Ruijin Hospital From 19th-century French Jesuit Hospital to present-day state-of-the-art



Banners for the Centennial Anniversary of Guangci/Ruijin Hospital in Shanghai (1907-2007). “Show great kindness, pursue excellence” reads the
motto on the right-hand banner. Courtesy of Ruijin Hospital.

Aurora Academy (Zhendan Xueyuan, literally, “Thunder of Sunrise”) was founded in Shanghai in 1903 by a Chinese Jesuit, Joseph Ma Xiangbo, as a French-Catholic institution whosemission was tomodernize his country. In 1907, the Jesuits acquired nearby land on which they built l’Hôpital Sainte-Marie, later known as Guangci Hospital—literally, “Great Mercy Hospital.” It became a teaching hospital for the Academy’smedical students. In 1917, the Academy achieved university status, supplying doctors to the Catholic hospitals of China, and also training nurses and medical technicians. Under a succession of French Jesuit principals it was a beacon of French language and French medicine, practiced by a mixture of French and Chinese nationals. In 1952, with the closure of independent educational institutions throughout China, Aurora University merged into Fudan University), while its medical school merged into Shanghai Second Medical College. Guangci became Ruijin Hospital and developed into one of China’s leading university hospitals. In the 1980s, Shanghai Second Medical College reconnected with its past by offering a 7-year course in French language and medicine. Ever since there has been a vigorous exchange program between the two countries at every level, personified by Ruijin’s internationally renowned hematologist Chen Zh , who followed his postgraduate studies at Shanghai Second Medical College with a doctorate in Paris and is now China’s minister of health. With increasing numbers of French physicians and scientists coming to Ruijin Hospital to learn rather than to teach, the hopes that a French-trained Chinese Jesuit pinned on his fledgling Aurora Academy have finally been realized.
Medicographia. 2009;31:198-204. (see French abstract on page 204)

Ruijin Hospital, which originated as the medical wing of Aurora University, literally “Thunder of Sunrise”), a French-Catholic institution founded in Shanghai in 1903 and dissolved in 1952, is today affiliated to the Shanghai Jiao Tong University School of Medicine. Despite changes of name—it began life as l’Hôpital Sainte-Marie, then became Guangci Hospital, literally, “Great Mercy Hospital”)— it retains vigorous reminders of its French past during the first half of the 20th century when most of its doctors, whether French or Chinese nationals, were not only fluent French speakers but the respected and expert practitioners of a French-accented medicine. The history of Aurora University, its medical school, and hospital provides a fascinating glimpse of enlightened European and Catholic outreach in a largely impoverished oriental metropolis during the early 1900s. It is also a striking example, within the medical sphere, of accommodation and cross-fertilization between two ancient and contrasting cultures, those of France and China. The founder of Aurora University was a Chinese Jesuit, Joseph Ma Xiangbo (1860-1939). Born into a well-to-do Catholic family, his early education was in the Chinese classics. At the age of 12, he was enrolled in St Ignatius College, newly opened by the French Jesuits in Shanghai. After ordination at the age of 30, he returned to St Ignatius as its principal. Excelling in astronomy, mathematics, and Latin, he set out to translate European scientific works into Chinese. In 1876, however, he left the priesthood, married, and spent the next 21 years working in business and government on behalf of the Chinese Self-Strengthening Movement that advocated learning from the West. In that capacity he traveled abroad, not only to Korea but also to the United States and Europe. But as the Movement waned and after his wife died, Ma Xiangbo rejoined the Jesuits in Shanghai in 1898 and five years later opened the Aurora Academy (Zhendan Xueyuan) with the purpose of furthering his original aim of translating the Western books that China needed in its drive toward modernization, and he chose its name, “Thunder of Sunrise,” to mark the Chinese new dawn that he hoped it would usher in.

Ruijin Hospital continues Guangci Hospital (Hôpital Sainte-Marie).
Bottom left of the picture, one can see the low red-tiled brick buildings of the former French hospital. Courtesy of Ruijin Hospital.
French-trained Jesuit priest Ma Xiangbo (1840-1939), founder of Aurora Academy in Shanghai in 1903, which lives on today its merging with Shanghai Jiaotong University. © Culture Sino-France, with kind permission.

