From the time Dr. MacKay arrived in Tamsui, he offered medical treatments, western medicine, surgeries, tooth extractions and hospitalization services at his own rental residence. The general public was suffering from malaria at that time and MacKay’s quinine was very efficient and widely welcomed, which led more and more people to his clinic for treatments. Therefore, in May 1873, MacKay rented another residential building and turned it into a clinic, named “MacKay’s Clinic.” Later, he received a donation from an American woman, whose last name was also MacKay, and used this donation to build a hospital combining both eastern and western styles, with a Minnan style flat house and western arched windows. On September 14, 1879, he officially established the MacKay Clinic, which later became MacKay Hospital. It was the first western hospital in northern Taiwan. By 1894, the total number of patients reached ten thousand annually.