Introduction: The Misunderstood Database of ‘Miasma’

From the perspective of Digital Humanities, local chronicles are not just historical narratives but a ‘dynamic database’ of environmental and survival struggles. The Health Chronicles in the Revised Taiwan Provincial Chronicles document the arduous journey from a “land of miasma” to a modern public health system. This is more than a medical history; it is an evolutionary tale of governance using “administrative power” to intercede in biological spaces.

Geographic Connectivity: Historical Coordinates of Epidemic Control

Based on the Health Chronicles and Major Events, key landmarks in this evolution include:

  • Chihkan (Tainan): The epicenter of major epidemics during the Ming-Zheng period.
  • Keelung Mountain: Recorded in the early Qing as a site of “miasmic spirits” and high mortality.
  • Mengjia (Wanhua, Taipei): Site of the Yangji Asylum established during the Guangxu era for the elderly and disabled.
  • Tamsui, Anping, Kaohsiung, and Makung: Ports where early weather and customs observations served both epidemic prevention and shipping.

1. The Shadow of Miasma: A Recorded Crisis of Survival

In early Taiwanese records, ‘Miasma’ (Zhangli) was a term of high frequency.

  • Ming-Zheng Hardships: In 1661, as Zheng Chenggong’s troops arrived at Chihkan, “eight or nine out of ten were sick” due to environmental maladjustment.
  • Early Qing Mortality: Records from 1682 near Keelung describe “corpse fires flickering” and eerie sounds echoing through the hills.
  • Witchcraft and Superstition: In the absence of scientific data, locals relied on “rice divination” and spells to ward off diseases.

This social condition only began to shift in the mid-Qing era as land reclamation and “the smoke of ten thousand households” (urbanization) helped dissipate these endemic “vapors”.

2. The Dawn of Modernity: Liu Mingchuan’s Medical Bureau

The blueprint for Taiwan’s modern public health system began with Governor Liu Mingchuan’s reforms in 1886.

  • Founding Public Hospitals: Liu established the ‘Government Medical Bureau’ and ‘Asylums’ in Taipei, hiring Western physician Dr. Hunsen.
  • Institutional Setback: These facilities were unfortunately abandoned in 1891 when successor Shao Youlian implemented fiscal tightening. This proves that administrative continuity is vital for public health infrastructure.

3. Data-Driven Governance: Sanitary Policing in the Colonial Era

The colonial period saw health administration enter the era of “Police Power” intervention—a controversial yet highly efficient transition.

  • Fiscal Prioritization: According to Fiscal Affairs, health expenditures accounted for 18% of urban budgets, surpassing pure administrative costs.
  • Statistical Breakthroughs:
    • Mortality Rates: Crude mortality dropped from 34‰ in 1906 to 20‰ by 1940.
    • Life Expectancy: Increased from 22.7 to 43.3 years for males, and 23.6 to 49.0 years for females during a 34-year span.
  • Grid-Based Surveys: Standardized surveys covered population, physique, infectious diseases, water quality, and even home lighting.

4. Post-War Miracles: From Eradication to Prevention

Following the retrocession in 1945, the administration reorganized to combat the resurgence of plague, cholera, and smallpox.

  • Network Establishment: By 1966, the goal of “one health station per township” was achieved, totaling 362 stations.
  • Eradication of Four Major Diseases:
    • Plague: No cases since 1949.
    • Smallpox: Eradicated in 1955.
    • Malaria: Declared officially eradicated in 1965.
  • Final Data Verification: By 1981, life expectancy reached 69.74 for men and 74.64 for women, while infant mortality plummeted from 44.71‰ to 8.86‰.

Modern Revelations: The Vitality of Local Data

Through the health data in the Taiwan Provincial Chronicles, three governance logics emerge:

  1. Correlation between Land Development and Health: Early “miasma” was essentially an ecological disease of undeveloped land; reclamation and urbanization are the first lines of defense.
  2. Irreplaceability of Grassroots Networks: From ‘Yangji Asylums’ to ‘Health Stations,’ only a medical network that reaches the community (She or Bao) can achieve precise data collection and control.
  3. The Necessity of Investment: As seen in the 18% budget allocation of the early 20th century, progress in public health requires solid fiscal backing and long-term institutional commitment.

Conclusion

Geographic coordinates may change names, but the survival data recorded in local chronicles is eternal. From the ancient lament of “eight out of ten sick” to today’s world-leading public health indicators, every “breath” of Taiwan is precisely marked in the numerical shifts of these ancient archives.