Wu Lien-Teh and the Manchurian Plague

Wu Lien-Teh was a doctor who’s most well known for his public health work and the pneumonic plague epidemic in the early 20th century.

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Episode Transcript

Speaker 1 (00:01):
Welcome to Stuff You Missed in History Class, a production
of I Heart Radio. Hello, and welcome to the podcast.
I'm Tracy V. Wilson and I'm Holly Fry. Today's subject
is Rulanda, who I first heard about on two other podcasts,

(00:22):
which were saw Bones and Invisible. Both of those shows
talked about him in episodes they did on medical masks
that came out earlier on in the COVID nineteen pandemic.
We're gonna touch on the medical mask also, but this
episode is really more about who's public health work and
the neumonic plague epidemic that he is most known for today.

(00:45):
And just a little note about names before we start.
Wulianda is a romanization of the doctor's name in Mandarin,
and that's what he used during most of his career.
Like if you look at things that were published during
his lifetime, that's usually the byline that's on there in
English language publications, but you will also sometimes see romanizations
that came from Cantonese. And when he was first enrolled

(01:08):
in a British school as a child and what's now Malaysia,
a clerk for some reason recorded his name in sort
of a weird hybrid of Cantonese and Hokeyn romanizations uh
and in medical school and then the first part of
his career as a doctor, he usually went by G. L. Tuck,
which came from that weird hybrid romanization. So just for consistency,

(01:31):
we will use the name Wu Lianda for the whole episode. Also,
pretty much every place we are going to mention in
today's episode was part of a different country or known
by a different name, or romanized differently at the time.
We're going to clarify those things as much as we can.
And then when it's a matter of just like the
same name but a different romanization, we're just going to

(01:53):
try stick to the current one. Hopefully I caught all
of those. It was really a lot we Banda was
born in Penang, Malaya, on March tenth, eighteen seventy nine.
His father was a Cantonese goldsmith who had immigrated to
Penang from China, and his mother was ethnically Chinese, but
she was born in Penang. Wu was their fourth son,

(02:14):
an eighth child out of eleven. The goldsmith shop was
a pretty prosperous one, and the family lived in a
home above it. Today, Penang is in Malaysia, but at
the time it was one of the Straight settlements, which
were a collection of British territories along the Strait of Malacca.
Whose early education took place at the Penang Free School,

(02:35):
which was open to boys regardless of their religion or
their nationality. Classes there were taught primarily in English, and
when w was seventeen, he was awarded the Queen's Scholarship
that allowed him to travel to England to study at
Emmanuel College at Cambridge. This made him the second Chinese
student to study at Cambridge and the first Chinese medical

(02:57):
student at Cambridge. After earning his m d there, he
did a year of post graduate work in bacteriology at
the School of Tropical Medicine in Liverpool, and then he
did research at the Pasteur Institute in Paris. Wu returned
to Penang in nineteen o three. He had excelled in
his studies and he earned multiple awards at Cambridge and

(03:17):
he was a qualified doctor with additional experience in infectious
diseases in microbiology, but he couldn't get a job with
the Colonial Medical Service because it was only hiring British physicians.
So Wu spent a year working at the Institute for
Medical Research in Kuala Lumpur, studying the B vitamin deficiency
known as berry berry. He also spent some time in Singapore,

(03:41):
where he met his future wife, Ruth Huang Shu Chung.
By nineteen o four, we was back in Penang, where
he set up a private medical practice, and he also
became one of the editors of the Straits Chinese magazine.
This was a journal of arts, literature, and culture for
the Chinese residents of the Straight settlements. We're really not
going to touch on this much at all in this episode,

(04:03):
but we had just a deep and lifelong love for
literature and art. In addition to his private practice, we
also started an aggressive campaign against opium, including founding Penang's
Anti Opium Association and serving as its president and physician
in chief, all when he was still just twenty four.
He campaigned for other reforms as well, including education for

(04:26):
girls and a prohibition on gambling. Wu's anti opium campaign
ruffled the feathers of high powered people who were involved
in the opium trade, and in nineteen o seven, possibly
in retaliation for this work, a search warrant was issued
for his medical clinic, and authorities found an ounce of
opium tincture and a cupboard. A couple of different explanations

