PERSPECTIVE From Sick Man of Asia to Sick Uncle Sam MARTA HANSON L ike a lot of other people, I’ve had to adjust to working from home during the COVID-19 pandemic. My medical-historian colleagues and I, however, have been kept busy by high demand for putting this crisis in historical per- spective. As soon as the American Association of the History of Medicine agreed to cancel its May 2020 annual conference, members began to orga- nize a virtual meeting to respond to the corona- virus crisis. The resulting two-day webinar on the theme “Creating a Usable Past: Epidemic History, COVID-19, and the Future of Health” sought to mine history for critical insights about our pandemic present. During the closing discussion on “Pandemic Legacies and the Future of Health,” Ruth Rogaski, a historian of China, provided a valuable perspec- tive. The current pandemic could not be under- stood without integrating the historical legacies of East Asia’s past epidemics into the analysis, she argued. Not only did epidemics accompany for- eign invasions of China starting with the Opium Wars (1839–60), but experiences with epidemics also fundamentally shaped all modern Asian nation-states. Over the transition from the late nineteenth to the early twentieth century, the Qing dynasty (1644–1911) proved incapable of defending itself from either foreign incursions or epidemic dis- eases. European observers and Chinese reformers alike began to cast China as the “Sick Man of Asia” or the “Sick Man of the Far East.” They borrowed the image from the earlier trope of the “Sick Man of Europe,” allegedly inspired by Tsar Nicholas I when he referred to the Ottoman Empire, just before the Crimean War (1853–56), as “a sick man on our hands, a man gravely ill.” Of course, the “Sick Man” label was not only slapped on Turkey and China; even a rising new power, the United States, was not immune. In 1860, the New York Times published “Sick Man of America,” an editorial focused on the US govern- ment’s failure to solve the “great Mexican ques- tion” at the end of Mexico’s War of Reform (1857–60). For the most part, though, the term was used in an Orientalist way to denigrate Eastern empires (see Figure 1). But the provocative sug- gestion that the United States was itself a “sick man” would turn out to be prescient 160 years later. EAST–WEST ROLE REVERSAL Among all these variations on the theme, the racist “Sick Man of Asia” trope may have been the one that had the greatest long-term impact on the Figure 1. “Another Sick Man,” by Sir John Tenniel, published in the British magazine Punch, 1898. Here the “Sick Man of Europe” (Turkey) consoles the “Sick Man of Asia” (China). MARTA HANSON is an associate professor of the history of medicine at Johns Hopkins University. 241