In 1908, Aurora University introduced a French-style undergraduate curriculum including a three-year preparatory program and a three-year advanced program. The preparatory program included subjects such as French, English, history, philosophy, geography, elementary mathematics, physics, and other natural sciences. On successful completion of this program, students opted between the four majors of the advanced program: humanities, law,medical science, and philosophy. Fromgrade 2 of the preparatory program upwards, all courses except Chinese were taught in French.
Meanwhile the Jesuit Apostolic Vicar of nearby Nanking, Próspero París (1846-1931), had bought 165 acres of Shanghai land east of the main thoroughfare Jinshenpu Lu modern Ruijin No. 2 Avenue in order to found a hospital. The first construction phase consisted of four Western-style two-floor brickand-timber houses, two of which contained wards for a total of 100 patients. The opening ceremony took place on October 13, 1907. Known initially to Europeans as the “Hôpital Sainte-Marie,” it was renamed Guangci Hospital several years later.
Aurora Academy selected a site near the hospital to found a medical school. Its students could do their ward work in the hospital, and the most outstanding graduates were selected as interns. In those early days, two French doctorsmanaged the inpatients while nuns cared for the outpatients, from examination through diagnosis to treatment and dispensing. Wards were arranged hierarchically (missionary ward, first-class male and female wards, second-class civilian wards) and by specialty (obstetrics, isolation, etc).
There were also special wards, such as for French armed forces personnel, police officers from Annam (the French protectorate in central Vietnam), and criminals.
The first operating rooms opened in 1918 and catered for three or four major cases daily, primarily in gastrointestinal surgery (hemorrhoids, appendix, bowel, stomach, and biliary tract), but also urinary tract and gynecological surgery. In 1921, Guangci Hospital became one of the first in China to open a department of radiology. Its Pasteur Building housed some celebrated laboratories. The French Concession’s Industry Bureau funded the five-floor St Vincent de Paul building containing 300 beds. The board of directors, set up in the 1930s, included the French consul general, the heads of the Industry Bureau, and relevant Church dignitaries. In 1936, the Hospital founded a nursing school for specialist nurses and medical technicians. By 1940, when Guangci Hospital registered with the Shanghai government, it had become a 780-bed institution and the largest hospital in the Far East.
Having started out as wholly French-Catholic in inspiration and practice, deploying exclusively French treatments dispensed by French doctors and nuns, Guangci Hospital evolved over the years to absorbmore and more influence from its Chinese environment. It became a Sino-French institution hosting an uninterrupted and indeed increasing interchange of science and talent that attracted—and continues to attract—some of China’s best medical brains onto both its faculty and student body.
In 1933, Dr Kuang Ankun, who had obtained his medical degree in Paris, returned home as professor of internal medicine at Aurora University and chief of internal medicine at Guangci Hospital. He transformed the theory and practice of his specialty at the University. His immediate concerns were the prevention and treatment of diseases such as relapsing fever, typhoid, and amebic dysentery, and he was among the first in China to diagnose lupus erythematosus and temporal arteritis, attracting considerable public interest at the time. He was followed in 1935 by Dr Xu Baoyi, a surgeon with degrees from the University of Lyon, who returned home to become professor of surgical science at Aurora University and chief of surgery at Guangci Hospital. His skill in thyroid and gastrointestinal surgery, including surgery of the biliary tract, earned him a regional and international reputation. He was elected to the International Society of Surgery and chaired the Shanghai Medical Association.

Still extant maternity (“Maternité”) ward of former Hôpital Sainte-Marie, founded by French Jesuits in 1907, now part of the modern Ruijin Hospital. Courtesy of Ruijin Hospital.

