Chinese Sovereignty and the
Manchurian Plague
Introduction
Sovereignty is one of the defining attributes of any country. A country with sovereignty will be respected and recognized as such internationally; likewise, because of the importance of national sovereignty, one might assume that sovereignty disputes can only impact a country negatively. However, in 1910, an outbreak of pneumonic plague in Manchuria would have an unforeseeable impact on one of the most well-known disputes at the time, playing out between Russia, Japan and China. In the midst of these challenges to its sovereignty, China was pushed to prioritize fighting the outbreak, and indeed this convergence of disaster proved vital for the development of public health in modern China as well as the strengthening of its sovereignty.
To understand how an outbreak of the plague could afford opportunity, we must consider how the outbreak complicated an already tense diplomatic situation in Manchuria. In the process, we will focus in particular on the key role played by Wu Lien-Teh in the fight against the plague, revealing how the epidemic presented a challenge to public health that, when met successfully, would strengthen China’s sovereignty.
On October 25, 1910, Russian of officials working along the Chinese Eastern Railway discovered that two Chinese workers in Manchouli had fallen ill with symptoms of pneumonia. The next day, on October 26, nine more victims were found dead from the same disease. An autopsy later revealed the unexpected presence of Yersinia pestis , the bacteria well known as the pathogen responsible for bubonic plague. It became clear that they were dealing with a major health crisis arising from an unfamiliar form of the plague. 1 Crucially, all of the early victims of this outbreak were Chinese hunters hired to support the booming trade in tarbagan fur that had been growing along the railway. Tarbagans, a kind of large marmot, were found in large numbers in eastern Mongolia, where they were hunted to fuel the growing European market for their fur. The rapidly rising price of tarbagan fur prompted Russian and Chinese businessmen to hire large numbers of Chinese peasants to hunt the animals. They did not yet know that these tarbagan populations harbored the plague bacteria, and indeed it was this increased trade in their fur that sparked the Manchurian outbreak. 2
From these first fatal cases, the disease spread rapidly along the Chinese Eastern Railway to engulf the entire northeast of China by mid-December. The Manchurian plague would ultimately last more than six months and spread across half of China, killing more than 60,000 people. However, it did not take long for the threat of this disease to be recognized, and indeed it soon garnered global attention. By late December 1910, Russia proposed to send doctors to control the situation in Fujiadian, the Chinese area of Harbin. Russia’s response echoed widespread doubts that China had the capability to control the outbreak independently. However, the Chinese government also moved to appoint their own experts, many of whom proved instrumental in fighting the disease. 3
It was also December when the Qing government sent the physician Wu Lien-Teh to northeast China to bring the situation under control. There, Wu performed the crucial autopsy through which he discovered the presence of the bacteria in the tissues of one of the disease's victims. Scientists first identified Y. pestis as the pathogen responsible for the plague in 1894, but they were looking more specifically at the plague’s characteristic bubonic variety, in which the bacteria cause swelling in the lymph nodes in the neck, armpits, and groin. These swollen lymph nodes are the buboes for which the bubonic plague is named. However, the victims of the disease in Manchuria died with symptoms of pneumonia. From the autopsy he performed, Wu concluded that they were dealing with a pneumonic form of the plague. This meant the plague was spreading through respiratory droplets in the air, not simply through vectors like rats or fleas as the bubonic
plague was understood to spread.
In response to this discovery, Wu quickly established resolute measures to control the spread of the disease, including traffic control, isolation of epidemic areas and establishment of isolation hospitals. In a desperate and controversial move, Wu even obtained special permission from the Emperor to cremate more than 2,200 bodies of patients who could not be buried in the frozen ground. He also made a pioneering call for the wearing of masks to reduce exposure to airborne pathogens. Wu’s measures paid off, and the outbreak was quelled by April of 1911. 5
China’s success in controlling the epidemic played an important role in strengthening China’s position following the Russo-Japanese War in 1905. When the epidemic began in 1910, northeast China was nominally part of China, but in reality Japan and Russia had divided influence over South and North Manchuria between them. Both countries had established their presence along the Chinese Eastern Railway, not only stationing a large number of troops but also setting up municipal management organizations, which took over local police, judicial systems, and health supervision that were originally under the jurisdiction of China. After the pneumonic plague emerged and began spreading at a terrifying rate, Russia and Japan acted quickly to control the epidemic – but this was not simply performed in the interest of public health. Russia and Japan seized the opportunity to intervene in local measures of disease control and prevention that would normally belong to Chinese internal affairs.6 The Manchurian plague would prove to be not only a challenge to public health, but also an opportunity for China to address these challenges to its sovereignty.
