In the 19th and 20th century, shifting sanitation responsibilities led to an extension of colonial space. As explored by Brenda Yoeh, in this sense, administrators become Foucultian “specialists of space”, as they negotiate displacement, hygiene, and co-existence between peoples.¹ In the case of the Manchurian plague, preservation of health ceased to be an individual care, and moved into the sphere of international concern. Dr. Wu Lien-teh’s 1959 memoir, Plague Fighter: The Autobiography of a Modern Chinese Physician, offers an in-depth glimpse into attitudes towards sanitation during the Manchurian Plague outbreak of 1910-11. Sanitary discourse of the period was not a simple divide between Western and Chinese medical populations, but rather, strongly impacted by those carrying dual identities, being simultaneously West and the Rest. 

Dr. Wu Lien-teh’s background complicates the distinction between ‘Western’ and ‘Chinese’ medical authority. He was born in Penang, British Malaya in 1879, and became the first Chinese descendant to attend Cambridge. ² He describes himself as “Chinese”, specifically Cantonese from Sin-ning,³ Dr. Wu was a product of the medical hierarchy of his era, and often dismissed the agency and humanity of the Chinese laborers he was meant to represent. He is not a representative for all Chinese doctors of the period, but provides an example of Western ideologies bleeding into medical procedure and verbiage of the time. 

Dr. Wu’s descriptions of Chinese laborers reproduce negative psychological stereotypes. Of the Chinese laborers who had potentially been exposed to the plague, he reported an “apathy or a fatalism, so typical of the east”⁴ He does not acknowledge that their agency is being stripped from them in forceful quarantine. Rather, he describes them as simply giving up. When faced by a plague that has wiped out villages, and has a “100%” casualty rate,⁵ fatalism appears to be a perfectly rational emotional reaction. Dr. Wu is transforming a normal psychological reaction into a negative reflection on the region as a whole. 

Dr. Wu holds Chinese medical practices to contradictory standards. In reference to simple acts of sweeping and cleansing homes, he states that “the less-educated peoples of Asia had great, if ill-founded, faith in such measures during epidemics.”⁶ The dismissal of Chinese attempts to maintain cleanliness and order in their homes is made ironic when paired with the contemporary medical rhetoric blaming the Chinese for the ‘filth’ of their living.⁷ Dr. Wu espouses that a less-than-pristine hospital resembled the “corner of old backward China.” He criticizes it for “abundance of cobwebs”, and chairs that had not been “dusted for days.”⁸ Though he acknowledges that such measures were ‘ineffectual’ against stopping plague, he still demonizes the Chinese hospital for its backwardness, and yet cites cleaning measures as evidence of a less ‘advanced’ cultural psyche. His account simultaneously condemns cleanliness in the face of plague as irrational, while pointing to neglected spaces as evidence of inferior medical treatment. 

Dr. Wu’s adoption of imperial attitudes towards the Chinese laborers affected by the plague was not monolithic within Western educated Chinese doctors. Western medical education did not necessarily lead to acceptance of Western medical hegemony. Dr. Ho Kai, a prominent figure in fighting the plague in Hong Kong at the end of the 19th century was educated at Aberdeen University, and yet remained a strong advocate of the Chinese community in Hong Kong. He criticized the recommended burning of Chinese neighborhoods, and the forced isolation of them in hospital ships.⁹ Western medical training could coexist with a commitment to Chinese interests. 

Plague Fighter: The Autobiography of a Modern Chinese Physician, complicates supposed power relations between Western medical authorities and Chinese subjects. Dr. Wu’s descriptions of laborers as fatalistic and of his country as backward reveal the extent that these attitudes permeated medical discourse. He frequently adopts frameworks used to judge the Chinese population, and their actions as ‘typical of the East’ as a whole. A brief comparison to Ho Kai reveals that this attitude was not inevitable, and that Western educated Chinese doctors occupied varying realms of Western hegemony vs. Chinese advocacy. Boundaries between Western and Chinese medical thought were not simply defined along national or racial lines, but muddled by pervasive imperial dogma. The distinction between East and West in Dr. Wu’s memoir is not simply geographical, but ideological. 

1. Yeoh, Brenda S. A. 2003. Contesting Space in Colonial Singapore. NUS Press. 86 [↩]
2. Elle, Ning. 2015. “Remembering ‘Plague Fighter’ Dr Wu Lien-Teh.” Saw Swee Hock School of Public Health, January 16. https://sph.nus.edu.sg/news/remembering-plague-fighter-dr-wu-lien-teh [↩]
3. Wu, Liande. 1959. Plague Fighter: The Autobiography of a Modern Chinese Physician. Cambridge: W. Heffer & Sons Ltd. 7 )) as well as a “British subject”. (( Ibid. 15 [↩]
4. Ibid. 18 [↩]
5. Ibid. 27 [↩]
6. Ibid 13 [↩]
7. Sutphen, Mary. “Not What, but Where: Bubonic Plague and the Reception of Germ Theories in Hong Kong and Calcutta, 1894–1897.” Journal of the History of Medicine and Allied Sciences 52, no. 1 (1997): 81–113. https://www.jstor.org/stable/24624205. [↩]
8. Wu, 1959 8 [↩]
9. Sutphen, 1997 [↩]