¹ Robertson, R., ‘Globalisation or glocalisation?’, Journal of International Communication, 18.2 (2012), pp. 191, 199CrossRefGoogle Scholar.

² King makes the insightful observation that the first globally multicultural societies were found on the periphery, notably colonial cities, not the core. See King, A., ‘Introduction: spaces of culture, spaces of knowledge’, in King, A. (ed.), Culture, Globalization and the World System, MacMillan/SUNY, Binghamton, New York, 1991, p. 8CrossRefGoogle Scholar.

³ Robertson, ‘Globalisation or glocalisation?’, p. 205.

⁴ Hamashita argues that modern Chinese nationalism in the twentieth century was created in this region and was inextricably linked to Southeast Asia. See Hamashita, Takeshi, ‘Changing regions and China: historical perspectives’, China Report, 37.3 (2001), p. 351CrossRefGoogle Scholar. The region has also become a leading economic zone for China in the twenty-first century.

⁵ Recent work includes Wills, J. (ed.), China and Maritime Europe, 1500–1800: Trade, Settlement, Diplomacy, and Missions, Cambridge University Press, Cambridge, 2011Google Scholar; van Dyke, P., Merchants of Canton and Macao: Success and Failure in Eighteenth-Century Chinese Trade, Hong Kong University Press, Hong Kong, 2016Google Scholar; Wong, J., Global Trade in the Nineteenth Century: The House of Houqua and the Canton System, Cambridge University Press, Cambridge, 2016CrossRefGoogle Scholar.

⁶ Faure, David, ‘Becoming Cantonese, the Ming dynasty transition’, in Faure, D. and Liu, T. T. (eds), Unity and Diversity: Local Cultures and Identities in China, Hong Kong University Press, Hong Kong, 1996Google Scholar; Faure, D., Emperor and Ancestor: State and Lineage in South China, Stanford University Press, Stanford, 2007Google Scholar; Siu, H. and Liu, Z., ‘Lineage, market, pirate, and Dan: ethnicity in the Pearl River Delta of South China’, in Crossley, P., Siu, H. and Sutton, D. (eds), Empire at the Margins, University of California Press, Berkeley, 2006Google Scholar. On the ‘non-Chinese’ languages of the southern populations in this region and problems of regional and national identities, see Meibao, Cheng 程美寶, Diyu wenhua yu guojia rentong: wan Qing yilai Guangdong wenhua guan di xingcheng (地域文化與國家認同：晚清以來廣東文化觀的形成 Regional Culture and National Identity: Formation of the Concept of Guangdong Culture since the Late Qing), Sanlian shudian, Beijing, 2006, Chapter 2, pp. 44–110Google Scholar. Dudbridge warns us of the oversimplification of straightforward ‘civilizing’ processes by a northern Han culture among the various dialectic regions in China: see Dudbridge, G., Books, Tales and Vernacular Culture, Brill, Leiden, 2005, pp. 217–37CrossRefGoogle Scholar.

⁷ Struve, L., The Southern Ming, 1644–1662, Yale University Press, New Haven, 1984Google Scholar.

⁸ Dudbridge's idea of China's ‘basic defining characteristic’ consists of a central authority which acts as a source of social prescriptions, and a robust and heterogeneous population spread across the land. See Dudbridge, Books, Tales, p. 233, note 6. He also raises the important question of the extent to which ‘boundaries on the dialect map march with breaks in the continuity of social institutions’, ibid., p. 231.

⁹ An obvious example is the integration of the Cantonese marriage resistance custom, potentially subversive of the Confucian family ideal, into Confucian culture itself. See Siu, H., ‘Where were the women? Rethinking marriage resistance and regional culture in South China’, Late Imperial China, 11.3 (1990), pp. 32–62CrossRefGoogle Scholar.

¹⁰ Robertson, R., European Glocalization in Global Context, Palgrave MacMillan, New York, 2014CrossRefGoogle Scholar.

¹¹ Crossley, P., What is Global History?, Polity Press, Cambridge, 2008Google Scholar. Crossley pertinently puts forward ‘contagion’, often neglected by theorists of globalization, as one of the main themes in global history writing. See ibid., Chapter 4, which evokes classical studies by W. McNeill and A. Crosby.

