William C. Summers—

Historical discourse on the development of non-Western countries is overwhelmingly framed in terms of colonialism and its aftermath. This is especially true in the case of medicine and public health. The role and conception of health and sickness have been invoked as central to both modernization and nationhood. Mark Harrison, in his sweeping account of disease and the modern world, asserts, “I aim to show that disease was central to the development of modern states and their machinery of government.” Other scholars, too, have emphasized the importance of medicine and public health in the colonial enterprise, as well as a means to understand history more generally. Zinsser and McNeill put disease front and center as an important historical cause (an “actor,” in modern jargon). Yet in the case of China, and Manchuria in particular, this framework is more complex. China, while subject to repeated assaults from the Great Powers, including Japan, was not truly colonized, and except for some specific instances was at least nominally sovereign over its territory.

The responses to the plague in Manchuria represented not so much an evolution of colonial practices or a postcolonial hybrid of one sort or another, but rather a varied mixture of colonial policies, local practices, and ad hoc efforts. Coming at a time when the failing Qing government was faced with rebellion in the south and in Shanghai, challenges on the international stage, and traditionally weak central control of the provinces, the emergency of the plague in Manchuria seemed to result in an abrogation of responsibility, leaving it to the various local groups that might rise to the occasion. As Judith Farquhar has noted: “Wherever medical work has emerged as a genre of practice, it is often messy and smelly and most of the time very mundane.” Such a statement could well characterize the hodgepodge efforts to deal with the great Manchurian plague.

The Manchurian context varied from place to place depending on the local mix of foreign and Chinese influence. In Russian Harbin, the quasi-military approach to quarantine was dominant. In Japanese Dairen, the softer, yet just as insistent, velvet glove diplomacy of the public health expert Gotō Shinpei was tempered by the harder military authority of the Kwantung Army. In between, in Mukden, we see a more Chinese approach, yet undoubtedly Western in its motivation. As Ruth Rogaski has argued, public health in China was imbued with the entire project of modernization and the agenda of the late Qing reformers. She traces the concept and term weisheng from its traditional meaning of self-cultivation to a much broader concept of sovereignty, identity, and responsibility for the national welfare, captured in her term “hygienic modernity.” As several observers have suggested, the legacy of the responses to the Manchurian plague would shape the development of both the notion of public health as well as the recognition of Western medicine as state medicine in China.

In contrast to the interplay of the colonial power with the subsequent postcolonial government as Anderson has described in the Philippines, where the American public health model was adopted and then adapted by the Filipinos, in China, a more eclectic development occurred. To be sure, it was infused with Western concepts and practices, but as Rogaski has suggested, the mediating role of the Japanese as an already Westernized yet Asian nation made such transitions more immediately acceptable. The rhetoric of postcolonial studies often employs the concepts of resistance and acceptance, yet again these notions may not apply so simply to Manchuria. In Harbin, major resistance seems to have come not from the local Chinese and Korean inhabitants but from the non-Russian Westerners, the businessmen and foreign diplomatic community, fearful of precedents set by the Russian administrators that under other circumstances would have been viewed as reasonable, but instead were seen as preludes to even tighter Russian hegemony.

The Japanese preparedness in the Leased Territories of the southern Liaotung peninsula was both massive and, probably, effective in channeling the plague to the southwest and away from Dairen. The resistance of the Chinese in the Leased Territories seems to be minimal, probably the result of the careful colonizing policies of Japan, aimed at ingratiating the Japanese rule over the local population. These policies were, of course, followed repeatedly as Japan styled itself as the “white Asian” nation in its vision as the leader of a Greater East Asia Co-Prosperity Sphere.

The post-Qing development of Westernized institutions aimed at epidemic diseases in North China, in particular plague and cholera, would contribute to the ongoing changes in both medicine and public health. The prestige accorded China on the international front from having handled the challenges of the Manchurian plague and the postplague conference in Mukden would further its “hygienic modernity” as well as its self-confidence as a nation capable of modern science. The embrace of scientism and of “Mr. Science” as a national icon in the 1920s was certainly helped by this early success.

By the summer of 1911 the plague was past, the Qing dynasty was no more, and Russian ambitions in Manchuria were becoming increasingly unrealistic. But Manchuria was still a land in turmoil. As a Chinese borderland, it was still not fully integrated into Chinese national consciousness, not secure from foreign designs, and not able to chart its own course with confidence. The Great Plague had been a challenge, a disruption, and one of those unforeseen contingencies that constrain and channel the course of human events. For China, it was one of many stresses that contributed to the rapidity of the final days of the Qing; for its neighbors, it was an opportunity to be exploited as best they could for their own geopolitical goals.

From The Great Manchurian Plague of 1910–1911 by William C. Summers. Published by Yale University Press in 2012. Reproduced with permission.

William C. Summers is professor emeritus of therapeutic radiology, molecular biophysics and biochemistry, and history of medicine at Yale University.

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