1894 Hong Kong plague

Outbreak of bubonic plague in Hong Kong in 1894 Staffordshire Regiment cleaning plague houses, Hong Kong. Wellcome L0022366.jpg Soldiers cleaning out plague houses Bubonic plague Yersinia pestis Hong Kong 1894 20,000 93% 3 (Hong Kong Island, Kowloon and New Territories) The 1894 Hong Kong plague, part of the third plague pandemic, was a major outbreak of the bubonic plague in Hong Kong. While the plague was harshest in 1894, it returned annually between 1895 and 1929, and killed over 20,000 in total, with a fatality rate of more than 93%. The plague was a major turning point in the history of colonial Hong Kong, as it forced the colonial government to reexamine its policy towards the Chinese community and invest in the wellbeing of the Chinese. Origins Third plague pandemic The third plague pandemic originated from plague reservoirs of Rattus tanezumi in Yunnan, China. Plague outbreaks were documented in Yunnan province gazetteer records as early as 1772, gradually spreading along provincial trade routes in subsequent decades. In the 1850s, driven by trade networks, troop movements, and refugee migrations (see Panthay Rebellion), plague outbreaks accelerated in the province. These outbreaks spread to parts of nearby Guangxi and Guangdong by the 1860s, reaching the Pearl River Delta in the 1890s.Benedict 1996December 2025 An outbreak in neighboring city of Guangzhou from January 1894 onwards killed 80,000.Pryor 1975 62 By March 1894, British scientists and doctors in Hong Kong became aware of the outbreak in China. By the end of April, the government in Hong Kong requested Dr. Alexander Rennie, the consular surgeon for Canton, to report on the disease. Rennie identified it as the bubonic plague, but said it would not be particularly contagious except to those living in filth, poor ventilation, and with a poor water supply.Sutphen 1997 85-86 The spread to Hong Kong from Guangdong was accelerated by the unrestricted movement of workers and boats into Hong Kong.HKMSSS 2006 26-27Pryor 1975 62 The outbreak also coincided with the replacement of junks with steamships, which made travel between infected ports faster and more convenient,Benedict 1988 132-134 and the return of Chinese celebrating Qingming Festival from Guangzhou to Hong Kong.Kang 2015 69 On March 2, 1894, a large Chinese procession was held in Hong Kong, which involved the arrival of 40,000 laborers from Canton.Public Health Reports 1906 656 Living conditions of the Chinese The Chinese-majority Tai Ping Shan district, where the first cases appeared,Pryor 1975 61 was characterized by having poor ventilation, drainage and sanitary services, and was overcrowded.HKMSSS 2006 27 In 1880, Colonial Surgeon Dr. Philip Burnard Chenery Ayres reported that, while he was investigating the sanitary conditions of the Chinese, "many and many a time have I come out of the houses to vomit in the street, in spite of using strong scents and essences to prevent it," and he warned that "while this state of things continues we stand in danger of being visited at any moment by some fearful epidemic, and I do not think the most advanced sanitary authority at home would combat this opinion."HKMSSS 2006 27-28 In 1881, Royal Commissioner Osbert Chadwick was sent to Hong Kong to investigate the sanitation situation of Hong Kong. Chadwick proposed improvements on drainage, water supply and night soil removal system, which he hoped to be implemented "without waiting for the necessity to be demonstrated by the irresistible logic of a severe epidemic." His recommendations were not acted upon, save for the establishment of the Sanitary Board.Ching 2018 48-49 The summer of 1894 saw Hong Kong suffering from a dry spell, which did not wash away the usual house refuse accumulating on the streets. This helped the growth of rats and fleas, and was thought to have accelerated the spread of the plague.Pryor 1975 66 Spread in Hong Kong thumb|right|Soldiers cleaning plague houses posing with a coffin The first case was discovered by Scottish doctor James Alfred Lowson, acting superintendent of the Government Civil Hospital, on May 8, 1894.HKMSSS 2006 28-29 The patient, named "A. Hung", was