Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)

Graduate Group


First Advisor

Arthur N. Waldron


This dissertation reveals how acceptable, clean, responsible behaviours were defined through overlapping, transnational networks of both medical professionals and laypeople, and how the proliferation of these developments featured in the everyday lives of Chinese in the early twentieth century. Responding to previous studies of public health in Republican China on the central government’s institutions, the project instead explores aspects of daily life and public opinion from grassroots actors, highlighting myriad nuanced lived experiences and the inherent value that ordinary Chinese placed on health and social responsibility. Chinese society in the early twentieth century was cosmopolitan in its outlook and influenced by internationally-circulating ideas of health, wellness, and innovative progress; even small, rural communities exercised local autonomy to institute hygiene education campaigns, leading to innovative collaborations between international organizations and local leaders.

The first chapter is an extended case study of the province of Shanxi between 1918 and 1928, and an intervention into previous scholarship which assumes that effective public health was impossible before the establishment of national infrastructure in 1928. Beginning with plague control in early 1918, Shanxi leveraged global-local partnerships into opportunities for the development of localized public health campaigns. Hygiene initiatives gained popularity precisely because reformists carefully addressed local concerns, and because the public recognized the tangible benefits to their daily lives. The themes apparent in the first chapter are then explored at length. Each following chapter focuses on a specific communal space in which new expectations of hygienic behaviour were formed. The chapters are focused on the “School”, “Kitchen”, “Home”, and “Public Streets”. At each site, the maturation of hygiene teaching and practice was driven by, and indeed made possible by, individuals at the local level, even when they mirrored national developments.

Together, the chapters are a comprehensive exploration of idiosyncratic hygiene improvement developments and their participants, elevating lived experience and local agency along the way. Moreover, the dissertation asserts China’s establishment as an important, proven participant in the global organizations for the advancement of public health.

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