(04:49):
have been proposed for why he had it, and one
was that he had bought it in case he needed
to treat opium patients, and another was that it had
been in there when he bought the practice. Regard us
of exactly what had happened, doctors had to have a
license to have opium tincture on hand, and who didn't
have one? So he was convicted and charged to fine,

(05:10):
and he found the whole incident to be just humiliating.
Not long after the opium incident, Wu was offered a
job as the vice director of the Imperial Army Medical
College in Tianjin, China. He accepted this position and he
traveled to London in Berlin for additional training in military hygiene.
And it was after taking this position and moving to

(05:30):
China in nineteen eight that he started using the Mandarin
version of his name. So we're almost to the epidemic
that was really a defining moment in Wu's career. But
before we get to that, China had been through just
a colossal amount of upheaval during Woo's lifetime, and some
of that upheaval directly affected northeastern China, which was known

(05:51):
at the time as Manchuria, and that's where this epidemic
took place. So briefly, China lost the First Sino Japanese War,
which ended in eight One of the outcomes of that
war was that China had to seed some of Manchuria
to Japan. China also had to pay reparations to Japan
that it simply could not afford, so it had to

(06:13):
seek out loans from other countries, including Russia. In eighteen
ninety six, China signed a secret and unequal treaty with Russia.
Russia gave China the money it needed to pay the reparations,
and China gave Russia access to land in Manchuria. In theory,
this treaty was also supposed to ensure mutual defense against Japan,

(06:34):
but in reality it allowed Russia to establish a foothold
in Manchuria and set the stage for it to claim
additional Chinese territory. This is often pointed to as one
of the as part of the context for the Boxer rebellion,
like it was part of what was fueling a lot
of anti foreigner sentiment in China that in nineteen o four,

(06:56):
Russia went to war against Japan, with a lot of
the fighting happening in Manchuria. As many as twenty thousand
Chinese civilians were killed as a result of the fighting.
This war ended with the Treaty of Portsmouth in nineteen
o five. Theodore Roosevelt was awarded the Nobel Peace Prize
for his peace negotiations, including the negotiation of this treaty

(07:18):
in nineteen o six. This treaty as another sort of
in theory aspect to it, though in theory both Russia
and Japan recognized Chinese sovereignty in Manchuria under the Treaty
of Portsmouths, but in reality, both Russia and Japan still
had substantial interests there, including railroads that each of them

(07:38):
had built. The railroads were incorporated into the treaty, with
each nation allowed to keep troops in Manchuria based on
the length of their railroad line, purportedly for protection from
bandits and other defense. Because of all this, by the
early twentieth century, Manchuria had become kind of a patchwork
of Japanese, Russian, and Chinese influence, with ethnic diversity within

(08:02):
the Chinese population as well. Russia controlled the Eastern Chinese
Railway as part of the Trans Siberian Railway and that
ended at the Russian port of Vladivostok. Japan controlled the
South Manchariat Railway, and along their respective rail lines, Russia
and Japan each controlled cities and towns that had large

(08:24):
numbers of Russian and Japanese nationals, as well as people
from other countries living there. Russia and Japan also had
trading rights along their railway routes, and then China also
controlled a portion of the railroad as well, which was
the Imperial Chinese Railway. All of these railroads were a
big part of the spread of plague through Manchuria starting

(08:44):
in nineteen ten, and we're going to get into that
after we first paused for a sponsor break. One of
the primary industries in Manchuria in the early twenty century
was the fur trade, specifically the tarbagant marmot. This marmot

(09:06):
can carry plague, and Manchuria went through regular, almost seasonal
outbreaks of plague that generally followed the hunting season. These
outbreaks were usually the bubonic form of the plague, which
is characterized by fever, weakness, and painfully swollen lymph nodes,
which are called bubos, and these outbreaks tended to be

(09:27):
localized and they would last for a few months, and Russian, Japanese,
and Chinese officials in Manchuria all had their own procedures
for dealing with them. So when trappers and fur traders
in Manjoli started getting sick in mid October of n
at first people didn't realize that that was actually something different.

