The main bases of LMS missionary work in Central China were Shanghai (Kiangsu province, later Jiangsu) and Hankow [Hankou] (Hupeh province, later Hubei). Other stations included Wuchang [Wuhan], Hanyang, Hwangpei, Siaokan [Xiaogan], and Tsaoshih. The Central China mission was in effect divided into East China and Central China, with Shanghai and district being the focus for East China, and for a period, the mission also included work in Hunan and Szechwan [Sichuan] provinces. However, the LMS had withdrawn from these two provinces and handed over their work to other missionary societies by 1915.
The Shanghai mission, the first in Central China, was established by 1845, and staff included Walter Medhurst, William Milne and William Lockhart, together with William Muirhead who joined in 1847 and Joseph Edkins (1848). The new Chinese translation of the Bible (the 'Delegates Version') was one of the early successes of the mission, and much work was carried out on Bible translation. Despite upheaval caused by the Taiping rebellion in 1853 work continued, and particularly successful was the mission hospital established by William Lockhart. Early mission work was pre-eminently centred around preaching, and much work was carried out on the distribution of tracts and educational work. By the beginning of the 20th century, the Shanghai mission was in danger of stagnating, as resources were moved to other stations. Under the guidance of Ernest Box, the mission was reinvigorated and the Directors authorised a boy's school that was to become Medhurst College, and in 1909 a theological school was established. Medhurst College flourished, and in 1927 its first Chinese Principal was appointed. However, the College was almost completely destroyed by the Japanese bombardment of 1937.
The Hankow mission was established in 1861 by Griffith John, who was successful in evangelisation work amongst the Chinese community. In 1866 a mission hospital was established. Significant early missionaries in Hankow included Thomas Bryson, Thomas Gillison, Arthur Bonsey and Charles Sparham. The Hankow mission was particularly successful in medical missionary work; in addition to the earlier hospital, the Margaret Hospital for women was built in 1889. A small medical school was established in Hankow, and was subsequently moved to Tsinan [Jinan] in order to establish a union medical college (Tsinan Medical School, Shantung University).
In terms of educational work, a school was opened in 1898, which was reorganised in 1907 to become the Griffith John College. The School was successful, despite the disturbances in the 1920s and 1930s; in early 1927 to late 1928 it was occupied by the Chinese military authorities. Teachers at the College included Cyril Knott (previously of the Central China Teaching College at Wuchang) and Stanley Boxer. Griffith John College was partly destroyed by the Japanese in 1937. At Wuchang, Amy Foster, wife of Arnold Foster, established a girl's boarding school, which provided the foundation for the I Hsan Girl's School.
The Central China field was relatively unaffected by the Boxer Rebellion, except for violence at Tsaoshih. However, the revolution of 1911 saw a great deal of damage done to Hankow and work was disrupted in Shanghai. There was also fighting at Wuchang and Hanyang.
During the period before 1945, the Central China mission was beset by civil war, floods, and other conflicts, making sustained progress difficult.