Medical Sciences . . . ... . . . 8
Research Areas Under the Twelve-Year Plan of the
Ministry of Health . . . . . . . . . . 8
Research on Infectious Diseases . . . . . . 8
Schistosomiasis . . . . . . . . . . .. . . 8
Tuberculosis . . . . . . . . . . . . . 9
Malaria . . . ... . . . . . . . . . 9
Japanese B Encephalitis . . . . . . . . . . 9
Typhus . . . . . . . . . . . . . . . . 10
Bacillary Dysentery . . . . . . . . . 10
Antibiotics Research . . . . .. . . . . . . 10
Common Antibiotics . . . . . . . . . . 11
Penicillin . . . . . . . . . . . . . . 11
Chioramphenicol . . . . . . . . . . . 11
Chlortetracycline . . . . . . . . . . . . 11
Streptomycin . . . . . . . . . . 11
Indigenous Antibiotic Substances . . . . . . . 11
Industrial and Occupational Diseases . . . . . 12
Nutrition . . . . . . . . ... . . 13
Basic Theoretical Problems . . . . . . . . 13
5-23 cTT~r_rrr? a?'""'.'
T v
 CONTENTS - Continued
Page
Radiobiology and Nuclear Medicine . . . . . . . 15
Radiobiology . . . . . . . . . . . 15
Nuclear Medicine . . . . . . . . ... . 15
Psychology and Neurophysiology . . . . . . . 16
Military and Civil Defense Aspects . . . . . . . . 16
Nuclear Warfare Defense . . . . . . . . . . 16
Chemical Warfare Defense . . . . . . . . 16
Biological Warfare Defense . . . . . . . . . 17
Traditional Chinese Medicine . . . . . . . . 17
Chinese Communist Medical Education and Manpower . 18
Education . . . . . . . . . . . . . . . . . 18
Physician Training . . . . . . . . . . . 18
Postgraduate Physician Training . . . . . . . 19
Subprofessional Practitioners . . . . . . . . . 19
Institute Training . . . . . . . . . . . . . 20
University Training . . . . . . . . . . . 20
Undergraduate . . . . . . . . . . . . 20
Graduate . . . . . . . . . . . . . . 20
Manpower . . . . . . . . . . . . .. . . . 20
Physicians . . . . . . ... . . . . . . . 21
Professional Research Personnel . . . . . . 21
Chinese Communist Facilities and Equipment for Medical
Research . . . . . . . . . . . . . . . 21
Facilities . . . . . . . . . . . . . 21
Equipment . . . . . . . . . . . . . . . . 22
FIGURES
Following Page
4. Hall of Chemistry, Academia Sinica, Peking
5. Kuo Mo-jo, President, Academia Sinica . .
6. Li Teh chuan, Minister of Health . . . . . . 6
7. Flooded Rice Paddy where Cercariae of Schistosoma-
Japonieum Invade Through the Skin . . . . . 14
 CONTENTS - Continued
Following Page
8. Antibiotic Research at Drug Research Laboratory,
Academia Sinica . . . . . . . . . . . . . 14
9. Feng Teh-pei, Director, Department of Physiology and
Biochemistry, Academia Sinica .. . . . . . . 14
10. National Vaccine and Serum Institute, Kunming . 14
11. C. H. Huang, MD, Chief, Virus Diseases, China Union
Medical College, Peking . . . . . . . . . 14
12. Electron Microscope of Foreign Manufacture, Institute
of Scientific Research, Ch'ang-ch'un . . . . . 14
13. 10 MW Heavy Water Reactor Supplied by the USSR to
the Institute of Atomic Energy, Academia Sinica,
Peking . . . . . . . . . . . . . . 14
14. Central Control Board for the 10 MW Heavy Water
Reactor . . . . . . . . . . . . . . 14
15. Counting Equipment for the Detection of Radioactive
Tracers . . . . . . . . . . . . . . . . 14
16. Chinese Communist Gun Crew Simulating Atomic
Warfare Conditions . . ... . . . . . . . 16
17. Chinese Communist Radioactive Decontamination
Team on a Naval Vessel . . . . . . . . . 16
18. Lecture on Acupuncture and Cautery for Western-
Trained Doctors, Hsian Medical College . . . . . 16
19. Method of Needling and Cautery Being Introduced in
Treatment of Appendicitis . . . . . . . . . . 16
20. Chinese Medical Students in the Pathology Labora-
tory, Peking Medical College . . . . . 18
21. Chinese Medical Students in the Biochemistry Lab-
oratory, South China Medical College, Canton . . 18
22. Chekiang University, Hangchow . . . . 18
23. Buildings of the Harbin Precision Instrument Plant . 20
24. X-ray Machines Manufactured at the Shanghai Medi-
cal Precision Instruments Factory . . . . . 22
25. Exhibition of Chinese Manufactured Microscopes,
Balances, and Transits at the 12th International
Fair, Casablanca, May 1957 . . . . . . . 22
 COMMUNIST CHINA'S CAPABILITIES AND POTENTIALITIES
IN MEDICAL SCIENCES
PROBLEM
To assess Communist China's current and future trends and
capabilities in national health and medical research through
1967.
CONCLUSIONS
1. Communist China is exploiting and ap-
plying Soviet and Western medical research
and .has made significant strides in control-
ling its major disease problems, educating its
physicians and medical scientists, and estab-
lishing health standards consistent with the
attainment of its national objectives.
2. Communist China's public health pro-
gram is directed primarily toward the appli-
cation of public health measures on a na-
tional scale in order to overcome serious in-
fectious disease problems that have plagued
China throughout its history. Since 1950,
the Chinese Communists have been very suc-
cessful in attacking this serious infectious dis-
ease phase of the health and medical prob-
lem. The success they have had with their
public health program should result in an
increase in life expectancy and productive
work years for the average worker, as well as
a decrease in the man-years lost through epi-
demic and endemic diseases.
3. The paradoxical resulting increase in
population will produce major problems for
planners with respect to adequate medical
care, food supply, and other essential com-
modities. By Western standards, Communist
China's present medical manpower and facili-
ties are not adequate to provide an acceptable
level. of care, aside from the serious infectious
diseases, for either the current population or
the expanded population that has been pre-
dicted for the next 15 years. The manpower
and facilities are completely inadequate to
cope with a national disaster producing mass
casualties.
4. Communist China is directing. its limited
medical research effort toward five major
areas in support of its national public health
program. To date, the volume of medical re-
search has been severely limited by the lack
of well-trained investigators and assistants,
and the health program has been staffed
largely by semiprofessional personnel. The
few well-trained scientists are used primarily
for teaching and for modest research based
on priority programs.
5. The organization and planning of pub-
lic health and medical research programs in
Communist China are highly centralized and
patterned after those of the Soviet Union.
The planning aspect appears to be sufficiently
flexible to allow maximum use of current
medical assets.
 6. During the period 1962-67, approxi-
mately 2,000 PhD level Chinese Communist
medical investigators will become active in
research. This additional manpower will pro-
vide some improvement in the quality and
quantity of medical research. Furthermore,
the Communist Chinese Government will con-
tinue to emphasize nonscientific traditional
medicine during the next 10 to 15 years in
order to exploit the, large number of tradi-
tional doctors in whom the people have faith,
and thus compensate to some degree for the
serious shortage of scientifically trained
physicians.
SUMMARY
Achievements accruing from the overall
Chinese Communist health program in com-
bating epidemic diseases and establishing
concepts of sanitation among the people are
impressive when measured in terms of the
rate of progress that has been made under
the severe handicaps of trained manpower
shortages and overcrowded medical facilities.
Communist China'ss research in medical
sciences is primarily concerned with five high
priority areas.
1. Epidemic diseases. These diseases, most
seriously affecting the health of the people,
include schistosomiasis, tuberculosis, malaria,
Japanese B encephalitis, typhus, and dysen-
tery. Of the six diseases, schistosomiasis and
tuberculosis take the largest toll of life and
man-hours. Although the great epidemics of
pre-Communist days are now being controlled,
these diseases will not cease to be of primary
national importance until 1962-67. Even
then, tuberculosis and Japanese B encepha-
litis will continue to be of economic and social
importance.
2. Antibiotics research. This research is
directed toward improving production tech-
niques for common antibiotics and investigat-
ing potential indigenous antibiotic substances.
At present, China's supply of the most im-
portant antibiotics is low, but there is enough
for use in the largest clinics and hospitals.
The rural population has extremely limited
access to drugs. It is possible that China
will be self-sufficient in the important anti-
biotics within 5 years for both civilian and
military purposes. Until then, a national
disaster would find them extremely short of
all antibiotics.
3. Industrial and occupational diseases.
The industrialization of China is causing
great increases in accidents and in diseases
such as silicosis, pneumonitis, and tubercu-
losis. Although investigators have uncovered
many health hazards and recommendations
have been made for their remedy, it is un-
likely that positive results of any medical pro-
gram will be able to keep up with the rapid
rate of industrialization, and worker health
will continue to be subordinated to produc-
tion quotas until at least 1967.
4. Nutritional research. Chinese work in
this area is directed at: (a) finding combina-
tions of native foods that will afford maxi-
mum nutrition per unit of weight and which
'will act as partial substitutes for animal
products that are in. short supply, and (b)
establishing a set of nutritional standards
for Chinese workers in various occupations.
These efforts are marginal at best and are
being handicapped by a general food short-
age which will take many years to overcome.
In the meantime, the "leap forward" will
probably not be seriously weakened unless
the. present food : population ratio becomes
lowered by crop failure. Nutritional research,
although important, will not greatly alleviate
food shortage problems.
5. Basic theoretical problems. Research
in this area is limited not only by the short-
age of trained manpower, but also by the
relative priority assigned to other research
under the 12-year plan. All basic research is
conducted in support of priority national ob-
jectives and is expected to remain limited
until 1962-64. The four most important types
 of research concerned with theoretical prob-
lems are :
(a) Physiological research, which empha-
sizes current Soviet trends of neurohumoral
control of bodily processes rather than con-
ditioned reflexes alone.
