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The Pioneer Plague Fighter, Dr Wu Lien-Teh

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The Pioneer Plague Fighter

Dr Wu Lien-Teh (Chinese: 伍連德; pinyin: Wu Liándé), the Father of Modern Medicine in China. World renown epidemiologist and plague fighter. Pioneer in research and control of plague and other related infectious diseases. You most probably would not know this unpretentious brilliant doctor scientist who was born in 1879 in Penang, the beautiful island on North-west Malaysia, where I was born and bred, and I am still living here. Dr Wu was the pioneer plague fighter sent to Manchuria (North-eastern China) in 1910 by China to fight the pneumonic plague there.

Dr Wu Lien-Teh’s name was often mispronounced. The “Teh” is pronounced “Ter”. Dr Wu’s brilliant academic credentials are too long to note here, let alone his tremendously great achievements in the field of epidemic research and control contributions, not only in China but also across the world especially through the League of Nations at that time. This article is about some of his outstanding contributions to medical science, especially plague and epidemic control. He introduced many “firsts” in terms of diagnostic applications, disinfection and protection protocols, quarantine and separation procedures, and even method of disposal of corpses.

Dr Wu, formal pose with his decorations. 1922.

Dr Wu, formal pose with his decorations. 1922.

Dr Wu’s outstanding credentials

During his student years in the most prestigious school in Penang, the Penang Free School, Dr Wu won the prestigious Queen’s Scholarship (named after Queen Victoria) awarded to only two top students each year in the then Straits Settlement of Penang, Malacca and Singapore. For that year Dr Wu was the only one awarded as none passed the grade. This entitled him to be admitted to Cambridge University for medical studies. Dr Wu was the first Chinese medical student at Cambridge. At age 24, he completed his M.D. degree, 2 years ahead of the time required. During his medical training, Dr Wu won virtually all the available scholarships and top prizes. At the onset, Dr Wu had the opportunities to embark on research, mainly in bacteriology, with eminent scientists, not only in England but also in France and Germany. That was when he learned to speak French and German.

Dr Wu Lien-Teh spent almost 30 years of his most active life in China from 1908 to 1937. Initially, Dr Wu opened a private clinic in his home island of Penang and was also active in social issues such as the opposition to opium smoking. On one occasion, a delegation from the China Foreign Commission passed by the port of Penang, and one of its members, Mr Alfred Tze was introduced to Dr Wu. Dr Wu must have made a great impression on Alfred Tze that upon returning to China, he recommended the Chinese government to invite Dr Wu to take up the post of Vice-Director of the Imperial Army Medical College in Tientsin, China. Dr Wu accepted and went to China in 1907. He was only 28 years old. From then, Dr Wu embarked upon his remarkable career as a medical research scientist which lasted 30 years, if not for the Japanese invasion of China that year. Meanwhile, Alfred Tze rose to become His Excellency Saoke Alfred Sze, Chinese Ambassador to the United Kingdom and later Chinese Ambassador to USA. Both Dr Wu and Alfred Sze became long-lasting friends. Alfred Sze was three years older than Dr Wu. One, a brilliant statesman having obtained his M.A. degree from Cornell University in America, and the other a brilliant medical scientist. Dr Wu dedicated his 600-page autobiography to two eminent personalities. One is His Excellency Saoke Alfred Sze and the other, Sir William Napier Shaw, his senior tutor at Cambridge University.

Dr Wu, working in his first plague laboratory, Harbin, Manchuria, Jan 1911

Dr Wu, working in his first plague laboratory, Harbin, Manchuria, Jan 1911

The pneumonic plague in Manchuria

Dr Wu wrote in his opening chapter of his 600-page autobiography “Plague Fighter”:

“Late in the bitterly cold afternoon of December 24, 1910, there arrived at the large railway station of Harbin in North Manchuria a young Chinese doctor, short of stature even for a southern Chinese, being just 5 feet 5inches tall, accompanied by his assistant, a lanky Cantonese.” (Page 1, “Plague Fighter, The Autobiography of a Modern Chinese Physician” by Dr Wu Lien-Teh)

From the very first opening sentence, Dr Wu displayed his humility, underestimating his lack of height. In all honesty, the average height of southern Chinese men was at that time 5 feet 5 inches. Dr Wu was indeed of correct height for a southern Chinese.