(09:47):
Mentally was right on the border with Russia. It was
one of the major centers in the fur trade in Manchuria.
Large numbers of seasonal hunters and trappers would come to
the area and they would stay in these crowded, poorly
ventilated huts and ends. Some of these were literally underground,
so they were in these confined quarters with very bad ventilation.

(10:10):
Demand for marmot for had also skyrocketed after the discovery
that it could be dyed to look like sable. Some
hunters had resorted to digging sick animals out of their
burrows to get their pelts, although unlike with healthy marmots,
these sick animals were not generally also used as food.
The first deaths were reported in Manjoli in late October

(10:33):
of nineteen ten, with the first victims being Chinese fur trappers.
Russia and Japan both had medical facilities in their respective
railroad towns. In Manjuli, Russia's medical centers were staffed with
nine doctors, more than seventy nurses, and twenty six assistants.
As more cases came in, they diagnosed the disease asneumonic plague,

(10:56):
caused by the same organism as bubonic plague, but characterized
by shortness of breath, chest pain, and coughing up blood,
followed quickly by death if there was no treatment. Today,
plague is treatable with antibiotics, which didn't exist yet in
nine so the fatality rate for pneumonic plague was close
to Authorities in Manjali informed international authorities in the towns

(11:21):
along the railroad lines of what was happening. The Japanese
controlled cities in particular started taking a lot of steps
to try to prevent the introduction of infection into those cities,
including screening all incoming travelers and quarantining their Chinese population
on mass but it still was not immediately obvious just

(11:42):
how serious this situation was, since the clearest symptom of
pneumonic plague was coughing up blood, and since death typically
followed within forty eight hours of that symptom, isolating people
who were potentially exposed before they showed symptoms was really
the only way to try to control the spread of
the disease. Contact tracing was difficult since so many of

(12:05):
the victims were migrant fur trappers and laborers who didn't
know anyone and couldn't provide details about who they had
had contact with. So Russian authorities in Manjolie essentially treated
the entire Chinese population, especially the poorest Chinese people, as
potentially infected. They detained Chinese people in groups of twenty

(12:26):
five and if nobody experienced any symptoms in five days,
at which point if they had been infected it would
be obvious, then they were all free to go. But
if anybody in the group did experience symptoms, that meant
that anyone else who had been isolated with them was
now potentially infected and their five day weight started over. Soon, though,

(12:48):
isolation facilities and Manjolie were totally overwhelmed, and authorities had
to start quarantining people in empty rail cars. This mass
isolation was obviously difficult, people didn't understand why they were
being detained, so they would often break or try to
evade quarantine, and they tried to hide any symptoms of illness.

(13:09):
Beyond the mass quarantine, authorities were also taking steps that
were not effective at containing the disease, like focusing on
exterminating rats, which were not spreading the neemonic form of
the plague. Yeah, if this were a ubonic plague outbreak,
then rats and their fleas would have been part of
the problem. In fact, right on November eight, plague was

(13:31):
first detected in Harbon, which is another Russian town farther
southeast on the railroad line and that also had a
Chinese quarter known as Fuchatien. The first death in Harbon
was reported on November nine. Russian authorities in Harbon started
taking similar measures to what had been done in Manjoli,
while also trying to coordinate with Chinese authority in Fuchatien,

(13:54):
but it became increasingly clear that the epidemic could not
be contained through this patchwork of effort by Chinese, Russian,
and Japanese authorities, all of which were operating in different
towns and districts. As November war on, both Russia and
Japan started threatening to send in their own health ministers
to take over if China did not take stronger action.

