Wu Lien-Teh: The father of modern medicine in China

Virtually unknown to most Malaysians, Penangite Dr Wu Lien-Teh was a highly respected epidemiologist and plague fighter in the international medical fraternity. His life story and his heroic feats remain the stuff of legend.

By Koh King Kee

Born in Penang in 1879 to a family of immigrants from Taishan, China, Dr Wu Lien-Teh received his primary and secondary education at Penang Free School. At 17, he was admitted to the Emmanuel College, Cambridge under the prestigious Queen’s Scholarship, where he completed his medical degree two years ahead of requirement, and virtually won all possible prizes and scholarships in a class of 135 students.

With a Research Studentship granted by Emmanuel College, he pursued a postgraduate study of malaria at the Liverpool School of Tropical Medicine, and bacteriology at the Hygiene Institute of Halle in Germany and the Institute Pasteur in Paris. He was the first student of Chinese decent to graduate with an MD from Cambridge University.

Upon returning to Malaya, Wu joined the Institute of Medical Research, Kuala Lumpur, where he did a short stint researching beriberi before setting up his private clinic in Penang. Wu spoke out on many social issues including equal education opportunities for women and the banning of the opium trade in the Straits Settlements. As head of the Selangor Literary and Debating Society, Wu lent strong support to a protest campaign, pressuring the railway authorities to withdraw racist policies that denied first-class carriages to Asians.

Though private practice brought him some wealth, the young doctor wanted to help more people and put his knowledge and training “to seek positions of usefulness rather than of gain” . That opportunity came in 1907, when he was offered the position of assistant director of the Imperial Army Medical College in Tientsin by Grand Councillor Yuan Shi Kai of the Ch’ing Dynasty government. This set off a chain of events that was to change the course of China’s modern medical history.

Plague fighter breaks out in China
In the fall of 1910, the deadly epidemic that had wiped out a quarter of Europe’s population in the 14th century broke out in the north-eastern region of China. The first fatality was reported in the border town of Manchouli, near Russia, and the disease quickly spread to Harbin, the new international township that grew from the development of railways in the region. Within four months, it spread over five provinces and six cities, claiming over 60,000 lives.

The epidemic soon turned into an international health crisis as residents of Harbin started deserting the city and discarded corpses on the streets. The mounting death toll alarmed the diplomatic community in Peking. Foreigners were fearful of mingling with the local Chinese and even restricted them from entering the diplomatic enclave. Meanwhile, the Ch’ing government was also concerned that Japan and Russia, its two dominant neighbours with controlling interests in the north-eastern regions of China, could use its failure to contain the epidemic as a pretext to take over plague control themselves, further encroaching on China’s sovereignty.

At this critical juncture, Wu was tasked to investigate the epidemic under the recommendation of Alfred Sze Sao Ke, the Councillor of the Foreign Office in Peking. This appointment was first offered to the chief medical officer of the Imperial Navy, Dr Xie Tian Bao, who declined the appointment for fear of infection. Wu arrived at Harbin on Christmas Eve with an interpreter, without any sophisticated medical instruments. Little did the young doctor from Penang realise that he was about to face a deadly war, one without bullets and cannons!

New discoveries, new methods
Three days after his arrival in Harbin, disregarding prevailing laws and superstitious beliefs, Wu performed the first ever postmortem in China on a Japanese woman who had died from the epidemic. From further research and ground reports, Wu concluded that the devastating epidemic was pneumonic plague, a disease that could be transmitted by human breath or sputum, a view contrary to the general belief held by western experts that plague could only be transmitted by rat or flea bites. He quickly reported the findings to Peking and requested additional funding and medical staff to strengthen the anti-plague campaign.

Dr Mesny, a prominent French doctor from Peking with previous experience in bubonic plague in India, was the first volunteer to arrive in Harbin. This he did in January 1911. He however doubted Wu’s competency and refused to take instruction from him. Wu was forced to tender his resignation in an attempt to resolve the conflict in the interest of the anti-plague campaign. The Peking government however rejected his resignation and relieved Mesny of his duty instead. Mesny died of pneumonic plague six days later after failing to wear a gauze and cotton mask while diagnosing patients infected by the epidemic.

The highly publicised death of Mesny shocked the international community and triggered greater support for Wu’s leadership in combating the epidemic. Now as the undisputed director of the campaign, Wu wasted no time in setting up special hospitals for plague patients, quarantine stations, blockades to monitor movement of the population and patrol teams to check every household for updates.

At the same time, Wu convinced Russian and Japanese authorities to cease all train operations under their control. The Peking government took parallel steps by stopping trains travelling between Tientsin and Peking. These joint efforts effectively cut off all transport to and from the region, preventing migrant workers from surrounding provinces to return home for the traditional Chinese New Year Festival. Failure to cripple the transport system would have resulted in a catastrophe of unimaginable scale. Migrant workers would have returned to their respective villages and towns, carrying the deadly disease with them.

Making the breakthrough 
Despite initial actions, the death toll in Harbin continued to rise. One day in the deep of winter, Wu stumbled upon a burial ground littered with thousands of exposed coffins and corpses of plague victims. He was horrified, for he knew that the corpses in the freezing winter would serve as a perfect incubator for the plague bacillus. The urgent task was to remove the unburied corpses and coffins by mass cremation, an act strictly prohibited by law and tantamount to sacrilege under age-old traditions.