a ward boy, presumably working in the Government Civil Hospital.Solomon 1997 59Choa 1993 133 "A. Hung" died 5 days later.Choa 1993 134 On May 10, 1894, the city was declared an infected port.Pryor 1975 62 On the same day, a Sanitary Board meeting was convened. The Sanitary Board was headed by James Stewart Lockhart. At the meeting, Lowson argued for a strong quarantine policy, including the removal of Chinese from their houses. Some on the Board, including Dr. Kai Ho, expressed concerns that the policy would offend the Chinese, and that the Chinese would refuse to comply to such government policies.Sihn 2017Sutphen 1997 90-91 The Sanitary Board opted to follow the advice of Lowson.Solomon 1997 59 On May 12, a Permanent Committee was formed to enforce quarantine measures. The committee was chaired by J. J. Francis and included Captains-superintendent Francis Henry May and Ayres.Sihn 2017 Lowson was given de facto charge to contain and combat the plague.Ching 2018 50 The Whitewash Brigade On May 11, legislation was passed to make the reporting of cases compulsory and to allow authorities to enter houses to search for and remove infected persons for isolation.HKMSSS 2006 29Pryor 1975 63 House-to-house inspection and disinfection were performed by the local garrison, the Shropshire Light Infantry.HKMSSS 2006 30 The inspection and disinfection team was known as the "Whitewash Brigade",CRASSH 2018 consisting of around 300 men and 8 officers.Choa 1993 135 During an inspection, the occupants were given new clothes and sent to temporary lodgings on Chinese boats anchored off Stonecutters IslandPryor 1975 65 or to government-hired buildings, including the Alice Memorial and Nethersole Hospitals.HKMSSS 2006 30 Their own clothes and fabrics in the house would be sent to a steam disinfecting station. The house was then sprayed with a solution of perchloride of mercury or fumigated by chlorine gas, the floor and furniture cleaned with Jeyes Fluid and the walls lime-washed ("whitewashing").Pryor 1975 65 Household items suspected of being contaminated were burnt.HKMSSS 2006 30 Members of the Shropshire regiment became the first Europeans to be affected by the plague.HKMSSS 2006 29 At least one officer died to the disease.Choa 1993 135 Clashes with Chinese community thumb|right|Soldiers burning household items At the time, Chinese residents of Hong Kong had a deep mistrust of Western medical science, making the containment of the plague difficult. The distrust was exacerbated by ineffective treatment and highly intrusive policies by the colonial government.Benedict 1996 149 The Chinese would hide their sick from the authorities,Pryor 1975 63 and infected bodies would be thrown out at night to avoid detection.Pryor 1975 65 The western practice of using ice to cool down a fever was rejected by the Chinese, who viewed extreme cold as damaging to the body.Benedict 1988 139 The quick and hasty burials performed by the government, with the bodies covered in quicklime, were also offensive to the Chinese.Yu 2017 49 In 1903, the government had to reimburse the cost of disinfected clothing to the Chinese, as they had disliked the smell of disinfectant.Wong 2015 124 The house-to-house inspection was especially resisted by the Chinese community.Pryor 1975 63 Chinese ladies were reluctant to let strangers, let alone foreigners, enter their boudoirs.HKMSSS 2006 30 Rumors of British soldiers seeking to rape Chinese women arose.Kang 2015 101-102 In one instance, on May 19, the Whitewash Brigade was pelted with stones, bricks and rubbish.Yu 2017 49 In another instance, around 100 women, relatives of the deceased, organized a meeting at Tung Wah Hospital, where they wailed and cried against the community leaders and hospital administration. The government responded to the meeting by forbidding searchers to enter Chinese households without permission, and by allowing patients to choose Chinese treatment in Chinese hospitals.Benedict 1988 140 Members of the Chinese community continued to petition Governor William Robinson to halt the cleansing operations completely, and to allow patients to travel to China to seek treatment. Robinson initially refused, but