[Music from a yangqin, an instrument played in Guangzhou, begins and fades]

Qiu was skilled. With a knife, he cut at two acupuncture points [cutting knife] on each arm. Scooping the lymph with a pick, he inserted it: first on the left arm for boys, first on the right arm for girls.

Knife, pick, lymph. A vaccination toolbox. With the prick of an arm and insertion of lymph^[1], Qiu’s vaccination rendered the body immune from smallpox.

When we think of vaccination, we typically recall Edward Jenner (1749-1823), an English physician who made the first smallpox vaccine. He noticed that milkmaids never caught smallpox. Instead, they had caught cowpox when tending to grazing cows, [cow moos] and were immune.

小刀、小簪、种痘: [xiaodao, xiaozan, zhongdou]. Jenner could never understand these words. So how did the vaccination knife come into Qiu’s hands?

[ocean waves intensify]

19th century Canton. The Qing dynasty is crumbling. British merchants, the Spanish, and the Dutch have anchored ships on their shores. They stationed factories [hammering nails], established companies, and secretly smuggled opium. [moving coins] Cautious Qing government officials restricted them [gate closes] to a tiny strip of land: the port of Canton. [clamor of a port]

The British looked for new ways to carve their influence into China. Alexander Pearson (1780-1874), a surgeon for the British East India Company, taught Jennerian vaccination to Chinese factory employees. The company’s writer, George Staunton (1781-1859), translated his teachings with his limited Chinese and published it with Canton’s woodblock printing.^[2] [printing with engraved blocks]

Now the British merchants liked to portray vaccination as a gift [glitter effect] to the Chinese from the West. [party horn] Staunton himself named his translation as a qishu, a.ka. strange book, portraying vaccination as some mystical magic capable of ridding all their ills. [magical sound]

This story—of the heroic introduction of vaccination in China by the British—is a tale told many times^[3]. [glitter effect]

But were the British really responsible for spreading vaccination in China? The English could not even step beyond the port of Canton. [gate closes] So who ‘gifted’ vaccination to the Chinese?

No one.

Inoculating^[4] against smallpox was ongoing. Variolation^[5], a similar method to vaccination, existed as early as the 1550s. The earliest vaccinators made the trek to Canton port and learned how to use the [knife, pick, lymph]. Some were already trained in variolation and quickly picked it up; others were completely unfamiliar with medicine.

Qiu Xi（邱憘, unknown) is the most famous vaccinator in China. Remember those factory employees Pearson taught? Qiu Xi was one of them.

Qiu was inventive. [lofi beat] He injected ideas from Chinese healing beliefs into vaccination. He wrote his own version of Pearson’s techniques, Yindou lue (引痘略, 1817), which actually made sense to the Cantonese. Qiu lists the same 3 tools in Staunton’s version: knife, pick, lymph. But instead of a bare arm, Qiu shows a man’s full body, clad with flowing robes, a common motif in Chinese acupuncture visuals.^[6] [wind blows]

Qiu was ingenious. To make vaccination mainstream, he sought out the popular, wealthy, and powerful. Qiu asked government officials, rich merchants, and famous scholars, the 19th century’s celebrities, [bustle of a shopping square] to be vaccinated and share their experiences, much like influencers posting the latest makeup product on Instagram. [camera flashes]

Otherwise, why should the Chinese trust these techniques when the British weren’t even trusted beyond their slice of land?

But Qiu was not the only creative vaccinator. Both English and Chinese vaccinators ran into a challenge. It was hard to keep the lymph fresh and potent.

This was Pearson and Qiu’s procedure: put dried lymph on a pick. Wrap it in a goose feather tube [wrapping] and then seal with honey and wax.

Chinese vaccinators used the materials they had, innovating new ways to store the lymph. Some wrapped the lymph with longan pulp, [unpeeling longan] a fruit used to relieve blood and qi deficiency. Some sealed the lymph into bamboo or porcelain tubes. Some buried the tubes underground [shoveling dirt] or used an airtight crystal box sealed by wax, [squeak of sealing box] techniques from variolation^[7].

There were as many different techniques as there were vaccinators. Starting from the southern tip of Canton, vaccination spread across the coast, and north towards Beijing. [Peking opera ensemble]

Now… back to the tale of the heroic introduction of vaccination, [glitter effect] if Chinese vaccinators spread vaccination with their own methods and theories, is it really a ‘Western’ gift? [party horn]

Perhaps the answer to this is revealed by seeing what happened to Staunton’s book. [ocean waves grow] As ships linked trade across oceans, sailing between England, India, and Canton, the woodblock printed book was brought to Scotland^[8]. Originally stored horizontally and lying down in Canton book collections, it could not fit the vertical bookshelves of European libraries. Book collectors fitted hardcovers over the xuanzhi^[9].

