The Great Pneumonic Plague of 1910-1911

13594165The Great Manchurian Plague of 1910-1911: Geopolitics of an Epidemic Disease

by William C. Summers
Yale U Press, 2012

Manchuria was a political mess at the turn of the 20th century. Although it was the homeland of the Qing dynasty, the Chinese considered it a backwater. Japan and Russia on the other hand saw it as potential colonial territory, a beachhead for Japan’s mainland ambitions or access to a valuable ice-free Pacific port for Russia. By 1910 an uneasy truce held giving Russia and Japan corridors to build railroads with stations and towns to support them while technically still in Chinese sovereign territory. The importance of Manchuria to global politics and trade was underscored by the presence of European and American diplomatic representatives in these upstart towns and ports. Into this delicate situation, the discovery that marmot fur could be dyed to pass as ermine brought a flood of primarily Chinese hunters into the region. The drive for furs (and marmot oil) led many to cast aside traditional hunting practices and safeguards, setting the stage for the plague to come.

The beginning of the plague was sparsely recorded. Starting in October 1910 scattered reports were sent that plague had appeared at sites along the railway, but concern was slow in coming. Summers credits the nearly annual outbreaks of plague, low concern for locals, and the temporary camps of hunters for the lack of information on beginning of the plague. Deaths quickly jumped into the thousands in towns along the rail line but never spread very far from the lines. Summers notes that of the over 43,000 recorded cases during the outbreak only one single person survived (p. 19). Some estimates place the mortality closer to 60,000 when early cases and locals away from the rail line are included. Summers notes that this puts the death toll in the range of the great London plague of 1665. By February 1911, the plague was over; blatant proof the plague outbreaks can flourish in winter (as it sometimes did in medieval European winters).

This plague has some unique features. First, there is no report of bubonic plague at all; it was exclusively pneumonic. Most plagues are primarily bubonic with flair ups of pneumonic transmission. Etiology was confirmed by autopsy and the then new bacteriological techniques including culture. American doctor Richard Strong, working with the Chinese under Wu Lien-Teh, did 25 autopsies before the International Plague Conference called by the Chinese in Mukden. There is no doubt the Yersinia pestis caused this epidemic.

Without antibiotics, quarantine and isolation were the only effective means of control. The means were brutal but effective. In the Russian zone the Chinese were crowded into train cars and not let out until there were several days with no one displaying any symptoms. If a case of pneumonic plague was locked in the car with others, the prognosis for the others was predictably terrible. Within this relatively small region, we can also see three different national approaches (China, Russia, and Japan) to controlling the epidemic each always subordinated to their respective political anxieties.

The chapter on origins of the plague begins to move toward was Edmund Russell envisioned as evolutionary history in his book of the same name (2011). The most useful information here is the history of marmot activity and traditional hunting. Summers hypothesizes that traditional shaman-like practices may have aided hunters in only taking healthy animals. Concern for the health of the animal was one of the early traditions abandoned by hunters eager for furs. Following the reports of the time, Summers believes the plague originated in the marmots, and was distinct from the third pandemic lineage. In accordance with modern strain maps, Summers predicts that the 1910-1911 Manchurian outbreak strain will belong to either the antiqua or medievalis biovars (p. 128-9). If this is true, as is likely, it’s a relatively modern challenge to our notion that plague during pandemics has a single lineage and origin. It should be possible to type this outbreak from graves of the epidemic (which should be relatively easy to locate at barely a century old) or even tissue archived from the autopsies (if it was saved and can be located).

Summers is clearly in his element when he discusses the politics of turn of the 20th century politics. This is a region and time period that most Americans know very little about but is still critically important for Asian politics today with the still uneasy relationship between China, Korea, Japan, and Russia. Summers account lays out the different approaches to healthcare and attitudes toward the epidemic as a national and economic threat. This carried over to the International Plague Conference that nevertheless managed to focus on science and medicine. While the scientific politics was interesting I would have liked to hear more about the contents of the wide-ranging Conference report.

