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Lewis's Medical-Surgical Nursing: Assessment and Management of Clinical Problems-Mosby (Eleventh Edition) Mariann M. Harding Download

The document provides information about the book 'Lewis's Medical-Surgical Nursing: Assessment and Management of Clinical Problems' by Mariann M. Harding, including its authors and contributors. It outlines the contents of the book, which covers various nursing concepts, patient care, and management of clinical problems. Additionally, it includes links to download the book and other related resources.

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100% found this document useful (2 votes)
332 views52 pages

Lewis's Medical-Surgical Nursing: Assessment and Management of Clinical Problems-Mosby (Eleventh Edition) Mariann M. Harding Download

The document provides information about the book 'Lewis's Medical-Surgical Nursing: Assessment and Management of Clinical Problems' by Mariann M. Harding, including its authors and contributors. It outlines the contents of the book, which covers various nursing concepts, patient care, and management of clinical problems. Additionally, it includes links to download the book and other related resources.

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© © All Rights Reserved
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Lewis's Medical-Surgical Nursing

Assessment and Management of


Clinical Problems

ELEVENTH EDITION

Mariann M. Harding, RN, PhD,


FAADN, CNE
Professor of Nursing, Kent State University at Tuscarawas, New
Philadelphia, Ohio

Section Editors

Jeffrey Kwong, RN, DNP, MPH,


ANP-BC, FAAN, FAANP
Professor, Division of Advanced Nursing Practice, School of Nursing,
Rutgers University, Newark, New Jersey
Dottie Roberts, RN, EdD, MSN,
MACI, OCNS-C, CMSRN, CNE
Executive Director, Orthopaedic Nurses Certification Board, Chicago,
Illinois

Debra Hagler, RN, PhD, ACNS-BC,


CNE, CHSE, ANEF, FAAN
Clinical Professor, Edson College of Nursing and Health Innovation, Arizona
State University, Phoenix, Arizona

Courtney Reinisch, RN, DNP, FNP-


BC
Undergraduate Program Director, Associate Professor, School of Nursing,
Montclair State University, Montclair, New Jersey
Disclaimer
This title includes additional digital media when purchased in print
format. For this digital book edition, media content may not be
included.
Table of Contents

Cover image

Title page

Copyright

About the Authors

Contributors

Authors of Teaching and Learning Resources

Reviewers

Dedication

Preface

Concepts Exemplars

Special Features
Section One. Concepts in Nursing Practice

1. Professional Nursing

Conceptual Focus

Professional Nursing Practice

Influences on Professional Nursing Practice

Patient-Centered Care

Teamwork and Collaboration

Safety

Quality Improvement

Informatics

Evidence-Based Practice

2. Health Equity and Culturally Competent Care

Conceptual Focus

Determinants of Health

Health Disparities and Health Equity

Culture

Cultural Competence

Cultural Diversity in the Health Care Workplace


Cultural Factors Affecting Health and Health Care

Nursing Management: Promoting Health Equity and Increasing


Cultural Competency

3. Health History and Physical Examination

Conceptual Focus

Data Collection

Nursing History: Subjective Data

Physical Examination: Objective Data

Types of Assessment

Problem Identification

4. Patient and Caregiver Teaching

Conceptual Focus

Role of Patient and Caregiver Teaching

Teaching-Learning Process

Process of Patient Teaching

5. Chronic Illness and Older Adults

Conceptual Focus

Chronic Illness

Nursing Management: Chronic Illness


Older Adults

Attitudes Toward Aging

Biologic Aging

Age-Related Physiologic Changes

Special Older Adult Populations

Social Support for Older Adults

Social Services for Older Adults

Medicare and Medicaid

Care Alternatives for Older Adults

Legal and Ethical Issues

Nursing Management: Older Adults

Section Two. Problems Related to Comfort and


Coping

6. Stress Management

Conceptual Focus

What is Stress?

