At the end of 2019, as the scientific world, public health systems and national governments set about a vigorous response to the global outbreak of the new infectious disease known now as COVID-19, popular attention turned to books in the popular science literature market – Plagues and Peoples, Spillover Animal Infections and the Next Human Pandemic, The Next Pandemic, and Guns, Germs and Steel. While publications on relevant pathogens, immunity, vaccine development and zoonoses were rapidly introduced or reprinted, the production figure for original Chinese-language works paled next to that of translations. New works mainly focused on health care and protection, varieties of care for young families, or simple compilations of materials, and their number remains limited even if we include systemic books on Taiwanese biomedicine. Compared with the unique aspects of essentially Taiwan-specific areas of biomedical research (such as snake venoms, hepatitis, and traditional Chinese medicine (TCM)), other subjects lacked the depth and variety of perspectives necessary to succeed on the international market. There is, despite this, nothing lacking in Taiwan’s scientific research and ability to construct narrative. In the past decade or more, younger scholars have invested themselves enthusiastically in the task of making professional knowledge available to the public; special diligence has been shown in the interdisciplinary fields of STS (Science, Technology and Society). The Secret History of the Spanish Influenza in China appropriately reflects this present situation.
The author, Pi Kuo-Li, is an Associate Professor at the Graduate Institute of History at National Central University and a specialist in the social history of Chinese medicine, history of disease, history of the body, and modern Chinese warfare and technology. Pi’s pre-pandemic research crystallizes in his work Medical Care, Diseases and Society: Understanding and Responses to Influenza Epidemic in the Early Period of Republic of China. Following more than six years of hard labor, this new book, with its underlying theme of the search for the disease and social response and mentality in popular culture, was published in February 2022. From the grand perspective of the global history of disease, this book compensates for previous Western-centered works on the Spanish flu – that great global public health system crisis – and their severe lack of content or grave misunderstanding of greater China during that time. The fatal disease, which raged from 1918 through April 1920, resulted in the death of at least 20 million worldwide (the highest estimate reaches 100 million). By share of global population China should have experienced millions or tens-of-millions of deaths, and yet searching relevant materials gives a number of only 600,000. What explains such an enormous gap?
China at the time was in the chaotic and confused state of civil war, and was unable to produce accurate statistics on deaths or completed records pertaining the Spanish Flu (for the West, the Great War also significantly contributed to the discrepancy between real and estimated deaths), especially as it engaged with the clearer threats of plague, smallpox, and malaria. Yet Pi successfully analyzes medical books and journals according to multiple perspectives drawn from Chinese and Western medicine (these, intriguingly, united in their advance during these years, rather than struggling in opposition – a likely factor in reducing the harm caused by Spanish Flu), while pointing to comparative descriptions of real cases from daily life and popular culture. The book thereby enters a dialogue with classic Western works on the pandemic. The author describes this as a “diversity of medical history research” perspective – a search for the interactive links between elite medical views and intellectual constructs with daily life and material culture at the lower levels.
In summary, The Secret History of the Spanish Influenza in China uses historical research to consolidate ideas on how, in the time of Spanish Flu, popular Chinese society and Eastern and Western currents of medical thought recognized and approached an infectious disease – one not far separated from the “cold flu” concept long familiar to TCM, though with a much higher fatality rate. In doing so, the book constructs a humanistic base for conversation amid the largely Western-directed history of infectious disease, which helps us prepare for the next unexpected and life-threatening plague.