This research paper was written in October 2021, when the second year of the COVID-19 pandemic was drawing to a close. It was the concluding assignment of the course “A Cultural History of Pandemics” which I attended as part of the Liberal Arts and Sciences degree at Leiden University College The Hague.

While we were still experiencing first hand the societal disruptions and individual loss caused by a pandemic, we took time in class to study and reflect on the many ways that culture and social discourse have been, and still are, affected by infectious disease. Whether it be the 1918 Influenza, smallpox, tuberculosis, or HIV/AIDS - there are always stories being told and retold about the how, what, and why of a pandemic. These stories are products of the respective cultural and historic context and, in turn, shape contemporary and current perceptions of people, places, and circumstances.

The cultural histories of pandemics are preserved in newspaper articles, photographs, reports, paintings, novels, poems, or objects. These historical documents enable us to study the cultural representations of pandemics and the stories told about them. This is what the following essay sets out to do for one particular outbreak of pneumonic plague. It was part of the third plague pandemic which lasted from 1855 until the 1950s and caused the death of more than 20 million people.1

Cultural narratives of pandemics shape ideas about places, people, and past events. At the same time, they reflect a culture’s perception of the context and origins of an outbreak. The plague epidemic in Manchuria from 1910 to 1911 provides an excellent opportunity to investigate how such narratives can be created. Chinese rule over the region was challenged by expansionist ambitions of Russia and Japan, meaning that Chinese authorities needed to appear capable of handling the outbreak.2

A key moment for this was the International Plague Conference in Mukden in April 1911, right after the epidemic had subsided.3 At the conference, the chairman Dr. Wu Lien-teh presented the delegates with a photo album documenting the work of the Chinese plague prevention service in the city Fuchiatien. In the context of how cultural narratives of pandemics are created, this “small souvenir” is of great interest.4 Essentially, the album was used as a tool to support and spread the Chinese narrative of the Machurian plague and to ensure that the international perception of the epidemic aligned with Chinese interests right from the start.

Already in 1967, Carl F. Nathan analysed government reports and correspondences from during the epidemic and concluded that the Manchurian plague was as much a political as it was a public health crisis.5 While focussing on the Russian perspective, Mark Gamsa agrees that Chinese authorities were well aware of the political stakes attached to handling the outbreak capably.6 Likewise, the authors Lei, Summers, and Peng view the demonstration of Chinese competence as essential to the prevention of expansionist aspirations by Russia and Japan.7 However, the epidemic had domestic impacts as well. Like Nathan, Cornelia Knab describes the administrative practices and reforms during and after the outbreak as the onset of medical modernity in China.8 As main reason for this “historical defeat of Chinese medicine”, Sean Hsiang-lin Lei presents political considerations of the Qing government.9 Although neither traditional nor Western medicine could cure a patient, Western medicine offered diagnosis, quarantine, and disinfection as tools for limiting the transmission of plague which was essential to defend Chinese sovereignty.10 This is in line with the multi-layered relation between nationalist considerations and the acceptance of Western medicine described by Jia Peng. Influenced by colonial and imperialist perceptions, a narrative emerged that framed the acceptance of modern medical practice as proof of patriotism.11

Interestingly, the narrative first introduced by Wu is still reproduced in academic literature. Gamsa and Knab criticize the lack of a more critical stance on which voices shaped the dominant narratives on the cause and implications of the outbreak.12 They ascribe the persistence of Wu’s narrative to its neat alignment with compelling “narratives of national progress” and the “fruits of scientific discovery.” 13 Another perspective is offered by the anthropologist Christos Lynteris, who zooms in on how narratives of the Manchurian plague were created. According to Lynteris, Wu combined the Russian theory of the Siberian marmot as plague reservoir with blaming greedy and ignorant marmot-hunting migrants and their unhygienic living conditions as cause of the outbreak.14 This narrative was readily accepted and repeated both within China and abroad since it met existing stereotypes and “longestablished colonial ideas about the relationship between race, class, space, and disease.”15 Although Lynteris mentions the photo album presented by Wu, his research is of a broader scope and does not include a detailed analysis of its role as a tool for disseminating the Chinese narrative.16 The present paper is a first contribution to filling this gap.

