A group of ministers led by Rev. Carstairs Douglas visited the island for a short stay, and noticed especially the dearth of medical resources and the seriousness of disease and epidemics. They decided to send Presbyterian missionaries to Taiwan to both provide medical care and proselytize, and James Maxwell was the first.
英國長老教會的杜嘉德等牧師來台短期停留，他們看到當時台灣衛生醫療條件不佳，疫病嚴重，於是建議教會派員來台宣教。