(14:16):
China also realized that Russia, Japan, or some other country
entirely could use this epidemic as a pretext for a
full on invasion of Manchuria, which was highly attractive to
multiple nations thanks to its geography and its natural resources.
So China's counselor of Foreign Affairs tasked Wu Leenda with
traveling to Harbin to try to contain this epidemic. In

(14:39):
a lot of ways, Wu was really the logical choice
for this. He was a respected doctor with experience in microbiology.
He was ethnically Chinese, which might make local Chinese people
more receptive to his direction than they were to Russian
or Japanese officials. Sending Wu also demonstrated that China did
have its own medical experts who had trained at prestigious

(15:02):
universities and institutes. But Wu was also an English speaking
doctor who had grown up in British territory and had
trained in the West, and he wore Western clothes and
thought traditional Chinese medicine had value only as a historical
and cultural artifact. And all of this made him the
target of suspicion from many Chinese people. He also didn't

(15:24):
speak Mandarins, so a senior medical student had to serve
as an interpreter, and since Wu was only thirty one,
authorities and medical experts from other countries questioned his medical
knowledge because of both his race and his age. We
got the order to go to Harbon on December nineteenth,
and he got there five days later. And at this
point medical authorities and local people in Harbon and elsewhere

(15:48):
really had suspected a number of possible sources of disease transmission.
One was again rats and their fleas, with widespread efforts
to control the rat population and bounties placed on rats
and some affected cities. Another was money. Authorities in Harbon
were sterilizing paper money with steam and sterilizing coins with

(16:10):
mercuric chloride. There are also people who blamed the disease
on contaminants and inferior quality opium, suggesting that the reason
that poor people seemed to be the most affected was
that they could only afford the cheapest opium sold on
the black market. Shortly after arriving in Harbon, Wu conducted
a post mortem examination on a Japanese woman who had

(16:33):
died of the disease. This is sometimes noted as the
first autopsy conducted in China. Autopsies were highly taboo among
Chinese people, and that is why we sought out the
body of a non Chinese patient for examination. Wu was
able to culture plague bacteria from that woman's tissue samples,
confirming that the disease at work wasneumonic plague. Who also

(16:56):
concluded that this numonic plague was spreading from per sen
to person through things like coughing, and so in addition
to the isolation efforts and the sanitary cordons around the
affected cities that were already in place, we recommended the
use of masks to protect healthcare workers from the disease.
He was not the first person ever to recommend masks

(17:18):
as a protection against plague. The beaks plague doctor masks
that I think most people could imagine. They date back
to the seventeenth century, and that pointed nose portion of
the mask was stuff with garlic or herbs or other
fragrant materials to protect against miasmas, which were believed to
cause illness. The Manchurion plague happened during the Third Plague

(17:42):
pandemic which started in eighteen fifty five, and in the
late nineteenth century. After that pandemic had started, medical authorities
in both Germany and Japan had recommended using cloth or
sponges to cover the noses and mouths of patients who
had respiratory symptoms, as well as their attendants. Wooze mask
design was one of several in the nineteen epidemic, but

(18:04):
it is also recognized as the one that was most
effective and the most widely used. It was the simplest
to put on and where, and it could be made
quickly with inexpensive materials. We described the mask this way
and the treatise that he wrote on demonic plague quote.
This consists of two layers of gauze enclosing a flat,
oblong piece of absorbent cotton six inches by four inches.

(18:28):
It can be easily made by cutting the usual surgical
gauze nine inches wide, as supplied from the shops, into strips,
each measuring three feet in length. Each strip is then
doubled lengthwise so as to contain the middle flat piece
of cotton wool measuring four inches by six inches at
either end of the gauze. Two cuts each measuring fifteen

(18:49):
inches are made, thus turning the pad into a three
tail gauze bandage with a central piece of wool for
covering the respiratory entrance. The upper tail of one side
should be passed around the side of the head above
the ear and tied to the other corresponding tail. The
lowermost tail should, in similar manner, be passed under the
ear and tied to the one on the other side,

(19:11):
while the middle tail should be passed over the crown
of the head so as to fix the pad and
prevent it from slipping down the neck um. This was
a way thicker mask than like the cloth masks that
people are wearing today. It reminds me of like not
a current modern fancy cloth diaper that's colorful and hazard

(19:32):
removable inserts, but like the cloth diaper from when I
was a kid uh in the seventies, like it was
thick and heavy. So, as Tracy mentioned, the resulting mask
was really really thick. And there was sort of a
double benefit here because in addition to offering protection from disease,
it also helped protect the wearer's face during the Manchurian winter,