(b) Pharmacological research, which is
centered primarily in the search for more
effective antischistosomials and secondarily
in testing the efficacy of native herbs used in
traditional medicine.
(c) Biochemical investigations, which con-
sist mainly of repeating Western and Soviet
work and are centered in protein metabolism
with emphasis on nucleic acids and the
enzyme-coenzyme systems involved.
(d) Microbiological research, which stresses
infectious diseases with emphasis on vaccines
against trachoma, Japanese B encephalitis,
bacillary dysentery, brucellosis, schistosoma,
and leptospira.
In addition to the five major research areas,
the Chinese are devoting increasing atten-
tion to nuclear medicine and the understand-
ing of human behavior but are giving only
marginal support to their civil defense pro-
gram.
(a) Nuclear medicine is getting underway
with the installation of at least two Co60
clinical treatment devices in Peking. In addi-
tion, radioactive antimony, iodine, and phos-
phorus have been used clinically. China has
a 10-MW heavy-water atomic reactor supplied
by the USSR that is producing 33 radioactive
isotopes, including Co6?, Na24, P32; and Ca45
Research includes the effect of ionizing radi-
ation on. water, proteins, nucleoproteins, and
nucleic acids and on some phases of the
pathophysiology of radiation sickness. The
single reactor is expected to produce all of
the research isotopes which can be used until
at least 1967.
(b) The understanding of human behavior
and its scientific manipulation and control is
believed to be the ultimate goal of psychologi-
cal and neurophysiological research in China.
Although most Chinese behavioral research
is still centered in Pavlovian reflexology,
newer Western concepts and methods of elec-
trophysiology have been introduced since 1956
that are expected to establish the future trend
for such research. Soviet experience and re-
search in behavior are apparently well under-
stood by the Chinese Communists, and Soviet
methods have already been applied in the
rectification movement visited upon scientists
in 1957-58 and in the systematic efforts to
break down the family system which are be-
ing carried out in the communes.
(c) Medical support of military and civil
defense includes protection of the military
and civilians against nuclear, biological, and
chemical warfare agents. In general, the
medical establishment is capable of render-
ing reasonable care to the military but can
serve only in a first aid capacity for the
general population within the foreseeable fu-
ture.
Traditional medicine in China cannot be
properly included among scientific research
areas because it is essentially nonscientific,
but it is receiving considerable emphasis and
therefore merits some consideration. It is of
three distinct types : herb medicine, acupunc-
ture, and moxibustion. Of the three, only
herbal medicine appears to have even limited
value and is receiving the most research at-
tention. Political considerations stemming
from the critical physician shortage play a
leading part in the propagation and advance-
ment of traditional medicine. The people.
have an age-old faith in the traditional doc-
tors which the regime is exploiting to tide
them over until the shortage of trained physi-
cians is alleviated. Some 20,000 traditional
doctors have been placed in Western-style
clinics, probably in an attempt to orient them
towards Western medical concepts without
causing them undue "loss of face."
The organization of medical sciences in
Communist China is presently divided among
(i) a department. of the Academia Sinica; (ii)
the Academy of Medical Sciences of the Min-
istry of Health; (iii) research institutes of
the Ministry of. Health; (iv) the Chinese Peo-
ple's Liberation Army Academy of Medical
Sciences, under the Ministry of Defense; and
(v) the research laboratories of the medical
colleges and comprehensive universities. Co-
ordination of activities is through the State
Council's Medical Division of the Planning
 Committee for Scientific Development. By
1967, it is probable that all medical research
activities except for military medicine will be
vested in the Academy of Medical Sciences
but that planning procedures will not change
appreciably.
Planning of medical research is based pri-
marily on the 5-year plan principle which
presently operates under a 12-year master
plan (1956-67) for scientific and technical
development. Five-year and one-year plans
continue to be formed and executed within
the general framework of the 12-year plan,
which gives considerable flexibility of plan-
ping and allows for ad hoc changes in em-
phasis where necessary. The Chinese have
recently published their intention to com-
plete the 12-year plan by 1962. This decision
is unrealistic and an extension of the medical
sciences part of the national plan is expected
before 1962.
Medical education in Communist China
primarily stresses Western concepts of medi-
cine but, at the same time, supports the con-
cept and practice of traditional Chinese medi-
cine vigorously in order to compensate for
the shortage of trained Western-style medical
practicioners. China's expanding economy
and large disease problem has necessitated a
rapid expansion of the medical education sys-
tem in order to produce the largest number
of physicians and investigators in the shortest
possible time. In their haste, the Chinese
have overcommitted both the facilities and
the instructional staff. This has resulted in
poor training, lack of a standard system of
professional degrees, and overspecialization
beginning at the undergraduate level. These
factors will limit the adaptability of workers
graduated during the First Five-Year Plan
and make them dependent upon continued
tight central organization and planning.
By 1967, there should be a standard system
of MD and PhD level degrees patterned after
those of the USSR, and the overcrowded and
substandard medical educational facilities of
today should become adequate to accommo-
date a balanced program of education and
research that would be sufficient to fulfill
high priority goals. Nevertheless, it will
take at least 10 to 15 years to eliminate the
effects of the inadequacies of the present
educational system.
Chinese Communist clinical and research
manpower consists of approximately 43,000
health workers,* with from 2 to 4 years of
training; about 3,000 investigators in medical
sciences, including about 150 at the PhD
level; 500,000 traditional doctors without any
scientific training of which some 20,000 are
associated with Western-type medical insti-
tutes; and about 20,000 subprofessional "doc-
tor's assistants." The 43,000 health workers
represent a medical worker to population
ratio of about 1:15,000 on the average. By
1967, there are expected to be approximately
100,000 MD's, about two-thirds of whom will
have had 5 years of training, and the physi-
cian to population ratio should be about
1:8,300. By then, there should also be 504,-
000 traditional doctors; 35,000 "doctor's
assistants"; and 5,000 well trained medical
investigators, including some 2,200 trained to
the PhD level. The traditional doctors can
be eliminated as a useful group in any peace-
time activities but might be psychologically
useful in the event of a national disaster with
casualties too numerous to be treated by
Western-style medical workers.
Facilities for medical research can be ex-
panded with the labor and materials that are
available at a much greater rate than teach-
ers and scientists can be produced to use
them. Present laboratories and institutes are
overcrowded and generally inadequate; but,
as a result of a new building plan, medical
facilities are expected to be expanded. By
1967, there should be adequate facilities to
house all available medical research person-
nel and to accommodate large medical and
graduate classes comfortably.
China's medical equipment is being pro-
duced in increasing but still inadequate
amounts. Most of the Chinese manufactured
equipment is nonprecision with most of the
precision equipment being imported from
* The present total of 43,000 does not differentiate
between MD's, pharmacists, and possibly other
health workers.
4
 Bloc and Western countries. First priority
is given to equipping undergraduate teaching
institutes and colleges and secondarily to
equipping graduate and priority senior re-
search programs. Self-sufficiency may be
reached in nonprecision equipment by 1967;
but extensive production programs for pre-
cision equipment will not be instituted before
1967, due to the lack of industrial potential
as well as sufficient numbers of trained in-
vestigators to make such an effort worth-
while.
DISCUSSION
INTRODUCTION
The nine years of Communist regime in
China have been characterized by a rapid
rate of development in science and technol-
ogy. Before the Communists took over, China
was one of the most technically backward
countries of the world. Since 1949, it has.
been directed by a new regime .that has laid
the organizational and conceptual founda-
tions of a modern technical-industrial nation.
An outstanding example of this rapid rate
of development is the rise of medicine and
public health. Combining Soviet organiza-
tional and material aid with a very small
cadre of its own Western-trained medical sci-
entists, Communist China is exploiting and
synthesizing Soviet and Western medical
thinking, and has made significant strides in
controlling its major disease problems, in edu-
cating physicians and medical scientists, and
in establishing health standards consistent
with the attainment of its national objectives.
The use of Western-trained medical and
other scientific personnel has necessitated a
comprehensive program of political indoctri-
nation which involves "phasing" the politi-
cally neutral scientist into the increasingly
regimented life of the Communist state while
simultaneously extracting from him a maxi-
mum of effort and zeal. This process pro-
ceeded from the "let all schools of thought
contend" principle to the sudden rectification
program of 1957-58 in which principle sci-
entists publicly cleansed themselves of bour-
geois ideas of individual competition and sub-
scribed to the party line of collective efforts
in science. Thus consolidated, the "great leap
forward" of 1958 brought forth a maximum
effort in all priority areas of medical research
and other disciplines and culminated in the
somewhat rash assertion that the goals of the
12-year plan (1956-67) of scientific develop-
ment could be achieved by 1962.
ORGANIZATION AND PLANNING OF
CHINESE COMMUNIST MEDICAL
RESEARCH
Organization
The Scientific Planning Committee of the
State Council was inaugurated in 1956. In
1957, the Committee had 106 members and
was headed by Nieh Jung-chen, who is a vice
premier and the top person dealing with sci-
entific activities. All science in Communist
China is ultimately controlled by this group.
Medical education and research have been
organized in a pattern similar to that of the
Soviet Union and the program has been estab-
lished in close collaboration with Soviet ex-
perts at all levels. By 1956, medical research
was being carried out in one department of
the Academia Sinica; in the Academy of Med-
ical Sciences, under the Ministry of Health;
in the Chinese People's Liberation Army
Academy of Medical Sciences, under the Min-
istry of Defense; and in the research labora-
tories associated with medical colleges. The
Medical Division of the State Councils' Plan-
ning Committee for Scientific Development
is the final authority to which all of these
organizations are responsible.
Academia Sinica - The Academia Sinica
(AS, Chinese Academy of Sciences) can be
considered equivalent to the Academy of Sci-
ences, USSR, although it is presently a con-
siderably smaller organization.