Physiologic Response to Stress

Mind-Body-Spirit Connection
Effects of Stress on Health

Coping Strategies

Relaxation Strategies

Nursing Management: Stress

7. Sleep and Sleep Disorders

Conceptual Focus

Sleep

Physiologic Sleep Mechanisms

Insufficient Sleep and Sleep Disturbances

Sleep Disturbances in the Hospital

Sleep Disorders

Nursing Management: Insomnia

Obstructive Sleep Apnea

Nursing and Interprofessional Management: Sleep Apnea

Periodic Limb Movement Disorder

Circadian Rhythm Disorders

Narcolepsy

Parasomnias

Special Sleep Needs of Nurses


8. Pain

Conceptual Focus

Magnitude of Pain Problem

Definitions and Dimensions of Pain

Classification of Pain

Pain Assessment

Pain Treatment

Nursing and Interprofessional Management: Pain

Institutionalizing Pain Education and Management

Ethical Issues in Pain Management

Managing Pain in Special Populations

9. Palliative and End-of-Life Care

Conceptual Focus

Palliative Care

Hospice Care

Death

End-of-Life Care

Legal and Ethical Issues Affecting End-of-Life Care

Nursing Management: End of Life


Special Needs of Caregivers and Nurses in End-of-Life Care

10. Substance Use Disorders

Conceptual Focus

Drugs Associated with Substance Use Disorder

Nursing and Interprofessional Management: Tobacco Use


Disorder

Alcohol

Nursing and Interprofessional Management: Alcohol Use Disorder

Use of Other Substances

Nursing and Interprofessional Management: Stimulant Use

Depressants

Nursing and Interprofessional Management: Depressant Use

Inhalants

Cannabis

Caffeine

Nursing Management: Substance Use

Section Three. Problems Related to Homeostasis


and Protection
11. Inflammation and Healing

Conceptual Focus

Inflammatory Response

Nursing and Interprofessional Management: Inflammation

Healing Process

Nursing and Interprofessional Management: Wound Healing

Pressure Injuries

Nursing and Interprofessional Management: Pressure Injuries

12. Genetics

Conceptual Focus

Genetics and Genomics

Genetic Disorders

Genetic Screening and Testing

Pharmacogenomics and Pharmacogenetics

Gene Therapy

Stem Cell Therapy

Nursing Management: Genetics and Genomics

13. Immune Responses and Transplantation

Conceptual Focus
Normal Immune Response

Altered Immune Response

Allergic Disorders

Nursing Management: Immunotherapy

Nursing and Interprofessional Management: Latex Allergies

Autoimmunity

Immunodeficiency Disorders

Human Leukocyte Antigen System

Organ Transplantation

Graft-Versus-Host Disease

14. Infection

Conceptual Focus

Infections

Types of Pathogens

Emerging Infections

Health Care–Associated Infections

Infection Prevention and Control

Human Immunodeficiency Virus Infection

Nursing Management: HIV Infection


15. Cancer

Conceptual Focus

Biology of Cancer

Benign Versus Malignant Neoplasms

Classification of Cancer

Prevention and Early Detection of Cancer

Interprofessional Care

Surgical Therapy

Chemotherapy

Radiation Therapy

Nursing Management: Chemotherapy and Radiation Therapy

Late Effects of Radiation and Chemotherapy

Immunotherapy and Targeted Therapy

Nursing Management: Immunotherapy and Targeted Therapy

Hormone Therapy

Hematopoietic Growth Factors

Hematopoietic Stem Cell Transplantation

Gene Therapy

Complications of Cancer

Nutritional Problems
Infection

Oncologic Emergencies

Cancer Pain

Coping with Cancer and Treatment

Cancer Survivorship

16. Fluid, Electrolyte, and Acid-Base Imbalances

Conceptual Focus

Homeostasis

Water Content of the Body

Electrolytes

Mechanisms Controlling Fluid and Electrolyte Movement

Fluid Movement in Capillaries

Fluid Spacing

Regulation of Water Balance

Fluid Volume Imbalances

Fluid Volume Deficit

Fluid Volume Excess

Nursing Management: Fluid Volume Imbalances

Sodium Imbalances
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different content
the time our friends were in China the passage to Han-kow was to be had for
twenty-four dollars—quite a decline from four hundred to twenty-four.
The boys had expected to find the boats in China small and inconvenient. What
was their astonishment to find them like the great steamers that ply on the
North River, or from New York to Fall River or Providence. They found the cabins
were large and comfortable, though they were not so numerous as on the
American waters, for the reason that there were rarely many passengers to be
carried. The captain, pilots, engineers, and other officers were Americans, while
the crew were Chinese. The managers of the company were Chinese, but they
left the control of the boats entirely in the hands of their respective captains.
One boat had a Chinese captain and officers, but she was a small affair, and,
from all that could be learned, the managers did not find their experiment of
running with their own countrymen a successful one.
At the advertised time the three strangers went on board the steamer that was
to carry them up the river, and took possession of the cabins assigned to them.
Their only fellow-passengers were some Chinese merchants on their way to
Nanking, and a consular clerk at one of the British consulates along the stream.
The captain of the steamer was a jolly New-Yorker, who had an inexhaustible
fund of stories, which he was never tired of telling. Though he told dozens of
them daily, Frank remarked that he was not like history, for he never repeated
himself. Fred remembered that some one had said to him in Japan that he
would be certain of a pleasant voyage on the Yang-tse-kiang if he happened to
fall in with Captain Paul on the steamer Kiang-ching. Fortune had favored him,
and he had found the steamer and the captain he desired.
Frank observed that the steamer had been provided with a pair of eyes, which
were neatly carved on wood, and painted so as to resemble the human eye. The
captain explained that this was in deference to the Chinese custom of painting
eyes on their ships and boats; and if he looked at the first boat, or other
Chinese craft, large or small, that he saw, he would discover that it had eyes
painted on the bow. This is the universal custom throughout China; and though
a native may have a suspicion that it does no good, he would not be willing to
fly in the face of old custom. In case he should leave his craft in blindness, and
any accident befell her, he would be told by his friends, "Serves you right for not
giving your ship eyes to see with."
The steamer descended the Woosung River to its intersection with the Yang-tse-
kiang, and then began the ascent of the latter. The great stream was so broad
that it seemed more like a bay than a river. This condition continued for a
hundred and fifty miles, when the bay narrowed to a river, and the far-famed
Silver Island came in sight. It stands in mid-stream, a steep hill of rock, about
three hundred feet high, crowned with a pagoda, and covered from base to
summit with trees and bushes and rich grass. At first it might be taken for an
uninhabited spot, but as the boat approaches you can see that there are
numerous summer-houses and other habitations peeping out from the verdure.
A little beyond the island there is a city which straggles over the hills, and is
backed by a range of mountains that make a sharp outline against the sky. This
is Chin-kiang, the first stopping-place of the steamer as she proceeds from
Shanghai to Han-kow. She was to remain several hours, and our friends
embraced the opportunity to take a stroll on shore. Here is Frank's account of
the expedition:

A CHINESE FAMILY PARTY.


"The streets of Chin-kiang are narrow and dirty, and the most of them that we
saw seemed to be paved with kitchen rubbish and other unsavory substances.
The smells that rose to our nostrils were too numerous and too disagreeable to
mention; Fred says he discovered fifty-four distinct and different ones, but I
think there were not more than forty-seven or forty-eight. The Doctor says we
have not fairly tested the city, as there are several wards to hear from in
addition to the ones we visited in our ramble. I was not altogether unprepared
for these unpleasant features of Chin-kiang, as I had already taken a walk in the
Chinese part of Shanghai.
A GENTLEMAN OF CHIN-
KIANG.
"Everybody says that one Chinese town is so much like another that a single one
will do for a sample. This is undoubtedly true of the most of them, but you
should make exceptions in the case of Canton and Pekin. They are of extra
importance; and as one is in the extreme north, and the other in the far south,
they have distinctive features of their own. We shall have a chance to talk about
them by-and-by. As for Chin-kiang, I did not see anything worth notice while
walking through it that I had not already seen at Shanghai, except, perhaps,
that the dogs barked at us, and the cats ruffled their backs and tails, and fled
from us as though we were bull-dogs. A pony tried to kick Fred as he walked by
the brute, and only missed his mark by a couple of inches. You see that the
dumb animals were not disposed to welcome us hospitably. They were evidently
put up to their conduct by their masters, who do not like the strangers any more
than the dogs and cats do, and are only prevented from showing their spite by
the fear that the foreigners will blow their towns out of existence if any of them
are injured.
"We bought some things in the shops, but they did not amount to much either
in cost or quality. Fred found a pair of Chinese spectacles which he paid half a
dollar for; they were big round things, with glasses nearly as large as a silver
dollar, and looked very comical when put on. But I am told that they are very
comfortable to the eyes, and that the foreigners who live in China, and have
occasion to wear spectacles, generally prefer those made by the Chinese
opticians. A pair of really fine pebbles will cost from ten to twenty dollars. The
glasses that Fred bought were only the commonest kind of stuff, colored with a
smoky tint so as to reduce the glare of the sun.

