If there is one object that symbolizes and crystalizes our collective experiences during the Covid-19 pandemic, it is, without doubt, the facemask. It is both a central component of the administratively prescribed strategies to contain the pandemic and—in addition to social distancing—the most widespread personal protective measure. That being said, the strategy of mass masking was not self-evident at the beginning of the Covid-19 outbreak. The act of mask-wearing was first perceived as a unique East Asian phenomenon as Covid-19 started to gain global media attention. Medical authorities outside of East Asia, including the WHO, were generally reluctant to impose mass masking in public. However, in early April 2020, an increasing number of governments in Western countries changed their facemask policy and started to issue guidelines for universal mask-wearing (Goldstein et al. 2020). The use of facemasks by the general population was framed as an urgent and effective strategy to impede COVID-19 transmission (Gandhi et al. 2020; Howard et al. 2021; Holakouie-Naieni et al. 2020).

Facemasks in times of COVID-19 are more than just biomedical devices covering one’s mouth and nose. The global spread of the virus has made them highly charged symbols in political debates, popular culture, and everyday interactions. In order to make sense of their dynamic symbolic meanings, an increasing number of social and cultural studies on masks have been published since the outbreak of COVID-19. Studying the socio-material meanings of COVID facemasks, Lupton et al. (2021: 84) reveal “the manifold complexities, forces and intra-actions of symbolism, discourse, politics, culture, and embodiment in which the face mask in COVID is entangled.” Ma and Zhan (2020) make visible social stigmatization experienced by masked Chinese students in America. The so-called ‘mask culture’ is criticised by Zhang (2021) as an Orientalist discourse that perpetuates and reproduces stereotypes about Asian people. Last but not least, Han (2020: 6) reveals how Chinese official facemask narratives have constructed mask-wearing “as a deontic value that all citizens should embrace”.

This article, however, does not engage directly with the present-day phenomena of masking, but rather its ‘history of the present’ (Roth 1981; Dean 1994; Garland 2014). From a genealogical perspective, meanings are historically contingent and are only fixated through the operation of power (Foucault 1984). It is therefore important to pay attention to the process of meaning-making that is located in specific historical contexts. To be more specific, this article traces the genealogy of masking in the history of modern China. Genealogy is, however, different from history. A conventional history of facemasks may simply juxtapose different designs of masks from different periods in a temporally linear and continual order. This, however, often runs the risk of technological determinism. Genealogists, on the other hand, focus on discontinuities and multiple processes of emergence. It is a reflexive art of problematization that traces how power struggles and contingency are constitutive of the emergence of contemporary practices and institutions (Garland 2014: 372). In this sense, a genealogical study of masks does not intend to formulate a sweeping social theory of masking, but to develop some heuristic tools that make sense of and problematize present-day masking practices.

In what follows, this article focuses on socio-material conditions that give rise to the emergence of masking strategies in the Chinese history of epidemic control. Schematically speaking, it examines two kinds of masking strategies: One that is implemented in a top-down manner and one that is initiated by the public ‘from below’. These two strategies emerge in two epidemic events. The first one concerns the birth of modern facemasks (gauze masks) in the context of the Manchurian plague 1910/11. The anti-plague mask was first made thinkable by new forms of medical knowledge and historical anecdotes, then implemented as a biopolitical strategy aiming at an ‘unhygienic’ population, and finally celebrated as a symbol of “hygienic modernity” (Rogaski 2004). The second moment witnessed the emergence of collective mask-wearing practices in the context of SARS 2002/03. The central question this time was not so much a medico-political one concerning implementing masking policy, but rather an ethical question on wearing them. How are people incited to recognize their obligations to wear facemasks? During the SARS outbreak, facemasks became a symbol of care in the neoliberal regime of responsibilization. In the last section, this article will discuss how this genealogical study of masks can contribute to a rethinking in COVID times.

At the end of 1910, a year before the collapse of the Qing dynasty, a vehement plague ravaged Northern Manchuria. By the time the epidemic had waned in March 1911, it had cost more than 60,000 lives in total. The fatality rate proved to be 100%. The plague first made its appearance in Manzhouli, a Chinese town bordering on Russia. Along the railway lines and roads, the disease surged southwards to other cities in Manchuria—a vast territory contested by Japan, Russia, and Qing. At the outset of the outbreak, the Russians were quicker to react to the plague than the Qing government. The disease was first diagnosed in the Russian concession city of Harbin on 27 October and an improvised plague hospital was soon built (Gamsa 2006: 148). At the same time, Japan was putting diplomatic pressure on Beijing while preparing to invade Manchuria from Korea. Both countries questioned Qing’s ability to contain the plague and framed the plague epidemic as a political issue of international importance (Flohr 1996: 367; Bu 2017: 48). Unlike previous plague events, which were ‘perceived’ by Qing as a regional or national issue, the outbreak this time posed a threat to Qing’s sovereignty over Manchuria (Lei 2010: 77). Instead of resorting to war and the army, which was a common solution to sovereignty problems, the outbreak of the Manchurian plague required the Qing government to resort to new strategies.