 At least ten de-
Of the five departments of the AS, only the
Department of Biology is concerned directly
with medical sciences, although the Organic
Chemistry Research Institute of the Depart-
ment of Physics, Mathematics, and Chem-
istry does do a certain amount of research in
the chemistry of alkaloids, steroids, carbohy-
drates, polypeptides, and microbiochemistry
which has medical application. In 1956, six
institutes and one laboratory of the former
department were concerned with medical
research.
Coordination between the institutes respon-
sible for important national scientific prob-
lems was insufficient in 1955 according to
Kuo Mo-jo. The AS, therefore, established a
special committee responsible for coordinat-
ing interinstitutional research and for secur-
ing the cooperation of workers pursuing re-
search in other establishments. This special
committee is also charged with maintaining
contact with the Chinese scientists abroad.
2 3 13-17 19 20
Chinese Academy of Medical Sciences-The
Chinese Academy of Medical Sciences (AMS)
was formed in 1956 under the Committee on
Medical Research of the Ministry of Health
and included the Central Institutes of Health,
Peking.
par men s and six institutes are known to be
associated with the AMS, and an additional
two departments and three laboratories are
probably associated with it. The China Union
Medical College was added in 1958, and the
Clinical Psychology Department of the AS
will probably be expanded and moved to the
AMS by 1962. It is the policy to convert de-
partments into separate institutes whenever
possible, particularly when the work of the
department is concerned with a research area
currently receiving high priority. The Indus-
trial Hygiene Department, for example, was
raised to institute status with six subordi-
nate departments in 1957 as a result of the
new overall medical research policy aimed at
improving industrial and labor health condi-
tions. Eventually, all departments will be-
come institutes and the general organiza-
tional pattern will continue to follow that of
the Soviet Academy of Medical Sciences.
Visiting scientists have been informed that
institutes presently under the Ministry of
Health or Provincial Governments will even-
tually be brought under the AMS in Peking.
This organizational goal will probably be
accomplished by 1967.3 4 8-11 29
Chinese People's Liberation Army Academy
of Medical Sciences - The Chinese People's
Liberation Army Academy of Medical Sci-
ences (CPLAAMS) was apparently estab-
lished about 1951 in Shanghai under the Min-
istry of Defense. The CPLAAMS is primarily
concerned with military medicine, although
its medical research establishments are work-
ing closely with civilian research centers in
an attempt to fulfill the 12-year medical re-
search plan ahead of schedule.
 SECRET
27993 6-59
 27994 6-59r
 -
27992 6-59 SECRfT
 Figure 4. Hall of Chemistry, Academia Sinica, Peking.
Figure 5. Kuo Mo-jo, President, Academia Sinica. Figure 6. Li Teh Chuan, Minister of Health.
 Research Laboratories Associated with
Medical Colleges-Since the 1954 reorgani-
zation, research in basic and applied medical
sciences has been carried out in the higher
medical colleges which now number approxi-
mately 38 and which are organized under the
Department of Medical Training of the Min-
istry of Health. Most of this research is car-
ried out at the six largest medical schools,
the most important of which is the China
Union Medical College. Other medical col-
lege laboratories engaged in important re-
search include those of the Canton Medical
College, Hangchow Medical College, Shanghai
First Medical College, Shanghai Second Medi-
cal College, and Peking Medical College. Co-
ordination of the research activities of these
laboratories with those of other national
research organs would presumably occur
through the Ministry of Health, but no de-
tails are currently available.
Planning
In June 1955, the status of planning for
scientific research in Communist China was
described by Kuo Mo-jo as poor and inade-
quate. He indicated that China at that time
had no clear idea of the capabilities of her
manpower, what fields to expand, or what
institutes to enlarge. International coordi-
nation was particularly poor. In the last 2
years, however, organizational improvements
have led to more realistic and comprehensive
planning which has been reflected materially
by the "great leap forward" of 1958.
In 1956, the Medical Division of the Plan-
ning Committee for the Scientific Develop-
ment of the State Council published a long-
range, 12-year plan for scientific and tech-
nical development in China upon which the
1-year and 5-year plans of all ministries are
to be based. The purpose of the 12-year plan
is to bring China up to the world level of com-
petence in certain prescribed areas of science
and technology by the end of the Third Five-
Year Plan, 1967. The plan outlines overall
tasks for research; points out central prob-
lems important for social construction in
China; decides the number of research per-
sonnel necessary; makes organizational ar-
rangements for an interinstitutional, multi-
disciplinary approach to medical research;
determines the rate and sequence of develop-
ment; and establishes coordination proce-
dures among the AS, AMS, various ministries,
and other research organizations.
The Medical Science. Research Committee
of the Ministry of Health, guided by the 12-
year plan, prepares 1-year and 5-year plans
for medical research in cooperation with the
AMS.
The First Five-Year Plan concerned itself
primarily with applied research on nationally
important diseases, leaving fundamental re-.
search for a later time. In November 1956, a
1-year plan for medical research in 1957 was
developed, based on the 12-year plan, and dis-
tributed to all responsible medical research
units. It called for research on some 280
subjects, which included: the prevention and
cure of diseases most seriously endangering
the health of the people; antibiotic research;
sanitation; medical equipment; theory and
practice of Chinese traditional medicine; pro-
tection of worker health and the prevention
and treatment of occupational diseases; nu-
tritional research and physical culture; and
basic theory of surgical and medical proce-
dures, physiology, biochemistry, pharmacol-
ogy, and others. Over 140 medical research
units responded, pledging themselves to some
3,000 individual research projects which were
reviewed by the Committee on Medical Re-
search in February 1957.
Leadership and coordination were to be im-
proved by the addition of several experts in
both traditional and Western medicine to the
 Committee on Medical Research of the Min-
istry of Health. These experts were. to estab-
lish provincial and municipal research com-
mittees to formulate and examine research
plans from institutes and laboratories in their
respective areas.
Each medical research organization selects
its own topics based on the broad directives
of the 12-year plan and on the information
given in the proposed 1-year or 5-year plan
originating from the Ministry of Health. Pro-
posed topics must be discussed by the Scien-
tific Research Standing Committee of the
originating unit, be approved by the con-
trolling agency for that unit (AMS and Min-
istry of Health Committees), and then be
submitted to the Medical Division of the Sci-
entific Planning Committee of the State Coun-
cil for final decision.
Although the main planning body for medi-
cal research is to be vested in the AMS, the
Chinese feel at this time that tighter minis-
terial control must be exercised over priority
projects because of the lack of trained in-
vestigators and facilities. It is planned, how-
ever, that these shortages will be sufficiently
alleviated within the period of the 12-year
plan to allow all of the planning, adminis-
tration, and execution of medical research to
be carried out under AMS.
Political influence in planning can be best
exemplified by the 1957 health plan, which,
by party direction, includes an extensive in-
vestigation of the efficacy of traditional prac-
tices and medicines, over the objections of
many, medical men.
In spite of the political considerations and
other faults which could be termed "growing
pains, the 12-year medical plan has pro-
ceeded at such a rapid rate that it has been
decided to attempt its completion by the end
of the Second Five-Year Plan, 1962. This
ambitious attitude follows the Soviet decision
to reduce their 15-year plan to 7 years but, in
the case of China, is less than realistic. An
extension of the plan will probably be neces-
sary before 1962 3
CHINESE COMMUNISTS' OBJECTIVES, MAJOR
ACHIEVEMENTS, AND TRENDS IN MEDICAL
SCIENCES
Research Areas Under the Twelve-Year Plan
of the Ministry of Health
Research on Infectious Diseases -A very
large part of China's medical research effort
is devoted to the prevention and cure of six
infectious diseases that are responsible for
extensive worker absenteeism. These are:
Schistosomiasis - The control of schisto-
somiasis, caused by the blood fluke Schisti-
soma japonicum, is essential to the Chinese
economy. The rapidly increasing population
will need increasing amounts of food, and this
means the expansion of the agricultural areas,
especially the rice growing areas, and an in-
crease in healthy agricultural manpower.
Most of the estimated eleven million persons
afflicted with this disease are rice farmers or
persons residing in the rice growing areas
where the host snails, Oncomelania, are
abundant and where human feces are used
for fertilizer. Left unchecked, this disease
alone could cut down the effective working
time of farmers sufficiently to produce a rice
shortage. Schistosoma teams presently num-
ber about thirteen hundred, but only about
one million of the eleven million infected per-
sons have received the three-day course of
treatment. Research teams from the Insti-
tute of Materia Medica.of the AS and the Chi-
nese People's Liberation Army, Academy of
Medical Sciences are attempting to find, an
antischistosoma drug which is less toxic than
the tartar emetic (antimony potassium tar-
trate) now in common use. The most promis-
ing drug so far among the many tried is the
water soluble ammonium antimony gluconate
which appears to be as effective as tartar
emetic and only one-third as toxic. Because
no immunization methods exist, great em-
phasis has been placed on snail destruction
and feces sterilization. The large remaining
problem is to get enough public health diag-
nostic and treatment teams to the people.
Although the antischistosomiasis campaign
was originally to be completed by 1967, the
"leap forward" policy has made it necessary
to meet the goal by 1962. The disease will be
SET
 partially under control by that time only if
vector control campaigns are successful.' 1 27 28
56 58 60 62 64 77
Tuberculosis - Tuberculosis is probably
the most widespread serious infectious dis-
ease in China. It is not a reportable disease
and, therefore, it does not receive the pub-
licity of schistosomiasis or encephalitis. The
number of persons infected is unknown but
can be assumed to be even greater than those
infected with Schistosoma. Approximately
70 percent of the cases of tuberculosis are
primary minimal and have been discovered
only since the use of mass chest X-ray cam-
paigns. Although the number, of tuberculosis
beds has increased 22 times since 1951, hos-
pitalization is still inadequate even for the
advanced cases.