(19:54):
and we recommended that this mask be worn by doctors, nurses, pharmacists,
and other medical staff, as well as patients and their
family members and caregivers. Also anyone who had contact with
any of these people, people who were doing contact tracing
or house to house searches for sick people, and people
cremating victims bodies, and ideally everyone. And the monograph that

(20:18):
I read from a moment ago, which he went on
to publish about the plague fifteen years later, we described
masks as the most important method of personal prophylaxis. But
he also really stressed that preventing pneumonic plague required a
combination approach masks, gloves, goggles and gowns, handwashing and other
hygiene measures, disinfecting of surfaces and instruments, quarantines, and the

(20:43):
use of vaccines and anti plague serums. He also noted
that people wearing masks needed to be vigilant against allowing
their masks to give them a false sense of security
so that they like slacked off on all of those
other measures. More recently, doctor Wos masks have become part
of a sort of cautionary tale involving French physician doctor

(21:04):
Gerard Maynie, who was head professor at pay Young Medical College.
In Wo's account, Maynie was both dismissive of the idea
that the plague was being spread from person to person
through respiratory droplets and dismissive of Wo's medical expertise because
he was Chinese. Many did his rounds at a plague
hospital without wearing a mask and then contracted the disease

(21:27):
and died. The basics of all of this are true.
Manie did die of pneumonic plague during this epidemic after
treating patients without a mask, and apart from Wu's own
account of how Many treated him, the entire international response
this epidemic was rife with racism. Non Chinese people dismissed
the work of Chinese doctors and medical staff. International efforts

(21:50):
are based on the idea that Chinese people were dirty,
backward disease vectors. Wu himself also contributed to some of this,
characterizing the migratory trappers who come to Manchuria seeking work
as ignorance spreaders of disease. But an important addition to
all of this is that there was also a vaccine
for plague in It had been developed by a Jewish

(22:12):
doctor from Russia, Valdemar Mordecai Hofkina in eighteen ninety six,
just two years after the plague by Silis had first
been identified. Maynee had been vaccinated against the plague, as
had a number of Russian medical staff who also contracted
the plague in this epidemic and died. When we wrote
about this in his autobiography, it's sort of an illustrative

(22:36):
tail in which MAYNEI easily becomes the villain and then
in in sort of viral posts about masks that have
been floating around the internet more recently, and like that
sort of amplified even more. But Maynie did not just
disregard WOOS precautions and go into a plague where with
no protection at all. He thought that he was protected
because he had received a vaccine. It was only later

(22:59):
that it became clear or that the vaccine dosage that
conferred immunity and bubotic plague was not enough to protect
someone who was exposed to plague through their respiratory system.
UH and mucus membranes. That monograph on plague that we've
referenced a couple of times has these charts where it
was like it took multiple doses and this other plague

(23:20):
serum to like maybe offer some protection from pneumonic plague
in a way that was way more simple and straightforward,
in like one dose for a bubonic league. The international
community had already recognized the Manchurian plague is having the
dangerous potential to spread along railroad and shipping roots, but
Mani's death seems to have spurred more aggressive action. It

(23:43):
was no longer primarily poor Chinese trappers and laborers who
were dying. It was also respected Western doctors. So we'll
have more on all this. After a break in January
of nineteen eleven, not long after the death of doctor

(24:04):
Gerard Mini, the Chinese government deployed twelve hundred troops to
Manchuria to assist with quarantine enforcement, as well as six
hundred police officers who were dispatched to conduct house to
house searches. A new plague hospital was built in Harbon,
with the old one being burned completely to the ground.
Dr Willie and Da coordinated with the Japanese, Russian, and

(24:26):
Chinese authorities to shut down each of their respective sections
of the railroad. He also focused on cleanliness and hygiene
the masks we talked about earlier, and on trying to
find strategies for controlling the disease that would be accepted
by the local people who really didn't trust Western doctors,
like Western medicine was a really new introduction in China
at this point. Has included recommending that people in Harbon

