Modern medicine in China began with the arrival of Anglo-American Protestant missionaries in the early 19th century. Conditions were vastly different from the times of the Jesuits in Peking during the 17th and 18th centuries, when the priests enjoyed the endorsement of the Court and high officials. Faced with hostile and xenophobic officialdom and populace, surgeons of the British East India Company in collaboration with missionaries took the initiative. In 1805 Dr Alexander Pearson (1780-1874) introduced smallpox vaccination in Macao and Canton. Reverend Dr Robert Morrison (1782-1834) of the London Missionary Society with another East India Company Surgeon, Dr John Livingstone (1829) opened a dispensary for the poor in Macao in 1820. These pioneers paved the way for later Anglo-American medical missionaries who revolutionized medical practice in China.