6
Sovereignty Disputes and Public Health in China
The Invaluable Work of
Wu Lien-Teh
Many individuals were key to the fight against the plague in Manchuria, including of course Wu Lien-Teh. Wu acted decisively and sometimes controversially to ensure the epidemic would be stopped, in the process serving to strengthen Chinese sovereignty.
Before he joined the fight against the plague, Wu Lien-Teh already had been making significant contributions to medicine in China. He was the first Chinese student to receive a medical doctorate from the University of Cambridge, after which he conducted research in Europe. In 1907, he was invited to serve as deputy superintendent (vice President) of Tianjin Military Medical School, the predecessor of today's National Defense Medical Center (NDMC). 21 At the time, the students were taught by Japanese teachers, who limited their education to ordinary nursing. This was clearly a preparation for future aggression. When Wu discovered this, he instated a series of measures that enabled the school to move swiftly out of Japan's shadow. Under Wu’s direction, the school began to train truly qualified military doctors for China, and the students' skills were greatly improved.
Thus before the outbreak of the plague, Wu Lien-Teh was already committed to protecting the sovereignty of the country. Wu’s reform of the Tianjin Military Medical School undermined Japanese machinations to curtail medical expertise in China, allowing him to ensure a higher quality of medical education in China.
of medical education in China.
We have already seen how the outbreak in 1910 presented opportunities for both China and foreign powers in Manchuria. As the outbreak spread, both Japan and Russia moved to claim greater control over the northeastern provinces, believing that the Qing government was incapable of quelling the epidemic.22 It was in response to this threat that the government dispatched Wu to control the situation. His findings and innovations were crucial to fighting the plague, and this success helped to protect Chinese sovereignty. 23
In fact, Wu developed many modern control solutions still in use today. He required patients to be quarantined in specialized plague hospitals, and all contacts were quarantined. Six hundred policemen were assigned to patrol day and night to prevent evasion of inspection. The deployment of an additional 1,600 infantry stationed outside the city day and night ensured that quarantine measures and traffic restrictions were properly observed. We have also mentioned his controversial decision to cremate bodies of plague victims in the winter of 1910-1911, when the frozen ground made it impossible to bury them. At that time, burial was considered the only proper treatment for the dead, however, given the drastic situation, the Qing government approved Wu's proposal.
His findings were also crucial in changing how physicians treated patients. After learning that the plague bacteria was infecting the lungs, Wu established measures to protect against airborne pathogens. Everyone was required to wear thick masks (later called the Wu-reformed surgical mask) initially designed by Wu himself. This mask consisted of two pieces of gauze held together by absorbent cotton . The mask was both highly effective and cheap to produce. However, Wu’s theory of pneumonic plague was at first resisted by many physicians, who were reluctant to take on his novel suggestions. This changed when Dr. Mesny, a French-born physician who joined the efforts in Harbin, was infected and died of the plague. Against Wu's advice, Mesny continued to work according to his old experience with the bubonic plague and examined four patients, unprotected.24 Mesny’s death served to bolster
confidence in Wu’s expertise, prompting the widespread adoption of his methods in the fight to control the epidemic. These measures were crucial to the swift resolution of the outbreak.