In the midst of this crisis, China’s vice minister of foreign affairs, Shi Zhaoji (Alfred Sao-ke Sze, 1877–1958), recommended Dr. Wu Lien-teh, a Cambridge-trained physician, as the head of a medical team assigned to help fight the epidemics. Three days after his arrival in Fujiadian, a satellite town (inhabited mainly by the Chinese) within walking distance of the Russian-dominated city of Harbin, he dissected the first corpse of a plague victim and analyzed bacterial cultures from organ specimens (Lei 2014: 25). It was soon clear to him that the organism under his microscope appeared to be identical with the Bacillus pestis that Kitasato Shibasaburo (1853- 1931) and Alexandre Yersin (1863–1943) had co-discovered during the Hong Kong plague in 1894. But Wu observed a novel fact, namely that these bacilli were found exclusively in the victim’s lungs, which could suggest that the plague this time was very different in nature from the one 17 years before. Wu then proposed a “bold theory” (Lynteris 2018: 444) that the plague in Manchuria had taken a pneumonic rather than a bubonic form. The latter had been the newly established knowledge about the plague among the international scientific community since the beginning of the third plague pandemic 15 years before. Wu believed that the plague in Manchuria was not transmitted by infected rat fleas but spread directly from person to person through the air. In order to block the spread of this contagious disease, he designed a gauze cotton mask and recommended that it be worn by doctors and paramedical staff who were involved in the containment of the plague (Wu 1926: 397f). Although the design of Wu’s mask resembled recently established surgical masks used in the operation room at the turn of the twentieth century, it was the first time that gauze masks were used in the context of epidemic control (Lynteris 2018: 444).

It would be too rash and too technically deterministic to assume that Wu’s bold theory with a pneumonic plague would automatically lead to the legitimization of using gauze masks. After all, the mode of disease transmission had been contentious since the outbreak of the Manchurian plague. So was the efficacy of facemasks (Farrar 1912: 15f; Wu 1926: 395). What’s more, the use of facemasks was a rather unthinkable strategy in the Chinese history of plague containment. How could a young physician like Wu, whose bold theory was somewhat contrary to the medical knowledge held by many senior foreign epidemiologists, convince Chinese officials to adopt gauze masks in epidemic control? What kinds of institutional, discursive, and strategic conditions needed to be created so that the use of anti-plague masks could become thinkable, feasible, and perhaps even indispensable?

The idea of facial masking as prophylactic measures against epidemics had been rather unthinkable to medical practitioners in the Chinese dynasty times. This was primarily due to the fact that contagion was almost never invoked as the cause of epidemics as in the Western tradition (Benedict 1996: 105; Leung 2010: 25). If contagion was mentioned, it tended to be understood as caused by a multitude of factors including for example the diqi (earth qi), moral degradation, or bad fengshui rather than by a single cause. Common responses to epidemics in Qing dynasty were “charitable relief, cleanup campaigns, appeals to the plague gods, and participation in community ceremonies” (Benedict 1996: 128). In this sense, the emergence of anti-plague masks in the context of the Manchurian plague articulated a shift in plague epistemology. Central to this shift was a new understanding of contagion informed by germ theory.

The Manchurian plague was indeed of a very special kind. Examining the uniqueness of this epidemic event, Lei draws our attention to an official report submitted to the Qing court after the Manchurian plague in 1911, in which Xi Liang (1853–1917), governor of the region recalled: “In the beginning [of the outbreak], [we] did not believe that this plague could chuanran [spread by contagion or infection]; all the protective and therapeutic measures were based on the conventional ways that China used to cope with wenyi [warm epidemics].” (cite in accordance to the original version in Lei 2010, 94).

The Chinese term chuanran was commonly used by medical practitioners to describe the transmission of diseases after the twelfth century (Leung 2010, 37). It is better to locate traditional understandings of chuanran in what Rosenberg called the configuration approach (Kuriyama 2000: 13), in which outbreaks of diseases are considered to be triggered by “a dynamically interacting web of influences” (Leung 2010: 44) in the environment.