when compradors of major hongs threatened to have their staff leave their posts, Robinson allowed patients to travel to Guangzhou for treatment, and corpses to be transported there for burials.HKMSSS 2006 30-31 However, the whitewashing operations was to be continued. As a result, an anti-government poster campaign was launched in Canton and Hong Kong. This inflamed more rumours against the English doctors, who were said to be making medicine with the bodies of plague victims. Robinson responded by moving the gunboat HMS Tweed to Taipingshan and offering a reward for information leading to the arrest of the poster distributors. Viceroy Li Hanzhang of Canton was also requested to make a statement to deny the rumours. However, these efforts proved ineffective in building trust between the Western and Chinese communities.Pryor 1975 63 Whitewashing could only continue after a great deal of persuasion and explanation by both the government and some esteemed members of the Chinese community.HKMSSS 2006 30 After a time, the operations were suspended.Choa 2000 115 Temporary hospitals Established hospitals around the major areas of outbreak would only accept suspected patients for observation. Once the symptoms of plague appeared, they would be moved to specialized plague hospitals.HKMSSS 2006 29 The plague hospitals included a temporary hospital at the Kennedy Town Police Station (known as the "Kennedy Town Hospital",Wong 2015 125 opened on May 14Choa 1993 134) and the hospital ship Hygeia (海之家), ran by staff of the Nethersole Hospital.HKMSSS 2006 29Pryor 1975 63 When patients were removed according to the policy from Tung Wah Hospital to Hygeia, violent protests erupted in the city.Kang 2015 103-104 Tung Wah Hospital had been a reputable hospital in the Chinese community. It practiced Chinese medicine and was seen as a symbol of Chinese independence in a colonial city.Sutphen 1997 91 Thus, the hospital came under fire from the Chinese community when they allowed patients to be transferred away to plague hospitals. At one point, doctors had to carry pistols to protect themselves.Solomon 1997 60 The riots led to the establishment of a temporary plague hospital at Kennedy Town glass works, known as the "Glassworks Hospital" on May 21.Kang 2015 103-104 This hospital would be staffed by personnel from the Tung Wah Hospital.HKMSSS 2006 29Pryor 1975 63 The patients were offered a choice between the Glassworks Hospital and plague hospitals with European staff. The Chinese-majority patients overwhelmingly chose the Glassworks Hospital.HKMSSS 2006 29 The hospital quickly became overcrowded and sanitary conditions worsened. On June 8, another temporary hospital at an unfinished pig depot was also set up, known as the "Slaughterhouse Hospital", again using staff from Tung Wah Hospital in hopes of relieving the situation at the Glassworks Hospital.HKMSSS 2006 29Pryor 1975 64Kang 2015 105 When the Chinese medicine offered by the Glassworks Hospital proved to be ineffective, and conditions of the hospital continued to worsen, it was closed down on June 16, and its patients were transferred to either Guangzhou or to the Slaughterhouse Hospital. Subsequently, a "New Glassworks Hospital" was set up at the site, this time staffed by European doctors from the Alice Memorial and Nethersole Hospitals.HKMSSS 2006 29Pryor 1975 64 In July, a hospital was established in Lai Chi Kok near a graveyard, but it did not receive any patients. This was attributed to the Chinese refusing to be admitted into the hospital as they felt "they were sure to die."Choa 1993 136Choa 2000 114 Hygeia was later used only to house European, Eurasian and Japanese patients.HKMSSS 2006 30 Economic downturn The plague saw a mass exodus of panic-stricken Chinese workers back to China, causing a significant economic downturn in the city.Pryor 1975 64 The North-China Herald noted that "it is not the plague they are flying from, as they are going to the nest at Canton from which [the plague] came to Hong Kong. They seem rather to be flying from the sanitary measures taken in Hong Kong."Benedict 1988 140 Some were seeking a proper burial on Chinese grounds.Yu 2017 49 At the height of