(24:49):
set off their Chinese New Year firecrackers inside their homes,
hoping that the sulfur fumes from those firecractors would act
as sort of an airborne disinfectant. Heaven forbid such an
idea take hold here. At the moment um, Wu had
also arranged for a mass cremation of plague victims in Harbin.
He had discovered that there were more than two thousand

(25:10):
bodies that had not been buried because the ground was frozen,
and some of the bodies were lying on the ground
because the city had run out of coffins. Wu was
concerned that animals might feed on those corpses and become
a new reservoir for the disease. The idea of a
mass cremation like this was anathema in Chinese society, who

(25:31):
had to secure an imperial edict for the cremation, which
was the first of its kind in China. This cremation
took place in the last day of January nineteen eleven,
with Chinese New Year having been on. Even with that
imperial edict that granted formal permission, though, this was still
a deeply traumatic event for a lot of local Chinese people.

(25:51):
In addition to the cultural and religious taboos that were involved,
a lot of people who had died were too young
to have descendants who could perform their funeral rights. A
lot of others were migrants or immigrants who didn't have
a local family at all, and whose bodies were being
burned far away from their ancestral homes. Simultaneously, Wou marked

(26:12):
this is an important moment in controlling the spread of
the disease and a turning point in the progression of
the epidemic. By this point, the epidemic had been brought
under control in Manjoli, where the first cases had been reported.
The last people held for quarantine and Manjoli were released
on December twenty two, but the disease had also spread

(26:32):
further along the railroad, including to the Chinese town of
Mukden now known as Shenyang, where a sick traveler from
Harbon arrived on January second. In all of the cities
and towns where the disease was still spreading. Authorities conducted
house to house searches looking for sick people, detained people
until it was clear they were not ill, and quarantined

(26:53):
people who showed symptoms or had had contact with people
who had This whole effort still suffered from a lack
of coordination and oversight, though the city of Mukden hadn't
really prepared for the epidemic, even though it was clear
that it was moving towards them down the rail lines.
The Chamber of Commerce there tried to set up its
own isolation hospital, catering to the Chinese merchant class, but

(27:17):
the infection control procedures at that hospital were not particularly rigorous,
including many of the doctors working without masks. The illness
spread through the hospital itself, killing two hundred fifty patients
and both of the doctors. At that point, authorities ordered
that hospital to be closed. The Chamber of Commerce and
McDon also had organized the Sanitary Brigade to help conduct

(27:41):
house to house inspections and searches in the city. That
effort apparently went better. As all of this was going on,
China asked for other nations to send medical experts to Manchuria,
both to help control the outbreak and to study the disease.
Two American doctors, Richard P. Strong and Oscar Tigue, were
in the Philippines and they were among the ones who

(28:02):
arrived in Manchuria. Their focus was more on study than
on control, since autopsies were so taboo, They focused their
work on unclaimed unidentified bodies, conducting twenty five autopsies that
contributed enormously to the understanding of mnemonic plague. Researchers also
tried to confirm whether the Tarbagan marmot really had played

(28:24):
a part in this epidemic, but their research at that
point was hampered by the fact that these animals hibernate
in the winter. Like they could go try to find
some that were hibernating, but that still wasn't going to
really help them determine whether whether like that was not
a real world scenario to what it had been like
back in November. Studies conducted later on, though, did confirm

(28:46):
that these marmots can contract neumonic plague and they can
spread it from one to another, so it seems likely
that the first case of plague in this epidemic was
contracted from a sick marmot, but that's not likely something
that will ever be proved for certain. The last new
case of pneumonic plague in Harbon was reported on March first,

(29:08):
nineteen eleven, with scattered cases elsewhere being reported over the
following weeks. In April of nineteen eleven, China outlawed tarbigan hunting.
As the plague was winding down, the first International Plague
Conference was convened in Mukden from April third to twenty,
and this was the first international conference of its kind

(29:28):
to be held in China. This conference involved a whole
lot of like in fighting and international drama. Russia's delegation
was primarily made up of military people, which China took
as an implied threat to try to take over more territory.
At first, Japan announced that it was going to boycott
the conference altogether, apparently because it felt like it was

