- The Business of Vaccination in Nineteenth-Century Canton
Lu Xun (1881–1936) wrote a vivid account in 1933 of his first vaccination when he was two or three years old in his home town, Shaoxing. He was vaccinated at home, instead of in a vaccination bureau, "meaning that it was probably a grand occasion." He could still remember the vaccinator as a man "with a plump, round, and reddish face, wearing a big pair of tinted glasses." What struck him most was that the vaccinator spoke a language that was totally incomprehensible to him, like the one "spoken by mandarins," and his appearance "was similar to that of a mandarin."1 Lu Xun's memoir also tells us other interesting details about vaccination during the late nineteenth and early twentieth centuries: vaccination bureaus were common but only seasonal in major towns; vaccination was far from universal while traditional variolation was still a choice. Lu Xun was typically sensitive to local traditions, but here he misses a central point in the story of vaccination in China. Praising Shanghai as "probably the most civilized place in China" because vaccination there was popular and convenient, he ignored the fact that, as far as vaccination was concerned, Canton should have been the city of reference since the technique was first introduced into that city in the early years of the nineteenth century and the practice became widely accepted there first.
The story of the introduction of Jennerian vaccination in China via Macao and Canton is a story told many times, especially by Chinese historians, sometimes in great detail.2 One of the first English accounts can be found in [End Page 7] H.B. Morse's Chronicles of the East India Company Trading to China, first published in 1926.3 The story was told again in greater detail in History of Chinese Medicine, co-authored by K.C. Wong and Wu Lien-teh in 1936. In this book, the authors described how Alexander Pearson, surgeon to the East India Company in China, practiced vaccination in Macao, around 1802,4 a few years before the arrival of the Spanish Balmis expedition with a new supply of lymph, and wrote a pamphlet on the technique that was to be translated into Chinese by George Staunton in 1805 with the support of a Cantonese hong merchant. The establishment between 18055 and 1810 of a charitable vaccination dispensary by hong merchants in their Public Hall in Canton, employing one of the first Chinese vaccinators, Qiu Xi, who published his own book in 1817, was also mentioned with details.6 Wong and Wu, as well as historians writing the story in Chinese, considered the spread of the technique in Canton to have been smooth during the nineteenth century.7
In this paper, we step aside from the grand narrative of the heroic introduction of vaccination in China, and try to answer questions that interested Lu Xun: Who were the vaccinators? Who were the other actors in the story? What kind of institutions were the vaccination bureaus? How did society perceive this curious, foreign technique? We shall also look more closely at Canton, where vaccination was first publicly practiced. In other words, we shall examine the social fabric allowing the smooth dissemination of a new technology into a nineteenth-century Chinese urban society. We shall also look at an emerging medical culture in a metropolis that, unlike Shanghai and Beijing, was far from the political and cultural centers of late imperial China, and yet was a city where business and commerce occupied a central place in people's daily life.
Who, then, were the vaccinators? Sources show that indigenous Cantonese became the main vaccinators soon after the initial introduction of the practice in Macao. According to Pearson, before the arrival of the Balmis expedition [End Page 8]
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from Manila, "[vaccination] had been quite extensively conducted by the Portuguese practitioners at Macao, as well as by...