An impressive number of French physicians and surgeons subsequently joined the Aurora University faculty and served on the staff of Guangci Hospital. Their specialties covered surgery, pediatrics, infectious disease, and radiology. Working alongside French or Belgian-trained Chinese nationals, such as the surgeon Dr Fu Peibin, the obstetrician and gynecologist Dr Tang Shiheng, the urologist Dr Cheng Yixiong, the otorhinolaryngologist Dr Liu Tao, and the dermatologist Dr Zhu Zhonggang, they laid the foundation for the Hospital’s future development.
In 1952, all the faculties of Aurora University, including its medical school, were combined with the faculties of Fudan, which Ma Xiangbo had helped establish, East China Normal University, and Shanghai Second Medical College. Guangci Hospital became the College’s affiliated teaching hospital. The College was renamed Shanghai Second Medical University in 1985, and in 2005 was merged with Shanghai Jiao Tong University to be renamed Shanghai Jiao Tong University School of Medicine. Guangci Hospital itself was renamed Dong Fang Hong Yiyuan (“The East is Red”Hospital”) in 1966, then Ruijin Hospital in 1972.
In the 1980s, Shanghai Second Medical University reconnected with its roots by recruiting students for a 7-year course in French language andmedicine, the first of its kind in China. It has since contracted with some 18 French universities and medical schools to host exchange students and teaching faculty in multiple medical disciplines. Up to two thirds of the University’s foreign exchange medical students have studied in France. In 1996, Ruijin Hospital agreed a staff training and academic exchange scheme with the Paris university hospital authorities. One of the aims spelled out in the Sino-French health cooperation agreement announced by French President Jacques Chirac during his visit to China, when he came to Ruijin Hospital, was to support the Frenchmedicine program. Students on the program not only complete a broader introductory course in the humanities and social sciences, they also receive a firmer foundation in the natural sciences, a more solid grounding in basic medical theory and a more systematic introduction to clinical medicine. At the same time, they become proficient in French, to the extent that they can read French medical documents and communicate in the language. Half the students on the programare given the opportunity to work for periods as hospital doctors in France with all costs borne by the host country.

Zhendan Daxue (Aurora University) building in 1939. © Culture Sino-France, with kind permission.

The program faculty combines staff from the Ruijin Hospital School of Clinical Medicine, notably Drs Wang Zhenyi, Chen Zhu, and other members of the Chinese Academy of Sciences, with teachers from France, in particular during the first year, when the curriculum comprises no fewer than 726 hours of lectures and exercises in basic French. Between 1997 and 2007, France sent over some 120 teaching staff from a wide range of university hospitals. The Ruijin School of Clinical Medicine has also edited and published the French version of major textbooks in medicine and surgery. In conjunction with universities in Lyon and Paris, it has set up the SPIRAL resource server to enable its students to access exactly the same teaching programs and course materials, including interactive video and audio lectures, to the extent that its students are virtually sitting alongside their French counterparts.

MD diploma delivered by Aurora University in 1949. © 2009, china-news.org (2001)/chine-informations.com (2005). All rights reserved.
Detail of map of Shanghai (1928) showing Aurora University (red circle) and Sainte Marie (Guangci) Hospital (green circle). On the upper right, the Chinese Old City (recognizable by its circular shape) and Huangpu river (right top and bottom corners). All rights reserved.
Layout of present-day Ruijin Hospital in Shanghai. Courtesy Shanghai Ruijin Hospital.