Summers does a good job of being very diplomatic will all parties concerned. In doing so, he does overlook a major legacy of the Manchurian plague. There seems little doubt that this plague, witnessed and closely reported on by Russia, the United States and Japan, played a role in plague being developed as a biological weapon. This plague illustrated the deadly efficiency and sustained transmission of pneumonic plague. This book should be read as a prologue to Japan’s biological ‘experiments’ during World War II beginning in Manchuria (see Sheldon Harris’ Factories of Death) and the continuing programs of the United States and Russia during the Cold War.

This book makes a valuable contribution to plague studies, and early 20th century public health practices. Yet there are still unanswered questions on genetics, epidemiology, and ecology. I hope this book along with Myron Eschenberg’s Plague Ports(2007) and others are ushering in a new period of focus on the plague in the 19th-20th century.

On Giants Shoulders #54: A Sleigh Load of History

Welcome to On Giant’s Shoulders #54, the history of science blog carnival! Here, we celebrate the history of science with all its oddities, and modern science delves into the past. I can’t think of a better way to spend my third blogoversary (of regular blogging) here at Contagions. Just a few days away from the winter solstice, I managed to fill my sleigh with a load of science history links. Cuddle up with a warm mug of hot chocolate (or whatever warms you) and settle in for some good reading.

Festive Science and the Holiday Season

Since the culture war between science and religion heated up, there has been friction between science and religious holidays like Christmas. Rupert Cole of Notes & Theories reminds us that this was not always so. In Victorian England, the popularity of science and Christmas festivities peaked with the public at the same time and reveled in each other. Victorian Christmas plays and pageants were followed by science lectures to explain the featured science and technology! Public Christmas trees were decorated with scientific instruments that were given to children. Those were the days. Though some science folks still know how to mix up the traditions. In a throw back to at least the sixteenth century, Diane Mcllmoyle of Esmeralda’s Cumbrian History and Folklore writes about the holiday tradition of mummer’s plays with its requisite quack doctor.

History of Pseudoscience

Let’s kick this carnival off with a stimulating discussion on, of all things, the omnipresence and worth of (what we call today) pseudoscience. Rebekah Higgitt of The H Word addresses claims that pseudoscience is on the rise with a history lesson, and ThonyC of Renaissance Mathematicus goes one step further asserting that pseudoscience has sometimes been helpful to the development of science. Faye Flam of Lightning Rod writes on Michael Gordin’s recent research on pseudoscience. Continuing with the supernatural, Lindsey Fitzharris of The Chirurgeon’s Apprentice discusses Abraham Lincoln’s conversations with the dead.

Darwin and Evolution

As always posts on Charles Darwin must be featured in On Giant’s Shoulders. Suvrat Kher of Rapid Uplift writes about Darwin’s slow, deep-thinking methods. Michael Barton of The Dispersal of Darwin calls out more quote mining of Darwin by anti-Darwinists. James Randerson writes of the private life of Charles Darwin. The Alfred Russel Wallace Correspondence Project also launched this month to coincide with the centenary anniversary of his death in 2013. Tim Jones of Zoonomian celebrated the birthday of the other famous Darwin, the polymath Erasmus Darwin (d. 12.12.1731). He also visits Annie Darwin’s grave and reviews Dr Gully’s water cures.

Joachim D of Mousetrap posted on Herbert Spencer’s synthetic philosophy and the centrality of evolution in his thinking.

Archaeology

Kristina Killgrove of Powered by Osteons summarized Nutrition and Well-Being in the Roman World: The Evidence of Human Bones, a conference this fall in Rome. Katy Myers of Bones Don’t Lie discusses how isotope data from bones informs on the social structure of an Anglo-Saxon settlement. In another post she discusses skeletal weapon trauma in medieval Ireland confirming the violence in Irish medieval records. In her most recent post she discusses the discovery and analysis of the graves of victims of the attempted mutiny of The Batavia off the coast of Australia in 1628.