Many primary minimal tuberculosis cases
are treated at work, in outpatient clinics, and
at home. The Chinese claim that in a series
of studies performed between 1952 and 1956
which involved some six hundred patients
observed over a period of 1 year, the control
group receiving no medication or bed rest did
not worsen or improve. Further, it is claimed
that when isoniazid (INH) was administered,
79 percent of the no bed rest group improved
and only 3 percent became worse. All pa-
tients initially had both positive roentgeno-
grams and sputum.
This research appears to be similar to the
findings of Western investigators and lays
the groundwork for claims that tuberculosis
can be controlled without extensive loss. of
working time. However, the Chinese have
overlooked the factor that nonisolated ambu-
latory patients with positive sputum are a
constant source of infection. The large num-
ber of cases of active tuberculosis balanced
against the available medical resources pre-
cludes adequate hospital treatment and will
surely result in a serious strain on Chinese
economy. It is not likely that China will gain
practical control over its tuberculosis problem
before 1967, and control comparable to that
in the United States will probably not be
accomplished until a standard of living com-
parable to that of the United States is
achieved.21 28 62-66
Malaria - There has been a high morbidity
from malaria in the coastal and southern
provinces for many years. However, by 1957,
the government had successfully placed me-
dicinals, such as atabrine and quinine, within
the reach of the people and had controlled
mosquito breeding areas through large DDT
spraying campaigns. Although the malaria
elimination plan will continue to emphasize
mosquito abatement measures, considerable
research is being done on antimalarials. This
includes toxicological and therapeutic studies
on the antimalarial chlorophenyltriazine
(chloroguanide) whose potency is said to be
20 times that of quinine and 10 times that
of proguanil. Clinical tests using chloro-
phenyltriazine at the Kweichow Cadres Hos-
pital reportedly showed that tertian, quartan,
and malignant forms could be brought under
control in two to four days. No reference is
made in the literature to earlier (1945) West-
ern work with this drug. Other work includes
a comparative study of the toxicology of
dichroine and quinine, attempts to overcome
the emetic effect of dichroine, and the gen-
eral screening of the Dichroa and Hydrangea
for possible antimalarial effects. Although
no new antimalarials are expected to be de-
veloped, by 1962, the mosquito eradication
program outlined for the Second Five-Year
Plan will probably reduce the incidence of
the disease to the point where it will no
longer represent a major public health threat
to the Chinese.27 28 56
Japanese B Encephalitis - Although influ-
enza and the common cold can be considered
the most important virus diseases in China
from the point of view of lost man-hours, most
Chinese viral research is directed against Jap-
anese B encephalitis, and a SovBloc Central
Coordination Institute for Japanese B En-
cephalitis Research has been located in
Peking.
Much of the Chinese encephalitis research
consists of repeating Soviet and Western
work, although the published results of many
of the experiments would lead the uninformed
to believe that they are of Chinese origin.
Three examples, however, which appear to be
original Chinese work are: (1) the isolation
of a Peking strain of Japanese B encephalitis
REMET 9
 which is less effected by changes in tempera-
ture, pH, and culture media than the more
common Nakayama strain, and which has
created interest in the West; (2) the isolation
of several different naturally occurring. strains
of Japanese B encephalitis which differ in
pathogenicity; and (3) the development from
local strains of a new encephalitis vaccine
which is claimed to be more effective and less
toxic than the one used presently.
This type of original investigation indicates
a limited, narrow effort in medical virology
on the part of a very few competent virolo-
gists.
Following earlier Soviet work, the Chinese
have claimed that when the Japanese B en-
cephalitis virus is given subcutaneously to
mice under conditions of normal sleep their
mortality rate decreases. This is another fac-
tor used to explain partially the observed dif-
ferences in severity of the disease. Another
follow-up experiment by C. J. Wu has con-
firmed the Soviet observation that farm ani-
mals exhibit a clinically nonapparent Jap-
anese B encephalitis viremia in endemic
areas during preepidemic periods. This
work would suggest that farm animals may
play a part in the cycle of the disease. Al-
though the Chinese work to date establishes
the presence of viremia in the animals, it has
not been shown to indicate impending epi-
demic in humans nor does it indicate that
animal reservoirs contribute to epidemic con-
ditions.
An advance in the early diagnosis of Jap-
anese B encephalitis was made by the Soviets
in the form of a more sensitive complement
fixation test run at low temperature. Subse-
quent work was done by M. S. Chow et al.
using the sera of 397 patients; each serum
specimen was processed by means of the old
and the new methods. A 49 percent increase
in positive findings using the new test was
observed, which tends to confirm the Soviet
results. Although no treatment for Japanese
B encephalitis exists other than an often in-
adequate antiserum, such an improved diag-
nostic test could be of considerable impor-
tance in early identification and evaluation
of an epidemic.
An end to the encephalitis problem in China
will not come until specific drugs are discov-
ered which are active against these small
viruses. Since it is unlikely that such a dis-
covery will be made in China, the problem
will exist until the results of future foreign
advances can. be applied.62 65 66
Typhus - The typhus problem is still seri-
ous in China and points up the inadequacies
in the Chinese public health system. The
failure to eliminate typhus as a major epi-
demic disease is due to the lack of sufficient
vaccine and chlortetracycline and of enough
trained medical personnel to cover the rural.
areas. It is significant that traditional doc-
tors are not used even to administer vac-
cines or antibiotics in the rural areas where
they still provide the largest amount of med-
ical care. Research on typhus presents no
new approaches, and the control effort is be-
ing directed at an increase in both the quality
and quantity of typhus vaccine and antibi-
otics.
If the development of the antibiotic and
biological industry is completed on schedule
(1960-62), typhus can be expected to be un-
der control probably by 1965. Until then,
any natural disaster or war could cause seri-
ous epidemics .112
Bacillary Dysentery - Research on dysen-
tery has centered mainly around the sero-
logical typing of the disease found in China.
Results show that Shigella flexnerei and S.
sonnei are the main groups present and that
most of the strains are sensitive to sulfathi-
azole, dihydrostreptomycin, and chloramphen-
icol. China is capable of producing drugs in
sufficient quantities to deal with this prob-
lem; therefore, the lack of trained manpower
and environmental sanitation rather than
the lack of drugs is responsible for the high
(but unstated) incidence of dysentery.
The Second Five-Year Plan should see a
significant decrease in this disease, but com-
plete control will probably not be effected for
at least another 20 years.62
Antibiotics Research - The infectious dis-
ease problem in China has necessitated a
large research effort in antibiotics directed
 by the National Antibiotics Research Com-
mittee. This effort is divided into two areas:
the improvement of production techniques
for common antibiotics and the investiga-
tion of indigenous antibiotic substances.
Common Antibiotics - The. largest research
area to date has been improving the produc-
tion techniques for penicillin, synthesizing
chloramphenicol, and developing and produc-
ing chlortetracycline and streptomycin.36 67-71
73-75
Penicillin production is well established
and research is directed at the use of indige-
nous raw materials, such as cotton seed and
peanut cake, instead of corn steep liquor, and
maize paste, instead of lactose. Research on
production techniques in 1956 resulted in in-
creased yields and an increase of the period
in which a tank could operate without "in-
fection."
The quality of Chinese penicillin is pres-
ently below Western standards, although it
has been improved considerably since 1956.
Soviet aid has not emphasized production
techniques although the Soviets subsidized
the building of the large Shanghai Pharma-
ceutical Factory Number 3. For some un-
known reason, the. Chinese have not taken
full advantage of Western published work on
penicillin, because many of the problems
stated in their journals were solved some
years ago in the West. For instance, no work
has been observed which deals with oral peni-
cillin.
Chloramphenicol
Chioramphenicol (chloromycetin) research
in Communist China still seems to be cen-
tered on the development of a commercially
feasible method of isolating chloramphenicol
from its isomers at the end of the synthesis,
although Western work on this problem has
been published since about 1950. The most
promising research in this direction is the
use of a four step synthesis based on the
prins reaction and reported by. H'sing Ch'i-i
in May 1957. The product is a less potent
mixture of isomers called synthomycin. So-
viet.production methods are used and most
of the practical Chinese research has been on
methods of quality stabilization and the pro-
duction of a pure, tasteless synthomycin.
This drug appears to be generally available
in the clinics of the larger cities.
Chlortetracycline
Chlortetracycline (aureomycin) was pre-
pared in crystalline form in China in 1955,
and pilot plant production started in 1956.
Most of the research since 1956 has been on
reducing the number of steps in the refining.
process and the use of better solvents. Lim-
ited production was started late in 1957 by
the Shanghai Pharmaceutical Factory Num-
ber 3 using a strain of Streptomyces aureo-
faciens yielding over
2,300
units/ml from
which 80 percent of
pure
chlortetracycline
could be obtained. The quantity of chlortet-
racycline to be manufactured is expected to
surpass the quantity presently imported, and
self-sufficiency will probably, be achieved by
1962.
Streptomycin
Streptomycin production is presently quite
limited, and the drug is found only in the
larger clinics. Apparently,. the Chinese have
not .yet selectively bred a strain of organism
that is sufficiently potent and also resistant
to bacteriophage. Present research is directed
at finding a potent phage-resistant strain to
be used in a new but as yet undescribed ion
exchange extraction method which is said to
produce pure streptomycin.
Indigenous Antibiotic Substances-The sec-
ond main area of antibiotics investigation in
Communist China has been concerned with
indigenous antibiotic substances and a re-
search program of considerable magnitude
has been in progress since 1956. To date, the
only known antibiotic discovery to come out
of this program is an allegedly new tumor-
inhibiting actinomycin which has been la-
beled actinomycin K. Considerable claims
have been made for this substance, but noth-
ing has been published on its structural for-
mula or on experimental details. The Insti-
tute of Pharmacology of the Academia Sinica
11
 in Shanghai indicates that the new strain of
actinomyces was derived from, nigrescent
actinomyces found in the soil of Kwei-lin in
Kwangsi province. The material is said to
resemble actinomycin C, but chemically it is
a new substance. In experiments run against.
abdominal implants of Ehrlich ascites tumor
virus in mice, it is claimed that the tumors
were generally inhibited and life prolonged.
