The Sick Men of the World: Assessing Yan Fu’s Metaphor
1895 was not a good year for China. China had just lost the first Sino-Japanese War, the latest in a century of humiliation at the hands of foreigners. Amidst this chaos, Chinese scholar and later reformist Yan Fu described China as “the sick man of Asia.” In his article “On Strength,” he compared the country to a sick man in dire need of help. Traditional government, opium, and foot-binding were the maladies which were killing China. Overtime, Westerners would adopt his phrase as a metric to measure Chinese progress. The current COVID-19 pandemic has shed light on several maladies which plague both Western and Chinese societies. Rather than work together, both sides have elected to pursue tit-for-tat spats which have placed millions of lives in harm’s way and make both sides the sick men of the world. Understanding this history is the first step to combating the stereotypes that are being spouted by leaders in both the U.S. and China.
The “sick man of Asia” phrase was first applied by the West during a century-long outbreak of bubonic plague in China. Between 1894 and 1950, 15 million people died in the pandemic, decimating China’s dense population. Efforts to stop the virus were limited to local charities with minimal oversight from the imperial government. Western commentators believed that the reason why China suffered so dramatically at the hands of the plague was due to the country’s poor sanitation practices. Who was to blame for the poor sanitation? Who else but the Qing government, they argued. The government’s inability to provide for adequate sanitation was proof of China’s deteriorating health. Westerners therefore built off Yan Fu’s idea in order to develop an interesting metric which would be used throughout history to gauge China’s progress in modernization: China’s ability to respond to pandemics.Â
To be fair, the West’s assessment was pretty accurate. Ironically, during the Black Death in the 14th century, China could say the same thing of medieval Europe, whose utter lack of clean drinking water and sanitation poisoned the country. While the plague was a global event, Europe was its epicenter, losing an estimated one third of its population. While China was damaged by the plague, it did not suffer losses nearly as catastrophic. This has been largely attributed to the much more organized government and public sanitation practices of the much richer and much more powerful China.Â
But late 19th century China was not as clean or as powerful. It was at the bottom of the international food chain. With the new view of China as unsanitized and inadequate, propaganda began to be spread within Western countries portraying Chinese immigrants as unclean and unfit for citizenship. Posters depicting Chinese living in decrepit conditions popularized the media. New Chinese arrivals at Angel Island were given rigorous health screenings; even a common cold could send one back to China. American society began doing everything it could to keep the Chinese out, and in 1882, passed the infamous Chinese Exclusion Act. Chinese in America? No! No! No!
In the 20th century, China awakened and recognized its dire need to modernize. With the fall of the Qing dynasty, the period between 1911 and 1949 was marked by economic, press, and social freedoms. In the spirit of Yan Fu’s metaphor, the country was beginning to self-medicate. This change was distinctly felt in the health sector, which saw Chinese participation at international health meetings, expansion of medical schools, and new opportunities for women to enter the health profession. It also saw the creation of the Ministry of Health in 1928. China’s modernization efforts captured the attention of the Western countries. On a trip to China during the 1910s, one Western diplomat remarked that he had never seen a nation so promising and full of potential.
Then Mao came along.Â
In 1949, Mao’s Chinese Communist Party (CCP) took control of China. While the CCP did care about public health, it came second to political considerations. This mindset was put on display during the period immediately preceding the Cultural Revolution and during the Cultural Revolution. In 1964, Mao began an attack on the Ministry of Health, arguing that it represented elitism and bourgeois thought. During the Cultural Revolution, doctors and scientists were targeted; as a result, hospitals dried up. The Revolution itself also spread infectious diseases. In 1966, at the very start of the Cultural Revolution, there was an outbreak of meningitis in Beijing. Students who championed Mao’s revolutionary cause spread it across the country. No one stopped them either, because political considerations came first. Stop the students, and you’d stop the revolution. The death toll was 160,000.Â
Mao’s death in 1976 began a period of reform. China’s new relatively liberalized economy was put to the test with an outbreak of HIV/AIDS in the 1990s. Unfortunately, the outbreak exposed the awkward relationship between the country’s underregulated markets and overregulated government. The 1990 HIV/AIDS pandemic established the response to future pandemics: rumors of a public health crisis, government attempts to cover up, whistleblower, reluctant admittance, and draconian remedies. This pattern would appear again in the early 2000s with the outbreak of the SARS virus, COVID-19’s predecessor. When SARS (2002) was first discovered in Guangdong, the government initially downplayed the problem, trying to make sure that no foreign country would discover the true extent of the outbreak. However, Jiang Yanyong, a Beijing physician, leaked the full extent of the pandemic to the West. The international panic triggered a highly-publicized effort to fight the virus by Beijing. SARS 2002 greatly jeopardized China’s newly found status on the world stage, having just joined the WTO the previous year and scheduled to host the 2008 Olympics. The entire world watched in suspense to see whether the modernizing nation could handle a pandemic, as well as handle its new status as a world power.
This brings us to COVID-19. Not surprisingly, many comparisons have been made between COVID-19 and SARS 2002. For starters, China’s initial reaction to COVID-19 was very similar to 2002. Local officials in Wuhan attempted to keep a lid on the outbreak, but were exposed by doctor Li Wenliang, who later died of the disease, which triggered a reversal of Beijing’s policies. However, China has matured greatly since 2002. While China’s initial reaction was not the greatest, it was still very fast at sharing the genetic information of the novel virus to health centers around the globe, a much-needed headstart for the world to get working on a cure/vaccine. Chinese officials also shared as much information as was available for best practices to handle the spread of the virus, including quarantine, mask-wearing, and social-distancing, practices we are all more than familiar with.Â
Moreover, it is not only China who has a reputation for covering up the effects of the virus. United States officials, since the outbreak started, have elected to use racially-charged language and a wide array of diversion tactics to draw attention away from the ballooning COVID situation in the United States. Racially-charged language has resurfaced Sino-phobia and xenophobia among many Americans, which has led to a drastic increase in the number of hate crimes being committed against Asian, specifically Chinese Americans. Meanwhile, the United States leads the world in new infections (assuming China’s numbers are actually true). Many American politicians have placed politics over lives, placing a much larger emphasis on economic recovery rather than the need to prevent new infections. Despite these theories being largely rebuked by Sweden’s situation (a country which elected to keep everything open as an experiment and is now suffering huge infection rates without any noticeable benefit to the economy), many in Washington continue to downplay COVID. Both Washington and Beijing have elected to instead lock out each others’ news organizations in an endless tit-for-tat political spat that has placed millions of lives in harm's way. Both countries exhibit a high degree of immaturity, choosing to fight each other rather than work together as the world’s dominant superpowers. They are both sick, and need to seIf-medicate.Â
COVID-19 has left the world in strange, and dare I say it, unprecedented times. Unfortunately, the pandemic is far from over. Not only will COVID-19 never truly be eradicated (it will continue to exist just as Ebola and smallpox do), the problems it has exposed in our world will remain as blueprints for future generations to solve. Many of those problems lie in how governments respond to global disasters in an increasingly globalized world. In addition to keeping each other safe, we must also be informed by learning the history and misinterpretations of the past in order to strive for a better future and not be dictated by the politics of sick men.
Submitted by CHSA’s Summer Education and Research Chris Ying. Chris is a sophomore at UC Berkeley where he is majoring in History and Mathematics. His writing is based on his research and lectures from his history class.

