To understand the function of the album, a brief introduction to the peculiar biological aspects, the socio-political context and the dominant Chinese narrative of the Manchurian plague epidemic is necessary. As part of the third pandemic of bubonic plague, the Manchurian plague took place right at the onset of medical modernity. The invention of the microscope had enabled the discovery of the plague bacterium in 1894 and the rats-and-fleas model of transmission had recently been established.17 Plague was perceived as endemic in Manchuria, using the Siberian marmot instead of rats as animal reservoir.18 There were occasional cases among humans, but the disease usually failed to spread in the sparsely populated land.19 However, recent economic development had resulted in an extensive railway system and a large population of migrant workers employed in agriculture, construction, and the fur trade.20 Most of them had travelled to the region alone, seeking for work to sustain their families at home, and lived in cheap, densely populated living quarters.21

The origins of the epidemic can be traced back to first cases in the railway town Manzhouli in October 1910.22 Along the railway lines, plague spread rapidly to the regional cities where it concentrated among the poor.23 It differed from earlier epidemics of bubonic plague by spreading exclusively in the highly transmissible pneumonic form, with a mortality rate of 100%.24 Without available treatment, the epidemic resulted in 60,000 deaths before it subsided in March 1911.25 The helplessness of the authorities was especially problematic since the geopolitical struggle in Manchuria between China, Russia, and Japan inextricably linked plague control efforts to questions of Chinese sovereignty and prestige.26 The International Plague Conference in April 1911 provided an excellent opportunity to demonstrate the capability of the Chinese plague prevention service. In his inaugural address as chairman of the conference, Dr. Wu Lien-teh lay the cornerstone for the Chinese narrative of the outbreak.27 Emphasis was put on the Chinese success in containing the outbreak, due to a joint effort and the rigorous application of modern hygienic practices.28 Furthermore, the greedy and irresponsible hunting-practices of the migrant workers and their unhygienic, crowded living conditions were singled out as cause of the plague epidemic.

The scapegoating of migrant hunters for causing and driving the plague epidemic through careless behaviour and lack of hygiene is reflected in the album by characterizing the migrant quarter of Fuchiatien as a place of disease and death. Despite declaring the pneumonic nature of the Manchurian plague in his inaugural address, Wu’s album emphasises the spatial configuration of the town and “the low, dark, dirty and over-crowded houses.”29 The first four photographs all show rows of low houses and unpaved streets, before zooming in on “[a] crowded alley”. (see Figure 2)

The picture is dark, wooden beams and pipes run across, creating an untidy and confusing look. There is no pavement; the houses are built directly into the “swampy plain” underneath Fuchiatien.30 The same motif is repeated in a photograph titled “Types of dirty houses”. (see Figure 3)

A pile of dirt in the foreground dominates the scene and, at a first glance, seems rise almost as high as the roof of the building. Tools are carelessly lying around, the windows are shut, and only one chimney is visible in the far back, suggesting a dark and unventilated interior. In his address, Wu makes clear that these dirty houses and “narrow streets [are] inhabited principally by coolies”, the migrant workers.31 Thus, these pictures add to the repeated reference to the migrant population as inherently dirty, unhygienic vehicles of plague.32 Viewing polluted space as breeding ground for plague would have been intuitive for the gathered scientists. Shortly before, the “theory of true recrudescence” which stated that plague could lie latent and re-emerge from soil, had legitimized the burning of whole quarters in Hong Kong.33 Such radical disinfection measures were applied in Fuchiatien as well.34

Singling out the migrant hunters as culprits served a second purpose: It allowed the presentation of the plague prevention service as an “hygienic model army”, unified in the fight against plague and its helpers.35 Several photographs show staff from various occupational and social groups lined up together in close formation. In “Staff of Section I”, medical personnel wearing masks and white laboratory-coats lines up with assistant staff in overalls (Figure 4).