In the latter half of the nineteenth century, the word chuanran acquired a new meaning as new concepts from biomedicine were translated into the Chinese context. Despite the immeasurability between chuanran in the traditional Chinese medical sense and contagion informed by the germ theory, the former was arbitrarily used as the Chinese term to translate the latter (Leung 2010: 45). One should, however, not claim that chuanran has since then been used interchangeably with contagion, but rather reserve a more nuanced understanding of chuanran that encompassed multiple, mixed, and sometimes ambiguous meanings at the beginning of the twentieth century.

When Xi Liang confessed that local gentry and medical practitioners did not believe that the plague could chuanran, he “might already have incorporated modern biomedical ideas of germs” (Leung 2010: 45). With his remark on chuanran, Xi performed what Lydia Liu terms as “translingual practice” (Liu 1996), a discursive practice that transgressed the irreducible differences between a multi-causal mode of chuanran and a mono-causal one. By doing this, Xi dissolved the ambiguity between the two and justified the latter as the legitimate meaning of chuanran. This new understanding of chuanran marked a shift in the attitudes of Qing officials towards a new way of understanding and governing epidemics.

In retrospect, Lei (2014, 23) emphasizes the role of germ theory in framing the Manchurian plague 1910/11. The germ theory was introduced into China through the translation of foreign biomedical books and became dominant around 1900 (Leung 2010, 45). It legitimized a series of new anti-plague strategies including the use of masks during the plague in Manchuria. Some of these new measures such as forced quarantine and mass cremation were enforced so rigorously as to be perceived by Manchurian people as “the most brutal policies seen in four thousand years” (Lei 2010: 82). However, the germ theory did not just ‘come’ through translation. As will be shown below, historical anecdotes during the Manchurian plague also played a central role in introducing the idea of deadly viruses to the general public and convincing them of the efficacy of mask-wearing.

As already mentioned, Wu’s diagnosis of an airborne plague was a rather contentious theory at the beginning of the outbreak. Visualizing the plague bacillus, Wu’s microscope helped to convince local officials of the cause of the plague, but the static microscopic image could not show how the pathogen was transmitted (Lynteris 2016: 10). Confident of their updated knowledge about the bubonic plague, many foreign experts ridiculed Wu’s airborne thesis and therefore refused to wear masks even when they were in close contact with plague patients (Lei 2010: 79). Dr. Gérald Mesny, a senior colleague on the Chinese anti-plague team and the head professor of Beiyang Medical College, was one of them. He expressed strong resistance to Wu’s discovery. In his autobiography Plague Fighter, Wu recalled their encounter in the third person:

Dr. Wu was seated in a large padded armchair, trying to smile away their differences. The Frenchman was excited, and kept on walking to and fro in the heated room. Suddenly, unable to contain himself any longer, he faced Dr. Wu, raised both his arms in a threatening manner, and with bulging eyes cried out ‘You, you Chinaman, how dare you laugh at me and contradict your superior?’ (Wu 1959: 19)

A few days later, the news arrived that Mesny had become infected with the plague when he visited a Russian epidemic hospital without wearing a mask, and he passed away a few days later. The death of Mesny, a leading figure on the anti-plague team, soon led to a wave of panic in Manchuria (Lei 2010: 80) and constituted “the turning-point” (Nathan 1967: 11) of the anti-plague campaign by the local government. Wu (1959: 22) wrote in his biography later that “[from now on] almost everyone in the streets was seen to wear one form of mask or another”.

The Mesny anecdote can be read as a historical contingency, after all, he might not have died if the plague had not been airborne. On the other hand, it would be anthropocentric to tag everything that is caused by forces beyond human beings as contingent without seriously considering the power of nonhuman actants. This is especially true given that the mortality rate of the Manchurian plague was 100%. The death of Mesny demonstrated what the microscopic lens could not prove: the pneumonic character of the plague in Manchuria (Lei 2010: 80). In this sense, the Mesny anecdote can be read as a central heterogeneous event that legitimized Wu’s monocausal ‘airborne theory’ as well as the necessity to use gauze masks as protective equipment against contagion.

The interest in Wu’s gauze masks was not given at the beginning, nor were they generated through scientific reasoning. The adaptation of anti-plague masks would be impossible without the ‘ally’ of the ferocious virus. In this anecdote, the plague bacillus helped convince the efficacy of facemasks and therefore transform them into protective devices, while the latter in turn ‘proved’ the contagious nature of the former. In this sense, one cannot examine the facemask as an isolated object but rather as a “hybrid actor”^Footnote1 (Latour 1994: 33). In other words, the power of masks as personal protective equipment does not emerge from the mask itself, but rather in their assemblages with other elements such as a biomedical understanding of the virus, human bodies, and affects (Lupton et al. 2021: 7–9).