Today Ruijin Hospital is a 1600-bed general teaching hospital occupying a 30-acre site with a floor area of 60 acres and over 3000 staff, including some nationally and internationally known figures such as Dr Chen Zhu, but also Drs Wang Zhenyi and Chen Saijuan, both members of the Chinese Academy of Engineering. In addition to its 34 clinical departments, the Hospital has nine departments of medical technology. It also encompasses six Shanghai institutes (Traumatology and Orthopedics, Hypertension, Endocrine and Metabolic Diseases, Burns, Hematology, and Digestive Tract Surgery), plus two of the Ministry of Health’s Key Laboratories (Human Genome, and Endocrine and Metabolic Diseases). Ruijin Hospital has been renowned for its expertise in treating major burns ever since saving steelworker Qiu Caikang in 1958, a case that instantly assumed iconic status in the country’s medical culture. After pioneering organ transplantation in the 1970s, the Hospital became renowned in the 1990s for breakthroughs in the management and molecular biology of leukemia. In terms of sheer volume, the Hospital has around 60 masters’ and PhD students at any one time, each with an accredited supervisor. Over 2 million patients annually attend its outpatient and emergency departments, and around 25 000 undergo surgery.
Hospital staff have an impressive array of over 300 awards to their credit, including the E. I. Evans Prize (American Burns Association), the G. Whitaker International Burns Prize (Italy), Catherine Cancer Prize (USA), the Charles Rodolphe Brupbacher Foundation Prize (Switzerland), the Prix de l’Oise (French Ligue Nationale Contre le Cancer), the Simone and Cino del Duca Foundation Prize (France), and the He Liang and He Li Fund Technology Prize (Hong Kong).

Prof Li Hongwei. Graduated from Shanghai Second Medical College in 1961. Tenured professor at Ruijin Hospital. Director of the General Surgical Society of the Chinese Medical Association. Director of the Department of Surgery and Shanghai Digestive Surgical Institute. Foreign member of French National Academy of Surgery. Courtesy of Ruijin Hospital.
Prof Lin Yanzhen. Graduated in 1949 from Aurora University. Tenured professor at Ruijin Hospital. Current Honorary Director of Shanghai Digestive
Surgery Institute and Editor in Chief of the Journal of Surgical Theories and Practice. Foreign member of French National Academy of Surgery. Courtesy of
Ruijin Hospital.

In November 2002, France inaugurated its first large-scale cooperation structure, the Sino-France Research Center for Life Science and Genome Research, which was set up in Ruijin Hospital. This sealed 10 years’ collaboration between Ruijin, its Institute of Hematology under Dr Chen Zhu, and French National Center for Scientific Research (CNRS) laboratories UPR9051 and UMR7151 at Saint-Louis Hospital in Paris. An important research focus, headed by Chen Zhu, has been in acute promyelocytic leukemia, with particular regard to the mode of action of arsenic trioxide, the role of cyclic adenosine monophosphate (cAMP), and the ubiquitination reaction. These and other studies have led to publications in Science, Cancer Cell, Proceedings of the National Academy of Sciences, EMBO Journal, Journal of Experimental Medicine, Journal of Clinical Investigation, Blood, American Journal of Human Genetics, Oncogene, and Leukemia.
In 2004, Ruijin Hospital signed a cooperative agreement with Servier, the largest independent French pharmaceutical company, to sponsor study visits to leading French hospitals by six Ruijin endocrinologists and cardiologists. Servier has been present in China for over 20 years, during which time it has won the trust of the country’s pharmacists and physicians. Over the last two decades, it has been working extensively with Chinese academia via the Sino-French exchange program and cooperative research in epidemiology, public health, and other fields. Servier representatives regularly visit close on 1400 hospitals in China’s northern, southern, and eastern provinces.
France has been unstinting in its recognition of the outstanding contributionsmade by Ruijin Hospital staff in fostering Sino-French partnerships. It has made Drs Kuang Ankun, Li Hongwei, and Chen Zhu chevaliers of the Legion of Honor, while Drs Lin Yanzhen, Li Hongwei, and Chen Zhu have been elected members of the French Academy of Sciences. In many ways, Chen Zhu personifies the success of Sino-French cooperation. After medical studies in Jiangxi, he took a postgraduate course at Shanghai Second Medical University from where he went to Paris to earn a doctorate in hematology at Saint-Louis Hospital. On 29 June 2007, he was appointed China’s Minister of Health, the second non– Communist Party member—alongside Wan Gang appointed Minister of Science and Technology on 27 April 2007—to rise to such a key position since the late 1970s.

Chinese Minister of Health Chen Zhu speaking during a press conference on AIDS in China held in Beijing, Thursday, November 29, 2007. © Ng Han Guan/AP/SIPA.

