A doctor explaining X-ray to a woman.

Chinese Anti-Tuberculosis Flyers, ca. 1940

By Liping Bu ~

Originally published in Hidden Treasure: The National Library of Medicine, 2011.

Tuberculosis carried a social stigma for both the individual and the nation in the early twentieth century, when China was depicted as the “Sick Man of East Asia.” The adoption of Western ideas, standards, and practices of health was taken to be a yardstick of progress, while traditional religious beliefs and health practices were disparaged as superstitious and backward. When the newly founded National Anti-Tuberculosis Association of China began conducting anti-tuberculosis campaigns in 1933 it used images, motifs, and visual styles influenced by, and sometimes directly borrowed from, European and American posters, flyers, and pamphlets. The anti-TB campaigns and the formation of an activist public health movement were tied to modernization efforts.

The Chinese anti-TB campaigners believed that visual images must play a vital role in health education and mobilization campaigns in a nation where many were poorly educated or illiterate. The flyers shown here are part of a series made in the 1940s under the anticommunist Kuomintang government. Branded with the double-barred Cross of Lorraine, the international anti-TB trademark, the flyers placed the fight against tuberculosis in a distinctively Chinese framework. In one flyer (beneath, bottom left) the domestic scene is completely Western, but in the far background next to the window can be seen a Chinese painting of winter-plum blossoms. Winter blossoms symbolize perseverance and vitality in a harsh environment, a common theme in traditional Chinese art and rhetoric. Next to the image of a mother kissing her baby the flyer says “love but don’t harm your son.” In keeping with contemporary Western campaigns it argues that kissing is bad because it transmits germs that cause TB.

Four flyers depicting anti-tuberculosis efforts.
Flyers from a larger series of anti-tuberculosis flyers, Shanghai, 1940s and 1950s
Chinese Public Health Collection, National Library of Medicine

Another flyer (above, top right) shows a man in traditional dress spitting a hob of sputum—which is revealed by a microscope to contain bacteria—in an alley where innocent children play. The text cautions that spitting is an “unforgivable mistake” because it spreads tuberculosis, and instructs readers to correct this bad habit. An old woman in another flyer kneels before an altar and prays for health, with a poster inset that advertises tradition nostrums and quack remedies (above, top left). The flyer featuring a seated man, with a question mark and whirls of confusion around his head (above, bottom right), urges people to see a doctor at the first sign of illness rather than engage in wishful thinking and passively hope that diseases will go away on their own.

A doctor explaining X-ray to a woman.In contrast, a detail from another flyer shows a doctor explaining a lung X-ray to a young woman. The title, “Knowing people’s faces but not their lungs,” plays on the Chinese proverb “Knowing people but not their hearts.” The accompanying text argues that to prevent and treat TB, people should seek the advice of doctors trained in scientific medicine (the germ theory, good hygiene, nutrition, physical fitness, and sanitary engineering), who are equipped with the latest technologies—the microscope, X-ray, tuberculin test, BCG vaccine, and mass media. The underlying premise is that in heeding the advice of health experts the Chinese people can modernize themselves and their nation.

This collection of 5 1/8 x 7 1/2 flyers was developed by the National Anti-Tuberculosis Association of China and was used as part of anti-tuberculosis campaigns in the 1940s. Visit the National Library of Medicine to view this and other print collections in the History of Medicine Reading Room.  For questions about this collection, please contact the History of Medicine Division Reference staff at NLM Customer Support.

Liping Bu is Professor of History at Alma College. She has published extensively on public health and international cultural relations. Working with health images, she has created several featured collection websites at the National Library of Medicine including Chinese Anti-Tuberculosis Posters, 1950–1980. Her recent book is Public Health and the Modernization of China, 1910–2010.

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