CHINESE SPECTACLES.
"We went outside the town, and found ourselves suddenly in the country. It was
a complete change. Going through a gate in a wall took us from the streets to
the fields, and going back through the gate took us to the streets again. We saw
a man ploughing with a plough that had only one handle, and made a furrow in
the ground about as large as if he had dragged a pickaxe through it. The plough
was pulled by a Chinese buffalo about as large as a two-year-old steer, and he
was guided by means of a cord drawn through the cartilage of his nose. It was a
poor outfit for a farmer; but the man who had it appeared perfectly contented,
and did not once turn his eyes from his work to look at us.

PLOUGHING WITH A BUFFFALO.


"A little way off from this ploughman there was a man threshing grain on some
slats; they looked like a small ladder placed on an incline, and the way he did
the work was to take a handful of grain and thresh it against the slats till he had
knocked out all the kernels and left nothing but the straw. Such a thing as a
threshing-machine would astonish them very much, I should think, and I don't
believe they would allow it to run. Labor is so cheap in China that they don't
want any machinery to save it; when you can hire a man for five cents a day,
and even less, you haven't any occasion to economize.

THRESHING GRAIN NEAR


CHIN-KIANG.
"The man who brought the bundles of grain to the thresher had them slung over
his shoulder, as they carry everything in this country; two bundles made a load
for him, and they were not large bundles either. Such a thing as a farm-wagon is
as unknown as a threshing-machine, and would not be useful, as the paths
among the fields are very narrow, and a wagon couldn't run on them at all.
Land is very valuable in the neighborhood of the towns, and they would
consider it wasteful to have a wide strip of it taken up for a road. And, as I have
just said, labor is very cheap, especially the labor of the coolies who carry
burdens. All the men I saw at work in the field were barefooted, and probably
the wages they receive do not leave them much to spend on boots, after they
have supported their families and paid their taxes. They must have a hard time
to get along, but they appear perfectly cheerful and contented."
CARRYING BUNDLES OF GRAIN.
From Chin-kiang the steamer proceeded up the river. The account of what they
saw was thus continued by the boys:
"The southern branch of the grand canal enters the river at Chin-kiang; the
northern branch comes in some distance below. The river is plentifully dotted
with junks, but this condition is not peculiar to the vicinity of the canal. All the
way up from Shanghai to Han-kow it is the same, and sometimes twenty or
thirty boats will be sailing so closely together as to endanger their cordage and
sides. Perhaps you have seen New York Bay on a pleasant afternoon in summer
when every boat that could hoist a sail was out for an airing? Well, imagine this
great river for hundreds of miles dotted with sails as thickly as our bay on the
occasion I have indicated, and you can have an idea of the native commerce of
the Yang-tse-kiang. Nobody knows how many boats there are on the river, as no
census of them is taken. The mandarins collect toll at the river stations, but do
not trouble themselves to keep a record of the numbers. I asked a Chinese
merchant who is a fellow-passenger with us how many boats there are engaged
in the navigation of the Yang-tse and its tributaries, and he answers,
"'P'raps hunder tousand, p'raps million; nobody don't know.'
"Another says, 'Great many big million,' and he may not be far out of the way,
though his statement is not very specific.
A RIVER SCENE IN CHINA.
"I have heard a curious story of how the foreigners have secured more
privileges than are allowed to the native merchants. Every district has the right
to tax goods passing through it. At each district there is a barrier, commanded
by a petty official, with a military guard, and here each native boat must stop
and pay the transit tax. For long distances these taxes amount to a large sum,
and frequently are a great deal more than the goods cost originally. These taxes
are known as 'squeezes,' and the barriers where they are paid are called
'squeeze stations.' But the foreigners have secured a treaty with China, or,
rather, there is a clause in one of the treaties, which exempts them from the
payment of the transit 'squeezes;' they only pay the customs duties, and the
local tax at the place of destination. Transit passes are issued by which goods
belonging to foreigners, though carried in native boats, are exempt from
squeezing, but these passes can only be obtained by foreigners.
"Since the law went into operation, many Chinese merchants have gone into
partnership with foreigners; the former furnishing the capital and attending to
all the business, while the latter obtain the transit passes and give the name to
the firm. A gentleman whom we met in Shanghai is associated with some
wealthy Chinese; they put in the money, and he furnishes his name and gets the
passes, which none of them could do.
"The native junks will always give a free passage to a foreigner who will pretend
to own the cargo, since they can escape the squeeze if he plays his part
successfully. The captain says that last year a sailor who wanted to join an
English gun-boat at a place up the river was carried through for nothing by a
junk whose cargo he pretended to own. He passed as a 'foreign merchant,' but
the fact was he had never bought anything in his life more valuable than a suit
of clothes, and had sold a great deal less than that.

