Disease Maps and Policy: The Case of the ‘Manchurian Plague’
In the autumn of 1910, the first reports appeared in the local press in Manchuria, a region in the Northeast of China, that there had been cases of a deadly pneumonic plague in the city of Harbin. The fight against this disease, which would become known as the “Manchurian plague,” became in many ways a precedent for the Chinese government, and the successful management of the outbreak was even reviewed and presented at a conference in 1911. From among the multitude of maps created for this particular occasion, one map by the Justus Perthes publishing house is the focal point of this article. In its aim to include all available information, the map is not entirely comprehensive, but rather reveals the specific perspective of a doctor exploring the origins of the disease.
Highly contagious and fatal if not treated within 24 hours, this pneumonic plague claimed 60,000 lives by March 1911 and is still considered one of the worst epidemics in recent history (Gamsa 2006: 147). For the Chinese state, its containment represented a milestone. The epidemic would have been much more deadly if the government had not intervened and deployed medical personnel and technical resources to stifle the spread of the pneumonic plague. By taking charge of the matter, the Qing government also pursued political goals, which included preventing further colonial land grabs and extensions into Qing imperial territory in the Northeast by rivals Japan and Russia.
These measures to combat the plague marked the beginning of a new era in China: for the first time, public health was taken up as a government task. Also, the Qing government acknowledged the benefits of Western medicine as it openly used the fight against the pneumonic plague in its pursuit of international recognition. Dr Wu Lien-teh (1879–1960), a Malaysian-born, Cambridge-educated physician and bacteriologist, was appointed head of the North Manchurian Plague Prevention Service. By March 1911, the spread of the plague was under control and by April of that same year, Dr Wu participated in the First International Plague Conference hosted by the Chinese government in Shenyang, for which abundant cartographic material was created and displayed. What kind of information then do we get from the maps created in the wake of the Manchurian pneumonic plague?
Marta Hanson has examined the various international maps published by participants in the aftermath of the 1911 international conference. She convincingly demonstrates that the British maps in particular can be read as a message from the government of China to the international community that it was capable of managing its own internal affairs. The maps by the Russian participants of the conference showed more precise knowledge of the region (especially around Harbin) and documented the borders of the Qing Empire. They thus served to document political conditions and the territorial claims of both Russia and the Qing Empire (Hanson 2017).
Paul Langhans’ “Pestkarte der Mandschurei” (1911)
The map presented here, designed by Rudolf Pöch under the direction of Paul Langhans at the Justus Perthes publishing house in Gotha, was published in German in 1911 as “Pestkarte der Mandschurei.” It was based on a “New War Map of East Asia” (1900), also published by Paul Langhans in Gotha, who in turn had worked the maps on which it was based, which were published in Stieler’s Hand Atlas by Hermann Habenicht and Carl Barich.
An anthropologist, ethnographer and physician, Pöch was considered an expert in the field of plague research, as he had taken part in the expedition of the Imperial Academy of Sciences of Vienna to study the plague in Bombay in 1897. However, his scientific methods were highly controversial. In Bombay, for example, he had carried out dissections on deceased persons against the protest of the population. On later trips to Africa, New Guinea and Australia, he pursued a “salvage anthropology” approach, striving to archive the cultures there academically and in museums through sometimes illegal practices. Here again, he had, for example, exhumed corpses against the will of relatives, thus violating not only local habits but also moral rules. In his teaching at the University of Vienna from 1913 onwards, Pöch focused on the classification of people into ‘races’ and theories of development as well as ‘racial hygiene’ (Schasiepen 2021). At first glance, the map does not take up this specific research orientation, although it is nevertheless highly argumentative, as we will see.
Like the Russian and British maps, the map shows how and with what intensity the ‘Manchurian Plague’ (as it is called in the title) had been spreading throughout the country: The probable origin of the disease is to be found on the Russian-Chinese border in the city of Manchuria (Manzhouli). From there, the disease spread rapidly and intensively (as also shown in related British maps) along the newly built railway line via Zizikar (Qiqihar), Charbin (Harbin), Kirin (Jilin), Changtu, Mukden (Shenyang) south to Shanhaiguan and Port Arthur (Dalian).
The map’s depiction of the epidemic fits insofar as it is known today that the plague had its beginning among Siberian marmots (marmota sibirica, Tarbagans) before being transmitted to humans. By the beginning of the 20th century, Siberian marmots had become a sought-after commodity: readily available, easy and cheap to hunt, their fur could quickly be dyed into imitation sable, mink or otter fur by means of chemical dyes produced in Germany. Afterwards, the dyed furs could be sold at a high price. The prospect of quick wealth attracted many migrating Chinese fur hunters from the South, who came in droves to the North. Unlike the local hunters, mostly Buryats, the newcomers had no experience with the marmots and therefore could not distinguish infected from healthy animals (Hanson 2017: 252).
The unchecked hunting of millions of animals and their skinning by inexperienced trappers led to the transmission of the bacterium Yersinia pestis to humans and triggered the pneumonic plague that reached the city of Harbin in late autumn 1910. The plague spread rapidly, exacerbated by the cold Manchurian winter that caused hunters to huddle in small tents and huts. This, in turn, promoted infection, especially by droplet infection through the air. The disease was ultimately carried to all areas of China by Chinese hunters travelling home to their families on the recently reopened train routes for the 1911 New Year.
