This paper examines the spread of the Manchurian plague and the response of the Chinese government, Western powers, and Japan. Imperial medicine had served the Western management of colonies in East Asia. Western powers had used the new knowledge of medical science as a tool for imperial expansion and colonial control. However, this paper argues that Western powers did not agree with a new theory that the pneumonic plague was transmitted through respiratory infections, as discovered by Wu Liande (1879-1960), a Chinese plague fighter, and promoted by Kitasato Shibasaburo (1852-1931). Many officials still continued to believe the rat-flea theory, which held that the plague was transmitted through fleas from rodents, and they focused on reduci...