A NINE-STORIED PAGODA.
"The river above Chin-kiang is in some places very pretty, and the mountains
rise out of the water here and there, making a great contrast to the lowlands
farther down. There are several large cities on the way, the most important (or,
at all events, the one we know the most about) being Nanking. It was famous
for its porcelain tower, which was destroyed years ago by the rebels. Every brick
has been carried away, and they have actually dug down into the foundations
for more. There is only a part of the city left; and as we did not have time to go
on shore, I am not able to say much about it. But there are several other cities
that were more fortunate, since they were able to save their towers, or
pagodas, as they are generally called. These pagodas are always built with an
odd number of stories, usually five, seven, or nine; but once in a great while
there is an ambitious one of eleven stories, or a cheap and modest one of only
three. We saw one handsome pagoda of nine stories that had bushes and
climbing-plants growing from it. I suppose the birds carried the seeds there, and
then they sprouted and took root. They make the pagoda look very old, and
certainly that is quite proper, as they are all of an age that young people should
respect.
LITTLE ORPHAN ROCK.
"There is a funny little island—and not so little, after all, as it is three hundred
feet high—that stands right in the middle of the river at one place. They call it
the Little Orphan Rock, probably because it was never known to have any father
or mother. There is a temple in the side of the rock, as if a niche had been cut
to receive it. Fred thinks the people who live there ought not to complain of
their ventilation and drainage; and if they fell out of the front windows by any
accident, they would not be worth much when picked up. Away up on the top of
the rock there is a little temple that would make a capital light-house, but I
suppose the Chinese are too far behind the times to think of turning it to any
practical use. Great Orphan Rock is farther up the river, or a little out of the
river, in what they call Po-yang Lake.
"Around the shores of Po-yang Lake is where they make a great deal of the
porcelain, and what we call 'China ware,' that they send to America. The captain
says he has frequently taken large quantities of it down the river to Shanghai,
and that it was sent from there to our country. They dig the clay that they want
for making the porcelain on the shores of the lake, and they get their fuel for
burning it from the forests, not far away. The entrance to the lake is very
picturesque; there is a town in a fortress on a hill that overlooks the river, and
then there is a fort close down by the water. Probably the fort wouldn't be of
much use against a fleet of foreign ships; but it looks well, and that is what
pleases the Chinese."
ENTRANCE TO PO-YANG LAKE.
CHAPTER XXV.
THE TAE-PING REBELLION.—SCENES ON THE GREAT
RIVER.
The evidences of a large population along the Yang-tse were easy to see; but,
nevertheless, Frank and Fred were somewhat disappointed. They had read of
the overcrowded condition of China, and they saw the great numbers of boats
that navigated the river, and consequently they looked for a proportionately
dense mass of people on shore. Sometimes, for two or three hours at a time,
not a house could be seen; and at others the villages were strung along in a
straggling sort of way, as though they were thinly inhabited, and wished to
make as good a show as possible. There were many places where the land did
not seem to be under cultivation at all, as it was covered with a dense growth of
reeds and rushes. In some localities the country appeared so much like a
wilderness that the boys half expected to see wild beasts running about
undisturbed; they began to speculate as to the kind of beasts that were to be
found there, and finally questioned Dr. Bronson on the subject.
The Doctor explained to them that this desolation was more apparent than real,
and that if they should make a journey on shore, at almost any point, for a few
miles back from the river, they would find all the people they wanted. "About
thirty years ago," said he, "they had a rebellion in China; it lasted for a long
time, and caused an immense destruction of life and property. The rebels had
possession of the cities along the Yang-tse, and at one period it looked as
though they would succeed in destroying the government."
"Did they destroy the cities that we see in ruins?" Fred asked.
"Yes," answered the Doctor, "they destroyed several cities so completely that not
a hundred inhabitants remained, where formerly there had been many
thousands; and other cities were so greatly injured that the traces of the rebel
occupation have not been removed. I believe there is not a city that escaped
uninjured, and you have seen for yourselves how some of them have suffered.
"The rebellion," he continued, "is known in history as the Tae-ping insurrection.
The words 'tae ping' mean 'general peace,' and were inscribed on the banners
of the rebels. The avowed intention of the leader of the revolt was to overthrow
the imperial power, and deliver the country from its oppressors. There were
promises of a division of property, or, at all events, the rebels were to have free
license to plunder wherever they went; and as there are always a great many
people who have everything to gain and nothing to lose, the rebellion gathered
strength as time went on. The leaders managed to convince the foreigners that
they were inclined to look favorably on Christianity, and the idea went abroad
that the Tae-pings were a sort of Chinese Protestants, who wanted to do away
with old abuses, and were in favor of progress and of more intimate relations
with foreign nations. Many of the missionaries in China were friendly to the
rebellion, and so were some of the merchants and others established there.

