THE PESTILENCE left about 2,500 people dead after storming across the border from Guangdong, where it killed 100,000 in Guangzhou alone. Quarantine measures were imposed, causing near rebellion in the community. Poor hygiene and filthy living conditions were blamed. The year, 1894, was a watershed in the history of Hong Kong. Public policy was put to the test and, as a result of the crisis, was never the same. Living conditions were improved and major advances in medicine and medical provision were made. The disease concerned was the bubonic plague. Surprisingly, many young people know little about it or its impact. History can seem remote and of little relevance, particularly in such a rapidly changing city as Hong Kong where so much of the past has been bulldozed. Moreover, the local curriculum gives scant attention to that outbreak. But now, in the time of another unfolding crisis in medical history, there could be new interest in the plague of 1894 and its aftermath. The Sars outbreak, public and government reaction to it, and its impact on the future, make knowledge about the plague all the more relevant. In particular, the past provides a crucial comparison with the present, and puts Sars in perspective. The Museum of Medical Sciences, tucked beside Ladder Street in Caine Lane, Sheung Wan, is housed in the University of Hong Kong's former Bacteriology Institute, later renamed the Pathological Institute. The institute was itself one of the outcomes of the plague, opened in 1906 to better understand infectious diseases and to develop vaccines for their control. Just as Sars has spurred geneticists in our universities to unravel the mystery of the coronavirus, so did the plague prompt advances in unlocking the secrets of the bubonic plague, and its links with rats, fleas and public hygiene. The bubonic plague - also known as the black death - has been one of history's greatest menaces, killing an estimated 137 million people in the major epidemics of the 6th, 14th and 17th centuries. But it was during this outbreak in Hong Kong that the causes of the disease were discovered, by French doctor Alexandre Yersin, a student of the pioneering microbiologist Louis Pasteur, and by Japanese scientist Shibasaburo Kitasato. Kitasato's discovery was published first. But it is Yersin's more accurate description and culture of the plague bacillus has been acknowledged in its official name - Yersinia pestis, according to the museum's current and timely exhibition on the disease. The museum is now planning a new exhibition of infectious diseases for next year. Then, Sars will take its place in history, to be compared with the plague and other ills. Dr Tse Tak-fu, chairman of the Hong Kong Museum of Medical Sciences Society, said: 'People should take a lot of interest in what happened at that time. There are a lot of similarities, but of course medical knowledge in much better today.' He and the museum's medical historians are now gathering information to compare the two outbreaks. One of those historians, Ringo Ng Kwok-leung, said: 'The Hong Kong plague is already in the history curriculum. But many students can't imagine the seriousness of it.' After Sars that might change, he believes. Although the numbers killed by Sars is much smaller than the plague, as well as contemporary diseases such as Aids and malaria, Dr Tse still sees it as very serious. 'It is frightening because it affects such a large proportion of medical workers and despite the science we are seeing a high mortality rate.' Its ability to spread across the world so rapidly is another factor that justifies the alarm and the enormous efforts to control the virus. Those efforts echo what happened just over a century ago. To stamp out plague, the government's Sanitation Board conducted house-to-house searches for victims and disinfected affected houses. While Amoy Garden residents were quarantined in New Territories holiday camps, plague patients were forced into isolation aboard the hospital ship, the Hygeia. 'Rumours abounded that they would be shipped off to Europe to be ground into powder as medicine for the royal family,' says the museum's literature. At that time there were deep suspicions about Western medicine and the idea of cutting up corpses for research. The Hygeia sparked such terror that the board was forced to open a second centre, in the Kennedy Town glassworks. Quarantining this week caused rioting near Tianjin, with villagers setting fire to a school the government planned to use as a quarantine centre. Another interesting parallel is how the two outbreaks spread, both originating in Guangdong. 'Whether Hong Kong is successful in controlling disease still depends on China,' said Lam Hon-kin, the museum's curator. 'Both have been related to animals.' Plague was spread via rats and fleas. The coronavirus is thought to have mutated and crossed species, like flu viruses, from ducks and pigs. During the plague, the government demolished a huge number of squatter dwellings in Sheung Wan. 'The government launched many policies to clean the area,' said Lam. Although 1894 was the worst year, it took 30 years to bring it under control. In that time it killed as many as 20,000 people. Tse remembers that even in his childhood there was an annual clean Hong Kong campaign that was part of the anti-plague rituals - another parallel with the current public and government response to Sars in which politicians lead a high-profile street cleaning campaign. Plague is just one of the major diseases that have had their impact on Hong Kong's history. Tuberculosis has killed even more . In 1955, 2,800 died, though from a population of more than two million rather than the 200,000 who lived here at the turn of the century. And in the early 1960s cholera struck, causing another round of quarantining, Hong Kong to be declared an infected port and 24 deaths. Like the plague, Sars is prompting us to review the way we live. Lam believes it may yet shape city and environmental planning. The question now is whether the public education related to Sars will lead to a longer-term interest in health sciences. Dr Tse hopes it will, and that they will have a greater place in the school curriculum. As Sars becomes part of Hong Kong history, students will have opportunities to learn about it from many sources - from the museum or on-line, for instance. It can also become a focus for oral history. 'Students can interview the doctors and nurses about the problems they faced, not only medical but the life and death situation they found themselves in,' said Lam. The museum, opened in 1996, is a learning resource that should now come into its own, to be included as a venue for school visits alongside the science, history and space museums. Apart from the plague, the museum tells the story of medical developments, both Chinese and Western. In the West students associate the invention of vaccination with the name of 18th century English doctor Edward Jenner. But the museum tells a different story. Smallpox immunisation is thought to date back to 10th century China and was widely used in the lower Yangtse River area in the 16th century. The process involved 'variolation' - the inhalation of material from smallpox patients. The method was improved in Turkey in the 18th century, before Jenner advanced immunology further, discovering how cowpox could be used to build resistance. In the museum, a platform used to extract cowpox from the belly of a living calf is on display, among many other medical implements, ancient and more modern. The museum also tells the stories of our hospitals, the first nurses, and the pioneering pathologists, such as Professor Wang Chung-hing, the chair of pathology at HKU who focused his research on tuberculosis, which also caused his own death, in 1930. 'Without the developments of medical science the progress of humans would have been much slower. People can live much longer, and achieve more,' said Lam. Sars had already been a 'good life-wide lesson', focusing attention on disease, its causes and how it can be controlled, said Lam. But whether Sars will become a formal part of Hong Kong's history, included in the school curriculum, will depend on the Curriculum Development Institute. Hui Chun-lung, chairman of the Hong Kong Teachers Association of Chinese History Education, says that it will take years to achieve such status. But that does not mean teachers cannot approach the teaching of history or science more creatively, by drawing on comparisons between the Hong Kong plague of the 1890s and Sars today. For more information about the Hong Kong Museum of Medical Sciences, visit its Web site at www.hkmms.org.hk