Known to history only as Hoo Loo, he bled out on an operating table 5,000 miles from home. How did he get there? Was he a victim? And what can his story tell us about the rise of modern medicine?
In the spring of 1831, hundreds of spectators and journalists gathered at Guy’s Hospital in London to watch as three British surgeons attempted to remove a massive tumor from the genitals of a 32-year-old Chinese farmer named Hoo Loo. The operation took one hour and forty-four minutes and was carried out without anesthesia. Hoo Loo lost consciousness several times and eventually died on the table. Once removed, his tumor weighed in at 56 pounds.
This tragic episode is the subject of “The Death of Hoo Loo: The 1831 Medical Incident That Shook the World,” published on the Chinese mainland last year. Though modest in length — just 150,000 Chinese characters — the book took its author, the Fudan University-based historian Gao Xi, 37 years to complete.
After graduating from Fudan’s history program in 1986, Gao spent a year teaching in the countryside before taking up a teaching post at Shanghai Medical University. It was there that she first came across K. Chimin Wong and Wu Lien-teh’s magisterial 1932 survey “A History of Chinese Medicine,” which features a tantalizingly brief summary of the case: In 1831, doctors affiliated with the British East India Company had sent a Chinese patient to London for treatment. The man died on the operating table.
The cover of “The Death of Hoo Loo: The 1831 Medical Incident That Shook the World.” From Douban
This terse description left a deep impression on Gao. It was the late 1980s, and China’s interest in and admiration for Western culture and history was arguably at its peak. How, Gao wondered, could a Chinese man have died during surgery in a country as advanced as Britain?
Gao’s career took off over the next decade, and she eventually completed a doctorate on the history of Chinese medicine under the renowned historian Zhu Weizheng. But if her academic interests broadened, the story of Hoo Loo stayed with her, even as her interpretation of the event gradually shifted. Influenced by postmodern historiography and postcolonial theory, she began to suspect that racial or colonial biases within the British medical system may have contributed to Hoo Loo’s painful surgery and death.
In 2020, Gao, by then a full professor at Fudan University, received an invitation from the Taiwanese historian Su Jing to review his new book, “Ten Essays on Western Medicine.” To Gao’s surprise, Su mentioned Hoo Loo’s case and included references to the British East India Company archives. This discovery, combined with decades of unanswered questions, finally convinced Gao that the time had come to examine the case more closely.
Her search began with the question that had puzzled her for years: Why did Hoo Loo die? She soon discovered that the British doctors who treated him had not, in fact, acted out of prejudice. His death was tragic but not unusual in an era of high surgical mortality and little to no anesthesia.
Yet Gao’s inquiry soon uncovered a far larger story: Although largely forgotten today, Hoo Loo’s death had sparked a significant debate within Britain’s medical community about the ethics of high-risk surgery and the responsibilities of physicians to their patients. It even entered the political discourse: Hoo Loo’s oversized tumor was used as a symbol of political corruption by cartoonists and commentators in debates over parliamentary corruption and unfair voting practices at the time. And in the decades that followed, as Sino-British relations deteriorated in the wake of the Opium Wars, the story of Hoo Loo was absorbed into Orientalist narratives, distorting the truth and clouding Western scholarship for generations.
In late March, Sixth Tone sat down with Gao for a wide-ranging conversation about Hoo Loo’s story, what it reveals about China and the West, and how even the most ordinary people can change the course of history.
A portrait of Gao Xi. By Zhang Jing/Shanghai Review of Books
Sixth Tone: The story in your book is likely to surprise many Chinese readers, few of whom would expect that, as early as the 1830s, a Chinese person would travel abroad to seek medical treatment.
Gao: Many Chinese people assume that modern Chinese history — and particularly its engagement with the West — began with the first Opium War in the early 1840s. But in fact, China had various forms of contact with the West well before that. In medicine specifically, the transmission of Western medical knowledge and the rise of medical philanthropy — the origins of modern medicine in China — can be traced back to May 27, 1805. On that day, Alexander Pearson, a ship’s surgeon working for the British East India Company, administered the first smallpox vaccination to a Chinese patient in the Portuguese colony of Macao.
Hoo Loo’s story is likewise closely tied to the East India Company. In November 1830, Thomas R. Colledge, a British doctor who worked at the Canton Factories, encountered Hoo Loo and hoped to send him to Britain for surgical treatment. Why did he do this? Not only did he believe that such an act could improve the image of Westerners among the Chinese, but he also saw value in Hoo Loo’s rare condition for British medical research — and especially for his mentor, Sir Astley Cooper, a leading surgeon at Guy’s Hospital.
Having worked as a ship’s surgeon for the East India Company for seven years, Colledge knew how to appeal to its interests. He argued to the company that helping Hoo Loo would demonstrate the superiority of Western over Chinese medicine and help dispel local perceptions of Westerners as “barbarians,” making it easier to conduct business in China. The East India Company agreed and funded the endeavor.
An illustration of Guy’s Hospital by J. Rogers after N. Whittock (1791-1860). From Wellcome Collection (CC 4.0)
Sixth Tone: You clearly lay out Colledge’s motivations in your book, but regrettably, there’s very little information about Hoo Loo himself. As you note, we don’t even know his Chinese name. Why is that?
Gao: Yes, that’s one great regret. In all the available records, he appears only as “Hoo Loo,” a Cantonese romanization of his name. Why? Because he was an illiterate peasant, someone who would otherwise never have left a trace in Chinese historical documents.