They are joined by several men in dark coats and uniforms on the far left and on a balcony above, likely representatives of the military which was responsible for closing off the city.36 Another staff photograph shows closed ranks of gleaming, white-clad figures – a “spectacle of masked unity” (Figure 5).37

Again, the medical staff is backed up by the “coolies” (migrant workers) who helped with isolation, disinfection measures, and burials.38 Unity is further demonstrated by showing medical staff in suits and uniform side by side with “lay staff” (likely civil servants) in traditional clothing (Figure 6).

The set-up seems deliberate with the two groups neither fully separated nor randomly mixed, but separated into two standing blocks, lining up behind the seated representatives of the other group respectively. There is special reference to the Taotai, the highest-ranking civil officer and military commander in the region. These pictures demonstrate unity among the different Chinese authorities and the imperial government’s central role in the plague prevention efforts. However, they gloss over existing differences and disputes between these groups. There was much distrust among the local population regarding the foreign-trained doctors. Especially since some, like Wu, were not fluent in Mandarin and they cooperated closely with Russian doctors.39 There are also reports of corruption and of medical staff refusing to cooperate.40

Regardless of such difficulties, the album presents the fight against plague as a Chinese success story. It shows the full range of comprehensive plague control efforts: Laboratory experiments and microscopic diagnosis, outbreak statistics, disinfection, ambulances, and strict quarantine measures all feature in the album. Special emphasis is put on the cremation of plague victims – 6 of the 61 photographs are dedicated to it. The album shows neat piles of coffins (Figure 7), a group of firemen pouring kerosene into the pits, and a separate cremation site for the Catholic community.

All of this suggests a competent handling of the many deaths, carried out with as much organization and consideration as all other plague prevention efforts. A stark contrast is provided by another photograph of the cremation pits, which is part of Wu’s documentation of the outbreak but not of the album (Figure 8).

Here, the coffins look like they have been dumped hastily. Several lids have come off, giving an eerie sight of the rigid arms and legs of the corpses inside. The ground has been trampled and there are heaps of dirt (or ash) in the background. The impression is much untidier and disorganized, running counter to the supposed “ease and simplicity” of the cremation efforts.41 Moreover, Wu claims that “once decided upon by the Government, [cremation] was accepted by the people without complaint or hindrance.”42 This is hard to believe, especially since cremation conflicts with traditional Confucian burial rites and most of the migrants came from Shandong province, “where Confucian rituals have been practiced longest and are most richly developed.”43 Indeed, there are reports about families hiding bodies, secret burials, and frozen corpses were still found in the streets of Harbin in July 1911.44

To conclude, the photo album presented at the International Plague Conference in Mukden served as an illustration of the narrative presented in Wu’s inaugural address. Fuchiatien is shown as a dirty breeding ground of plague, adding credibility to the story of migrant hunters as culprits. The degenerative state of the town is contrasted with the unity and success of the Chinese plague prevention efforts. This story supported Chinese rule over Manchuria and challenged the image of China as backward hotspot of disease.45 It should be noted that the cause of this exceptional epidemic of pneumonic plague and the exact role of the Siberian marmot remain unclear.46 However, it is reasonable to assume that the modernization of Manchuria created the conditions that resulted in the rapid spread and large scale of the outbreak. The construction of railway lines, economic development, and the need for cheap labour had encouraged migration in the first place.47 At the same time, modern medicine was seen as key to fighting the Manchurian plague. Thus, by blaming the backwardness of migrant hunters, Chinese authorities also conveniently circumvented uncomfortable truths of social inequality and the price of progress.

Review

This article was reviewed by the NOS-Editor Steffen Schwerdtfeger from Section 1 Medical Humanities. The author Karolina Kneller has later also become an Editor at NOS.

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