¹² A preliminary study of the rapid growth in printed medical texts is by Lu Yinlan 盧銀蘭, ‘Qingdai Guangdong yishu chuban zhuangkuang chutan’ (清代廣東醫書出版狀況初探 Preliminary Study on the Publication of Medical Books in Guangdong Province in the Qing), Master's thesis, Guangzhou University of Chinese Medicine, Guangzhou, 2007, especially pp. 13–21, where she tabulates a total of 321 published medical books in the province between 1821 and 1908, compared to only 17 in the period 1736–1820. Woodblock printing houses proliferated enormously from the mid-century in Canton, with more than 120 printing houses, third in the empire only after Peking and Suzhou. See ‘Wanqing Guangzhou keshu tanghao’ (晚清廣州刻書堂號 Printing Houses in Late-Qing Canton), http://blog.sina.com.cn/xuexiyuandi2011, [accessed 23 August 2019]. Brokaw shows a similar trend in the growth in regional publishing in her study of book printing in Qing and Republican China in Fujian: Brokaw, C., Commerce in Culture: The Sibao Book Trade in the Qing and Republican Periods, Harvard University Press, Cambridge, 2007Google Scholar, though she did not specifically study printed medical books.

¹³ Leung, A. K. C., Leprosy in China: A History, University of Columbia Press, New York, 2009CrossRefGoogle Scholar. Later, syphilis (yangmei chuang 楊梅瘡 ‘bayberry sores’) was described as a disease that emerged in the Lingnan region in the late sixteenth century. Its full impact was felt in the seventeenth century when the first monograph on the disease was printed in 1632. See ibid., p. 45.

¹⁴ 繼洪, Jihong, Lingnan Weisheng fang, Zhongyi guji chubanshe, Beijing, 1983Google Scholar, facsimile reproduction of an 1841 Japanese edition.

¹⁵ Leung, A. K. C., ‘The evolution of the idea of chuanran contagion in imperial China’, in Leung, A. K. C. and Furth, C. (eds), Health and Hygiene in Chinese East Asia, Duke University Press, Durham, 2010, pp. 25–50, esp. pp. 39–42CrossRefGoogle Scholar.

¹⁶ This tradition of popular recipes had existed since at least the publication of Ge Hong (葛洪 283–343), Zhou hou beiji fang (肘後備急方 Handy Recipes for Urgent Use), Renmin weisheng chubanshe, Beijing, 1956 (1983), based on a facsimile of a 1574 edition.

¹⁷ Lu Xun (1881–1936) reminisced in 1933 that when he was two to three years old, the only two medical books kept in his family in Shaoxing (Zhejiang province) were Dasheng pian (達生篇 On Smooth Child Delivery) and Yanfang xinbian. See ‘Wo de Zhong dou’ (My Vaccination) 1933, ‘Shihua zhiyu’ (拾花之餘 Sequel to the collection ‘Picking Flowers’), in Lu Xun zuopin jinghua (The Best of Lu Xun's work), Joint Publishing, Hong Kong, 2003, Vol. 2, pp. 237–39.

¹⁸ Jiang Xizeng 蔣希曾, a practitioner in Canton, published his Jingyan yi'an (經驗醫案 Experiential Medical Cases) in 1890 on three acute endemic diseases with high mortality in the Canton region with local names: ‘ban’ (癍), which are deep-rooted boils caused by chills and fever; acute vomiting and diarrhoea caused by a direct attack of cold on the stomach and intestine (zhong han 中寒), which were widespread in this region of extreme warmth and depleted the body of yang; and spring warmth (chun wen 春溫) which attacked the lungs and heart. Lu, ‘Qingdai Guangdong yishu chuban zhuangkuang chutan’, pp. 21–26, note 12, tabulated a long list of recipe books published after the 1880s on local epidemics sometimes called shiyi (seasonal epidemics).

¹⁹ Among these were Ji zong lu (濟眾錄 Record for Providing Relief to the Masses, 1903), Yanfang beiyong (驗方備用 Efficient Recipes to be Used, 1902), Jingyan liangfang (經驗良方 Good Recipes Based on Experience, 1889), and Jingyan zafang (經驗雜方 Miscellaneous Recipes Based on Experience, 1903). For a complete list, see Lu, ‘Qingdai Guangdong yishu chuban zhuangkuang chutan’, pp. 21–26.

²⁰ Hong, Zheng 鄭洪, Lingnan yixue yu wenhua (嶺南醫學與文化 Medicine and Culture in the Lingnan Region), Guangdong keji chubanshe, Guangzhou, 2009, pp. 270, 283–85Google Scholar. Zheng points out that prominent Qing and early Republican doctors practising in Guangdong, such as Jiang Xizeng 蔣希曾, Li Piliu, 黎庇留, Yang Heling 楊鶴齡, and Lu Jueru 盧覺愚, were key figures in the revival of the Cold-Damage school of therapeutic strategy: ibid., pp. 272–73.

²¹ Smith, H., Forgotten Disease: Illnesses Transformed in Chinese Medicine, Stanford University Press, Stanford, 2017Google Scholar.