Thus, began Dr Wu’s 30 years of illustrious medical achievements and contributions to China and the rest of the world in the field of plague and epidemic control and eradication.

Against all odds in terms of little information on the disease, lack of qualified staff, the extremity of the harsh climate, the unsanitary conditions, the remoteness of the location, and the initial resistance of the ignorant and superstitious locals as well as the racial slurs heaped upon him by egoistic Western diplomats and especially one French doctor, he successfully eradicated the epidemic within a short period of 3 months. He was only 31 years old then.

From this Manchurian “black death” epidemic of pneumonic plague, Dr Wu invented and initiated many firsts in matters of control and prevention, segregation and quarantine, and even the disposal of corpses.

The “Wu” face masks: Dr Wu created the special face mask to protect against air-borne infection, as he had ascertained that infection was air-borne from the infected cough and sputum. His special-designed masks did the job effectively. Later, the mask popularity was such that it was called the “Wu” mask. It was recently noted that the current N95 masks were designed from the Wu prototype.

Disinfecting protocol: Dr Wu introduced strict step-by-step disinfection procedure for staff before they leave the hospital.

Protective suits: Special protective suits to be worn by medical staff.

Segregation of the sick from the rest: Quarantine of confirmed patients to prevent spread of the disease in isolation wards.

Restriction in movement: This is the predecessor of the present “lock down” scenario of the Covid-19 pandemic.

Disposal of the dead by cremation: The coffins were literally piling up by the thousands. This posed a danger to health. It was impossible to bury the coffins in individual graves due to lack of manpower and the deep frozen state of the ground. Dr Wu concluded that the most practical and effective manner was by cremation. This was a never-thought-of idea of great taboo to the Chinese community. It was of such sensitivity that Dr Wu had to obtain a decree from the Emperor to allow the whole-scale mass cremation. Permission was granted by the Emperor, and a huge bonfire was set alight on 31 January 1911. The first in history of mass cremation of thousands of coffins!

The tally of deaths was 60,000. Just imagine if Dr Wu had not eradicated the disease on time. For this achievement, Dr Wu became very famous worldwide among the medical and scientific communities. He received top awards from the Emperor of China, the Tsar of Russia, the French government, and the Imperial University of Tokio, just to name three.

The 1910 pneumonic plague epidemic control operations conducted by Dr Wu was perhaps the first scientifically documented event of this topic in world medical history. Dr Wu became a world-renown authority on plague control and eradication. More challenges and achievements to come after the story of the French doctor, Mesny.

Collection of corpses, Fuchiatien, Manchuria, 1911

Collection of corpses, Fuchiatien, Manchuria, 1911

2nd Manchurian plague, 1921. Dr Wu extreme right.

2nd Manchurian plague, 1921. Dr Wu extreme right.

The ultimate price of foolish arrogance

One very arrogant French doctor by the name of Mesny arrived a week later than Dr Wu at Harbin. Dr Wu paid him a courtesy call and briefed him of the results of his (DR Wu’s) initial investigation of the disease and the importance of wearing special protective face mask. This is the extract from Dr Wu’s own writing,

[The Frenchman was excited, and kept on walking to and fro in the heated room. Suddenly, unable to contain himself any longer, he faced Dr Wu, raised both his arms in a threatening manner, and with bulging eyes cried out “You, you Chinaman, how dare you laugh at me and contradict your superior?”

Dr Wu replied, “I am sorry, Dr Mesny, that our talk intended by me to be a friendly one, should lead to such unpleasantness.”] (Page 19 of Dr Wu's Autobiography)

Dr Wu then left the place.

Dr Mesny later visited another hospital operated by the Russians. He examined a few infected patients without wearing a mask against the advice of Dr Wu. A few days later, he was infected with the pneumonic plague and died 6 days after he examined the infected patients without wearing a protective mask. The ultimate price of blind and foolish arrogance.

Subsequent events after end of the 1910 epidemic.