Further, it is claimed that all mice treated
with actinomycin K previous to tumor im-
plantation failed to develop the tumor. Tox-
icity tests indicated that the drug is well tol-
erated and is less toxic and more effective
than actinomycins A, C, and D. The drug is
said to be easy to produce.
Since no experimental details are available
it is possible that the Chinese are merely
overstating the effects of an antibiotic that
may not really be new. However, the Chinese
have the facilities, the competent personnel,
and the advisors required to do what they,
have claimed and final judgment must await
the examination of more detailed experi-
ments.
Until the First Five-Year Plan was well un-
derway, China imported essentially all of its
antibiotics. In 1956, the stated year's produc-
tion of penicillin was only thirteen billion in-
ternational units which is equivalent to only
260,000 fifty-thousand-unit doses. The pro-
posed penicillin production for 1957 was 14,-
800 billion international units although the
realization of this figure has not been con-
firmed. At present, China is producing a
supply of the most important antibiotics
which appears to be ample for use of the
largest, clinics. During the Second Five-Year
Plan, 1958-62, China is expected to become
self-sufficient in the production of penicillin,
chloramphenicol and synthomycin, chlortetra-
cycline, and possibly tetracycline. Also dur-
ing this period, erythromycin and nystatin
will be investigated. The management of the
Shanghai Pharmaceutical Factory Number 3
is even more hopeful and expects to be pro-
ducing sixteen different antibiotics within
three years.
It appears that China will be self-sufficient
in the important antibiotics within 5 years
for both civilian and military purposes. At
present, however, a national disaster would
find them extremely short of all antibiotics.
Industrial and Occupational Diseases-The
remarkable rate of progress that China has
made in the transition from an agricultural
to an industrial economy has meant the sub-
ordination of worker health to production
quotas. This in turn has given rise to a
great increase in accidents and in occupa-
tional diseases, such as silicosis, pneumonitis,
and tuberculosis. This has caused the Sci-
entific Planning Committee of the State
Council to call for a maximum research effort
aimed at the elimination of the causes of the
major industrial diseases and accidents as
soon as possible. In addition to working a
10-hour day, Chinese laborers spend several
more hours taking part in political meetings;
serving on street committees of one type or
another; and doing voluntary labor, such as
building factories, clearing land, or smelting
iron. This regimen imposes minimum health
conditions and will lead to minimal efficiency
unless the industrial medical program of the
Second Five-Year Plan is successful. Re-
search team recommendations include: (i)
equipping of all factories with anti-air-pollu-
tion devices; (ii) assuring eight hours sleep
per day for workers; (iii) reorganizing and
expanding medical services in industrial
plants for early diagnosis of occupational dis-
eases; (iv) making psychological studies for
work efficiency,. placement of equipment in
the shops, and mental and aptitude testing
of workers; (v) establishing sanitary inspec-
tion systems; and (vi) making nutritional
studies designed to bring workers up to
dietary standards that will insure maximum
efficiency and less illness using locally avail-
able foods.
These recommendations must be carried
out if China is to make the most of her skilled
labor, but even the large scale industrial
medical program that has been projected can-
not possibly keep pace with the speed of in-
dustrialization, and optimal working. condi-
tions will not be achieved until the current
practices associated. with industrialization
lessens.20 55
12 .SECRET
 Nutrition - China's large population and
inadequate agricultural . development has
made malnutrition with its deficiency diseases
one of the major problems to be solved in
the "building of Socialism." Nutritional re-
search is limited in scope and is centered in
the departments of nutrition of the medical
colleges and the Academy of Medical Sci-
ences. The main research : projects have
arisen from problems encountered in moving
large numbers of workers from their home
provinces to provinces where the food sup-
plies and eating habits are different and from
nutritional problems created by communali-
zation where large numbers of workers must
be fed from a common mess hall.
Research projects at Peking Medical Col-
lege in 1957-58 are generally representative
of the effort and include:
1. adapting of digestive enzymes to changes
in dietary habits;
2. studying soybean-wheat cereal combina-
tions to determine how the protein compo-
nents of both complement each other and
the best formula for such' a diet;
3, studying the protective effect of irradi-
ated bran oil against rickets;
4. studying the effect of mold on the nutri-
tional value of soybean curd.
Also, in 1957, the Academy of Medical Sci-
ences studied the rate of utilization of vege-
table proteins by animals and humans and
the relation between vitamin B2 and proteins.
Other research will include the nutritional
constituents of various fish and cereals; hu-
man requirement for vitamins B1, B2, and C;
and sanitation measures in the production of
egg products. All research is of a practical
nature with nothing original or unique being
apparent.
Communist China will be many years in
developing its food potential, particularly
livestock production, to the point where it
can adequately feed its expanding popula-
tion. This cannot be accomplished by 1967,
because adequate animal supplies will not
be available for at least 20 years. For the
immediate future, therefore, Chinese workers
will subsist on a nutritionally marginal diet,
but this diet will be better in many cases than
before 1949. To date, the relatively poor nu-
trition has not visibly hampered the "leap
forward," and there is no reason to feel that
it will do so in the future as long as the food :
population ratio does not become more acute
than it is now.4 11 75 76
Basic Theoretical Problems-Basic research
in the medical sciences is limited mainly by
the scarcity of trained manpower who can be
freed from teaching long enough to do effec-
tive original work. The basic research that
is being done is in support of the 12-year plan
for medical research. The following is a
brief outline of the type of work being done
in the major medical science disciplines:
a. Physiology - Although the study of the
nervous system still seems to predominate in
nearly all physiological research, attention is
being given to humoral as well as nervous
factors in studies of stress, which indicates
that trends in Chinese physiological thought
are similar to those of the USSR. Typical
research projects presently underway include
studies on: (i) the action of various drugs,
such as DL-tetrahydropalmitine, on condi-
tioned reflexes; (ii) problems of stress and
urinary 17-ketosteroids; (iii) neurohormonal
control of gastric secretion; (iv) the adapta-
tion of digestive enzymes to changes in dietary
habits; (v) the mechanism of the action of
nonspecific stimuli, such as croton oil, on
neurological changes caused by encephalitis;
(vi) changes in acetylcholine content of tis-
sues under conditions of central inhibition
and traumatic shock; (vii) the relation be-
tween dyscrinism and tumorogenesis; (viii)
and the influence exerted by hormones upon
the physiological processes of nerve. In addi-
tion, work concerning the effect of positive
pressure breathing on interoceptive reflexes
is being carried out at the Liberation Army
Academy of Medical Sciences, Shanghai. This
particular work has application in aviation
medicine, but no acknowledgement of this
aspect is made in physiology journals.
b. Pharmacology - Antischistosoma drugs
unquestionably occupy first place in Commu-
nist China's pharmacological research today.
 Compounds presently under consideration in-
clude : water soluble organic trivalent anti-
mony compounds of which only ammonium
antimony gluconate is both stable and effec-
tive; oil soluble organic trivalent antimony
compounds whose antischistosomal activity is
doubtful; organic pentavalent antimony com-
pounds; the derivatives of benzenesulfona-
mides and polyhydroxy acids; organic arsenic;
mercury and tin compounds; derivatives of
xanthones and thioxanthones; derivatives of
acridines, anthraquinones, chromanones, and
thiochromanones; the quinoline derivatives;
the piperazine derivatives; and derivatives of
4,4' diamino-diphenoxy-alkanes. Attention is
being given to decreasing the toxicity of tar-
tar emetic by facilitating its excretion with
such compounds as sodium dimercaptosuc-
cinate. In spite of this research, tartar emetic
and ammonium antimony gluconate remain
as the only reliable antischistosomal drug
readily available and will probably remain so
until about 1960-62. Considerable effort also
is being spent in the characterization and
analysis of Chinese medicinal herbs to de-
termine the active principal of those which
are found to possess therapeutic activity. Al-
though this work has been discredited to
some extent in the West, there is a possibility
of new drug discoveries from this source. To
date, no entirely. new drugs have been discov-
ered, but one hypotensive drug in the Rau-
wolfia group has been isolated.
Other fields of research include work on
new antihelminthics;. the tuberculostatic ef-
fect of hydrazine derivatives; the effect of
ginseng on alloxan diabetes, and on the vita-
min C content of the adrenal glands; the
effect of berberine-containing coptis herbs on
bacillary and amebic dysentery; and research
in antibiotics and anesthetics.
c. Biochemistry - A small but increasing
amount of work is being done in many of
the major areas of biochemistry by competent
Western-trained Chinese investigators. To
date, however, research has consisted mainly
of reports based upon earlier Western efforts
and no noteworthy contributions have been
made to world knowledge. This is due not
only to the lack of sufficient time and to
relatively low priority presently assigned to
basic work, but also because of a lack of com-
petent assistants.
The Department of Physiology and Bio-
chemistry of the Academia Sinica still leads
in basic biochemical research. This Depart-
ment, headed by Feng, Te-pei, covers the fol-
lowing fields:
(1) Protein research includes studies on
metabolism of proteins and amino acids and
on the biosynthesis of proteins and the
physico-chemical properties of proteins, espe-
cially those of the nervous system and con-
nective tissues. Specifically, studies are be-
ing made of the changes produced by sound
irritation in the cerebral proteins of mice.
Here, physico-chemical properties are to be
correlated with function.
(2) Enzyme research includes studies on
the respiratory enzymes, especially the . cyto-
chromes; dehydrogenases containing flavines;
and liver amino acid oxidases.
(3) Nucleic acid research includes gen-
eral studies on the metabolism of nucleotides
and nucleosides.
(4) Vitamin research includes studies
on the biosynthesis of vitamins C, E, and
riboflavin in animal tissues, with emphasis
on the enzyme systems involved.
d. Microbiology Efforts in this field are
about evenly divided among virology, bacteri-
ology, and parasitology.