Epidemiology

Katy Meyers of Bones Don’t Lie discusses a new study examining osteological and molecular evidence of TB at three neolithic sites in Germany at the transition to farming. I have a post on the Black Death Network reviewing the molecular evidence of the Black Death. If you have any interest in the 14th century crises — plague, famine, cattle murrain etc. — check out the Black Death Network. Spirochetes Unwound discusses the latest theory on the mysterious epidemic of 1616-1619 that decimated native Americans along the New England coast. Here on Contagions, I posted on the isolation of smallpox DNA from 17th century Siberia. The History of Vaccines blog posted a sketch of smallpox vaccine production in a cow, along with a discussion of vaccine production in 1872. Bringing us up to the 20th century, Rebecca Kreston of Body Horrors brings us the story of the first case of HIV in a 1961 Norwegian teenager who brought an unusual strain of HIV (group O) to his family and seeded it across in Europe.

Genomics

Genomics can help unravel the history of peoples who have left little documentary record. History of the Ancient World Blog has a post on a new study examining Scythian genetic admixture. Katherine Harmon of Observations covers a new study showing Gypsy or Roma origins in India about 500 CE/AD. This places the movement of the Roma out of India into Central Asia during the Great Migrations period that occurred when the Western Roman Empire fell in the fifth century. Interesting to think of the Roma as the last of the 1500 year old Great Migration peoples. Also covered on Past Horizons.

Mike Drout and his team at Wheaton have been applying DNA analysis and statistics software to Old English texts to determine authorship. They call it Lexomics — check them out.

Medical Practice and Public Health

Early modern medical practice was in the spotlight this month. Mike Rendell, The Georgian Gentleman puts a spotlight on contemporary views of 18th century medical practice. Home remedies were not any more successful, as ThonyC of Renaissance Mathematicus writes about in George Boole’s death from his wife’s homeopathy. Jai Virdi of From the Hands of Quacks explores the motivations of Dr Curtis‘ founding of the Royal Dispensary for Diseases of the Ear. The Secret Histories Project brings us a biography of the unconventional Dr. James Barry, child genius, military surgeon, and annoyance of Florence Nightingale. Venessa Heggie of The H Word, writes on the 70th anniversary of the Beveridge Report, that founds the modern British welfare state, about earlier attempts to build a social safety net in Britain with Elizabethan Poor Laws and the infamous Victorian workhouses. New blogger Jennifer Evans of Early Modern Medicine writes about the rhetoric of men pushing through the pain. Lisa Smith’s of the Sloane Letter project, she looks at the problem of bed wetting in the 18th century. Lindsey Fitzharris of The Chirurgeon’s Apprentice got ready for the holiday season by picking 12 (medical) instruments of Deathmas; most are sure to make you squirm. Caro of The Quack Doctor writes about the fun and games at Illinois Pharmacological Association meetings for traveling salesmen near the turn of the 20th century. Lynsey Shaw of the History of Military Aviation Hospitals writes on The Oxford Military Hospital, 1939-45.

Efforts to figure out the brain were popular this month. Michael Finn of Asylum Science wrote about the use of ophthalmoscope to view the living brain in asylums. The Public Domain Review reprinted “The Brain of Charles Babbage” (1909), the ‘father of the computer’. Darin Hayden wrote about a phrenological examination of Andrew White (who played a role in igniting the friction between science and religion).

On chemicals we are better off without, Marieke Hendriksen of the Medicine Chest writes about how mercury was viewed by early medical practitioners. Deborah Blum of Elemental writes about how early the US FDA knew about radiation dangers in cigarette smoke.

Pharmacy and Diagnostic Texts

Christina Agapakis of the Oscillator writes about the medieval Urine Wheel to diagnose metabolic diseases.

