1 Pneumonic plague (1910–1911) caused high mortality in multiple regions in Northeast China
On October 12, 1910, in Manzhouli, a small town in the Chinese northeast border with Russian Siberia, the first suspected case of plague that originated from Siberia was documented, and this condition was characterized by clinical manifestations, including high fever, hemoptysis, and cough [
1–
3]. Since then, numerous cases had been reported in regions along the Middle East Railway, especially in Harbin and Fuchiatien, where the first case of postinfection death was recorded on November 7, 1910 [
1]. The number of deaths increased to nearly 10 per day at the beginning of December 1910 and over 20 per day in mid-December [
1]. The epidemic further spread along the Middle East Railway, and more areas in Northeast China and adjoining regions were affected [
1,
3,
4]. The severity of the plague had caused widespread concern among the public, national governments, and international communities.
2 Establishment of a preventive system for plague control
Dr. Wu Lien-Teh (MD, University of Cambridge, 1905) [
2], who had been designated by the central government of the Qing Dynasty as the vice director of the Imperial Army Medical College in Tientsin (presently Tianjin) at the time, arrived with a free hand in Harbin for a plague epidemic control on December 24, 1910. After investigating and conducting field visits in infected areas, especially Fuchiatien, Dr. Wu discovered that this infection damaged the patients’ lungs and became transmitted from an infected person to a healthy person through close contact. Autopsy and subsequent bacteriological identification revealed masses of
Yersinia pestis in the blood and other organs, such as lung, kidney, heart, liver, and spleen [
2,
5]. These findings indicated that this microorganism is the pathogen causing the epidemic outbreak.
On the basis of epidemic analysis and autopsy results, Dr. Wu proposed targeted strategies, such as training of epidemic control workers, proper application of specially designed gauze-cotton masks (Wu’s masks), disinfection of living areas, establishment of isolation wards, restriction of population flow, management of high-risk people, and centralized collection and burning of infected corps [
1,
2,
6]. These countermeasures were implemented efficiently through Dr. Wu’s collaboration with local authorities and international colleagues. However, the number of deaths still increased in early stages of their implementation. For instance, nearly 200 deaths were documented in Harbin and Fuchiatien on January 15, 1911. The plague even spread to Beijing, Tianjin, and Shandong. On January 31, 1911, the number of deaths began to decrease significantly. On March 6, 1911, no deaths were reported, and this date served as the marker indicating the successful epidemic control of the pneumonic plague [
1]. The 6-month epidemic outbreak of pneumonic plague was finally eradicated in Northeast China at the end of April 1911, but the plague caused nearly 60 000 deaths in Northeast China and adjacent regions [
1,
3].
3 Dr. Wu Lien-Teh’s academic and cultural contributions to medical advancements in China
During plague control, the first standardized epidemic prevention hospital and bacteriological laboratory, which were marked as the North Manchurian Plague Prevention Service founded in 1912, and related anti-epidemic strategies were established by Dr. Wu Lien-Teh [
2,
4]. With the 10-year reserve and improvement of the preventive system and international collaboration, the second plague epidemic that originated from Russian Siberia was efficiently controlled with quick responses and scientific strategies in Northeast China in 1920–1921, and the total number of deaths was limited to 8500 [
3]. As part of the plague epidemic prevention, the International Plague Conference, which was the first international scientific conference in China, was held in Mukden (presently Shenyang), and Dr. Wu, as the chairman, gave his remarks and made an academic presentation on his plague control experiences and recommendations [
1].
To find the source of pneumonic plague, Dr. Wu and his colleagues not only demonstrated the respiratory transmission and the subsequent lung lesions in pneumonic plague but also explored the role of
Marmota sibirica in the transmission of plague by conducting wild expeditions, animal experiments, pathological autopsies, and bacteriological identification. Related research has been published in well-known journals, including
The Lancet,
The American Journal of Pathology and Bacteriology,
The Journal of Hygiene, and
Chinese Medical Journal [
3,
5,
7,
8], and in treatises, such as
A Treatise for Pneumonic Plague and
Plague: A Manual of Medical and Public Health Workers [
9,
10]. In 1935, according to his “
work on pneumonic plague and especially the role played by tarabagan in its transmission,” Dr. Wu Lien-Teh, a plague fighter, was nominated for the Nobel Prize in Physiology or Medicine [
11]. To supplement the shortage of medical professionals, Dr. Wu founded Harbin Medical School, which was the predecessor of Harbin Medical University (HMU), as the first Chinese higher medical education school in Northeast China in 1926. With 91 years of history, HMU has advanced as a world-renowned first-class modern medical school in China. Wu Lien-Teh Memorial was created in the original location and buildings of North Manchurian Plague Prevention Service in 2006, and Wu Lien-Teh Institute was established in HMU in 2015 (Fig. 1). These institutions greatly contributed to the advancement and enrichment of Dr. Wu’s spirit of loving the motherland wholeheartedly and succeeding through self-made efforts.
Higher Education Press and Springer-Verlag GmbH Germany, part of Springer Nature
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