Wu’s contributions to modernizing Chinese medicine likewise contributed to the fight for China's sovereignty. When Wu’s efforts in Manchuria quickly earned him an international reputation, this also bolstered the reputation of China. This was proven at the International Plague Conference, which was hosted in Mukden. Japan sent a large delegation, including Kitasato Shibasabu (北里柴三郎), 25 a famous Japanese physician, bacteriologist and immunologist, whom they attempted to instate as president of the conference in place of Wu. However, by then Wu had already firmly established his reputation internationally, due in part to his appearance in a number of European
and American newspapers, such as The Times, that emphasized his role in fighting the Manchurian plague. As a result, the remaining delegates at the conference supported Wu as president of the conference, enhancing China's standing in the scientific community as well as, indirectly, its political influence.
The Influence of Manchurian Plague on China’s Sovereignty
Under the threat of foreign powers, the Qing government was pressured to act in order to protect Chinese sovereignty. Their response to the Manchurian plague, and in particular the work of Wu Lien-Teh, would help to secure China’s position in Manchuria. However, the actions of the Qing government in controlling the epidemic often caused social discontent and even inspired resistance. Russia and Japan’s joint occupation of northeast China began in 1895, when China was defeated by Japan in the Jia Wu naval battle and Japanese forces poured into the northeast. Shortly afterwards, in 1896, Li Hongzhang signed the Sino-Russian Secret Treaty with Russia, which allowed Russia to build and manage the Chinese Eastern Railway across Chinese territory in Manchuria. 26 We have seen how the plague presented opportunities for these foreign powers to expand their territory in China, which China met with its decisive response to the epidemic. After the plague, China won the sovereignty of Manchuria, commanding the attention of the international community. With this in mind, it seems obvious that China’s sovereignty in Manchuria was in many ways enabled by the
plague.
After the Russo-Japanese War in 1905.27 the governing powers of the Qing dynasty were heavily curtailed by Western powers. Without the necessary military strength, China could not reclaim Manchuria by force. Meanwhile, Japan and Russia’s early response to the Manchurian plague involved considerably increased military presence in their Manchurian territories. Under the threat of Japan and Russia, the Qing government was urged to take action or else lose Manchuria entirely to foreign powers.
In response to the increased presence of Russian and Japanese forces, the Qing government sent troops to Manchuria to guard against further intervention from Russia and Japan. 28 However, in these circumstances, the Manchurian Plague also offered China a moment of opportunity. Effectively controlling an outbreak required drawing on state resources, using police and even the military to block traffic and carry out large-scale disinfection. If the Qing government could succeed in taking charge of the epidemic in Manchuria, China would be able to prove its ability to govern the region independently.
While China was not as quick to respond to the outbreak, the Qing government eventually took decisive action and allocated hundreds of thousands of special funds to the control and quarantine of the plague. Chinese authorities saw the need to demonstrate to foreign powers that they were dedicated to strictly – and independently – enforcing measures aimed at disease control and prevention.
This involved supporting Wu and others engaged in researching and fighting the plague, as well as
supporting Wu’s suggestions, even when they were controversial. For example, the autopsy in which Wu discovered the presence Y. pestis was performed in spite of the practice being forbidden. The Qing government nevertheless permitted surgical teams in Manchuria to perform autopsies in order to shed light on the cause of the epidemic.29
Wu’s many proposals for containing the epidemic, including isolating patients in hospitals, quarantining contacts, mobilizing the army to quarantine cities and block traffic, and burning the bodies of plague victims, were taken on board and successfully implemented to control the epidemic.
The Qing government’s speed in controlling the Manchurian plague prompted Western powers to reappraise China. According to Hu (2008), the capacity to independently carry out quarantine measures and epidemic prevention under local jurisdiction is an embodiment of national sovereignty in the modern world.30 In many ways, the plague provided China with this opportunity to demonstrate what its government could accomplish independently.
China would ultimately control the epidemic and enforce its sovereignty, but this came at the cost of internal political stability. The diplomatic tension between China and foreign powers prompted the Qing government to extend China’s state power downward to local government. However, as an old system of organization that had not yet undergone modern reform, local government lacked corresponding power constraints and mechanisms for supervision.