The International Plague Conference: Following the success in eradicating the pneumonic plague in Manchuria in 1911, China organized a grand scientific and medical international conference in April 1911 in Mukden, China, probably the first of its kind in the world. Dr Wu was given the task of preparing the conference which would last one month. A total of 11 nations attended. They were USA, Austria-Hungary, France, Germany, Great Britain, Italy, Japan, Mexico, Netherlands, Russia and China. Dr Wu being the Chairman of the conference. The conference deliberations were compiled into a 500-page “Report of the International Plague Conference, 1911”.

The Manchurian Plague Prevention Service: The success of the International Plague Conference brought about the establishment in 1912, of the Manchurian Plague Prevention Service with headquarters in Harbin. Dr Wu became its Director and Chief Medical Officer. This was the first well organized implementation of a public health service in the China.

The Chinese Medical Association: As early as 1910, Dr Wu had already outlined a plan for the establishment of a central Chinese Medical Association. And in 1915, the Chinese Medical Association was formed with Dr Wu as its first Honorary Secretary. Subsequently for two terms he was elected President from 1916 to 1920.

Further establishment of hospitals, laboratories and research institutions across China: In 1913, Dr Wu submitted a long memorandum on “Medical Education in China” to the Central Government of the new Republic of China suggesting:

“radical improvements in the training of medical students…..the establishment of a Central Medical Council to supervise such studies, and the need of studying the English language in addition to Chinese for medical students.”

From the period between 1912 to 1937, Dr Wu was instrumental for the establishment and building of many hospitals, laboratories, and research institutions all over China. Two most notable establishments were the Peking Central Hospital in 1918, which became the model civil hospital of China, and the National Quarantine Service in 1930, which controlled the movement of peoples in the major ports of China. Dr Wu was the first Director.

Health Section of the League of Nations: After the successful control and eradication of the 1910 Manchurian pneumonic plague, Dr Wu was recognized as the world’s foremost authority on infectious diseases, particularly the pneumonic plague. In 1926, his comprehensive 500-page scientific report “A Treaties on Pneumonic Plague” was presented to the League of Nations in Geneva. Following this publication, Dr Wu was invited by the League of Nations, Health Section, to make a study of health organizations and research institutions in 12 European countries. His knowledge of French and German greatly facilitated the arduous assignments.

A place in Chinese History: The “Biographies of Prominent Chinese” was published in 1925, and Dr Wu was accorded a full page in bi-lingual Chinese and English.

History of Chinese Medicine: Dr Wu was not only a brilliant bacteriologist; he was also a gifted medical historian. In 1932, he jointly co-authored and published the monumental 900-page “History of Chinese Medicine”.

Official delegates from 11 nations attending the International Plague Conference, Mukden, Manchuria, April 1911. Dr Wu, Chairman, 4th from right.

Official delegates from 11 nations attending the International Plague Conference, Mukden, Manchuria, April 1911. Dr Wu, Chairman, 4th from right.

The pride of China's health advancement. The first model civil hospital of China. Peking Central Hospital, opened in 1918.

The pride of China's health advancement. The first model civil hospital of China. Peking Central Hospital, opened in 1918.

Dr Wu co-authored the book, "History of Chinese Medicine", published in 1932.

Dr Wu co-authored the book, "History of Chinese Medicine", published in 1932.

Dr Wu impressive academic credentials and awards

Dr Wu’s list of academic achievements and awards is too long to list here. The Chinese Government awarded him numerous decorations, awards, and honors in recognition of his invaluable contributions to the knowledge and treatments of plague, cholera, scarlet fever and other communicable diseases, as well as the establishment of hospitals and centers of research for the advancement of science and medicine in China.

A selected number of awards are as below.

Second Class Double Dragon by the Imperial Throne.

Viceroy of Manchuria Gold Medal by the Chinese Government.

Major of the Imperial Army of China.

Order of Stanislaus Second Order by Czar of Russia.

Legion d’honneur by the French Government.

Degree of Chin Shih or Litt.D. by the Imperial University.

Degree of igaku-hakushi by Imperial University of Tokio.

Honorary degree of Doctor of Laws (LL.D) by University of Hong Kong.

Honorary degree of Doctor of Science (D.Sc) by St John’s University, Shanghai.

Elected by the Russians as Foreign Member of the Society of Microbiology of USSR.