In addition to Japanese B encephalitis,
virological investigations have included the
successful isolation and culture of trachoma
virus and the preparation of a preventive
vaccine. This work, done in conjunction with
Soviet investigators, is of outstanding impor-
tance because no successful mass treatment
for trachoma is known. The development of
a good vaccine, therefore, would have con-
siderable propaganda value if proven. Also,
studies have been made of the biological char-
acteristics of the influenza virus, and anti-
genic studies have been carried out on some
15 strains of these isolated in Peking.
Rickettsial research centers about typhus
and the employment of antibiotics against
tsutsugamushi fever.
14
 Figure 7. Flooded rice paddy where cercariae of Schistosoma japonieum invade
through the skin.
Figure B. Antibiotic research at Drug Research Labora-
tory, Academia Sinica.
Figure 9. Feng Teh-Pei, Director, Department of
Physiology and Biochemistry, Academia Sinica.
 Figure 10. National Vaccine and Serum Institute, Kunming.
Figure 11. C. H. Huang, MD, Chief, Virus Dis-
eases Department, China Union Medical Col-
lege, Peking.
Figure 12. Electron microscope of foreign
manufacture, Institute of Scientific Research,
Ch'ang-Ch'un.
 Figure 13. 10 MW heavy water reactor supplied by the USSR to the Institute of Atomic Energy,
Academia Sinica, Peking.
Figure 14. Central control board for the 10 MW heavy water reactor.
 Figure 15. Counting equipment for the detection of radioactive tracers.
 Bacteriological research includes:
(1) The isolation and characterization
of four strains of Shigella sonnei from rodents,
and the search for a good dysentery vaccine
to replace the relatively ineffective bacterio-
phage which is being propagandized.
(2) Testing the comparative sensitivities
of 160 strains of hemolytic staphylococci to
penicillin and to the Chinese drug coptis
sinensis. Reports claim to show 100 percent
sensitivity to coptis and only 35.62 percent
sensitivity to penicillin. No evaluation of
these claims can be made because no details
are available on any of this work. Its im-
portance lies in the possibility that the Chi-
nese are having the same difficulty with
highly resistant "hospital staphylococci" as is
being experienced in the United States and
other Western countries.
Parasitological investigations in addition
to schistosomiasis include :
(1) The study of new complement fixa-
tion tests for more rapid diagnosis of toxo-
plasmosis.
(2) Studies on the preparation of im-
mune sera for four leptospira strains, iso-
lated by agglutination tests, . which are
thought to be responsible for most epidemics.
(3) Investigations on the possible impli-
cation of the trypanosome in K'uo shan
disease.
Except for one or two good pieces of re-
search, the general character of the work in
microbiology is what could be described as a
"holding action." The few well-trained inves-
tigators attempt to keep up with their fields,
within the priority limitations set by the gov-
ernment; therefore, their work should not
be judged too harshly. . By 1962-65, well-
trained and experienced investigators will be
available for research and creditable work
can then be expected.4 11 62-64 76 78-92
Radiobiology and Nuclear Medicine
Radiobiology - Active Chinese research in
radiobiology started in September 1958 after
completion, in July, of a 10-MW heavy water
atomic reactor supplied by the Soviets and.
located at the Institute of Atomic Energy of
the Academia Sinica in Peking. On Septem-
ber 27, this reactor started production of 33
radioactive isotopes for research, including
cobalt-60, sodium-24, phosphorus-32, and
calcium-45. Using products of the new reac-
tor, research projects include the effects of
ionizing radiation on water, proteins, nucleo-
proteins, and nucleic acids and the study of
the pathophysiology of radiation sickness
when large local doses of radiation are ap-
plied to the vascular receptors of the.carotid
sinus and adjacent areas. The use of Chinese-
made carbon-14 in metabolic studies is ap-
parently not yet underway.1180 93
Experimental production of various types
of counters, spectrometers, vacuum pumps,
and pulse-height analyzers necessary for
atomic research also is being carried out.
Nuclear Medicine - The diagnosis and
treatment of diseases with Chinese-made
radioisotopes are getting underway. The
Medical Instruments Manufacturing Factory
at Peking has produced a pilot model of a
cobalt-60 apparatus for cancer therapy, and
the USSR has equipped the cancer clinic of
the Academy of Medical Sciences in Peking
with complete cobalt-60 treatment facilities.
Radioactive antimony has been reportedly
used in research on the neutralization of the
toxic effects of antimony in antischisto-
somials, and radioactive iodine and phos-
phorus are reportedly in use against thyroid
disease and blood dyscrasias at the Tsientsin
Medical College hospital. It is not clear at
this time whether the antimony-labeled anti-
schistosomal drug and the iodine-131 men-
tioned are of Chinese manufacture or whether
they are imported.
Both radiobiology and nuclear medicine
have just gotten underway in Communist
China. Prior to the building of the new
atomic reactor in Peking, China had no capa-
bility for such work other than those isolated
experiments which could be carried out with
imported isotopes. In spite of this tardy en-
try into the field, Chinese research on biology,
biochemistry, and clinical medicine can be
rapidly modernized provided that sufficient
isotope material can be made available. Since
the single reactor is of the high flux type,
 it should produce all of the isotopes necessary
for medical. research for the next 10 years.
With its expanding body of medical research
workers and continued Soviet aid, it is possi-
ble for China to approach the present world
level of knowledge in radiobiology and nuclear
medical research by 1967, although signifi-
cant advances in the field will continue to
originate in the USSR and the West.94-98
Psychology and Neurophysiology
The desirability for understanding human
behavior has always been a subject of intense
interest for the Communists. Until 1956,
Chinese Communist studies in psychology
and neurophysiology were based solely upon
Pavlovian reflexology. In 1956, however,
Chang Hsing-t'ung, a physiologist from Yale
University, returned to the mainland at Pe-
king University where he is presently con-
ducting experiments which represent an ex-
tension of Pavlov's theories, including micro-
electrode implantations and the recording of
responses in the visual system. This electro-
physiological work is patterned after that of
Magoun in the United States and more re-
cently. of Anokhin and Sokolov in the USSR
who have adopted the American investigative
approach.
Although this modern approach to neuro-
physiology in China is presently limited to
the work of Chang, it establishes a base line
for behavior studies at the same qualitative
level as that of the United States and Soviet
Union. The results of these studies promise
to shed more light on the nature of behavioral
mechanisms, and such knowledge interpreted
and scientifically applied in tightly controlled
social situations, such as those provided by
the developing communes, might help sub-
stantially in effecting consolidation of the
Communist regime by dissolving the tradi-
tional Chinese family system and by the
ideological indoctrination of racial and ? cul-
tural minority groups. An organized effort
to consolidate minorities is already forecast
by extensive plans for expanding the Insti-
tute of Psychology of the AS into Sinkiang,
Kirin, and Yunnan by 1962, for the purpose
of "closely studying the people."
It is strongly suspected that this psycho-
logical and neurophysiological research, as
well as the extension of the psychology in-
stitute facilities, is directed ultimately at be-
havior control.
Military and Civil Defense Aspects
Nuclear Warfare Defense -
For civilian use, a manual on de-
fense against nuclear, biological, and chem-
ical warfare has been published by the China
Youth Publishing House and edited by the
Liberation Army. Also, the Science Propaga-
tion Publishing House has published a civilian
manual entitled "Defense Against Atomic
Weapons for Civilians." This manual gives
a general description of nuclear weapons, and
tells how to prepare for and act under attack,
including self-aid and decontamination. Most
of the information contained in these man-
uals is of Soviet origin.
To date, the Chinese have not published
any data on radiation protective compounds;
and there is no word on plans to do so in
the future although such research is bound
to be undertaken at some time. As in the
case of chemical warfare, China is medically
defenseless against a nuclear attack and will
remain so for at least another 10 , years unless
great material aid is rendered by the.Soviets,
shelter areas are built, and other basic civil
defense measures are taken. 106-108
Chemical Warfare Defense - A CW attack
on Communist China by the West would be
disastrous for the Chinese. The civil popula-
tion cannot be protected even against stand-
ard gases due to lack of gas masks; and even
 Figure 16. Chinese Communist gun crew simulating atomic warfare conditions.
 Figure 18. Lecture on acupuncture and cautery for Western-trained doctors,
Hsian Medical College.
Figure 19. Method of needling and cautery being introduced in treatment of appendicitis.
SECG ET
 the army is not adequately protected against
G and V agents, even though it receives some
defensive and offensive CW training.
Biological Warfare Defense-
For at least the next 6 years, China will
have barely enough manpower, antibiotics,
and vaccine-serum production capability to
resolve its natural disease problemsl
it was realized that China could not become
self-sufficient in Western-type medical doc-
tors until at least 1968, even if the present
extraordinary rate of progress were to con-
tinue.
Chinese traditional medicine consists of
three basic disciplines: herbal medicine, acu-
puncture, and moxibustion. Of the three,
herbal medicine alone appears to have some
pharmacological basis. Some of the herbs
used for centuries have been found to have
.therapeutic value. One in particular belongs
to the Rauwolfia class and possesses hypo-
tensive activity. The remainder of these herbs
appear mainly to possess simple diuretic, lax-
ative, or analgesic properties although the
Chinese are confident that useful drugs exist
among the thousands of presently uncharac-
terized species available. Acupuncture and
moxibustion on the other hand are consid-
ered largely fraudulent and their greatest
value seems to be as a mass placebo in sup-
port of public health propaganda. Acupunc-
ture appears to be based upon the principle
of counter irritation applied in the form of a
9 or 10 centimeter needle with which the sub-
ject is impaled at one or more of 700 points
on the body. These points are often remote
from the site of the pathology. In spite of
the considerable amount of money and time
which have been spent on the pseudoscien-
tific development of this technique, the best
Western medical thought likens this treat-
ment to stepping hard upon the toe of one
afflicted with a headache.
In spite of the great "leap forward" in
Chinese public health since 1949, the present
ratio of trained medical personnel and facili-
ties to population makes China a prime target
for BW and she would stand to lose more by
offensive use of it than she could possibly
gain 36 109 110
TRADITIONAL CHINESE MEDICINE
The existence and propagation of tradi-
tional Chinese medicine is a monument to
the flexibility of Communist ideology. De-
clared decadent immediately after the "liber-
ation," traditional medicine was quickly rein-
stated as an "institution of the people" when
Moxibustion uses a considerably more
subtle approach to the problems of pathology.