When measures to control the epidemic were enforced, the actions of local government often proved devastating to those living in Manchuria. For example, some quarantine teams simply arrested vulnerable people, such as beggars and those forced to live on the streets, and took them to designated shelters without examining their health. In Yingkou, the epidemic prevention administration set up three shelters for the poor in order to stop the spread of the plague, but in some places, such as Fentian and Liaoyang, the poor were forcibly deported. In Changchun, women were moved to a designated area in the countryside on the grounds that they were more susceptible to the disease. There, women were forced into isolation and regular disinfection. In addition, because the majority of quarantine staff were temporarily transferred and recruited police, soldiers and civilians, it was inevitable that some would abuse their power or neglect their responsibilities.
The decisive actions taken by the Qing government may have blocked the spread of the plague to some extent, but patients suffered considerably, which spurred resistance and even violent conflict between the general public and the government. Many blocked their villages and organized epidemic prevention and quarantine on their own, in defiance of the government's forcible intervention.
Overall, the Manchurian Plague provided opportunities for China to improve its standing in the international community and promote its sovereignty. In its efforts to control the epidemic, the Qing government often neglected the conditions under which measures were enforced. At the cost of this internal stability, China was successful in controlling the epidemic and ultimately in gaining sovereignty in Manchuria.
Conclusion
The Manchurian Plague of 1910 was a devastating epidemic, claiming tens of thousands of lives in just over half a year. It also catalyzed significant and far-reaching transformation in China. When Russia and Japan, already in control of vast territory in Manchuria, acted to expand their power over the region during the outbreak, China was pushed to fully commit itself to independently controlling the epidemic. Under the support of the Qing government, Wu Lien-Teh and others made substantial contributions to medicine and worked to establish modern public health measures in China that would ensure their ability to quickly put an end to the epidemic. In this way, the threat to national sovereignty presented by Russia and Japan shaped the Qing government’s response to the epidemic, ultimately providing China with an opportunity to strengthen its sovereignty and, in the process, forever transform public health in China.
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Image credits
Cover Page
The view of Mukden Station. Taken from commons.wikimedia.org. Public Domain.
Introduction
Russo-Japanese War: members of the Japanese Red Cross carrying wounded Russian soldiers on stretchers; Red Cross tents in the distance, 1904. Taken from Wellcome Collection no. 565574i. Licensed under CC BY 4.0. Modified by author.s
People dying, as a result of the plague. Albert Lloyd Tarter © 1940-1949?. Taken from Wellcome Collection no. 10482i. Licensed under CC BY 4.0. Modified by authors.
Improvised ambulances used in 1911 Pneumonic plague epidemic. K. Chimin Wong and Wu Lien-Teh, 1910. Public Domain. Taken from Wellcome Collection. Licensed under CC BY 4.0. Modified by authors.
Early and Advanced Pneumonic Plague patients. K. Chimin Wong and Wu Lien-Teh, 1910. Public Domain. Taken from Wellcome Collection. Licensed under CC BY 4.0. Modified by authors.
Doctors' protective costume for pneumonic plague. Wellcome Collection M0001260. Licensed under CC BY 4.0.
A man dying from the plague in Manchuria. Albert Lloyd Tarter, 1940-1949?. Wellcome Collection no. 10473i. Licensed under CC BY 4.0. Modified by authors.
People deserting their homes, in Manchuria, as a result of being invaded by the Japanese and the arrival of plague. Albert Lloyd Tarter, 1940-1949?. Wellcome Collection no. 10468i. Licensed under CC BY 4.0. Modified by authors.
Sovereignty Disputes and Public Health in China
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Four medical workers and soldiers in front of the sanitation centre. In Wu Lien-Teh, Views of Harbin (Fuchiatien): Taken during the Plague
Epidemic, Chinese Plague Commission Royal College of Physicians of London (Commercial Press, Ltd, Shanghai, 1910-1911). Taken from Wellcome Library. Public domain.
