British population history: from the Black Death to the present day

Muslim Rebellion (1856-73) the movements of troops again disrupted the ecological equilibrium, and further plague epidemics ensued. The war also forced the opium traders to take an alternative trade route between Yunnan, which was a major Chinese opium growing area, and Lingnan. The ecological conditions of the new route were more favourable for the spread of plague. After 1860 plague gradually spread eastward and finally reached Canton and Hong Kong. Benedict is familiar with Andrew Cunningham's argument that the rise of laboratory medicine has radically transformed the identity of plague, and that bubonic plague defined by bacteriology should not be confused with "plague" recorded in the pre-bacteriological literature. But Benedict believes that "by supplementing the historical record with knowledge drawn from modern epidemiology, medical geography and regional analysis" (p. 11), this identification can be achieved. However, as the author admits, this approach faces several difficulties. It relies on the assumption that the environment of this region remained unchanged during the past two centuries (p. 24). This assumption has not been proved. Moreover, the nosology of traditional Chinese medicine differed significantly from Western medicine. Until the late nineteenth century, there was not even a Chinese word corresponding to "plague" (p. 8). Most Chinese historical literature documented only when and where epidemics occurred without giving detailed descriptions of them (p. 11). Given these difficulties, Benedict's assertion seems highly problematic. The second half of the book documents various Chinese responses to the alleged plague epidemics. Benedict gives a succinct account of the controversy between the Cold Damage school and Warm Factor school of Chinese medicine over the cause and treatment of "plague". She also gives a vivid description of popular religious beliefs about "plague" and the rituals practised to exorcise it. The account in chapter 5 of the conflict between British colonial authorities and the Dunghua Hospital, a powerful Chinese charity organization, is a nice study of native resistance to colonial medical policy. Until the end of the nineteenth century, the Chinese government seldom imposed public health measures during the plague epidemics because Chinese medicine did not consider the disease contagious. However, after China was defeated in the Sino-Japanese War (1894-95), the Chinese reform movement introduced public health institutions based on the Japanese model, which relied on policing to enforce health policy. Benedict uses the responses of the Shenyang city police to the Manchurian plague epidemic as an example to illustrate the character …