In June 2005, Ruijin Hospital and Shanghai Second Medical University hosted a week-long Sino-French medical meeting cosponsored by the Chinese and French Ministries of Health. The sessions, largely devoted to HIV-AIDS (human immunodeficiency virus—acquired immunodeficiency syndrome), emergent diseases, and the practicalities of medical exchange programs between the sponsor nations, were attended by key figures in these areas, not least Chen Zhu, and, on the French side, Prof Vincent Deubel, director of the Shanghai Pasteur Institute, and key advisers on health to the French government.
In 2007, Ruijin Hospital celebrated its 100th birthday in cultural continuity with the old Hôpital Sainte- Marie. French physicians were on hand to witness the unveiling of the centenary monument inscribed with the hospital’s significant contributions (such as China’s first kidney, liver, and heart transplants), to which their country had in no small measure contributed. It would have been clear to those present that France had ceased to be the unchallenged mentor in the Sino-French medical relationship. Exchange was no longer one-way. Increasing numbers of French physicians and bioscientists are now coming on training visits to Ruijin Hospital, to feed on the knowledge and experience of their Chinese colleagues, and to bring back to France a love and appreciation for what this once-French, but now wholly Chinese hospital is achieving in terms of both medical science and the care of its surrounding population. _

Cover of the Program of the 27th France-China Medical Days (27e Journées Médicales France-Chine) in Beijing, Wuhan, and Shanghai, 21-28 September 2008, an illustration of one among many longstanding partnerships between China and Servier.

L’HÔPITAL RUIJIN :
DE L’HÔPITAL FONDÉ PAR DES JÉSUITES FRANÇAIS AU XIXE SIÈCLE
À L’HÔPITAL UNIVERSITAIRE DE POINTE CHINOIS D’AUJOURD’HUI

L’ Académie Aurore (Zhendan Xueyuan, mot à mot « le tonnerre du lever de soleil », est une institution catholique française fondée en 1903 à Shanghai par un Jésuite chinois, Joseph Ma Xiangbo, destinée à contribuer à la modernisation de la Chine. En 1907 la Société de Jésus fit l’acquisition d’un terrain à proximité de l’Université Aurore sur lequel elle édifia l’Hôpital Sainte Marie, rebaptisé ultérieurement Hôpital Guangci, mot à mot, « Hôpital de la Grande Miséricorde »). Cet hôpital se transforma en centre d’enseignement pour les élèves de l’Académie Aurore. En 1917 l’Académie fut promue au rang d’université, la prestigieuse Université Aurore, et devint une pépinière de médecins, d’infirmières, et de techniciens médicaux pour les hôpitaux catholiques de Chine. Une succession de doyens jésuites français en fit un phare de la médecine et de la langue françaises où se côtoyaient étudiants français et chinois. En 1952, toutes les institutions éducatives étrangères en Chine passèrent sous direction chinoise et l’Université Aurore fusionna avec l’Université Fudan, tandis que son école de médecine fut intégrée à l’École de Médecine de l’Université de Shanghai No. 2. L’Hôpital Guangci, quant à lui, fut renommé Hôpital Ruijin, pour devenir un des centres hospitalo-universitaires de pointe de la Chine. Au cours des années 1980, l’École de Médecine de l’Université de Shanghai No. 2 renoua avec son passé en proposant un enseignement de 7 ans demédecine en langue française et en établissant un programme très dynamique d’échanges entre la Chine et la France à tous les niveaux. Nul n’illustre mieux le succès de cette entreprise que l’actuel Ministre de la santé chinoise, le Professeur Chen Zhu, hématologue de renommée mondiale, dont le brillant parcours médical s’effectua tant à l’École de Médecine de l’Université de Shanghai N° 2 qu’à la Faculté de Médecine Paris VII. De nos jours, un nombre croissant de médecins et scientifiques français se rendent à l’Hôpital Ruijin non seulement pour enseigner, mais pour apprendre. Les espoirs placés par le fondateur jésuite Ma Xianbo dans son Académie se trouvent ainsi pleinement réalisés.