Four medical workers and soldiers in front of the sanitation centre. In Wu Lien-Teh, Views of Harbin (Fuchiatien): Taken during the Plague Epidemic, Chinese Plague Commission Royal College of Physicians of London (Commercial Press, Ltd, Shanghai, 1910-1911). Taken from Wellcome Library. Public domain.
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Portrait Photograph of Wu Lien-teh. Library of Congress, George Grantham Bain Collection. Public Domain.
Three people in front of a hospital. In Wu Lien-Teh, Views of Harbin (Fuchiatien): Taken during the Plague Epidemic, Chinese Plague
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The Invaluable Work of Wu Lien-Teh
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Wu Lien-teh in a Harbin Lab. Unknown author, 1911. The University of Hong Kong Libraries. Reproduced from "Photographs of the Third Plague Pandemic," The Centre for Research in the Arts, Humanities and Social Sciences (CRASSH) of the University of Cambridge (2013-2018). Reproduced by permission of The University of Hong Kong Libraries.
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Wearing anti-plague masks, front and side views. The University of Hong Kong Libraries. Modified by authors. Reproduced from "Photographs of the Third Plague Pandemic," The Centre for Research in the Arts, Humanities and Social Sciences (CRASSH) of the University of Cambridge (2013-2018). Reproduced by permission of The University of Hong Kong Libraries.
Portrait of Kitasato Shibasaburo (北里柴三郎, 1853 – 1931). Taken from Wikimedia Commons. Public domain.
The Influence of Manchurian Plague on China’s Sovereignty
Changchun's historical photo location ---- Zhu Town (Zhujiang Road) viewed from Xinjingnan Square. Wanghongliu © 2014. Taken from commons.wikimedia.org. Public domain.
Changchun Historical Photo Location-Yoshino Town (Changjiang Road). Wanghongliu © 2014. Taken from commons.wikimedia.org. Public domain.
Japanese soldiers mutilating bodies at Port Arthur during Sino-Japanese War in 1894. J. C. Fireman (illustrator) and Trumbull White (book author), 1895. Taken from commons.wikimedia.org. Public Domain.
South Manchurian Railway headquarters. Image taken from commons.wikimedia.org. Public domain.
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Russian and Chinese Staff guarding Bridge between Railway Zone and Fuchiatien. In Wu Lien-Teh, Views of Harbin (Fuchiatien): Taken during the Plague Epidemic, Chinese Plague Commission Royal College of Physicians of London (Commercial Press, Ltd, Shanghai, 1910-1911).Taken from Wellcome Library. Public domain.
The conflict on the Manchurian Chinese Eastern Railway, 1929. Taken from commons.wikimedia.org. Public domain.
Manchurian Plague of 1910-1911. Taken from Flickr and reproduced under a Creative Commons license CC BY 2.0.
Old Harbin Station. Taken from commons.wikimedia.org. Public domain.
Staff of Quarantine Wagons. In Wu Lien-Teh, Views of Harbin (Fuchiatien): Taken during the Plague Epidemic, Chinese Plague Commission
Royal College of Physicians of London (Commercial Press, Ltd, Shanghai, 1910-1911). Taken from Wellcome Library. Public domain.
A woman’s quarantine wagon. In Wu Lien-Teh, Views of Harbin (Fuchiatien): Taken during the Plague Epidemic, Chinese Plague Commission
Royal College of Physicians of London (Commercial Press, Ltd, Shanghai, 1910-1911). Taken from Wellcome Library. Public domain.
Types of dirty houses. In Wu Lien-Teh, Views of Harbin (Fuchiatien): Taken during the Plague Epidemic, Chinese Plague Commission Royal
College of Physicians of London (Commercial Press, Ltd, Shanghai, 1910-1911). Taken from Wellcome Library. Public domain.
Some inmates of the Refuge for Homeless after quarantine. In Wu Lien-Teh, Views of Harbin (Fuchiatien): Taken during the Plague Epidemic, Chinese Plague Commission Royal College of Physicians of London (Commercial Press, Ltd, Shanghai, 1910-1911). Public domain.