Paris (AFP)

Frightened by an unknown disease that is spreading, the population rushes into makeshift masks, despite an expert debate on their usefulness. Familiar? However, the story took place over a century ago during the "plague of China".

The idea that a disease can be transmitted from person to person has existed since at least the 16th century "as a serious medical theory", explains to AFP William Summers, expert in history of medicine at Yale University .

But in the middle of the 19th century microbes were identified, allowing the development of "germ theories" to explain the mechanisms of infection.

So in the 1890s, masks appeared in operating rooms. It was at this point that a plague epidemic emerged in Hong Kong, before spreading.

This pandemic called "the plague of China" arrived in 1910 in Manchuria. There is great fear as the disease, with a mortality rate of almost 100%, takes the all-new railway lines to Beijing and even Europe.

"She killed everyone who was infected within 24 to 48 hours after the first symptoms," said Christos Lynteris, anthropologist at St Andrews University in Scotland. "It was apocalyptic".

Wu Lien Teh, a young doctor born in Malaysia and trained in Cambridge, was sent there. He fights to convince his colleagues that the plague is not only bubonic, linked to the bite of infected fleas, but also pulmonary.

- "Innovative and scandalous" -

"He thought that a plague sufferer, whose lungs are infected, could transmit the disease to others by air, without the intervention of fleas," explains Christos Lynteris. "It was innovative and scandalous at the time".

It also involved wearing a mask.

Health officials at the time, however, faced two problems, said Summers, author of a book on the Manchurian epidemic.

The first is political: the "chaos" in Manchuria over which the Russians and the Japanese dispute control over the declining Qing dynasty. The second is to succeed in making the population accustomed to traditional medicine accept an approach based on scientific discovery.

An event will bring the population out of its "lethargy", says Wu in his autobiography: the death of his French colleague Gérald Mesny, who, not taking his young colleague seriously, makes an unprotected visit to a hospital. Contaminated, he died within a few days.

Suddenly the demand for masks explodes. "Everyone wore it on the street, in one form or another," said Wu.

Images of this epidemic in Manchuria show nursing staff turbaned in bandages that cover their entire heads. Those who transport bodies press tissue over their noses and mouths.

Wu "tried to develop a system of fasteners to be able to wear a body and keep the mask", says Christos Lynteris, describing an "unprecedented" development of masks for workers at risk and the general population.

Stalling press photography draws the attention of the world to these masks, which become part of the image of the plague and "the way we imagine an epidemic," he continues.

- Bird beak -

Already hundreds of years ago, long before microbial theories, people were protecting their faces.

For example, faced with the bubonic plague in the Middle Ages, the complex costume of European doctors included a kind of mask in the shape of a bird's beak, supposed to protect against "miasmas", a kind of stale air carrying decaying materials and bad smells.

"It was then believed that dangerous atoms would not adhere to leather pants and blouses in waxed fabric," says historian Frank Snowden in his book "Epidemic and Society: from the Black Death to the Present."

He describes this beak-shaped mask "which extends the nose and shelters aromatic herbs protecting the wearer from the deadly odors of miasma".

A few centuries later, the discoveries of scientists, from Louis Pasteur to Robert Koch, revolutionize the understanding of the mechanisms of infection.

But imperial China resisted it, until the plague of Manchuria. China then became a "champion of medical modernity", according to Christos Lynteris.

With the SARS epidemic in 2003, the masks re-bloomed, becoming an essential accessory in the affected places, especially in Hong Kong.

But not in the West. Even if masks were used in the United States during the famous flu epidemic of 1918, Western societies "have no memory" of this crisis, notes the anthropologist.

"So the introduction of the mask today in Europe or America is a whole new experience".

© 2020 AFP