“Plague Fighter” a hundred years ago

  On the eve of the Spring Festival in 2020, the unexpected epidemic surprised many people. After all, 17 years have passed since the last SARS outbreak in 2003.
  As for the other epidemic that occurred 110 years ago, apart from a few professional scholars, I am afraid it has been completely obliterated in the dust of history. At this moment, it may be easier to evoke the “warmth and respect” advocated by Qian Mu when reviewing the Northeast rat epidemic that also occurred during the Spring Festival.
  Wu Liande and his people
  In October 1910, a plague broke out in Manzhouli, a small border town between China and Russia. Two weeks later, the epidemic also began to appear in Harbin, thousands of miles away. Xiliang, the governor of the three provinces in the Northeast, described the epidemic as “like a flood and a prairie fire.” In the following month, a terrible plague swept across the Northeast Plain. Until March of the following year, the epidemic finally subsided. In this rat epidemic, more than 50,000 people died in the Northeast.
  At this time, the Qing empire was in the midst of a ruinous impoverishment. There were constitutionalists who entangled in advocating the opening of the parliament quickly, and there were revolutionaries who rushed around to jointly plan an uprising. The regent Zaifeng and the Queen Mother Longyu were both mediocre people, and power eventually fell. In the hands of a group of narrow-minded Manchurian nobles, they self-defeatingly succeeded in launching two major defeats: the railway state and the royal cabinet. One year after the Northeast plague broke out, in Wuhan, where the new type of coronavirus pneumonia broke out today, the hastily sounded gunfire turned into a requiem for the Qing Empire. However, seeing that it has already passed the ghost gate with one foot, the dying Qing government has won an internationally recognized epidemic prevention victory.
  If you think about it carefully, the Qing government’s success is somewhat lucky. If a “plague fighter” does not appear in time, the outcome of this rat plague is really hard to predict. This “Plague Fighter” is Dr. Wu Liande who was nominated for the Nobel Prize in Medicine in 1935.
  Although the Harbin Wu Liande Memorial Hall has been open for more than ten years, and even Wu Liande’s deeds have been filmed into TV dramas, most contemporary Chinese people still know very little about this modern Chinese preventive medicine pioneer and founder of epidemic prevention. Wu Liande was born in an overseas Chinese family in Penang, Malaysia. At the age of 24, he obtained a doctorate of medicine from the University of Cambridge with a thesis on tetanus research. In 1905, the appearance of a man changed Wu Liande’s fate. This man was Shi Zhaoji, the first Chinese student studying in the United States to obtain a master’s degree. He later became China’s first ambassador to the United States, and one of the five plenipotentiary representatives of the Chinese delegation to the 1919 Paris Peace Conference. That year, Shi Zhaoji, who graduated from Cornell University, accompanied Duanfang and other five ministers to investigate constitutionalism as a first-class counselor. On the way, he passed Penang and met Wu Liande who was practicing medicine in his hometown. Two young people of similar age hit it off and became best friends for life. Two years later, Zhili Governor Yuan Shikai warmly invited Wu Liande to return to China to play. The recommender is Shi Zhaoji who has already served in the Ministry of Posts and Communications (Ministry of Transportation).
  When the Northeast rat epidemic broke out, Wu Liande, then assistant (vice principal) of the Tianjin Army Medical College, received Shi Zhaoji’s invitation. It turned out that the Northeast Plague has triggered a diplomatic crisis in the Northeast. At that time, the two major powers in the Northeast, Russia and Japan, have threatened that if the Qing government cannot take effective measures to control the epidemic, the two countries will act independently to protect their own interests. The spread of the plague is closely entangled with the sovereign crisis, so the Ministry of Foreign Affairs has become the leader of the epidemic prevention work for an unprecedented time. Coincidentally, You Cheng (Vice Minister) of the Ministry of Foreign Affairs is Shi Zhaoji who has just been promoted here. Under Shi Zhaoji’s recommendation, Shang Shu Natong of the Ministry of Foreign Affairs agreed to allow Wu Liande to go to Harbin as an imperial envoy to investigate the prevention and control of the plague organization.
  ”Prescribe the right medicine” in a difficult and troubled world
  At the end of 1910, Wu Liande took a train from Tianjin to the icy and snowy new railway town Harbin. At that time, Harbin was still under the jurisdiction of Jilin Province, and the capital of Heilongjiang Province was Qiqihar. Harbin is located on the T-section of the Eastern Railway and is one of the most important international trade centers in Northeast Asia. Fujiadian, the Chinese jurisdiction of Harbin, was the hardest hit area of ​​the rat epidemic. Wu Liande soon discovered that he was facing three major challenges in Harbin: First, Harbin lacks a unified municipal jurisdiction, and the Russians and Chinese are working independently; second, the pathological characteristics of the epidemic are still unknown, and effective prevention measures cannot be formulated; third, The epidemic is serious and he urgently needs reinforcements.