Instead of stimulating the organism by the
introduction of a long needle into the body,
a rolled cone of wormwood is placed at cer-
tain specified points of the body and its upper
tip ignited, thus producing a remote warming
of a circumscribed portion of the anatomy.
The claims for this form of treatment are
approximately the same as that for acupunc-
ture.
The regime has gone so far as to connect
traditional medical theory with the concept
of central nervous control of all bodily
processes. Chu Lien, Director of the. Tradi-
 tional Therapy Institute of the Ministry of
Health, declares that both acupuncture and
moxibustion work through complex reflex ac-
tions of the peripheral nervous system and
that this in turn will stimulate and readjust
the higher nervous system's power of control
and regulation and bring about the desired
cure. Comment on this would be superfluous.
Traditional doctors have been lauded pri-
marily for political reasons and in 1957 a
figure of 500,000 was given for them. Four
traditional medical colleges are said to pro-
duce about 100 graduates each per year,
which would make a total of 504,000 by 1967.
In addition, intensive 2- and 3-year courses
in traditional medicine are given Western-
type doctors, some of whom are ultimately to
carry out research. The ultimate was reached
when a 2-year postgraduate course in tradi-
tional medicine was offered for advanced tra-
ditional doctors. The practice has been to
have traditional- and Western-style doctors
working side by side in clinics in order to
lend greater credibility to traditional medi-
cine and possibly to expose traditional doc-
tors to Western medical concepts and prac-
tice without loss of "face." The Chinese are
using this method in order to exploit all of
the available manpower to cover the severe
lack of medical doctors. The people have
faith in traditional medicine and this can be
used to placate them until the traditional
doctors can be replaced by doctors with
Western-style training.23 27 35-41
CHINESE COMMUNIST MEDICAL
EDUCATION AND MANPOWER
Education
In the years before the Communist. victory,
Chinese medical education was confined to a
very few good Western-oriented medical col-
leges which produced small numbers of well-
trained physicians and investigators. Em-
phasis in the medical schools at that time
was on quality and owing to a scarcity of
equipment and instructors only a few stu-
dents per year could be admitted. This re-
sulted in vastly inadequate medical services
and allowed the almost unchecked progress
of communicable and other diseases.
With. the advent of Communism, an in-
creasing emphasis began to be placed on in-
dustrialization. Since maximum production
can only be achieved by a healthy labor force,
the Communists immediately set about to ex-
pand education in medicine and public health.
This expansion was to, establish a basic sys-
tem of public health, which along with an
increased research training program, could
be expected to reduce morbidity and mortality
from controllable diseases and thus reduce
the severe loss of man-hours in the new in-
dustries. The too rapid training of these pro-
fessional people, however, has resulted in
larger but still inadequate numbers of grad-
uates who are forced into rather narrow spe-
cialization, even at the undergraduate level,
a condition reminiscent of the Soviet frag-
mentation of education in the 1930's.
Physician Training - The training of phy-
sicians in China is carried out in 34 Western-
style civilian medical colleges that were sev-
ered from the universities in 1952-53 and
placed jointly under the Department of Medi-
cal Education of the Ministry of Health and
the Ministry of Education. At present, no
formal MD degree is granted in China, and
each medical college has its own qualifying
examinations. The five largest and most im-
portant of these schools are located in Peking,
Canton, Shanghai, Hangkow, and Mukden;
each represents the amalgamation of from
two to four schools. Each college has a direc-
tor, vice directors, and working committees
in charge of branches of general medicine,
education, hospital, and research.
Students are selected from among those
having 6 years of primary school, 6 years of
middle school, and having passed a 3-day
competitive entrance examination which in-
cludes biology, physics, chemistry, political
science, and Chinese. Approximately 50 per-
cent of the applicants were accepted until
1957, when the number was cut back in order
to relieve badly overloaded facilities and to
improve student quality.
The education branches of the largest medi-
cal colleges usually have five departments :
clinical medicine, pediatrics, pharmacology,
public health, and stomatology. Most medi-
18 SECRET
 Figure 20. Chinese medical students in the Pathology Laboratory, Peking Medical College.
Figure 21. Chinese medical students in the Biochemistry Laboratory, South China Medical College, Canton.
 Figure 22. Chekiang University, Hangchow.
 cal colleges have only four departments, pedi-
atrics being excluded. Clinical medicine, pe-
diatrics, and public health are presently 5-
year courses of study, while pharmacology
and stomatology are four years. Students
may specialize in any one after completing
the first two and one-half preclinical years
as stipulated by the Ministry of Health.
The first year of the medical course would
be considered in the United States to be on
a premedical level in that it includes pri-
marily, elementary inorganic chemistry and
other undergraduate premedical subjects.
This means that the Chinese student receives
only 3 years of schooling that could be con-
sidered at all comparable to a U.S. program,
plus one year of internship which is compa-
rable in both systems. In terms of total years
of education, the Chinese physician has ap-
proximately 17 years and the U.S. physician
20 years up through the 1-year internship.*
The extra 3 years or so of study undergone
by the U.S. physician provides a much firmer
grounding in basic medical sciences than is
possible under the present Chinese system.
In spite of these shortcomings, the best of
the Chinese medical students can be expected
to become reasonably competent physicians
after sufficient clinical experience.
Postgraduate Physician Training - After
graduation, the physician is placed in a
clinic or industry according to the needs of
the Ministry of Health; or if he is a superior
student, he may have the opportunity of con-
tinuing in postgraduate training consisting
of a 1-year clinical refresher course, a 2- or
3-year postgraduate course in a clinical spe-
ciality, or of a 4-year training program in re-
search and teaching.
The most important example of these post-
graduate colleges is the China Union Medical
College (CUMC) located in Peking under the
Academy of Medical Sciences, and formerly
called the Peking Union Medical College
(PUMC). Since 1953, this school has ac-
cepted only graduate students in basic medi-
cal research and clinical sciences and these
* This is assuming that the U.S. physician enters
medical school with only 90 hours of undergraduate
credit, otherwise the U.S. physician would have 21
or 22 years of schooling.
are selected from among the most highly
qualified graduates from all medical colleges.
The mission of this school is to maintain an
optimal level with respect to teaching and re-
search staff, facilities, and equipment in order
to train medical research workers and clinical
specialists and to provide department heads
and other leaders for medical schools, clinics,
and the institutes of the Academy of Medical
Sciences and the Academy of Sciences. This
school does not suffer from overcrowding, lab-
oratory space and equipment is generally ade-
quate, and the instructors represent the best
of the Western-trained workers and the pre-
war graduates of PUMC. The school has been
kept as a model installation and has been
reported by visiting scientists to compare
favorably with the better postgraduate medi-
cal schools in the West. Since 1951, 1,400
investigators and advanced clinicians have
graduated, and 350 were enrolled in 1957.
CUMC, with its optimal student enrollment
of 350, has less than one-tenth as many stu-
dents on the average as are enrolled in the
next five largest colleges.
The only major failing of CUMC to date is
that the few instructors, who are capable re-
searchers, are kept so busy writing texts and
guiding graduate students that they cannot
engage in significant amounts of research
themselves. This situation prevails in all of
the large medical colleges and institutes and
is one of the primary reasons for the rela-
tively small volume of good medical research
published in China today.
Sub professional Practitioners - Another
group of Western-type medical practitioners
in China are called "doctor's assistants."
These consist of an estimated 20,000 junior
middle-school graduates who have received
three years of elementary training in Western
medical techniques at special schools estab-
lished for this purpose during the educational
reorganization of 1952-53. They work either
with qualified physicians or independently as
public health workers. It is quite probable
that these sub-professonal persons may be
included in some of the more grandiose gov-
ernment figures of total numbers of Chinese
physicians.
19
 Institute Training - On 5 August 1955, at
the 17th Plenary Session of the State Coun-
cil, a 4-year program for training research
students in the institutes of the Academia
Sinica was presented. The plan was pat-
terned after Soviet programs and included
the presentation of an Associate Doctor of
Science degree upon completion of a thesis
and a series of examinations given by an
academic committee appointed by the depart-
mental and institute standing committees
concerned. Regulations were formed cover-
ing enrollment, training, remuneration, and
future employment in the institutes. En-
trance requirements were an undergraduate
degree and 2 or 3 years of experience.
During 1955, only the Academia Sinica be-
gan to undertake this postgraduate program.
In 1956, it was announced that the associate
doctoral program was to be extended to the
medical colleges and in 1957, to the 16 com-
prehensive universities under the Ministry
of Higher Education. This first attempt at
an associate doctoral program broke down al-
most immediately because of the inadequate
academic preparation of the students. The
situation is to be partially recovered by estab-
lishing a University of Science and Tech-
nology to provide adequate academic prepara-
tion for the AS. graduate program. This Uni-
versity will be controlled jointly by the
Academia Sinica and the Ministry of Higher
Education.
University Training-Undergraduate-The
departments of biology of the 16 comprehen-
sive universities offer undergraduate and
graduate courses in some of the basic biologi-
cal.sciences requisite for medical research. In
1955, the department of biology of Peking
University offered a 5-year course in zoology,
botany, plant physiology, and human physi-
ology with the first class graduating in 1960.
The curriculum consisted of 2 years of gen-
eral study in physics, chemistry, mathe-
matics, anatomy, zoology, botany, microbiol-
ogy, histology, embryology, and genetics, with
specialized studies beginning in the third
year. The fifth year students prepare and
defend a thesis, and graduation is largely de-
pendent upon its quality.
Graduate - The graduate training pro-
gram when completely developed, will encom-
pass 4 years and will require a thesis to be
publicly defended. Successful defense of the
thesis. will qualify the student for candidacy
for the degree of Associate Doctor. Present
plans call for graduate scholarships to be
available to all university students who qual-
ify; but, to date, this has not been done.