TAE-PING REBELS.
"So powerful did the rebels become that they had nearly a third of the best part
of the empire under their control, and the imperial authorities became seriously
alarmed. City after city had been captured by the rebels, and at one time the
overthrow of the government appeared almost certain. The rebels were
numerous and well officered, and they had the advantage of foreign instruction,
and, to some extent, of foreign arms. The imperialists went to war after the old
system, which consisted of sound rather than sense. They were accustomed to
beat gongs, fire guns, and make a great noise to frighten the enemy; and as the
enemy knew perfectly well what it was all about, it did not amount to much. The
suppression of the rebellion was largely due to foreigners, and the most
prominent of these was an American."
"What! an American leader for Chinese?"
"Yes, an American named Ward, who rose to be a high-class mandarin among
the Chinese, and since his death temples have been erected to his honor. He
came to Shanghai in 1860, and was looking around for something to do. The
rebels were within forty miles of the city, and their appearance in front of it was
hourly expected. They were holding the city of Soon-keong, and Ward proposed
to take this place by contract, as one might propose to build a house or a
railway line."
The boys laughed at the idea of carrying on war by contract, but were reminded
that they were in China, where things are done otherwise than in Europe and
America.
"The conditions of the contract were that Ward should raise a force of fifty
Malays, and undertake the capture of a walled city having a garrison of four
thousand rebels. If he succeeded, he was to have a certain sum of money—I
think it was ten thousand dollars—and was then to raise a force of one thousand
Chinese with twenty-five foreign officers, and was to have command of this
army for the purpose of suppressing the rebellion.
"Soon-keong has four gates, and they were opened at a certain hour in the
morning. Ward went there secretly one night, and sent fourteen of his men to
each of three of the gates, while he himself went with the remaining eight men
to the fourth gate. The rebels suspected nothing, and at the usual time the
gates were opened. Ward's men rushed in simultaneously at the four gates,
made a great noise, set fire to several buildings, killed everybody they met, and
pushed on for the centre of the town. In less than ten minutes the enemy had
fled, and the battle was over. Ward was in full possession of the place, and a
force of the imperial army, which was waiting near by, was marched in, to make
sure that the rebels would not return.
GENERAL WARD.
"Ward raised the army that he had proposed, and from one thousand it soon
grew to three thousand. It was armed with foreign rifles, and had a battery of
European artillery. The officers were English, American, French, and of other
foreign nationalities, and the men were drilled in the European fashion. So
uniformly were they successful that they received the name of 'the Invincibles,'
and retained it through all their career. The American adventurer became
'General' Ward, was naturalized as a Chinese subject, was made a red-button
mandarin, and received from the government a present of a large tract of land
and a fine house in Shanghai. He was several times wounded, and finally, in
October, 1862, he was killed in an attack on one of the rebel strongholds.
THE GATE WHICH WARD ATTACKED.
"Ward was succeeded by an American named Burgevine, who had been one of
his subordinates. Burgevine was quite as successful as Ward had been, and at
one time with his army of 5000 trained Chinese he defeated 95,000 of the Tae-
ping rebels. This made an end of the rebellion in that part of the country, but it
was flourishing in other localities. Burgevine had some trouble with the
authorities, which led to his retirement; and after that the Invincible army was
commanded by an English officer named Gordon, who remained at the head of
it till the downfall of the Tae-pings and the end of the rebellion. The success of
this little army against the large force of the rebels shows the great advantages
of discipline. In all time and in all countries this advantage has been apparent,
but in none more so than in China. If the power of Ward and his men had been
with the rebels instead of against them, it is highly probable that the
government would have been overthrown. A few hundred well-trained soldiers
could have decided the fate of an empire."
GENERAL BURGEVINE.
The conversation about the Tae-ping rebellion and its termination occurred while
the steamer was steadily making her way against the muddy waters of the
Yang-tse. The party were sitting on the forward deck of the boat, and just as the
closing words of the Doctor's remarks were pronounced, there was a new and
unexpected sensation.
The day was perfectly clear, but suddenly a cloud appeared to be forming like a
thick mist. As they came nearer to it they discovered what it was, and made the
discovery through their sense of feeling. It was a cloud of locusts moving from
the southern to the northern bank of the river; they had devastated a large
area, and were now hastening to fresh woods and pastures new. They filled the
air so densely as to obscure the sun, and for more than an hour the steamer
was enveloped in them. These locusts are the scourge of China, as they are of
other countries. They are worse in some years than in others, and in several
instances they have been the cause of local famines, or of great scarcity.
Of course many of the locusts fell on the deck of the steamer, and found their
way to the cabins. The flight of the cloud was from south to north, and Frank
observed a remarkable peculiarity about the movements of individual members
of the immense swarm. He captured several and placed them on the cabin
table. No matter in what direction he turned their heads, they immediately faced
about towards the north, and as long as they were in the cabin they continued
to try to escape on the northern side. After the boat had passed through the
swarm, the boys released several of the captives, and found that, no matter
how they were directed at the moment of their release, they immediately turned
and flew away to the north.
"They've one consolation," Fred remarked—"they have their compasses always
about them, and have no need to figure up their reckoning with 'Bowditch's
Navigator' to know which way to steer."
"Don't you remember," Frank retorted, "our old teacher used to tell us that
instinct was often superior to reason. Birds and animals and fishes make their
annual migrations, and know exactly where they are going, which is more than
most men could begin to do. These locusts are guided by instinct, and they are
obliged to be, as they would starve if they had to reason about their
movements, and study to know where to go. Just think of a locust sitting down
to a map of China, when there were millions of other locusts all doing the same
thing. They wouldn't have maps enough to go around; and when they got to a
place they wanted to reach, they would find that others had been there before
them and eaten up all the grass."
Frank's practical argument about instinct received the approval of his friends,
and then the topic of conversation was changed to something else.
Both the boys were greatly interested in the various processes of work that were
visible on shore. Groups of men were to be seen cutting reeds for fuel, or for
the roofs of houses, where they make a warm thatch that keeps out the rain
and snow. Other groups were gathering cotton, hemp, millet, and other
products of the earth; and at several points there were men with blue hands,
who were extracting indigo from the plant which produces it. The plant is
bruised and soaked in water till the coloring-matter is drawn out; the indigo
settles to the bottom of the tub, and the water is poured off; and after being
dried in the sun, the cake forms the indigo of commerce. In many places there
were little stages about thirty feet high, and just large enough at the top for one
man, who worked there patiently and alone. Frank could not make out the
employment of these men, and neither could Fred. After puzzling awhile over
the matter, they referred it to Doctor Bronson.
"Those men," the Doctor explained, "are engaged in making ropes or cables out
of the fibres of bamboo."
"Why don't they work on the ground instead of climbing up there?" Fred asked.
"Because," was the reply, "they want to keep the cable straight while they are
braiding it. As fast as they braid it it hangs down by its own weight, and coils on
the ground beneath. No expensive machinery is needed, and the principal labor
in the business is to carry the bamboo fibre to the platform where it is wanted.
This cable is very strong and cheap, and takes the place of hemp rope in a great
many ways. It is larger and rougher than a hempen rope of the same strength,
but the Chinese are willing to sacrifice beauty for cheapness in the majority of
practical things."
The Chinese have a way of catching fish which is peculiar to themselves, and
much practised along the Yang-tse. A net several feet square hangs at the end
of a long pole, and is lowered gently into the water and then suddenly raised.
Any fish that happens to be swimming over the net at the time is liable to be
taken in. He is lifted from the large net by means of a small scoop, and the
raising and lowering process is resumed. Fred thought it was an excellent
employment for a lazy man, and Frank suggested that it would be better for two
lazy men than one, as they could keep each other company.
The boys were desirous of seeing how the Chinese catch fish with the aid of
cormorants, and were somewhat disappointed when told that these birds were
rarely used on the Yang-tse, but must be looked for on some of the lakes and
ponds away from the great stream, and particularly in the southern part of the
empire. The Doctor thus described this novel mode of catching fish:
"Three or four cormorants and a raft are necessary in this way of fishing. The
cormorants are stupid-looking birds about the size of geese, but are of a dark
color, so that they cannot be readily seen by the fish. The raft is of bamboo logs
bound together, and about three feet wide by twenty in length. The fisherman is
armed with a paddle for propelling his raft and a scoop-net for taking the fish
after they have been caught by the cormorant, and he has a large basket for
holding the fish after they have been safely secured. Each cormorant has a cord
or ring around his neck to prevent him from swallowing the fish he has taken,
and it is so tight that he cannot get down any but the smallest fish.
FISHING WITH CORMORANTS.
"The birds dive off from the raft, and can swim under water with great rapidity.
Sometimes they are not inclined to fish, and require to be pushed off, and,
perhaps, beaten a little by their master. If they have been well trained, they
swim directly towards the raft, when they rise to the surface; but sometimes a
cormorant will go off the other way, in the hope of being able to swallow the
fish he holds in his mouth. In such case the fisherman follows and captures the
runaway, punishing him soundly for his misconduct. Whenever a bird catches a
fish and brings it to the raft, he is rewarded with a mouthful of food. In this way
he soon learns to associate his success with something to eat; and a cormorant
that has been well trained has a good deal of fidelity in his composition. I am
uncertain which to admire most, the dexterity of the fisherman in handling his
raft, or the perseverance and celerity of the cormorants."
On her arrival at Han-kow, the steamer was tied up to the bank in front of the
portion of the city occupied by the foreigners. Han-kow is on a broad tongue of
land at the junction of the Han with the Yang-tse. On the opposite side of the
Han is the city of Han-yang, and over on the other bank of the Yang-tse is Wo-
chang. Here is the brief description given by the Doctor in a letter to friends at
home:
"A hill between Han-kow and Han-yang rises about six hundred feet, and affords
one of the finest views in the world, and, in some respects, one of the most
remarkable. We climbed there yesterday a little before sunset, and remained as
long as the fading daylight and the exigencies of our return permitted. At our
feet lay the Yang-tse, rolling towards the sea after its junction with the Han,
which we could trace afar, like a ribbon of silver winding through the green
plain. Away to the west was a range of mountains, lighted by the setting sun,
and overhung with golden and purple clouds; while to the south was an
undulating country, whose foreground was filled with the walled city of Wo-
chang. The crenelated walls enclose an enormous space, much of which is so
desolate that foreigners are accustomed to hunt pheasants and hares within the
limits. They say that at one time all this space was covered with buildings, and
that the buildings were crowded with occupants. The three cities suffered
terribly during the rebellion, and more than three fourths of their edifices were
levelled. Looking from the hill, it is easy to see the traces of the destruction,
although twenty years have passed since the insurrection was suppressed. The
population of the three cities was said to have been four or five millions; but,
even after making allowance for the density with which Chinese cities are
crowded, I should think those figures were too high. However, there is no doubt
that it was very great, and probably more people lived here than on any similar
area anywhere else in the world."
Han-kow is a great centre of trade. Frequently the mouth of the Han is so
crowded with junks that the river is entirely covered, and you may walk for
hours by merely stepping from one boat to another. The upper Yang-tse and the
Han bring down large quantities of tea, furs, silk, wax, and other products, both
for home use and for export. There are heavy exports of tea from Han-kow
direct to England, and every year steamers go there to load with cargoes, which
they take to London as rapidly as possible. Our friends were told that there was
a large trade in brick tea, which was prepared for the Russian market; and as
the boys were anxious to see the process of preparation, a visit to one of the
factories was arranged. Frank made a note of what he saw and wrote it out as
follows:
A STREET IN HAN-KOW.
"The dry tea is weighed out into portions for single bricks, and each portion is
wrapped in a cloth and placed over a steam-boiler. When it is thoroughly
steamed, it is poured into a mould and placed beneath a machine, which
presses it into the required shape and size. Some of the machines are worked
by hand, and others by steam. Both kinds are very rapid and efficient, and we
could not see that the steam had much advantage. Five men working a hand
machine, and receiving twenty cents each for a day's labor, were able to press
six bricks a minute, as we found by timing them with our watches. The steam
press worked only a little faster, and the cost of fuel must have been about
equal to that of human muscle.
"Only the poorest kind of tea is made into bricks, and each brick is about six
inches wide, eight inches long, and one inch thick. After it has been pressed,
it is dried in ovens; and when it is thoroughly dried and ready for packing, it is
weighed, to make sure that it is up to the required standard. All bricks that
are too light are thrown out, to be mixed up again and done over. Nearly all of
this business is in Russian hands, for the reason that this kind of tea is sold
only in Russia."
Doctor Bronson arranged that the party should visit Wo-chang and see a
famous pagoda that stood on the bank of the river. There was not a great
deal to see after they got there, as the place was not in good repair, and
contained very little in the way of statues and idols. The stairways were
narrow and dark, and the climb to the top was not accomplished without
difficulty. Afterwards they went through the principal streets, and visited the
shops, which they found much like those of Shanghai and Chin-kiang. The
people showed some curiosity in looking at the strangers—more than they
had found farther down the river—for the reason, doubtless, that fewer
foreigners go there.