At this point, is it even possible to pinpoint this book as ‘Chinese’ or ‘Western’? It is made of xuanzhi, [paper flip] filled with woodblock printed Chinese characters, [stamping of woodblocks] yet enwrapped in a hardcover and currently shelved in an American university^[10]. [page turn]

[lapping waves begin and intensify]

So maybe it is more fitting to see vaccination in Canton—and medical knowledge—as fluid; as fluid as the waves carrying the ship with Staunton’s book across oceans; as fluid, rather than a magical ‘gift’ from the English.

 

Footnotes: 

^[1] Damaso, Clarissa R. “Revisiting Jenner’s Mysteries, the Role of the Beaugency Lymph in the Evolutionary Path of Ancient Smallpox Vaccines.” The Lancet Infectious Diseases 18, no. 2 (August 18, 2017). https://doi.org/10.1016/s1473-3099(17)30445-0. Lymph is the viral material that is used in vaccination. It usually consisted of pustular material from lesions on cow or vaccinated humans.

^[2] Pearson, Alexander. Yingjili-guo Xinchu Zhongtou Qishu : [A strange book on vaccinations recently come out of England]. Translated by Sir George Thomas Staunton. Canton, 1805. Woodblock printing was the predominant form of printing technology in Canton, which utilizes woodblocks engraved with Chinese characters.

^[3] Leung, Angela Ki Che. “The Business of Vaccination in Nineteenth-Century Canton.” Late Imperial China 29, no. 1S (2008): 7-39. doi:10.1353/late.0.0000.

^[4] Needham, Joseph, Ling Wang, Métailie Georges, and H. T. Huang. Science and Civilisation in China: Volume 6, Biology and Biological Technology, Part 6, Medicine . Cambridge England: Cambridge University Press, 1954. Inoculation is the general term for artifically inducing immunity to an infectious disease and includes variolation and vaccination.

^[5] Joseph Needham et al., Science and Civilisation in China: Volume 6, Biology and Biological Technology, Part 6, Medicine, 154. In variolation, patients are deliberately exposed to smallpox to induce immunity. Variolation and vaccination share similar concepts. Variolation directly uses dried smallpox powder, which was blowed into the nose, while vaccination typically uses lymph of cowpox origin, a weaker disease. Variolation sometimes induced smallpox in the patient, resulting in death.

^[6] Qiu, Xi. Yindou Lue: [A Brief Account of Inducing Pox] (1817).

^[7] Leung, “The Business of Vaccination in Nineteenth-Century Canton.”,  18.

^[8] Pearson, Alexander. Yingjili-guo Xinchu Zhongtou Qishu : [A strange book on vaccinations recently come out of England], 16. I am not completely certain whether the book was brought back to Scotland or England. However, the copy’s owner, Hay Donaldson, wrote a note at the beginning and signs as “Librarian to the Society of Writers to the Signet”, a Scottish organization.

^[9]  Tsai and van der Reyden, “Analysis of Modern Chinese Paper and Treatment of a Chinese Woodblock Print.” Xuanzhi was the paper used for making Chinese books, typically made from elm or bamboo.

^[10] Pearson, Alexander. Yingjili-guo Xinchu Zhongtou Qishu : [A strange book on vaccinations recently come out of England]. This book is currently in Yale University’s Cushing-Whitney Medical Library.

References

Damaso, Clarissa R. “Revisiting Jenner’s Mysteries, the Role of the Beaugency Lymph in the Evolutionary Path of Ancient Smallpox Vaccines.” The Lancet Infectious Diseases 18, no. 2 (August 18, 2017). https://doi.org/10.1016/s1473-3099(17)30445-0. 

Leung, Angela Ki. “The Business of Vaccination in Nineteenth-Century Canton.” Late Imperial China 29, no. 1S (2008): 7–39. https://doi.org/10.1353/late.0.0000. 

Needham, Joseph, Ling Wang, Métailie Georges, and H. T. Huang. Science and Civilisation in China: Volume 6, Biology and Biological Technology, Part 6, Medicine. Cambridge England: Cambridge University Press, 1954. 

Pearson, Alexander. Yingjili-guo Xinchu Zhongtou Qishu : [A strange book on vaccinations recently come out of England]. Translated by Sir George Thomas Staunton. Canton, 1805.

Qiu, Xi. Yindou Lue (A Brief Account of Inducing Pox). Kuiguanzhai (Beijing) edition, 1827., 1817.

Tsai, Fei Wen, and Dianne van der Reyden. “Analysis of Modern Chinese Paper and Treatment of a Chinese Woodblock Print.” The Paper Conservator 21, no. 1 (January 1, 1997): 48–62. https://doi.org/10.1080/03094227.1997.9638598.