the plague, around 1,000 persons were leaving Hong Kong daily.HKMSSS 2006 32 In May and June, it was estimated that 80,000 to 90,000 Chinese, out of a population of 200,000, left Hong Kong Island.Sutphen 1997 93 Owners of hongs left for China, leaving the businesses to caretakers, slowing down the business operations. The colony suffered a severe labour shortage. Inflation followed, with prices of food items rising by 30 to 50 percent.HKMSSS 2006 32 As visitors to Hong Kong had to be quarantined, trade between Hong Kong and China was decimated.Lee 2013 105 In June, Robinson reported to Secretary of State for the Colonies Lord Ripon that "without exaggeration I may assert that so far as trade and commerce are concerned the plague has assumed the importance of an unexampled calamity."Peckham 2013 220 Land resumption thumb|right|A plaque in Blake Garden commemorating the pandemic On May 31, a bylaw drawn up by the Sanitary Board allowed for the eviction and closure of houses deemed unfit for habitation. Houses on the streets of Kau Yu Fong (九如坊), Sin Hing Lee (善慶里), Nga Choi Hong (芽菜巷) and Mei Lun Lee (美侖里) were demolished, and a brick wall was erected surrounding those areas.Lee 2013 115 In September 1894, the Taipingshan Resumption Ordinance was passed, allowing the resumption of an area of about 10 acres in the Taipingshan district. The area accounted for 50 percent of the cases, and 385 houses in the area were destroyed.HKMSSS 2006 33Holdsworth Munn 2021 12 Around 7,000 inhabitants were displaced.Choa 2000 113 The area was walled up, and guards were stationed to prevent residents from re-entry.Severn 1925 37 This drastic measure called for, as described by Robinson, "the destruction and rebuilding of one tenth part of Hong Kong."Holdsworth Munn 2021 12 Reconstruction began in the end of 1895 and lasted until 1898. Drainage systems were improved, and balconies were installed for better ventilation.Ting Wong 1999 61 An area was marked out for the construction of a Bacteriological Institute. A public park was also constructed. It was named Blake Garden after then-Governor Henry Arthur Blake.Ting Wong 1999 61HKMSSS 2006 156 Today, a plaque stands at the park, commemorating the deadly epidemic.HKMSSS 2006 33 End of the 1894 plague At the peak of the 1894 plague, admissions to hospital averaged at 80 a day, and deaths peaked at over 100 per day.Pryor 1975 64 Taipingshan was not the only area affected by the plague. Areas such as Bowrington (now between today's Wan Chai and Causeway Bay), Sai Ying Pun, Shek Tong Tsui and Kennedy Town saw more deaths than Taipingshan.Benedict 1996 144 Internationally, steamships from Hong Kong carried the bacillus to every major seaport in the world,Benedict 1988 108 including India.Severn 1925 33 The plague subsided with the arrival of cold weather in the winter of 1894.HKMSSS 2006 27 Endemic In 1895, only 44 cases were reported,HKMSSS 2006 27 but the plague returned strongly in 1896, affecting mostly Chinese in the Taipingshan district. Once again, it subsided in winter, and it returned almost annually thereafter.Pryor 1975 64 The plague lasted until 1929, when the last cases were recorded.Pryor 1975 69-70Choa 2000 117 Statistics In total, between 1894 and 1929, there were over 24,000 cases with a mortality rate of over 90%.Pryor 1975 69-70 Between 1894 and 1923, there were 21,867 cases and 20,489 deaths, with a fatality rate of 93.7%.Choa 2000 117 In 1894, there was no law to enforce the notification of deaths.Severn 1925 34 Women suffered a higher mortality rate than men, most likely due to their role as the caretakers of the sick.Kang 2015 110 Cases, deaths and fatality rate, 1894–1901 YearPublic Health Reports 1906 656 CasesPublic Health Reports 1906 656 DeathPublic Health Reports 1906 656 Chinese plague deaths per 1,000Benedict 1996 142 Non-ChineseNoteA a plague deaths per 1,000Benedict 1996 142 Chinese Fatality RateBenedict 1996 142 Non-ChineseNoteA a Fatality RateBenedict 1996 142 Total Fatality RatePublic Health Reports 1906 656 1894 2,500 2,317 10.84 3.82 95.88 68.33 92.7 1895 44 Not known 0.15 0.00 83.72 0.00 Not known 1896 1,205 1,078 4.51 2.63 90.49 65.96 89.5 1897 22 Not known 0.08 