Michelle DiMeo of the Recipe Project writes about Dr Crawford Long’s exploration of the uses of ether for insect bites. Lisa Smith at the Recipe Project writes about a treatise claiming coffee cures the plague. In the area of hard to find reagents, Chelsea Clark of The Recipe Project shines light on the wonders of unicorn horns, bezoars and bones of a stag’s heart for poisoning. Alas, black markets for animal products like Rhino’s horn (a unicorn substitute) and bear gal bladder is still very active and taking its toll on increasingly rare animals. A little easier to resource, Jonathan Cey of the Recipe Project, shows us that feces-containing remedies were common in the early modern pharmacopoeia. So patients were more right than they knew when they said their medicine tasted like crap! Pamela Dangle also of The Recipe Project writes about some really “fishy” remedies for Melancholy (that seem rather unlikely to help, to me). Thinking of odd remedy names, Tim Jones of Zoonomian writes about medical misnomers of the past.

Physics, Astronomy, and Earth Sciences

ThonyC of Renaissance Mathematicus writes about the astronomical and medical roots of the first pocket diary (calendars). I’ll never look at those moon symbols on my calendar the same way again. Sorry Dad, the phases of the moon are not on the calendar to tell you when the fish are biting. Along similar lines of finding practical solutions to scientific dilemmas, Rebekah Higgit of The H Word writes about the catching and keeping of spiders to spin eyepiece filaments for astronomical observations. On the Royal Society blog, Rupert Baker writes about Thomas Hardy’s historical fiction on early astronomers and the royal society.

Let’s get a little textual with our astronomy, starting with Jenny Weston of Medieval Fragments who writes about medieval star-gazing. Astrolabes and Stuff discusses how to construct a medieval equitorium of Mercury and also for the Moon. Katy Barret of the Longitude blog writes about use of Cook’s journals and her longitude book collection. Sarah Werner of The Collation writes about volvelles (movable wheels) on folios of science and pseudoscience books.

Harald Sack at Yovisto writes about the golden-nosed astronomer Tycho Bahre and on Werner Heisenberg and the uncertainty principle. Alberto Vanzo of Early Modern Experimental Philosophy writes about the contributions Geminiano Montanari and the Italian academy. Matt Wisnioski guest posted on American Science about the motto “Change or Die!”

David Bressan of History of Geology writes about how philosophies of the nature of the world effected the study of the history of the Earth, and early efforts to measure its age. BibliOdyssey posts some of the original sketches and paintings of the discovery of Australia and its wildlife and then on Plant atlas from 1878-1783.

Dr SkySkull of Skulls in the Stars sets the record straight on Benjamin Franklin’s kite electricity experiments, outlines Priestly’s 1767 account of Franklin’s experiments and writes of the dangers of experimental ballooning in 19th century. Moving on from riding aloft to the winds on the plains, Carol Clark of Wonders & Marvels writes about the role of wind power in settling the arid American west.

Christian Hansen of Hummus and Magnets writes about the analytical programming of Babbage’s early calculating machines.

Lisa Smith will be hosting the next On Giant’s Shoulders carnival on the Sloane Letter Project in January. So watch for Lisa’s posts on twitter (@historybeagle) for more information.

I hope you found something enlightening and entertaining for a long winter’s night. Watch out for sleighs this holiday season, reindeer get spooked with all the holiday traffic!

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Bubonic Plague Music Video

Whoa, educational videos have changed a little since I was in high school. This video is by a group called History for Music Lovers (@historyteacherz). Their Bubonic Plague rap is set to Gwen Stefani’s Hollaback Girl. From the comments on You-tube, its being shown in history classes,  over 700,000 hits as of Nov. 15, 2012.

h/t to Tara Smith at Aetiology.

Opening the Plague Files

Book Citation: A.P. Cook & N.D. Cook.  The Plague Files: Crisis Management in Sixteenth-Century Seville.  Louisiana State University Press, 2009. 296 pp. ISBN: 978-0-8071-4360-5.

Topic:
Public Health Crisis Management

Time and Place:
Seville, Spanish Empire, 1579-1581.