  A few days later, the French military doctor Meni, who was the chief professor of the Beiyang Medical School at the time, was ordered to rush over. To Wu Liande’s surprise, the eagerly awaited reinforcements were only thinking about seizing power. It turned out that the 43-year-old Frenchman was in charge of dealing with the plague in Tangshan two years ago. He relied on his merits, relied on the old and sold the old, and quarreled with Wu Liande as soon as they met. After being scolded in person as a “Chinaman”, Wu Liande, who swallowed his anger, sent a telegram to Beijing to resign and refused to work with such a self-serving person. After 38 hours of suffering, Wu Liande was unexpectedly retained by the imperial court, while Meni was deprived of official orders. The reason, of course, is attributed to Wu Liande’s “iron fan” Shi Zhaoji. The meticulous Shi Zhaoji also used Wu Liande’s Cambridge medical doctor status to successfully lobby the British minister to help obtain the “superior emperor” in Dongjiaomin Lane? Recognized by the Beijing Diplomatic Mission. After all, the British, who have a high self-esteem, will never admit that the medical level of France is higher than that of Cambridge. After this turmoil, Wu Liande has only obtained the supreme command of epidemic prevention work in the three provinces of Northeast China, and can finally flex his muscles to deal with the terrible plague.
  The big difference between Wu Liande and Meni is, is the current epidemic plague a common plague? In the era when antibiotics were not invented, the plague was regarded as one of the most terrifying infectious diseases with extremely high mortality. The culprit of the plague was the plague bacillus discovered in 1894 by the Japanese scientist Shibasaburo Kitasato. Yersinia pestis can infect humans with the help of fleas from rodents such as mice, causing human lymph nodes to become inflamed, swollen and painful. If not treated in time, patients will often die of sepsis after three or four days. As the deceased had extensive bleeding and bruises on the skin, and the corpse appeared purple-black, so there was another name that made medieval Europeans talk about tigers? “Black Death”. Today, we already know that there are two forms of plague: lymphatic plague and pneumonic plague. The former plague is the most common, and the symptoms are characterized by enlarged lymph glands (especially those in the groin, armpits, and throat), with continuous development of abscesses, and the discharged pus is highly toxic; in the latter plague, Yersinia pestis Invaded the respiratory organs, pneumonia continued to develop, and within a few days of infection, the patient died of serious illness. The two types of plague occur in different seasons. Lymphatic plague is more common in summer, and pneumonic plague tends to occur in winter.
  Wu Liande reminded Mayny that this is an unusual plague. But Meni preconceived that this is just another bubonic plague that is not uncommon, so the top priority is to start rodent control. However, he obviously underestimated Wu Liande’s scientific research ability. A few days ago, Wu Liande had secretly completed the first autopsy in the history of Northeast China in Fujiadian, a Chinese jurisdiction in Harbin, and confirmed that the epidemic was pure pneumonic plague. Therefore, the focus of prevention and control measures is not to eliminate rodents, but to strictly isolate confirmed patients and separate them from suspected patients who do not cough. At the same time, medical staff should wear masks in addition to disinfection and sterilization to prevent patients from coughing and spraying droplets. infection. Mayney regarded Wu Liande’s new discoveries as nonsense, and paid a heavy price for it. Soon after, he visited a Russian hospital and contracted the plague, and died a few days later.

  Victory scientific organizations of the
  death of Khomeini’s for all doctors sounded the alarm, quickly change the public’s disapproval of the attitude. The public finally realized that only by carefully following the warnings and instructions of the person in charge of epidemic prevention can they avoid repeating Meny’s mistakes. All of a sudden, the overreacting public put on masks.
  At that time, Wu Liande also designed an anti-epidemic mask made of surgical gauze and sterile cotton wool with three pairs of straps. The first two pairs of straps are similar to the old-fashioned cotton masks we are familiar with. The bottom pair of straps is wound from bottom to top. The top of the head ensures that the mask will not easily slip off the face. Later, this mask was called Wu Liande mask. However, not everyone has mastered the correct way to wear a mask. Just like today, some people hang their masks loosely on their ears, and some people wear masks around their necks like amulets. In hindsight, these seemingly ordinary cotton gauze masks were the biggest contributor to the real eradication of the epidemic. Wu Liande later proved that the spread of pneumonic plague was mainly through droplets coughed out of the patient’s throat.