0.00 90.48 0.00 Not known 1898 1,320 1,175 4.75 3.39 90.51 64.47 89.0 1899 1,486 1,434 5.85 1.35 97.11 67.74 96.5 1900 1,082 1,034 4.10 0.98 Not known Not known 95.5 1901 1,750 1,666 5.73 2.81 93.34 Not known 95.2 NoteA a Including Europeans, Indians, Japanese, Filipinos, Eurasians, Malays and West Indians Investigation on the cause of the disease thumb|right|A bust of Alexandre Yersin at the Hong Kong Museum of Medical Sciences, near the site of the former Taipingshan district At the beginning of the outbreak, the plague agent was unknown. Although the germ theory was gaining attention in the 1880s, the medical circle of the United Kingdom was still deeply influenced by the miasma theory.Sihn 2017 For example, the decision by the colonial government to place patients on ships and to demolish houses was, in part, influenced by the miasma theory.Benedict 1988 139Wong 2015 125 Lowson speculated on the origins of the disease as "poison is probably developed from atmospheric conditions underneath houses in certain districts, and that it is caused simply by poverty and dirt. In the ordinary sense the disease is not infectious or contagious."Sutphen 1997 87 The means of transmission, now known to be the Oriental rat flea, was also not ascertained. For several years, it had been widely accepted that infection was through the gastrointestinal tract via contaminated food.Severn 1925 35 Before 1901, no efforts were made to remove rats and rat corpses, as there was no consensus about their role in the transmission of the plague.Benedict 1988 139 In 1895, Lowson wrote that "the question of the infection of rats previous to the epidemic being noticed in human beings has been made too much of."Severn 1925 35 Discovery of plague bacillus In April 1894, the Japanese Home Ministry was made aware of the plague in Hong Kong. In response, the Japanese government sent Kitasato Shibasaburō, a bacteriologist, to investigate the plague. On June 5, Kitasato departed Yokohama on City of Rio de Janeiro with a team of 5, arriving in Hong Kong on June 12.Taguchi 2003 On June 14, Kitasato discovered that the bacillus, now known as Yersinia pestis, was the direct cause of the plague. However, he was doubtful of its significance as the autopsy was done 11 hours after death.Solomon 1997 60 His finding was reported by Lowson, who had supported Kitasato's work, to The Lancet. His report was published a week later, on August 25. Pryor 1975 66HKMSSS 2006 35-36Lee 2013 109-110 Following Kitasato's discovery, Lowson reversed his position and adopted the germ theory.Sutphen 1997 99 At almost the same time, on June 15, French-Swiss bacteriologist Alexandre Yersin, a member of the Pasteur Institute working in Saigon, arrived in Hong Kong.HKMSSS 2006 35-36 He was sent there to investigate the outbreak.Solomon 1997 60 Unlike Kitasato, Lowson did not offer Yersin support, as Lowson considered France to be a colonial competitor to Great Britain in East Asia. At the hospital, Yersin would find all the cadavers reserved for Kitasato.Sihn 2017Solomon 1997 60 He was only able to obtain specimens after bribing English sailors responsible for disposing of the bodies of plague victims.Solomon 1997 61 Yersin discovered the bacillus on June 23. Even though Kitasato made the earlier discovery, Kitasato's description lacked precision, and the report was riddled with doubts and confusion. Expert opinion gave credit to Yersin.HKMSSS 2006 35-36Solomon 1997 61-62 The fact that Kitasato was in a hurry to publish his work was considered by some to be the reason for the imprecision.Solomon 1997 61-62Choa 2000 119 Japanese bacteriologist Aoyama Tanemichi and Ishigami Toru (ja 石神亨) also arrived with Kitasato as his assistants.Choa 1993 137Sutphen 1997 94 On June 28, two weeks after their arrival, they were infected by the plague and were sent to Hygeia.Choa 1993 138 In 1895, Aoyama wrote a report criticizing Kitasato's misidentification of the bacillus.Lee 2013 109-110 Even though the means of transmission was still not ascertained,CRASSH 2018 Yersin also found that the bacillus was present in the rodent as well as in the human disease, thus underlining the possible means of transmission.HKMSSS 