In general, China's medical education is
about 15 years behind that of the USSR;
but, by utilizing Soviet experience, China is
escaping many of the pitfalls previously en-
countered by the USSR. The end of the Sec-
ond Five-Year Plan, 1962, may see the estab-
lishment. of the Associate Doctor degree in
Medical Sciences, but the true equivalent of.
the Soviet Kandidat and Doktor degree or
the Western PhD probably will not be
achieved before at least 1967.
Manpower
The best medical research and clinical
manpower consists of Western-trained men,
those trained in the USSR, and the relatively
small number of pre-Communist. Chinese
graduates. These men have had to carry
most of the load of teaching and research
because present priorities emphasize teach-
ing over basic research. These men are kept
so busy writing textbooks that there is little
time for anything other than the general di-
rection of research activities. On the other
hand, the largest group of research and clin-
ical personnel consists of recent graduates
and even undergraduates, who are receiving
a minimum of direction at the time when
they should be. receiving maximum profes-
sional guidance. As long as these conditions
exist, it is estimated that it will take approxi-
mately 5 years of research experience after
graduation before these clinicians and inves-
tigators begin to produce creditable work.
Therefore, if the year 1954 is set as the prob-
able date when most medical colleges aban-
doned the 4-year curriculum and instituted
the 5-year training program and assume that
economic pressures will not allow a slacken-
ing of clinical and research personnel de-
mands until 1967 at the earliest, then the
period 1962 to 1964 will see the first 5-year
20 __8F08RZ'I"-
 Figure 23. Buildings of the Harbin Precision Instrument Plant.
 graduates with enough experience and back-
ground to render really effective service in
either clinical medicine or research.
Physicians - The actual number of West-
ern-style physicians with the MD degree or
its equivalent is in doubt because official fig-
ures do not distinguish between fully trained
MD's and those who practice medicine with
considerably less training. The number of
medical graduates trained in Communist
China during the period 1927-58 is approxi-
mately as follows:
YEAR
NUMBER OF GRADUATES
1927-47
9,489
1948-49
3,000
1949-57
34,500
1958
3,000
Total
49,989
An attrition of 7,000 over the whole period
1927 to 1958 gives a 1958 total of 43,000 phy-
sicians with a physician to population ratio
of about 1:15,000. This. total also includes
the physicians associated with the six Army
Medical Schools under the Chinese People's
Liberation Army. The figure of 70,000 West-
ern-type physicians that is often encountered
in reports on China probably combines either
the 43,000 graduate physicians plus approxi-
mately 20,000 "doctor's assistants" and other
subprofessional practitioners, or the 43,000
physicians plus some twenty-odd thousand
traditional doctors practicing in Western-
type medical institutes.
Professional Research Personnel An as-
sessment of present Chinese Communist med-
ical research personnel is difficult due to the
failure of the Communists to indicate any
breakdown of the total number as to experi-
ence or degrees. Although no disciplinary
breakdown can be made at this time, a pub-
lished Chinese total figure of 3,000 workers
in all categories of medical research has been
given as of 1958 and can be considered reas-
onable in the light of all existing evidence.
About one-twentieth or 150 of these 3,000 are
estimated to be trained to the PhD level.
China is just beginning its postgraduate
training in science and technology, and it is
unlikely that any more than 5,000 additional
workers will be trained to the PhD level in all
scientific disciplines by 1967. Twenty-five
percent or 2,000 of these scientists are ex-
pected to be in medical research, and this
figure added to the present 150 PhD level in-
vestigators will come to approximately 2,200
by 1967.9 16 23 25 29 30 35 36 42 43 45-50
Possible additions to this total figure are
the expected expansion and transfer of the
clinical psychology group from the AS to the
AMS; and the establishment of an "Organi-
zation for the Psychology of National De-
fense" in the Chinese People's Liberation
Army by 1962. Because there is no indication
of how many of the existing research per-
sonnel are qualified psychologists or psycho-
physiologists, no figure can be added to the
expected 1967 total for medical research per-
sonnel. The following table summarizes and
compares 1958 medical manpower figures
with 1967 estimates.*
CATEGORIES
1958
1967
Western-style physicians
43,000
100,000
Medical research workers
3,000
5,000
Doctor's assistants
20,000
35,000
Western-style physician :
population ratio
China does not have the medical manpower
capability to cope with a national health emer-
gency arising either from armed attack or
from a large-scale natural catastrophy. Even
with the. increase in medical manpower ex-
pected by 1967, China will still not have ade-
quate manpower to deal with national emer-
gencies because of the expected population
increase and the continuing unfavorable
physician-to-population ratio. Research ac-
tivity will increase sharply as well-trained in-
vestigators become available.
CHINESE COMMUNIST FACILITIES AND
EQUIPMENT FOR MEDICAL RESEARCH
Facilities
Facilities for medical research presently
include some ten departments, six institutes,
(and three separate laboratories of the China
Union Medical College) under the Academy of.
Ratios are based on estimates of a Chinese
Communist population of 648,000,000 in 1958 and
830,000,000 by the end of 1967.
 Medical Sciences; six institutes and one lab-
oratory of the Academia Sinica; the research
institutes of the Ministry of Health; the re-
search departments of the 34 Western-style
medical colleges and their associated hospi-
tals; and the research laboratories of the 16
comprehensive universities. These facilities
represent a considerable expansion over those
of 1949 and before.
The Communists are exploiting these ex-
panded facilities for their propaganda value
and are fond of presenting them in terms of
square meters of floor space. Such figures
are, of course, not a measure of research ac-
complishment as implied by the regime but
are imposing on paper and represent a posi-
tive advance which has a tendency to over-
shadow trained manpower deficiencies. For
instance, the Serum and Vaccine Institute is
declared to occupy an area of 190,000 square
meters without comparing this to the avail-
able area in the several pre-Communist units
of which it is composed. Similarly, a new
building for the Hupeh Medical College is
said to occupy 28,000 square meters, and the
50 new buildings of the Academy of Medical
Sciences occupy some large and equally vague
space, but all of this space contains only some
3,000 effective medical research personnel
with any advanced training.
With sufficient money, China could build
the necessary facilities to accommodate an
ideal medical research and training program
at least by 1967. She has the manpower to
do the building and the intelligent young
people to be taught but is limited by an in-
sufficient number of trained teaching and, re-
search manpower in basic medical sciences
adequately to staff such facilities. Until the
medical educational system catches up with
the needs of the economy, the full potential
of new medical research facilities cannot be
realized.
Equipment
The expansion of Chinese medical research
facilities in anticipation of future manpower
increases has necessitated the development of
a Chinese clinical and research equipment
industry. At the present time, China is pro-
ducing increasing amounts of nonprecision
equipment such as drying ovens and steri-
lizers and is trial producing some precision
equipment. However, most of the precision
equipment, such as centrifuges, electro-
phoresis apparatus, electron microscopes, and
the like, are imported from both Bloc and
Western countries and even the imports are
not keeping up with the demands. The lack
of this precision equipment is another one of
the several reasons for the dearth of first-
class medical research coming out of China.
China's medical equipment industry has
recently been placed under the First Ministry
of Machine Building in order to expand oper-
ations and to try to gain a measure of self-
sufficiency by the end of the 12-year plan in
1967. The Peking Medical Instrument Fac-
tory trial manufactured over ten kinds of
electronic medical research equipment in 1958
and has trial manufactured some 29 types of
precision instruments. The factory is now pro-
ducing portable X-ray units and low voltage
X-ray units for research. The Tientsin Medi-
cal Equipment Factory claims to have pro-
duced the world's first electronic time setter
for use in the protection of patients undergo-
ing various types of "electronic therapy." This
factory has also trial manufactured the first
Chinese X-ray electronic regulator and the
first Chinese precision electronic thermom-
eter. The National Shanghai Precision Med-
ical Machine and Instruments Factory and
the Cheng-ta National Factory manufacture
X-ray equipment which is said to be superior
to the Japanese models from the point of view
of installation and ease of repair. The Nan-
king Pharmaceutical Institute produced over
400 kinds of apparatus for their own needs
during 1953-56 but is admitted to be pres-
ently self-sufficient only in glassware. The
Chang Chun Optical and Precision Apparatus
Research Institute presently is producing a
limited number of glass electrodes, polar-
imeters, and microscope prisms. These indus-
tries are just getting started and very few
precision instruments are beyond the trial
production stage.
 Figure 24. X-ray machines manufactured at the Shanghai Medical Precision Instruments Factory.
Figure 25. Exhibition of Chinese manufactured microscopes, balances, and transits at the 12th Inter-
national Fair, Casablanca, May 1957.
 Education is currently receiving very high
priority; therefore, the manufactured and
imported medical equipment is used first
to equip the universities, medical colleges,
and institutes engaged in teaching with
instruments adequate for undergraduate
student purposes; secondly, to equip grad-
uate programs sufficiently to teach re-
search methods; and finally to equip com-
pletely all research installations with ade-
quate amounts of the latest research equip-
ment. As is true in all countries, research
institutes currently conducting high priority
investigations get the most and best equip-
ment. Since 1956, visiting scientists have re-
ported that most of the leading medical
schools appear to have sufficient equipment
for teaching purposes but that research
equipment is generally scarce. Only the
China Union Medical College and a few other
institutes under the Academy of Medical Sci-
ences have sufficient equipment to conduct
creditable research in the medical sciences.
As in the construction of facilities, the Chi-
nese can, with sufficient effort, produce
copies of the best research equipment and
become self-sufficient by 1967. However, un-
less present equipment priorities shift from
atomic energy and other industrial problems,
it will be far more expedient for the Chinese
to become self-sufficient in nonprecision
equipment with the production of only that
precision equipment which cannot be eco-
nomically imported. The need for the most
expensive and complicated equipment will be-
come apparent only when enough experi-
enced investigators are available to use it and
this will not be before 1962-64.
B EGRET 23