²² Xie Guan 謝觀 (1880–1950), Zhongguo yixue yuanliu lun (中國醫學源流論 On the Origins and Traditions in Chinese Medicine), Guting shudian, Taipei, 1970, reprint of the 1935 edition published in Shanghai, p. 47b.

²³ Chaoran, Zeng, Jiaoqi chuyan (腳氣芻言 Preliminary Words on jiaoqi), Juzhentang, Guangzhou, 1887, pp. 11a–bGoogle Scholar.

²⁴ Leung, A. K. C., ‘Weak men and barren women: framing beriberi/jiaoqi/kakké’, in Leung, A. K. C. and Nakayama, I. (eds), Gender, Health and History in Modern East Asia, Hong Kong University Press, Hong Kong, 2017, pp. 195–215Google Scholar; Arnold, D., ‘British India and the “beriberi problem”, 1798–1942’, in Medical History, 54.3 (2010), pp. 295–310CrossRefGoogle ScholarPubMed; Carpenter, K., Beriberi, White Rice, and Vitamin B. A Disease, a Cause, and a Cure, University of California Press, Berkeley, 2000CrossRefGoogle Scholar.

²⁵ Benedict, C., Bubonic Plague in Nineteenth-Century China, Stanford University Press, Stanford, 1996, pp. 1, 28, 34Google Scholar; Luo Rulan, Shuyi huibian (鼠疫彙編 Collated Texts on the Rat Epidemic), Guandong keji chubanshe, Guangzhou, 2008, facsimile of the 1897 Hanyuan lou edition, ‘Editorial notes’, pp. 1–5.

²⁶ Luo, Shuyi huibian, p. 9a.

²⁷ Ibid., pp. 7b–8a, 20a, 22a, 23a.

²⁸ In January 1894, Mary Niles (1854–1933), a Presbyterian missionary, witnessed a woman thought to be dying from the plague recover after being treated with several doses of ‘bear's gall’: Niles, M., ‘Plague in Canton’, China Medical Missionary Journal, 8.2 (1894), p. 116Google Scholar.

²⁹ For the chronology of the Balmis expedition (1803–06), see https://hsl.ecu.edu/wp-content/pv-uploads/sites/103/2017/09/Chronology-Smallpox-and-Balmis-Expedition.pdf, [accessed 18 September 2019].

³⁰ At least 62 editions were published under the same title Yindou lüe (引痘略 A Brief Account on the Technique of Releasing Pox), and many more under different titles, during the nineteenth and early twentieth centuries. See Quanguo zhongyi tushu lianhe mulu (全國中醫圖書聯合目錄 United Catalogue of Medical Books in China), Zhongyi guji chubanshe, Beijing, 1991, Vol 1, pp. 517–19.

³¹ Leung, A. K. C., ‘The business of vaccination in nineteenth century Canton’, Late Imperial China, 29.1 (June 2008), pp. 7–39CrossRefGoogle Scholar. The use of other animals, especially the buffalo, to replace the cow was also apparently common in parts of Southeast Asia after the vaccine was introduced in 1805. In Indochina, it was done by Pastorian doctors. See Guénel, Annick, ‘Lutte contre la variole en Indochine: variolisation contre vaccination?’, History and Philosophy of the Life Sciences, 17.1 (1995), pp. 69–70Google Scholar.

³² Elman rightly describes this work as the ‘first sustained introduction of the modern European sciences and medicines’ of this period. See Elman, B., On their Own Terms: Science in China, 1550–1900, Harvard University Press, Cambridge, 2005, p. 57CrossRefGoogle Scholar.

³³ ‘Appendix. Semi-Centennial Celebration of the Medical Missionary Society's Hospital in Canton, China in the Preston Memorial Church. December 31^st, 1885’, in Report of the Medical Missionary Society in China for the Year 1885, China Mail Office, Hong Kong, 1886, p. 25Google Scholar.

³⁴ Wong, F., ‘Report of the Medical Missionary Society's Hospital in Canton for the year 1867’, in Report of the Medical Missionary Society in China for the Year 1867, Canton, n.p., 1868, p. 16Google Scholar.

³⁵ Kerr, J., ‘Report of the Medical Missionary Society's Hospital in Canton for the year 1862’, in Report of the Missionary Society in China for the Year 1862, Printed by A. Shortrede and Co., Hong Kong, 1863, p. 6Google Scholar.