2006 35-36 After the role of rats in the spread of the plague was understood, the government offered money for caught rats. This policy ended when it was discovered that rat-catchers had been importing rats from Canton for a higher reward. Later, rat poison, glue traps, and rat disposal bins were all employed to help reduce the population of rats.Severn 1925 39-40 In 1896, Yersin returned to Hong Kong to test his plague serum. However, he found no suitable cases in hospitals, and left for China to carry out his tests in Amoy.Severn 1925 38 The bacillus was later renamed Yersinia pestis in Yersin's honour.Solomon 1997 61-62 Impact thumb|right|The Hong Kong plague medal Some historians consider the plague as the starting point of the colonial government's direct involvement and interference in the Chinese community of Hong Kong.Kang 2015 115 The epidemic allowed the government to displace Chinese medicine with Western medicine. Prejudices over Western medicine were overcome.HKMSSS 2006 33 Tung Wah Hospital, where Chinese medicine was originally practiced, was at first considered to be a menace to public safety by the colonial government.HKMSSS 2006 29 The plague allowed the government to reform the hospital.Wong 2015 127 In 1896, it was decided that the hospital would continue its operations, but with greater government oversight.Kang 2015 115 In 1897, the government mandated that the hospital should provide Western treatment. In the same year, over 85 percent of the patients opted for Chinese treatment. The percentage decreased to 68 percent by 1900.Kang 2015 116 A silver medal was struck "in honor of those who assisted in the cleaning up of Tai Ping Shan." On the obverse, a scene of the epidemic was engraved. On the reverse were the inscriptions "For services rendered during the Plague of 1894" and "Presented by the Hong Kong community."Severn 1925 34Choa 2000 117-118 In 1903, the Public Health and Buildings Ordinance was passed to improve the lodging standards of the Chinese. The ordinance, regulating the designs and sanitary conditions of tenement blocks, was drawn up according to recommendations by Scottish physician William John Simpson, who observed the plague in 1902.Pryor 1975 68 On March 15, 1906, the Bacteriological Institute was opened near the Taipingshan area. Headed by Scottish bacteriologist William Hunter, the institute was used for post-mortem and bacteriological examinations, along with the development of vaccines.Sihn 2017HKMSSS 2006 153 It is now the Hong Kong Museum of Medical Sciences. Annual cleaning-up events, known as "Cleaning up of the Environment" (洗太平地), were held until the early 1950s.HKMSSS 2006 34-35 Citations 30em References Association of Schools of Public Health Weekly Reports for June 15, 1906 Public Health Reports June 15, 1906 21 24 641–672 19313994 2081002 Public Health Reports 1906 Benedict Carol Bubonic Plague in Nineteenth-Century China Modern China April 1988 14 2 107–155 10.1177/009770048801400201 189268 11620272 220733020 https://www.jstor.org/stable/189268 January 4, 2021 subscription Benedict Carol Ann Bubonic Plague in Nineteenth-century China https://books.google.com/books?id=gxa7jcVIR9MC 1996 Stanford University Press 978-0-8047-2661-0 Centre for Research in the Arts, Humanities and Social Sciences Centre for Research in the Arts, Social Sciences and Humanities https://www.repository.cam.ac.uk/handle/1810/282067 Shropshire Regiment "Whitewash Brigade" emptying items from Chinese homes in Taipingshan, Hong Kong, and burning them on the street as an epidemic control measure during the 1894 plague outbreak. 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Civil Unrest and Governance in Hong Kong: Law and Order from Historical and Cultural Perspectives https://books.google.com/books?id=EgYqDwAAQBAJ July 14, 2017 Taylor & Francis 978-1-134-98744-3 46–62 Chapter 3: Exclusion as oppression: A quest for extra-legal status for Chinese medicine in colonial Hong Kong Category:Third plague pandemic Category:Disease outbreaks in Hong Kong Category:1894 disasters Category:1894 in health Category:19th-century disease outbreaks Category:1894 in Hong Kong Category:British Hong Kong