(29:50):
being upstaged by China. Japan did ultimately send five delegates,
though in the end, the delegates at the conference past
forty five resolution as recommendations for the Chinese government on
public health and plague prevention. And another thing to come
out of this conference was the establishment of the North
Manchurian Plague Prevention Service, which we will talk about more

(30:12):
in a moment. By the time the International Plague Conference
came to a close, the pneumonic plague epidemic in Manchuria
was essentially over official records document forty three thousand, nine
hundred seventy two cases of pneumonic plague and one survivor,
although because migrant laborers and trappers may not have been

(30:32):
listed on official tallies, some estimates are as high as
sixty thousand deaths. Since cases were clustered in railroad towns,
the death tolls in those communities were tremendous. Yeah, if
you look at the like the percentage of deaths like
deaths as a percentage of the whole population um like,
that number seems small, but that's because it's spread out

(30:54):
of the whole population of Manchuria and not just those
railroad towns. Uh. It is really not clear whether this
outbreak was brought under control through medical intervention or whether
it wound down through other factors. The way bubonic plague
outbreaks in Manchuria seemed to be cyclical and temporary, but
it is clear that efforts to stop traffic along the

(31:15):
railroads and established sanitary quardrons around cities and generally keep
people from traveling. That kept the disease from spreading much
beyond Manchuria. The creation of the North Manchurian Plague Prevention
Service was one of the last formal acts of the
Ching Dynasty before the Chinese Revolution of nineteen eleven, which
overthrew the Imperial dynasty and established a Republic of China.

(31:39):
The Plague Service started its work on October first, nineteen
twelve under the new Republican government. Sometimes, the North Manchurian
Plague Prevention Service as described as China's first public health agency,
but that's not entirely true. When we have talked about
public health reform on the show before, we've generally been
talking about the US or the UK, where typically philanthropists

(32:01):
or medical professionals are sometimes just really enthusiastic lay people
have done everything from creating new programs themselves to advocating
for change at the government level. But Chinese public health
followed a precedent that had been set in Germany and Japan,
where the first public health efforts were part of the police.
China had established a police based public health service in

(32:24):
nineteen o two, and the Ministry of Police established in
nineteen o five included a sanitary department. These officers carried
out health and sanitation directives, quarantine enforcement, and infection control procedures.
China was still implementing police sanitary departments in its cities
by the time the epidemics started, and there wasn't one

(32:45):
in Manchuria yet. So it is true that the North
Manchurian Plague Prevention Service was the first public health service
in northeastern China, and many of its efforts were still
connected to policing. The quarantine hospitals it established were mode
old after prisons, with patients being described using the same
general language as would be used for prisoners. Conversely, it

(33:08):
is absolutely true that this plague outbreak and the North
Mancharian Plague Prevention Service had a huge role in the
development of medicine and public health in China. The Chinese
government quickly recognized the role of Western medicine and treating
and preventing contagious diseases. During all this, it also started
to adopt the general idea that the government had a

(33:31):
responsibility to protect public health. Willianda was a major part
of this process. He helped found the National Medical Association
in China in nineteen fifteen. He served as secretary that
year and then as president from nineteen sixteen to nineteen twenty.
He helped establish hospitals, including six isolation hospitals that operated

(33:51):
under the Plague Prevention Service. He also helped found the
National Medical Journal of China and became the first Chinese
person to publish an article in the lancet Is Published
work in the field of medicine included co authoring a
massive history of Chinese medicine and publishing that treatise on
pneumonic plague that we've been talking about that happened in
nine and that treatise was the standard reference on numonic

(34:16):
plague for the next three decades. He also published ninety
two papers over the course of his career, thirty one
of them on the subject of plague, and he was
involved in a series of other epidemics in China, including
multiple other plague outbreaks and two outbreaks of cholera. Wu
was nominated for the Nobel Prize in Medicine for work
on numonic plague and especially the discovery of the role

(34:38):
played by the Tarbagan in its transmission in This made
him the first Chinese person to be nominated for a
Nobel Prize in medicine. Over his career, he was also
awarded honorary doctorates from Picking University, Hong Kong University, and
Tokyo University. Outside of his medical work, Who helped establish libraries,