Audience: 

Those interested in history, crisis management, public health, and political science; written for a general audience.

Discussion:

The Plague Files is an intensive history of the daily challenges and crises dealt with by the royal governor and city council of Seville from 1579 to 1582.  As its title implies, this book is about crisis management and it stays true to this focus. Seville was faced with two very different pandemics, influenza and plague, within the same year compounded by food shortages, economic pressures, response funding difficulties, response fatigue, and the potential of civil unrest. If you ever wondered what it would be like for plague and an influenza pandemic to go (sequentially) head to head in the same population, Seville in 1579-1580 is your ideal test population.  The challenges and limitations of both quarantine and a cordon sanitaire are highlighted throughout the book.

I was impressed by their case investigation and surveillance system.Workers were contracted and paid based on their service, so detailed reports were filed to justify their pay from the plague commission. Using these reports, the authors were able to trace the detailed steps of case investigators as they tracked exposed people and textiles that they viewed as contagious. Dispatched surveillance officers also had to file detailed reports of their efforts and findings to draw their pay. The Count of Villar, the royal governor, handed out penalties including jail time for officials and others who were deemed negligent in their duties.

It was fascinating to see how their concepts of contagion played into their public health response. Textiles were the gravest concern for controlling plague contagion inside the city walls. The trail of dead owners of some clothing or bedding seems to justify their concern. Yet, there is no evidence of personal protective equipment/behavior or concern over grain storage. On the other hand, the city was on the verge of starvation much of the time so they couldn’t be very choosy about grain shipment or storage. Physicians were advisers to the Plague Council but not central to the decision-making process. Most were hired to work for the duration of the plague, often one per hospital or outlying village. The Plague Council was primarily concerned with controlling movements of people, and  providing and paying for the poor and destitute who they knew were kindling for an explosive outbreak. Diagnosis was the physicians most useful duty to the plague council. Plague diagnoses were complicated by concurrent outbreaks of influenza, typhus, other ‘common fevers’ (possibly malaria), and malnutrition. There is no doubt that the plague with all its classic symptoms was the primary pathogen.

One of my take home lessons from The Plague Files is how long and relentless a plague outbreak could be. Response fatigue was a critical problem for everyone. People just get tired of the restrictions and become conditioned to the steadiness of death. Unlike the short, sharp influenza mortality, plague deaths often trickled in at less than ten per week for months punctuated by spikes of death.

Historical  & Scientific Content:

This microhistory draws almost entirely  from a cache of primary source documents in Seville’s Municipal Archive. Surprisingly, quotes from these documents are very short. The focus on Seville is so intense context is often lacking.

The science is anecdotal and kept at the level of sixteenth century understanding. They don’t apply modern understanding of plague or influenza.  Medical treatment is discussed vaguely; few specific treatments are detailed. For example, the council paid for apothecaries to stock and provide plague medicines but the authors didn’t discuss what they stocked or if they had difficulty obtaining medicines. It appears that there was no standard treatment or medication used in the region. They don’t make an effort to accumulate data or do any standard epidemiological analysis. By the end of the book I was craving some data. The volume of anecdotal evidence does provide plenty of evidence that diagnosis was not very secure for many individuals complicating data classification.  Historical epidemiologists will have to cope with other concurrent diseases, significant for plague outbreaks that last months to over a year. Ironically in the case of Seville, I suspect a standard epidemiological chart of total deaths vs time would have highlighted the difference between influenza and plague.

References, Illustrations, and Usability

It has a full bibliography but minimal footnotes, mostly to primary sources. I suspect that it would be fairly difficult to look for more information based on their footnotes and access to the primary sources.  They appear to have made minimal use of the secondary sources, or at least there are very minimal footnotes to them. It does have a glossary for Spanish terms; all quotes are translated. The illustrations were okay. It could have used a few more local maps fit into the text where appropriate.

I recommend this book primarily for biosecurity and crisis managers. Its usefulness to the sciences and humanities is primarily for anecdotal information.