In a chapter called ‘History of the Mask’ in A Treatise on Pneumonic Plague, Wu (1926: 391) revealed a far-reaching connection between anti-plague masks used in the Manchurian plague and plague doctor masks from the seventeenth-century Europe.

Before discussing the measures as practiced to-day [sic], we may dwell shortly upon the various means adopted for personal prophylaxis as practiced in the past. History takes us back to the time of the Black Death, when medical experts were apparently aware that, in the pneumonic type of plague, the infection was directly transmitted through the air. This seems highly advanced by the side of the practices adopted in later centuries, such as in Milan (1630), Rome (1636), etc., when the mask and other prophylactic implements were used without any clear idea of respiratory mode of infection beyond a vague hypothesis of some ‘miasma’ being present.

Putting aside the validity question of Wu’s retrospective diagnosis of the Black Death, his eagerness to brand the gauze mask as the climax of continual progress of personal plague prophylaxis appears problematic today. Wu’s praise of the beaked plague masks used in seventeenth century Europe as “highly advanced” (Wu 1926: 391) seems to be exaggerated.

In a recent study on historical plague doctor masks, Ruisinger (2020: 247) argues that the beaked mask was at best a marginal phenomenon of the plague before the seventeenth century. Ironically, the motif of the plague doctor costume was popularized in the eighteenth century by broadsheets that made fun of the superstitious foreign doctors from Southern Europe. In other words, the plague doctors with their beaked costumes became the symbol of plague par excellence not through their real existence but through the propagandist broadsheets spread around 1700 in Europe.

After all, Wu is not a historian, his misinterpretation of the historical plague mask, however, seems to fit better in his political agenda to introduce Western medicine into China (Lee et al. 2014). As will be demonstrated in the next part, Wu’s eagerness to modernize Chinese medicine and public health was expressed through the visuality of anti-plague masks presented in the first International Plague Conference.

By the end of March 1911, new plague cases had begun to decline throughout. One month later, the first International Plague Conference took place in Mukden, a Manchurian city with mainly Chinese residents. Held only months before the collapse of the Qing dynasty, the conference was the first international medical conference in modern Chinese history (Gamsa 2006: 153). It was held to debate the epidemiological and public health aspects of the outbreak. At the same time, the competition among political interests of Russia, China, and Japan over Manchuria culminated.

In the Mukden conference, Wu presented international delegates with a carefully crafted photographic album, in which “the white contour of the mask creates a strong contrast that renders Wu’s anti-epidemic army all the more visible.” (Lynteris 2018: 446) It is interesting to note that 17 years ago, a similar visual strategy based on the color white was also deployed in the internationally circulated photographic documentation of the plague in Hong Kong (1894) (Peckham 2016a: 51). The photographs of ‘Whitewash Brigade’ for example mobilized the trope of ‘white’ to whitewash the ‘backward’ Chinese, as white-uniformed personnel of the ‘Whitewash Brigade’ was authorized to demolish “unsanitary Chinese dwellings in the Western District [in Hong Kong]” (Peckham 2016a: 42). ‘Whiteness’ was used as a trope of cleanness and purity, which contrasts with dirt and danger. The visual contrast between white-uniformed British soldiers and dark shanty plague-affected towns in Hong Kong not only highlighted the ‘backward’ Chineseness as responsible for the transmission of the plague but also visualized the coming of hygienic modernity as a force of purification.

It can therefore be argued that, with the photographic album presented in the Mukden conference, Wu was not simply propagating the medical efficacy of these face-worn apparatuses in containing the plague but also their ‘modernizing’ efficacy—their potentiality to transform wearers into subjects of hygienic modernity. The strategic presentation of masks helped Wu to reverse the “civilizational and racial war against the supposedly irreducible link between germs and Chinese backwardness” (Lynteris 2018: 447), and demonstrated that the Chinese were now able to contain the plague with modern biomedical knowledge.

Gauze masks symbolized the ‘dream’ of Chinese medical elites to transform Chinese citizens into medically rationalized subjects. It is, however, hard to estimate the extent to which the medical rationality of mask-wearing was adopted by the general public during the Manchurian Plague. To this issue, Wu (1926: 339) once commented:

We remember seeing a man in the street with a stiff (wire-framed) mask over the nose only, while he was serenely smoking a cigarette. Sometimes the masks were wrapped around the neck ‘as a protection against cold’!

Another example is that some ‘coolies’ stamped the facemask with temple seals before wearing them. This act of stamping was supposed to turn facemasks into amulets (Farrar 1912: 3) These examples show not only how the scientific sense of mask-wearing failed to reach the population, but it also reveals the failure of the Chinese modernizers’ dream to transform its population into medically-reasoned subjects.