Furthermore, the map shows the surrounding area of Beijing, down to Shandong and into the Jiaozhou Bay as the “outermost distribution zone” (äußerste Verbreitungszone). Plague hotspots (Pestherde) and intensive distribution areas (intensive Verbreitungsgebiete) are also indicated and named, including cities such as Yantai, Jilin and Dalian. As on the British and Russian maps, borders are clearly displayed, the territories of Russia, Japanese-occupied Korea and China are marked in different colours, and the only outbreak shown outside China is the one in the Tarbagatai Mountains (1894).
Historicizing the Spread
This particular map was published in conjunction with the Erdkarte der Ausbreitung der Pest (“Global Map on the Spread of the Plague”). Pöch depicts with his Pestkarte the events in Manchuria with a level of detail that a map on the scale of the earth cannot provide. While the Erdkarte der Ausbreitung der Pest historicizes the spread of the disease, the Pestkarte der Mandschurei also shows previous outbreaks of pneumonic plague during the 19th century (marked in blue). Chalamuto, a place south of Dali Nuor in what is now Inner Mongolia, is mentioned as a definite place of origin of the ‘Tabargan plague’ of 1886–1898; Chailar (1905), a place south of Urga (1899, today’s Ulaanbaatar), and the Tarbagatai Mountains (1894) are also mentioned as places of origin of plague outbreaks. Also, in outbreaks of the 19th century, three dots in blue indicate pockets of plague, for example on the Liaodong Peninsula (Inkou, 1899 and Kaiping 1905) and at Beitang (1903).
However, Pöch’s map does not appear to be comprehensive: The blue arrows specified in the legend, which were supposed to denote the spread of earlier plague outbreaks, are missing from the map. Studying the text by Pöch that accompanies both maps confirms what the map is supposed to depict and what Pöch is concerned with: “It is possible that this plague in the interior of China is related to the plague of the tabargans, the marmot plague, which occasionally leads to human plague epidemics” (Pöch 1911: 23).
Following this, Pöch describes the spread of the epidemic throughout the entire country thanks to the newly built railroad, while giving no indication as to the ways in which the plague was carried into the country before the expansion of the railroad network. Thus, the map is not incomplete: rather, it reflects the specific view of Pöch as a researcher and epidemiologist, who does not consider the theory concerning the tabargans as a proven fact but only as one possible explanation for the outbreak. He assumes that the disease spread through the new railway networks and thus illustrates rather innovatively a dynamic event. The Chinese quarantine stations, with which the Qing government made efforts to contain the spread of the disease, are also mentioned.
Disease Containment as a Political Key Concern
Like the current COVID-19 pandemic, also a highly infectious disease that attacks the lungs and which probably originated in China and spread through airborne droplet infection, there were quite divergent opinions in China in 1911 about the government measures to contain the disease (Rogaski 2021). Some reacted to the use of modern Western medicine with apprehension, arguing that thousands of people died not because of the epidemic but because of government action (Gamsa 2006: 157). Other observers in China, meanwhile, judged the measures progressive and praised the Qing government for being tough and rigorous in its actions. For them, including many Chinese modernizers and reformers, the measures were ultimately a way to move away from the “sick man of Asia” status toward a modern state.
Thus, although the pneumonic plague was a humanitarian disaster, it also created an opportunity to rethink the relationship between government and public health. Just a few months after the pneumonic plague was contained, Republican revolutionaries abolished the Qing dynasty, ending 2,000 years of imperial rule in China. The new republic took to heart the lesson on health and governance learned during the ‘Manchurian Plague,’ establishing a series of medical colleges and hospitals and making public health a government priority. The maps made for the spread of the pneumonic plague thus document for the Western world the success achieved by the Republic of China while also demonstrating the new importance of public health for Chinese policymakers.
Gamsa, Mark, The Epidemic of Pneumonic Plague in Manchuria 1910–11. In: Past and Present, Vol. 190 (2006), No. 47, pp. 147–184, p. 147.
Hanson, Marta, Visualising the Geographies of the Diseases in China. Western Disease Maps from Analytical Tools to Tools of Empire, Sovereignty and Public Health Propaganda, 1878–1929. In: Science in Context, Vol. 30 (2017), No. 3, pp. 219–280.
Koch, Tom, Cartographies of Disease. Maps, Mapping, and Medicine. New expanded edition, Redlands/CA 2017.
Meyer, Philipp, Kartographie und Weltanschauung. Visuelle Wissensproduktion im Verlag Justus Perthes (1890–1945), Göttingen 2021.
Pöch, Rudolf, Die geographische Verbreitung der Pest um die Wende des 19. und 20. Jahrhunderts. In: Petermann’s Geographische Mittheilungen, Vol. 57 (1911), No. 4, p. 23.
Rogaski, Ruth, The Manchurian Plague and COVID-19. China, the United States, and the “Sick Man,” Then and Now. In: American Journal of Public Health, Vol. 111 (2021), No. 3, pp. 423–429.
Schasiepen, Sophie, Pöch, Rudolf. In: Österreichische Akademie der Wissenschaften (ed.), Österreichisches Biographisches Lexikon ab 1815 Online-Edition, Lfg. 10, 2nd edition (2021), URL: https://www.biographien.ac.at/oebl/oebl_P/Poech_Rudolf_1870_1921.xml [09.08.2022].
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