记得以前外公（聂其焜）房间的书架上并排放着三本相同的英文书，书名是“Doctors East, Doctors West”书脊下面还有这本书的中文名 “道一风同”。我一直没有抽时间阅读，之后这三本书在文革时消失了。
书的作者是Edward H. Hume，中文名胡 美 （1876 – 1957）。他1897年毕业于耶鲁大学，1901年从约翰霍普金斯大学获医学博士。1905 年应耶鲁大学雅礼学会邀请来中国，在长沙创办雅礼医院并任院长，教务长。1914年创始湘雅医学院。1927年回美国。
Hume 医生去世后不久，他的同事，朋友和家人集资成立了Edward H. Hume 纪念讲座，每年请一名世界著名东亚学者在耶鲁大学演讲至今。1960年的演讲者是哈佛大学汉学权威费正清教授 （John Fairbank）。
As the influence of the hospital spread through the city, we were called more and more frequently by the families of the influential old officials who were the aristocracy of Changsha. The Nieh family who lived in the great mansion on Liuyang Gate Street was one of these. I had often paid social visits to the magnificent establishment and enjoyed the flower-decked courtyards, the gracious reception halls with their stately blackwood furniture, and the wall paintings on silk scrolls, done in the style of the Sung Dynasty; but on this day I was summoned to see the old official himself, the head of the clan.
Governor Nieh had but recently returned from the highest official posts in two of the seacoast provinces. On account of failing health he had been living quietly at his town home. Brother Four, who had studied English with private tutors in Shanghai, was the son I knew best. He had often talked to me about his father’s fainting spells and attacks of nosebleed, so I was not unprepared for this emergency call.
The Governor’s official sedan chair had been sent to fetch me. We swung in through the great gateway, round the gorgeous dragon screen. In the main reception hall, the seven brothers stood waiting to receive me. All of them greeted me with ceremonial Chinese bows, but Brothers Three and Four, whom I knew so well, shook hands with me also. Brother Three acted as spokesman, addressing me in Chinese, so that all might understand. “Our father was taken ill suddenly. He was walking in the garden, day before yesterday, when he stumbled, fell, and became unconscious at once. He remains unconscious now, and his condition grows more serious every hour. Two of the most distinguished physicians in Hunan, Doctor Wang and Doctor Lei, have already examined him. Both of them agree that the outlook is exceedingly grave. Brother Four and I persuaded our five brothers to send for you. As you probably know, they have great confidence in Chinese medicine. We two believe that Western medicine also should be tried for our father. Will you go with us and examine him in the inner bedroom?
Following Brother Three and accompanied by the other six, I made my way to the patient’s room. He was propped up by two servants who sat beside him on the bed. This was a universal practice, it being believed that the more fully supine a patient lay in bed, the worse the outlook. Everything was done to persuade the body and spirit to stay together. To have the patient lie quite flat would be to invite dissolution.
The diagnosis was evident the moment I entered the darkened room: slow, stertorous breathing, deep coma. Undoubtedly there was a ruptured blood vessel in the brain.
I took my place by the patient and examined the pulse carefully and long, first on the left wrist, then on the right. Tongue, pupils, extremities, loss of muscular power, and all the other signs were noted. I observed that the seven brothers were all quite impressed with my care, especially with my detailed observations of tongue and pulse. There were glad, too, that I was using the thermometer. I heard them comment to each other as they saw me record my findings on a history card. When I was through, the spokesman asked whether I had made a diagnosis.
“Your father has had a stroke of apoplexy – chung feng, you call it.”
With one voice, the seven brothers called out, “Correct!”
Clearly they were the jury – I merely a witness put on the stand. It was my first vivid lesson as to the complete control by a Chinese family over diagnosis and decision.
“What procedure do you recommend?” the spokesman continued.
“You understand that this ‘stroke’ is undoubtedly due to a breaking of one the arteries in the brain. We should do all we can to reduce the pressure of his pulse.”
That caused a commotion. “Who ever heard of weakening the pulse strength in a dangerously ill patient?” one of the conservative brothers challenged. “A strong pulse is the one sure guarantee of life.”
At this point Brother Four broke in. He and I had become good friends, with great mutual confidence in each other. “Perhaps,” he said, “Doctor Hume has some classical authority for his position!”
I was grateful enough, both for the championing of my cause and, more particularly, for the fact that I had taken along in my medical bag, as always, a Chinese translation of Osler’s Practice of Medicine. I turned to the relevant page and handed the book over. Sir William Osler never had more attentive readers than those seven brothers, two ready to accept that dicta of a Western physician, and the other five skeptical, almost scornful.
They read of the procedure I was recommending: the head was to be lowered, the body to be kept warm, a high enema to be given.
“Will you not prescribe some drug?” the spokesman inquired, hopeful that I, his nominee, would not undermine his family’s confidence in me. He wanted me to do something really dramatic.
I wrote a prescription for a purgative, and described it to them carefully. They knew all about mercury as a cathartic for they had read about it in the writings of their own physicians. Yet the decision lay, not with this jury, but with their mother, who was now the final arbiter. The prescription was taken back to the women’s apartments by Brother Four, who returned presently, elated that he had persuaded her to approve both the drug and the entire course of action I had outlined. I gave some further instructions, promised to send over a hospital orderly as soon as possible, and bowed my way out to the great front gate. In the front courtyard I turned to bow again and be bowed to by the seven brothers. Two of them, at least, were particularly grateful for my visit.
Brother Four escorted me personally to the sedan chair and said that he would count on seeing me often, both professionally and as a personal friend. “You must not let the conservatism here discourage you. I hope our mother will be willing to have your orderly come over and stay here to carry out all your instructions. I fear my father will not survive this stroke, but we know you have done all that was possible.”
Governor Nieh died three days later, but our friendship with the family continued unbroken. I received the formal invitations to the public service of mourning and responded by sending the conventional white scrolls, inscribed with tribute phrases honoring the deceased leader. This was the correct way to express condolence.
The brothers all wore coarse hempen mourning robes, and strands of coarse hempen thread were braided into their queues, to remain for three full years. There was no feasting during those years; the mother and her seven sons, as well as the several daughters, remained quietly at home.
In the summer of 1913, the Yale University Mission in Changsha and the newly constituted Chinese Society for the Promotion of Medical Education set up a joint board with ten members from each group. We were wondering what name to give the new enterprise when our old friend, Mr. Nieh, made a suggestion. “The matter of a name is very important. We are proposing a co-operation between citizens of Human and the Yale University Mission. The literary name of our province is Hsiang. The first syllable of the name of the Yali Mission is Ya. Let us call our united body the Hsiangya Medical Educational Association. Everyone who hears that name will recognize that this means Hunan –Yale.”
The name conveyed just the meaning we desired. Hsiang was the name of the central river of the province, a waterway of great natural beauty. Our Chinese friends always welcomed a name that savored of mountains or rivers or lakes. The hospital, the medical school, and the school of nursing have, ever since then been known by the name of Hsiangya.