WO-CHANG.
Wo-chang is the capital of the province of Hoo-peh, and the governor-general
resides there. Our friends were fortunate enough to get a glimpse of this high
official as he was carried through the streets in a sedan-chair, followed by
several members of his staff. A Chinese governor never goes out without a
numerous following, as he wishes the whole world to be impressed with a
sense of his importance; and the rank and position of an official can generally
be understood by a single glance at the number of his attendants, though the
great man himself may be so shut up in his chair that his decorations and the
button on his hat may not be visible.
In a couple of days the steamer was ready for the return to Shanghai. The
time had been well employed in visiting the streets and shops and temples of
Han-kow, and learning something of its importance as a centre of trade. The
return journey was begun with a feeling of satisfaction that they had taken
the trouble and the time for the ascent of the Yang-tsu and made themselves
acquainted with the internal life of the country.
THE GOVERNOR-GENERAL AND
HIS STAFF.
CHAPTER XXVI.
FROM SHANGHAI TO PEKIN.
On their return to Shanghai, the Doctor informed his young companions that
they would take the first steamer up the coast in the direction of Pekin.
They had only a day to wait, as the regular steamer for Tien-tsin was
advertised to leave on the afternoon following their return. She was not so
large and comfortable as the one that had carried them to Han-kow and back;
but she was far better than no steamer at all, and they did not hesitate a
moment at taking passage in her. They found that she had a Chinese crew,
with foreign officers—the same as they had found the river-boat and the
steamers from Japan. The captain was an American, who had spent twenty
years in China, and knew all the peculiarities of the navigation of its waters.
He had passed through two or three shipwrecks and been chased by pirates.
Once he was in the hands of the rebels, who led him out for execution; but
their attention was diverted by an attack on the town where they were, and
he was left to take care of himself, which you can be sure he did. Another
time he saved himself by crawling through a small window and letting himself
fall about ten feet into a river. The night was dark, and he did not know where
to go; but he thought it better to take the chance of an escape in this way, as
he felt sure he would have his head taken off the next morning if he
remained. Luckily he floated down to where a foreign ship was lying, and
managed to be taken on board. He thought he had had quite enough of that
sort of thing, and was willing to lead a quiet life for the rest of his days.
They descended the river to the sea, and then turned to the northward.
Nothing of moment occurred as the steamer moved along on her course, and
on the morning of the third day from Shanghai they were entering the mouth
of the Pei-ho River. The Doctor pointed out the famous Taku forts through the
thin mist that overhung the water, and the boys naturally asked what the Taku
forts had done to make themselves famous.
ATTACK ON THE PEI-HO FORTS.
"There is quite a history connected with them," the Doctor answered. "They
were the scene of the repulse of the British fleet in 1859, when an American
commander came to its relief, with the remark, which has become historic,
'Blood is thicker than water!' In the following year the English returned, and
had better success; they captured the forts and entered the river in spite of all
that the Chinese could do to stop them. Do you see that low bank there, in
front of a mud-wall to the left of the fort?"
"Certainly," was the reply.
"Well, that is the place where the sailors landed from the small boats for the
purpose of storming the forts, while the gun-boats were shelling them farther
up the river."
"But it looks from here as if there were a long stretch of mud," Fred
remarked.
"You are right," the Doctor responded, "there is a long stretch of mud, and it
was that mud which partly led to the failure at the time of the first attack. The
storming force was compelled to wade through it, and many of the men
perished. The fire of the Chinese was more severe than had been expected,
and the ships of the fleet were badly injured. But when the attack was made
the following year, the muddy belt was much narrower, and the sailors passed
through it very quickly, and were at the walls of the fort before the Chinese
were ready for them.
"The navigation is difficult along the Pei-ho River, and the steamers of the
attacking fleet found the passage barred by cables stretched across the
stream. They had considerable trouble to break through these obstructions,
but they finally succeeded, and the rest of the voyage to Tien-tsin was
accomplished far more easily than the capture of the forts."
As the steamer moved on against the muddy current, and turned in the very
crooked channel of the Pei-ho, Frank espied a double-storied building with a
wide veranda, and asked what it was.
He was interested to learn that it was known as the Temple of the Sea-god,
and had been at one time the residence of the Chinese commander of the
Taku forts. It had a handsome front on the river, and a fleet of junks was
moored directly above it. Each junk appeared to be staring with all the power
of the great eyes painted on its bows, and some of the junks more
distinguished than the rest were equipped with two eyes on each side, in
order that they might see better than the ordinary craft. Flags floated from
the masts of all the junks, and in nearly every instance they were attached to
little rods, and swung from the centre. A Chinese flag twists and turns in the
breeze in a manner quite unknown to a banner hung after the ways of Europe
and America.