³⁶ See Lei, S. H-L., ‘Qi-transformation and the steam engine. The incorporation of Western anatomy and re-conceptualization of the body in nineteenth century Chinese medicine’, Asian Medicine, 7 (2012), pp. 319–57CrossRefGoogle Scholar; and, more recently, Lei, S. H-L., Neither Donkey nor Horse. Medicine in the Struggle over China's Modernity, University of Chicago Press, Chicago, 2014, pp. 71–73CrossRefGoogle Scholar.

³⁷ Yitan chuanzhen (醫談傳真 Truth in Medical Discussions), which included 16 anatomical drawings.

³⁸ Zhenge, Chen, Yigang zongshu, Zuijinglou, Guangzhou, 1890, Preface, pp. 1b–2bGoogle Scholar.

³⁹ Ibid., Chapter 2, pp. 52a–53a; Chapter 4, p. 65a. He notably invented a category called ‘ailments of the blood vessel’ in his fourth chapter.

⁴⁰ Ibid., Chapter 2, p. 27a.

⁴¹ Ibid., p. 30b.

⁴² Ibid., p. 52a. See also a fuller presentation of the different uses of the decoction during the 1894 plague in Canton in Lai Wen 賴文 and Li Yongchen 李永宸, Lingnan wenyi shi (嶺南瘟疫史 A History of Epidemics in the Lingnan Region), Guangdong remin chubanshe, Guangzhou, 2004, pp. 731–38.

⁴³ Gao Chengyuan 高承元, ‘Chen daji yu Kong xiaoji’ (陳大劑與孔小劑 Chen the bigdoser and Kong the smalldoser), in Guangzhou wenshi ziliao cungao xuanbian (A Selection of Papers on Historical Materials on Guangzhou City), Zhongguo wenshi chubanshe, Guangzhou, 2008, Vol. 6, pp. 352–55.

⁴⁴ Cadbury, W., At the Point of a Lancet. On the Hundred Years of the Canton Hospital 1835–1935, Kelly and Welsh Ltd., Shanghai, 1935, pp. 7–17Google Scholar

⁴⁵ Parker, P., ‘Ophthalmic Hospital at Canton: First quarterly report, from November 1835 to February 1836’, in Chinese Repository, Printed for the Proprietors, Canton, 1835, Vol. 3, p. 469Google Scholar; ‘Second quarterly report, from February to May 1836’, Vol. 4 (1836), p. 33; ‘Eighth report from January–June 1838’, Vol. 7 (1839), p. 106.

⁴⁶ Kerr, J., ‘Report of the Medical Missionary Society's Hospital in Canton for the year 1864’, in Report of the Missionary Society in China for the Year 1864, Shortrede and Co., Hong Kong, 1865, p. 6Google Scholar.

⁴⁷ P. Parker, ‘16^th Report of the Ophthalmic Hospital at Canton for the years 1850–1851’, Printed at the Office of the Chinese Repository, Canton, 1852, p. 32. Kerr, John, ‘Report of the Medical Missionary Society's Hospital in Canton for the year 1872’, in Report of the Missionary Society in China for the Year 1872, de Souza and Co., Hong Kong, 1873, p. 19Google Scholar.

⁴⁸ See Leung, A. K. C., ‘Strategies of a biomedical hospital in nineteenth century Canton: materiality advertised in Qizheng lueshu (Brief account of extraordinary clinical patterns) 1866’, in Études Chinoises, XXXV–1 (2016), p. 181Google Scholar.

⁴⁹ The hospital also showcased some of the more spectacular medical technologies to the Cantonese. See ibid., p. 196.

⁵⁰ Ibid., pp. 188–89.

⁵¹ Cadbury, At the Point of a Lancet, pp. 174–81. The lucrative private practice of Kwan Ato and some others was reported in Kerr, ‘Report of the Medical Missionary Society's Hospital in Canton for the year 1872’, p. 19, notes 48 and 49.

⁵² Lu Zhaoji 陸肇基, ‘Zhongguo zuizao di guanli xiyi xuexiao’ (中國最早的官立西醫學校 The earliest state Western medical school), Zhongguo keji shiliao, 12.4 (1991), pp. 25, 28. The reason for privileging Cantonese students was unclear, but was probably related to their superior English ability and possibly also to the long tradition of medical teaching in the Canton Hospital.

⁵³ Leung, A. K. C., ‘Charity, medicine, and religion: the quest for modernity in Canton (ca. 1870–1937)’, in Goossaert, V., Kiely, J. and Lagerwey, J. (eds), Modern Chinese Religion II, 1850–2015, Brill, Leiden, 2015, Vol. 2, pp. 579–611Google Scholar. Liang Qizi (Angela Leung) 梁其姿, Shishan yu jiaohua (施善與教化 Charity and Moral Transformation), Linkin Publishers, Taipei, 1997, shows that traditional late imperial charitable institutions mostly focused on homes for foundlings and widows, and hospices for the elderly.

