Epilogue• 277Each of these modern approaches found backing in ancient medical tradi-
tion: on the one hand, cleaning up polluted waters and rubbish to banish air-
borne “miasmas”; on the other hand, arming oneself against the “contagion”
of contact with sick persons by smoking or chewing tobacco and carrying
herbs around one’s neck or in the head of a cane. Plague waters mixed by
apothecaries and concoctions that included viper’s poison had their long his-
tory as common defenses. The Europeans had their Venice treacle, the Chi-
nese their special herbs, the Muslim world a wide range of prophylactics.
Yersin and Kitasato saw merit in both the environmental-miasmatist and
prophylactic-contagionist approaches, but each focused solely on one ap-
proach, trying to adapt it to their understanding of microbial infection. The
Koch school, familiar to Kitasato, concentrated on sanitation-based control
of an infectious disease, once the bacteria and their source were identified.
The question was basic: What were the appropriate preventive measures?
Their answers were in line with traditional thinking about miasmas and
therefore intelligible to the public: general hygiene, good drainage, pure
water supply, and cleanliness in dwelling houses and streets.^28 The Pasteur
school’s approach, while resembling the rival contagion theories of the past,
was more daring and probably less intelligible to the general public: instead
of the standby herbal and chemical prophylactics, it sought to derive anti-
dotes from the disease itself.^29 By cultivating plague bacilli in various media,
Yersin hoped to use them to trigger the body’s immune response, thus giving
protection against the invading organism.
The hygienic attack on plague at Hong Kong took place with little chance
of success. Living conditions in the poorer parts of Hong Kong were so ap-
palling that the logical solution was to burn down the Chinese town along
the wharves. Budgetary considerations saved the Chinese from that sad fate.
The sewer system was also an obstacle because of the smallness of pipes. The
public health program that Lowson put into effect echoed the Plague Orders
of 1665. The authorities relied on obligatory street cleaning, cleansing of the
houses of the infected with carbolic acid and lime, burning or boiling the
clothing of the dead, and burning bodies or burying them under three meters
of soil.
Meanwhile, Yersin worked feverishly in total isolation to find a modern
microbial solution. Skipping meals and sleep, he dissected buboes and made
media right through the long hours of the night. “From a bubo of a patient
who had recovered and had been convalescing for three weeks,” he wrote
wearily but with hope, “I was able to isolate a few colonies which completely
lacked virulence in mice.” He had found the long looked-for antidote! On a