(34:59):
and he amassed a collection of two thousand books that
he donated to Nanyang University as the Wu Lianda Collection.
He also donated six works of art to the Art
Museum of the University of Malaya. In nineteen thirty one,
Japan invaded Manchuria and Wu and his family fled to Shanghai.
Then in nineteen thirty seven, when Japan invaded Shanghai, he

(35:22):
and his family moved to Malaya. That same year, whose
wife died of tuberculosis. Two of their children had died
as well, one at the age of sixteen and the
other in infancy. Wu eventually remarried to a woman named
Le Shu Chin and had five more children, whose life
beyond this point is not as extensively documented in English

(35:43):
as his earlier career and his work in that epidemic.
He did publish an autobiography in nineteen fifty six, but
it is out of print and it was not accessible
as the research for this episode. It's also six hundred
and sixty two pages long. I've read some reviews of
it to try to get a sense of what it
was like, and and they were mixed. Um One specifically

(36:05):
said the book is too long, and the other talked
about it being pretty fascinating. It it does seem to,
like a lot of people's autobiographies, Dude, like it presents
him in a very good light. He obviously did astounding
and important work, but like even better light than might
be just rooted in that. Uh. We do know though,

(36:26):
that he spent the rest of his life working in
medicine and public health before dying on January sixty at
the age of eighty one, and the words of his
obituary in The Times of London quote by his death,
the world of medicine has lost a heroic and almost
legendary figure, and the world at large one of whom
it is far more indebted to than it knows. On

(36:47):
December nineteen fifteen, the Willanda Institute opened at Harvard University,
focusing on conducting research into infectious diseases. In ten, the
Lancet established the weakly jilliand prize for essays written in Chinese.
The theme for the contest is Chinese health workers experiences

(37:08):
during the COVID nineteen pandemic. I actually have a listener
mail that is a little related to what we've been doing.
Have at it. Uh. This is from Haley. I hope
I am saying your name right. Haley wrote in to
say hello. I've been searching for a good resource on
the history of fabric masks. I would appreciate any suggestions,

(37:28):
but thought I would throw it out as an episode
idea as well. Of course, I know you get many
emails and show suggestions, so no worries if you're not
able to answer. I know fabric masks were used in
eighteen though public interpretation of mask mandates diminished their usefulness.
I feel like they caught on in several East Asian
countries around the time of Stars, and their reception there

(37:49):
is very different, maybe because of that. They're not an
uncommon part of Japanese straight fashion. However, they've been a
staple and rave cyber goth and other fashion subgroups with
leanings towards a post apocalyptic aesthetic for years now. For example,
photos of burning man show lots of masks. I think
it must be an interesting history and I would love
to hear more on this topics. I'm passing it along

(38:09):
best Haley. So number one, thank you Haley for writing
this email. Number two, I thought it would be a
good time to provide some more information on the podcasts
I referenced at the top of this episode. UM. One
of the weird things that has come about because of
this pandemic is sometimes feeling like all the podcasts I
listened to or talking about the same topics. So uh.

(38:32):
The podcast Saw Bones from Sydney and Justin McElroy. On
March twenty they did an episode called Masks The History
of Medical Masks that includes a little bit about what
we talked about today, and then Invisible on April did
the podcast episode Masking for a Friend UM, which is

(38:56):
also about the history and design of masks UM. And
then the one of these three that I haven't actually
listened to all the way through is NPRS through Line,
which came out on May with an episode titled The
mask UM. All three of these episodes focused primarily on
like the medical use of masks and not like the

(39:16):
cultural or religious or theatrical use of masks, which, wow,
would be such a gigantic topic. Uh. I don't know
if that would be coverable in one episode, but there's
a lot of stuff that has come out in the
last couple of months about masks. Um If you'd like
to write to us about this or any other podcast

(39:38):
or a history podcast at i heart radio dot com.
We're also all over social media at miss and History.
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you like to get your podcasts. Stuff you Missed in

(40:00):
History Class is a production of I heart Radio. For
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