  Wu Liande discovered the pathological characteristics of the epidemic, and at the same time gained the trust of all walks of life at home and abroad. He quickly established a complete set of epidemic prevention measures. The top priority is to establish a strict isolation system in Fujiadian. He divided the Fujiadian into four districts, each district was in charge of a senior medical officer, led enough assistants to inspect and disinfect the houses in the district one by one, and sent all the plague patients found to the new plague hospital, family members and other contacts Were placed in isolation camp. He also borrowed more than one hundred carriages from the Russian Railway Administration in accordance with local conditions, and converted them into isolation camps that can keep warm and facilitate ventilation in an efficient and cost-effective manner.
  He also asked medical officers to submit epidemic reports to the medical officers in charge daily in order to count the number of deaths. Residents in the four districts are required to wear a government-issued armband on their right arm, which is divided into four colors: white, red, yellow, and blue. Those wearing an armband of a certain color can move freely within the zone it represents, but to enter another zone, special permission must be obtained. The same rules apply to military cordon lines outside the city, where officers and soldiers are not allowed to enter or leave the city without the authorization of the Epidemic Prevention Bureau.
  In order to ensure the implementation of the quarantine system, Wu Liande transferred more than 1,000 infantry from Changchun to station in groups to monitor the entry of strangers and prevent patients and contacts from escaping. He also recruited 600 police officers to form a police unit, received training in epidemic prevention work, and assisted medical officers with civil work. Wu Liande also rented buildings such as closed schools, evacuated inns, and cart shops as much as possible, and transformed them into four parts of prevention and control space: office area, disinfection station, medical staff dormitory, and isolation camp for contacts. Strictly rigid rules are complex, but they work well. In the first month of the quarantine system, the total number of people who died from the plague reached 3,413, and 183 people died on the worst day, and exactly one month later, the death toll dropped to zero. Wu Liande excitedly concluded: “! This is indeed the triumph of scientific organizations also”
  a hundred years ago “fight against SARS war” Influence and Inspiration
  Wu Liande prevention measures as well as a far-reaching influence, this is the cremation. At that time, a big problem faced by Wu Liande was how to deal with the piles of corpses. Due to the freezing weather, it was very difficult to dig the soil and bury it. Hundreds of coffins were thrown in disorderly cemeteries. In Wu Liande’s opinion, this is simply a natural cold storage room that Y. pestis can’t ask for. Once the weather gets warmer, Yersinia pestis will create more terrible epidemics through intermediate hosts such as rats and fleas. After careful consideration, he decided to implement cremation. However, this move is likely to trigger angry resistance from the local people. After all, entering the land for security is one of the oldest beliefs of the Chinese. Wu Liande is well aware of the big picture. On the one hand, he played the court and used the emperor’s heavenly power to force cremation. On the other hand, he invited the gentry to visit the cemetery, knowing reason and moving emotion. Finally, with the joint support of the court and the gentry, he successfully solved the problem of corpse disposal. Later, the method of burning and cremating corpses who died of the epidemic gradually became a common practice, and it has been influential today.
  Looking back at the battle against the epidemic a hundred years ago led by Wu Liande, everyone wearing masks would not help but feel familiar with each other. Wu Liande’s retrospective summary in his later years may provide us with profound enlightenment. In his memoir entitled “The Plague Fighter” Wu Liande, he said this:
  Realizing the seriousness of the situation, the central government adopted the advice of well-trained medical administrators and applied various scientific measures during the various stages of epidemic prevention, and finally succeeded in bringing the epidemic under control. The medical organization started hastily and faced various obstacles like China. However, its measures, such as autopsy and mass cremation of the victims of the epidemic, once received the strong support of the Beijing court, still proved its ability to benefit the people. During this period, the imperial court’s decree continued to be issued, needless to say, to order places, and its prestige was far stronger than that of the government after the republic was realized.
  In other words, Wu Liande believes that the success of the Gengxin Northeast Rat Epidemic prevention is based on the following three factors: professional command, concentration of power and decisive action. First of all, officials at all levels of the Qing government retreated when faced with difficulties and took the initiative to hand over the command of epidemic prevention to professionals; second, the Qing government had no doubt about employing personnel and gave Wu Liande full power; finally, in the face of extraordinary events, the Qing government dared to support Wu Liande decisively. Measures. What made Wu Liande very emotional is that ten years later, the rat plague (Bubonic plague) broke out again in the Northeast. The Beiyang government in the era of warlord separatism performed terribly, far inferior to the dying Qing government in the past. Even today, these principles summarized by Wu Liande are still worthy of our serious study.