Wu and wife Photograph: Cambridge University

Wu and wife
Photograph: Cambridge University

To overcome this obstacle, Wu organised a “sight visit” to the burial ground for all local officials. Shocked by the sight, the local officials quickly supported Wu in sending a petition for an imperial edict to sanction the cremations. On January 30, 1911 medical history was made when 3,000 corpses and coffins were cremated. Miraculously, the death toll from the epidemic dropped from 183 to 165 the same day and declined gradually to zero, with no further infections by March 1, 1911. The deadly epidemic was finally beaten!

The International Plague Conference
Following the success in combating the plague epidemic, Wu suggested to the Peking government that an international conference be convened to review and evaluate measures taken and to document experiences, so that recommendations could be drafted should the pandemic recur. The Peking government readily accepted his recommendation and the first international science conference hosted by China, the International Plague Conference, was held in Mukden from April 3-28, 1911.

Renowned scientists and epidemiologists from 11 countries, including the US, UK, Japan, Russia and France, attended the conference. Wu, who had now earned international fame due to his role in combating the Manchurian plague epidemic, was accorded the honour of presiding over the conference. The deliberations of the conference were later published as the Report of the International Plague Conference, 1911, which is till today a classic on the study of epidemiology.

The conference had a profound impact on the development of modern medical science in China. As Wu prophetically stated in his address to the conference: “…may I remind you that this is the first International Medical Conference held in China, and it is impossible to estimate its widespread effects. Besides the beneficial results of your observations and resolutions on the subject of plague, the impulses you will set in motion, by the fact of this conference, will react not only upon the national life but more particularly upon the future progress of medical science in China… ”

Wu was conferred the positions of “Medical Jinshi”, “Imperial Army Major” and a string of other honours by the Ch’ing government, and called to audience by the Regent, Dai Feng, at the Imperial Palace in Peking. He was honoured by the French and Russian governments as well.

Further battles 
Over the ensuing 20 years, Wu remained at the forefront of plague prevention in Harbin. He was director and chief medical officer of the North Manchurian Plague Prevention Service, formed as a result of resolutions passed at the International Plague Conference and which later became the world’s foremost plague research centre (until the Japanese invasion of China in the 1930s). His perseverance was duly rewarded when he successfully stamped out a recurrence of the plague in 1921 and the malaria epidemic of 1919.

During this period, Wu devoted much of his time and effort establishing hospitals, research centres and medical colleges in Harbin, Nanking and Peking. He founded the Chinese Medical Society and many other professional bodies in China. In 1931, he left for Shanghai after Japan launched its attack of China. He was arrested in Shenyang by the Japanese for suspected espionage and was only released after intervention by the British authorities. During his stay in Shanghai, Wu dedicated his time to the setting up of the National Quarantine System which had only recently been taken over by China from the foreign powers. He returned with his family to Malaya in 1937 after his home in Shanghai was bombed and gutted when Japan embarked on its full-scale invasion of China.

Life after returning to Malaya 
Wu went into private practice again after returning to Malaya, this time in Ipoh where he led a low profile civilian life that was not without some moments of drama! During the Japanese occupation, Wu was kidnapped by Communist guerrillas and released only after a ransom of 7,000 dollars was paid. Two months later, it was the Japanese’s turn to arrest him on suspicion of supporting the anti-Japanese forces. He was eventually cleared of the charge after a Japanese officer who was his patient testified to his innocence.

His long illustrious life came to an end after he suffered a stroke. He passed away on January 20, 1960 at the age of 81, barely one week after returning to his new home at Chor Sin Kheng Road, Penang.

Wu’s death was mourned by the international medical community, and The Times London commented on January 27, 1960: “By his death, the world of medicine has lost a heroic and almost legendary figure and the world at large one of whom it is far more indebted to than it knows.”

Photograph: Ang Ming Chee

Photograph: Ang Ming Chee

A legacy that lives on 
Wu’s contributions to the development of modern medicine in China were prodigious. During his 30-year span in China, Wu founded some 20 medical institutions including the Harbin Medical College, Peking Central Hospital, North-Eastern Military Hospital and National Quarantine Service.

Aside from the Chinese Medical Association, he was also a tireless promoter of many other professional bodies such the China Microbiology Society, China Society of Tuberculosis and Chinese Medical History Society. He represented China at major international medical conferences at a tumultuous time when China was undergoing successive political upheavals.

Wu was a prolific writer who co-authored the first medical history book of China in English and he spent 15 years writing his classic A Treatise on Pneumonic Plague. He was accorded no less than 20 honorary degrees from renowned academic institutions, including PhDs from John Hopkins University, US; Hong Kong University and The Imperial University of Japan.

Despite such incredible achievements, for more than half a century Wu remained relatively unknown in the land where he had devoted the best part of his life. It took the severe acute respiratory syndrome (SARS) epidemic of 2003 to catapult Wu back into the limelight.

Madam Li Lu ( ), a retired journalist who was suffering from SARS, stumbled across the name Dr Wu Lien-Teh while poring over reports of past pandemics. She was deeply moved by his courageous and selfless contributions after tracing his life history in China. Her report on Wu aroused wide interest and encouraged further academic research into his works in China.

In 2008, the Dr Wu Lien-Teh Memorial was built in the city which he saved – Harbin – and a hospital and school were named after him. Bronze statues were erected in Harbin Medical University and Beijing University Hospital to honour him, a man who is now regarded as the prime mover of China’s public health service and the father of modern medicine in China.

The original version of this article, “Dr Wu Lien Teh, A Name Malaysians Should Be Proud Of”, can be read online at http://kohkingkee.blogspot.com.

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