TEMPLE OF THE SEA-GOD AT TAKU.


The river from Taku to Tien-tsin was crowded with junks and small boats, and
it was easy to see that the empire of China has a large commerce on all its
water-ways. The Grand Canal begins at Tien-tsin, and the city stands on an
angle formed by the canal and the Pei-ho River. It is not far from a mile
square, and has a wall surrounding it. Each of the four walls has a gate in the
centre, and a wide street leads from this gate to the middle of the city, where
there is a pagoda. The streets are wider than in most of the Chinese cities,
and there is less danger of being knocked down by the pole of a sedan-chair,
or of a coolie bearing a load of merchandise. In spite of its great commercial
activity, the city does not appear very prosperous. Beggars are numerous, and
wherever our friends went they were constantly importuned by men and
women, who appeared to be in the severest want.

A CHINESE BEGGAR.
The usual way of going to Pekin is by the road from Tien-tsin, while the return
journey is by boat along the river. The road is about ninety miles long, and is
one of the worst in the world, when we consider how long it has been in use.
According to Chinese history, it was built about two thousand years ago. Frank
said he could readily believe that it was at least two thousand years old, and
Fred thought it had never been repaired since it was first opened to the
public. It was paved with large stones for a good portion of the way, and
these stones have been worn into deep ruts, so that the track is anything but
agreeable for a carriage. The only wheeled vehicles in this part of China are
carts without springs, and mounted on a single axle; the body rests directly
on the axle, so that every jolt is conveyed to the person inside, and he feels
after a day's journey very much as though he had been run through a
winnowing-machine.
The Chinese cart is too short for an average-sized person to lie in at full
length, and too low to allow him to sit erect; it has a small window on each
side, so placed that it is next to impossible to look out and see what there is
along the route. Altogether it is a most uncomfortable vehicle to travel in, and
the boys thought they would go on foot rather than ride in one of them.

SIGNING THE TREATY OF TIEN-TSIN.