⁵⁴ Sinn, E., Power and Charity: A Chinese Merchant Elite in Colonial Hong Kong, Oxford University Press, Hong Kong, 1989Google Scholar. Similar institutions were established in Macau (for example, Kiang Wu Hospital was also set up in 1872) and China in major cities like Shanghai and Canton in the 1870s.

⁵⁵ The minutes of the board meeting of the Tung Wah Hospital of 26 January 1904 recorded the board's appreciation of the repatriation of jiaoqi patients back to Guangdong province as they believed they would have a better chance of cure at the Fangbian Hospital. On the latter, see Leung, ‘Charity, medicine, and religion’, pp. 579–611.

⁵⁶ For a history of this hospital, see Paterson, E. H., A Hospital for Hong Kong. The Centenary History of the Alice Ho Miu Ling Nethersole Hospital, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, 1987Google Scholar.

⁵⁷ R. M. Gibson, ‘Beriberi in Hong Kong, with special reference to the records of the Alice Memorial and Nethersole Hospitals and with notes on two years’ experience of the disease’, manuscript dated 16 March 1900, p. 2.

⁵⁸ Cantlie, J., ‘Preface to the English edition’, in Pekehlharing, C. A. and Winkler, S. (eds), Beri-beri. Researches Concerning its Nature and Cause and the Means of its Arrest, translated by Cantlie, James, Pentland, Young J., Edinburgh and London, 1893, p. ixGoogle Scholar.

⁵⁹ Gibson, ‘Beriberi in Hong Kong’, pp. 34–36.

⁶⁰ Leung, Leprosy in China, p. 155.

⁶¹ Peckham, R., ‘Matshed laboratory: colonies, cultures, and bacteriology’, in Peckham, R. and Pomfret, D. (eds), Imperial Contagions. Medicine, Hygiene, and Cultures of Planning in Asia, Hong Kong University Press, Hong Kong, 2013, p. 127Google Scholar.

⁶² D. Arnold, ‘Tropical governance: managing health in Monsoon Asia, 1908–1939’. Asia Research Institute, National University of Singapore, Working paper series, no. 116, 2009. Beriberi was most intensely discussed in the 1920s by FEATM, especially at its Sixth Congress held in Japan in 1925. See Transactions of the Sixth Biennial Congress held at Tokyo, 1925, Kyorinsha Medical Publishing Co., Tokyo, 1925Google Scholar.

⁶³ Xie, Zhongguo yixue yuanliu lun, pp. 47a–b. Commenting on Zeng Chaoran's 1887 book, Xie stated that the disease disappeared in China after the Song dynasty and was ‘re-introduced’ into China from overseas.

⁶⁴ Zeng, Jiaoqi chuyan, pp. 11a–b, 12b–13a.

⁶⁵ Donghua Hospital Archives (hereafter DHA), 1919–1920 ‘Waijie laihan’ (外界來函Letters received) 130-B19/20-214, pp. 172–73, Doctor Yu Baochu to the Tung Wah Hospital refusing to take up the position in Tongshan Hospital in Kuala Lumpur as arranged by the two hospitals.

⁶⁶ DHA, Letter from the Donghua Hospital to the Colony's Medical Officer, 16 February 1933, pp. 432–38. Out of 75 people listed, 29 were either passing through Hong Kong or had resided in Hong Kong for less than two years.

⁶⁷ I would like to thank Wilt Idema for drawing my attention to a genre of modern Hakka and Minnanese Songs and Ballads about Overseas Migration (guofan ge 過番歌 ‘Songs on traveling to foreign land’) from late-Imperial and early Republican China that highlight the dread of catching all kinds of strange diseases in the Southern Seas.

⁶⁸ Benedict, Bubonic Plague, note 25.

⁶⁹ Luo, Shuyi huibian, pp. 12a–b.

⁷⁰ Ibid., pp. 12b–13a.

⁷¹ See, for example, Farrar, Reginald, ‘Plague as a soil infection’, The British Medical Journal, 2.2172 (August 1902), pp. 454–56Google Scholar. Farrar, a British doctor, believed that the bubonic plague observed in South Asia was dependent on ‘infection with a specific microbe of soil contaminated with the excreta of rats or other animals that have suffered with the disease’.

⁷² yuyi, Xian 冼玉儀 and runhe, Liu 劉潤和, Yishan xingdao (益善行道 To do Good and to Practice the Way), Sanlian shudian, Hong Kong, 2006, pp. 45–58Google Scholar.