Unveiling of Dr Wu's bust erected by the   Dr. Wu Lien-Teh Society, in front of the Penang Institute, Penang, Malaysia.  Picture shows the Chief Minister of Penang, family members and relatives of Dr Wu and other dignitaries.

Unveiling of Dr Wu's bust erected by the Dr. Wu Lien-Teh Society, in front of the Penang Institute, Penang, Malaysia. Picture shows the Chief Minister of Penang, family members and relatives of Dr Wu and other dignitaries.

My parting comment

Dr Wu’s first 3 years coincided with the last 3 years of the Manchu Qing dynasty. His career span through the political turmoil of China, from the fall of Qing dynasty, the warlord period, the Nationalist government, and the civil war with Mao’s army. It was in 1934, that Mao’s army embarked on the infamous historic Long March. During the initial change to the new Chinese regime, Dr Wu was appointed “Physician Extraordinary” to successive Presidents of China.

Dr Wu in a way had seen it all. The sick, the suffering, the dead, the infighting, the racial slurs, all the horrors of existence. Dr Wu had seen it all, which made this good doctor to be such an upright and compassionate human. The world might have forgotten him because he was not vocal. He only served, served and served. That made his personal life rich and meaningful. He passed away of stroke on 21 January 1960 in his home island of Penang where he was supposed to spend his quiet twilight years in an unassuming single-storied terrace house. He was 81 years old. He passed away hardly a week after moving into his new humble home.

Dr Wu left behind a very valuable book written by him, the 639-page “Plague Fighter, Autobiography of a Modern Chinese Physician". This book took Dr Wu 7 years to complete from 1950 to 1957. It was published in 1959, a year before Dr Wu passed away.

The world may have forgotten Dr Wu but not China. There are many memorial busts and statues of Dr Wu around China and many lecture halls named after him. There is also one Dr Wu’s bust in Penang erected by the Dr Wu Lien-Teh Society of Penang. There are also 2 roads named after Dr Wu, one each in Penang and in Ipoh, Malaysia. A very special recognition was accorded to Dr Wu by his alma mater, the Penang Free School. The school had a special “house” naming system for its sports activities. The students were divided into 5 houses, each taking on a color. One of the houses was and still is called Wu Lien-Teh house. The color is green.

My copy of Dr Wu's autobiography published in 1959.

My copy of Dr Wu's autobiography published in 1959.

Dr Wu’s Philosophy

“I have emphasized the need of faith, perseverance and originality: the first, because without it during troublous times we would simply have to throw up one’s hands and despair: the second, because no great scientific or medical benefit has yet been achieved without thorough attention to accuracy and details; the third, because with a conservative education handed down for 4000 years like ours, it is most essential for our minds to branch out in new directions so as to cope successfully with the progressive tendencies of the times.” (Comment of Dr Wu in 1924, after the 2nd Manchurian pneumonic plague 1920-1921. Page 89 of “Memories of Dr Wu Lien-Teh”)

“But in order to achieve the quickest and most permanent results in the most economical way, her leaders should absorb the best that the West can offer, such as, seriousness of purpose, service to others as well as self, a scientific temperament, rigid scrupulousness in management of business undertakings, attention to detail and a willingness to learn from outsiders even at the height of success. On the other hand, they should eschew the weaker points of western civilization, such as, undue worship of material success at the expense of the soul, over-indulgence in the ordinary comforts of life and luxuries, and lack of discipline in the family.” (Dr Wu, Shanghai, China, 1931. Page 9 of “Memories of Dr Wu Lien-Teh”)

My copy of "Memories of Dr Wu Lien-Teh", by her eldest daughter Wu Yu-Lin, 1995, reprinted 2016.

My copy of "Memories of Dr Wu Lien-Teh", by her eldest daughter Wu Yu-Lin, 1995, reprinted 2016.

The Plague Fighter Dr Wu Lien-Teh Part 1 of 3

Comments

Justin Choo (author) from Malaysia on March 31, 2020:

Jack Lee, Thank you for the encouraging compliment.

Jack Lee from Yorktown NY on March 30, 2020:

Congratulations on this excellent article detailing a historical significant life of Dr. Wu. Well done.