But it was not necessary to go on foot, as they were able to hire ponies for
the journey, and it was agreed all round that a little roughness on horseback
for a couple of days would do no harm. So they made a contract with a
Chinese, who had been recommended to them by the consul as a good man,
to carry them to Pekin. It was arranged that they should take an early start,
so as to reach a village a little more than half way by nightfall, and they
retired early in order to have a good night's sleep. They had time for a little
stroll before they went to bed, and so they employed it in visiting the "Temple
of the Oceanic Influences," where the treaty of Tien-tsin was signed after the
capture of the Taku forts and the advance of the English to the city. The
temple is on a plain outside of the walls, and contains a large hall, which was
very convenient for the important ceremonial that took place there. At the
time the treaty was signed the British officers were in full uniform, and made
a fine appearance, while the Chinese were not a whit behind them in
gorgeousness of apparel. Contrary to their usual custom, the Chinese did not
think it necessary to hang up any elaborate decorations in the hall, and the
attention of the spectators was concentrated on the dignitaries who managed
the affair.
There is another way of travelling in China, which is by means of a mule litter.
This is a sort of sedan-chair carried by mules instead of men; one mule walks
in front, and another in the rear, and the litter is supported between them on
a couple of long shafts. The pace is slow, being always at a walk, except at
the times when the mules run away and smash things generally, as happens
not unfrequently. The straps that hold the shafts to the saddles of the mules
have a way of getting loose, and leaving the box to fall to the ground with a
heavy thud, which interferes materially with the comfort of the occupant. For
invalids and ladies the mule litter is to be recommended, as well as for
persons who are fond of having the greatest amount of comfort; but our
young friends disdained anything so effeminate, and determined to make the
journey on horseback.
They took as little baggage as possible, leaving everything superfluous at
Tien-tsin; six horses were sufficient for all the wants of the party—four for
themselves and the guide, and two for the baggage. It was necessary to carry
the most of the provisions needed for the journey to Pekin, as the Chinese
hotels along the route could not be relied on with any certainty. No rain had
fallen for some time, and the way was very dusty; but this circumstance only
made it more amusing to the boys, though it was not so pleasing to the
Doctor. Before they had been an hour on the road, it was not easy to say
which was Fred and which Frank, until they had rendered themselves
recognizable by washing their faces. Water was scarce, and not particularly
good, and, besides, the operation of washing the face was an affair of much
inconvenience. So they contented themselves with the dust, and concluded
that for the present they wouldn't be particular about names or identity.
At noon they had gone twenty-five miles through a country which abounded
in villages and gardens, and had a great many fields of wheat, millet, cotton,
and other products of China; the fields were not unlike those they had seen
on their voyage up the Yang-tse; and as for the villages, they were exactly
alike, especially in the items of dirt and general repulsiveness. The modes of
performing field labor were more interesting than the villages; the most of the
fields were watered artificially, and the process of pumping water attracted
the attention of the boys. An endless chain, with floats on it, was propelled
through an inclined box by a couple of men who kept up a steady walk on a
sort of treadmill. There were spokes in a horizontal shaft, and on the ends of
the spokes there were little pieces of board, with just sufficient space for a
man's foot to rest. The men walked on these spokes, and steadied themselves
on a horizontal pole which was held between a couple of upright posts. Labor
is so cheap in China that there is no occasion for employing steam or wind
machinery; it was said that a pump coolie was able to earn from five to ten
cents a day in the season when the fields needed irrigation, and he had
nothing to do at other times.

MODE OF IRRIGATING FIELDS.


The night was passed at a village where there was a Chinese tavern, but it
was so full that the party were sent to a temple to sleep. Beds were made on
the floor, and the travellers managed to get along very well, in spite of the
fleas that supped and breakfasted on their bodies, and would have been
pleased to dine there. The boys were in a corner of the temple under the
shadow of one of the idols to whom the place belonged, while the Doctor had
his couch in front of a canopy where there was a deity that watched over him
all night with uplifted hands. Two smaller idols, one near his head and the
other at his feet, kept company with the larger one; but whether they took
turns in staying awake, the Doctor was too sleepy to inquire.

THE DOCTOR'S BEDROOM.


They were up very early in the morning, and off at daylight, somewhat to the
reluctance of the guide, who had counted on sleeping a little longer. The
scenes along the road were much like those of the day before, and they were
glad when, just at nightfall, the guide pointed to a high wall in front of them,
and pronounced the word "Pekin." They were in sight of the city.
"I'm disappointed," said Fred. "Pekin isn't what I thought it was."
"Well, what did you expect to find?" queried Frank.
"Why, I thought it was on a hill, or something of the sort; I had no reason to
think so, of course, but I had formed that picture of it."
"Nearly every one who comes to Pekin is thus disappointed," said Doctor
Bronson; "he expects to see the city from a distance, while, in reality, it is not
visible till you are quite close to it."
The walls were high, and there was nothing to be seen inside of them, as
none of the buildings in that quarter were equally lofty. But the effect of the
walls was imposing; there were towers at regular intervals, and the most of
them were two stories above the level of the surrounding structure. For nearly
a mile they rode along the base of one of the walls till they came to a gate
that led them into the principal street. Once inside, they found themselves
transferred very suddenly from the stillness of the country to the bustling life
of the great city.

PART OF THE WALL OF THE PEKIN.


"I'm not disappointed now," Fred remarked, as they rode along in the
direction indicated by the guide; "the streets are so wide in comparison with
those of the cities we have seen that they seem very grand, indeed."
"You've hit it exactly, Fred," Doctor Bronson replied, "Pekin is called the 'City
of Magnificent Distances' on account of the width of its streets, the great
extent of the city, and the long walks or rides that are necessary for going
about in it."
"Evidently they took plenty of room when they laid it out," said Frank, "for it
isn't crowded like Shanghai and the other places we have seen."
It was dark when they reached the little hotel where they were to stay. It was
kept by a German, who thought Pekin was an excellent place for a hotel, but
would be better if more strangers would visit the city. His establishment was
not large, and its facilities were not great, but they were quite sufficient for
the wants of our friends, who were too tired to be particular about trifles.
They took a hearty supper, and then went to bed to sleep away the fatigues
of their journey.
Next morning they were not very early risers, and the whole trio were weary
and sore from the effect of the ride of ninety miles on the backs of Chinese
ponies. Frank said that when he was sitting down he hesitated to rise for fear
he should break in two, and Fred asserted that it was dangerous to go from a
standing to a sitting position for the same reason.
They determined to take things easily for the first day of their stay in Pekin,
and confine their studies to the neighborhood of the hotel. With this object in

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