  The Northeast rat epidemic more than 100 years ago left us with numerous experiences and lessons. The author believes that it is particularly worth talking about the origin of the plague. It is the duty of every bacteriologist and virologist to explore the origin of the spread of germs. At present, there are still divergent opinions about the source of the new coronavirus. However, with the help of Russian scientists, Wu Liande determined the source of the plague very early. Soon after the epidemic was eliminated, he publicly released this major discovery at the Shenyang World Plague Research Conference. This plague research conference sponsored by the Qing government is probably the first international academic conference held in Chinese history. Many experts and scholars from 12 countries (such as Shibasaburo Kitasato) were invited to attend the meeting. This 26-day conference is a veritable “victorious conference” and “successful conference”. It not only provided extremely valuable academic papers for plague research, but also successfully reversed the international affairs of the Qing government, which was hit hard by the epidemic. Image. As the chairman of the conference, Wu Liande issued a remarkable chairman’s report. He pointed out that the pneumonic plague originated in Mongolian marmots, rather than rodents that are common everywhere.
  Who provoked the “smoke-free war”?
  With the help of Wu Liande’s research, we can further discover that the root cause of the rat epidemic in Northeast Gengxin is actually the globalization promoted by the development of railways. It is a well-known common knowledge among local residents such as Mongolia and Siberia that sick marmots can cause plague. Various traditional customs in the grassland area ensure that they will only hunt healthy marmots, while staying away from sick marmots and infected patients as much as possible to avoid the spread of the epidemic. After at least hundreds of years of life and death competition, Y. pestis, marmots and humans finally formed a delicate natural balance.
  However, with the opening of the Middle East Railway in 1903, Mongolian grasslands, Siberia and northeastern China were quickly included in the expanding global trade circle. The rare specialty mink fur here has become a world-renowned luxury product. The shortage of mink fur has also stimulated the emergence of alternatives. The shrewd fur traders turned their eyes to the Mongolian marmot. With the invention of a new technology, the color of marmot skin is comparable to mink skin after simple processing. In order to make huge profits, unscrupulous merchants purchase marmot skins at high prices. Shandong immigrants who rushed through the Guandong flooded the Mongolian grasslands by train like gold diggers. They ignore the hunting custom passed down from ancient times by the people of the grassland, and they must dig every hole and kill the otter when they see it. The ecological balance formed by Yersinia pestis, marmots and humans has been completely broken.
  Yersinia pestis quickly spread to densely populated areas along the railway line, from Manzhouli to Hailar, from Hailar to Harbin, from Harbin to Changchun, from Changchun to Shenyang, and finally spread to Beijing and Shandong. Within months, five to six million people died tragically in this terrible rat epidemic. Traffic and commerce in Northeast Asia also suffered heavy losses. Fortunately, scientists proved at the World Plague Research Conference that Northeast soybeans and other commodities would not spread the plague, which enabled domestic and foreign trade to become active again.
  Just as some scientists said bluntly, “For viruses, humans are viruses.” The outbreak of epidemics is always closely related to the drastic changes made by humans to the ecological environment. Since the Industrial Revolution, steamships, railways and telegraphs have promoted the increasing acceleration of globalization. As we all know, globalization has created unprecedented convenience for the rapid circulation of capital, commodities and people. At the same time, few people realize that globalization has also brought huge ecological challenges. On the one hand, the diversity of human living environment is disappearing, on the other hand, the spread of microorganisms is also advancing with the times. Once the epidemic breaks out, people all over the world will be in danger. Even though the death rate will be greatly reduced, strict isolation and quarantine measures will inevitably slow down the circulation of commodities and people, resulting in unprecedented huge economic losses.
  Since the nineteenth century, the rapid advances in biological sciences and medical technology have made humans confident. The complete elimination of various infectious diseases seems to be just around the corner. With the advent of vaccines and the invention of antibiotics, terrible plagues, such as plague, cholera, smallpox, typhus, and diphtheria, that have threatened human civilization for thousands of years have disappeared. However, the SARS virus in 2003, the bird flu virus in 2013 and the new coronavirus now sound the alarm for us time and time again. The survival of microorganisms and humans will be a long war. The real question is, are we ready?