But he was a real person, and I’ve tried my best to uncover whatever I could about him. For instance, I discovered the ship he took to England was the Duchess of Atholl, a merchant vessel operated by the East India Company. When I found an image of that ship, I was stunned. It brought the history vividly to life. I could picture Hoo Loo sailing at sea for three months before finally reaching his destination.
Then I started to wonder: He didn’t speak English, he had a massive tumor, and the journey took months — how did he manage? Surely someone must have accompanied him. So I dug deeper, and I found that, indeed, he wasn’t alone. He was accompanied by Richard H. Cox, an assistant ship’s surgeon with the East India Company and a physician at the Canton Ophthalmic Hospital.
An illustration of The East India Company’s “Duchess of Atholl” painted by Thomas Whitcombe, 1822. From Bridgeman Ary Library
Sixth Tone: Sadly, the story ends tragically, with Hoo Loo dying on an operating table in front of a live audience. How did that happen?
Gao: That’s a question I’ve asked myself for decades. For a long time, I thought it was because of racial discrimination — that the British didn’t treat him properly. Many Western scholars believe that, too. But the historical evidence tells a different story.
The archives of Guy’s Hospital show that even before Hoo Loo arrived in Britain, the hospital — thanks to Colledge’s efforts — had already created a pathological model of his tumor. This suggests they had thoroughly prepared for the surgery. Once he arrived in London, major newspapers like The Sun and The Star covered the case extensively. In these reports, Hoo Loo is portrayed positively: as gentle, polite, always smiling — in short, a likable figure. The surgeons who operated on him were among the most prominent in London. When Hoo Loo went into shock during the operation, a medical student named Samuel H. Ford even volunteered to donate eight ounces of his own blood. All of this indicates that the doctors took both the patient and the operation very seriously.
Still, Hoo Loo died. At the time, surgery was extremely dangerous. Many patients died on the table due to blood loss or sheer pain. As for the audience, Hoo Loo’s surgery took place in an “anatomy theatre” that could seat 680 spectators. People bought tickets to watch surgeries — a practice unthinkable today but entirely normal in the big cities of 19th-century Europe.
Sixth Tone: Even with the high mortality rate of surgery at the time, Hoo Loo’s death still caused a public stir in Britain.
Gao: That’s right. There was already significant public interest in the case, even before the operation. After his death, the discussions became more intense. Some believed surgery was the right course of action; others condemned the procedure as cruel and the doctors as heartless. One newspaper even referred to the operation as a “vivisection.”
The impact of the event quickly spilled beyond the medical field. At the time, British society was on the cusp of a political transformation. There was a growing consensus that corruption was undermining the nation’s well-being. Just a month after Hoo Loo’s death, a political cartoon drawn by the satirist John Doyle began to circulate. Titled “Hoo Loo Choo, Alias John Bull and the Doctors,” the cartoon depicts Hoo Loo as John Bull, the national personification of Britain. Inside his belly is a giant tumor symbolizing the corrupt institutions that were harming the nation’s economy. The doctors around him — stand-ins for political leaders — couldn’t agree on how to cut it out. The cartoon marks the point at which Hoo Loo’s death became imbued with new political significance.
The political cartoon “Hoo Loo Choo, Alias John Bull and the Doctors,” colored lithograph by J. Doyle, 1831. From Wellcome Collection (CC 4.0)
An illustration titled “Poor Hoo Loo and His Tumour,” from The Lancet, 1830-31, Vol. 2 Guy’s Hospital. From Wellcome Collection (CC 4.0)
Sixth Tone: And that’s when the tone of his story begins to change, right?
Gao: Yes. British attitudes toward China also shifted after the Opium War. Hoo Loo’s image became Orientalized, entangled with stereotypes of exotic diseases, mysticism, and backward Chinese medicine. He came to be seen as a monstrous or pathological embodiment of China itself. For example, a 1910 volume titled “The Diseases of China, including Formosa and Korea,” which was compiled from missionary hospital records and disease surveys, claimed that “Tumors are a sort of specialty of China … combined with a lack of ability to remove even the simplest growth, the Chinese are as a race particularly unembarrassed by the mere presence of morbid growths which a more sensitive race would find repellent indeed.”
Starting in the late 20th century, Western scholars, many of them under the influence of postmodern and postcolonial theory, began to treat Hoo Loo as a prime example of 19th-century European Orientalism. The 2008 edited volume “Victorian Freaks: The Social Context of Freakery in Britain” labeled him a “freak of imperial medical science.” A 2012 dissertation by a scholar at the University of Washington, titled “Giants, Dwarfs, and Skeletons on Display” argued that Hoo Loo’s public operation exemplified how displays of deformed bodies and the written reports about them commodified both the body and its cultural meaning.
But in my view, these interpretations distort the historical truth. I believe my research offers a more accurate reconstruction of the past, because I focus on how the Hoo Loo episode created both understanding and misunderstanding between China and the West. I believe history deserves to be restored, not reshaped by ideology.
Gao Xi poses in front of Guy’s Hospital in London. Courtesy of Gao Xi
Sixth Tone: So you’re saying these scholars, in their effort to critique imperialism, ended up distorting Hoo Loo’s actual experience. But isn’t it also true that this kind of cross-border medical journey could only have occurred within an imperial framework?
Gao: Yes, it’s a very complex issue. Let’s return to Hoo Loo. What exactly was his illness? Colledge didn’t know at the time, and neither did the surgeons who operated on him. When was it finally identified? In the 1870s. A British physician named Patrick Manson, working for the Chinese Maritime Customs Service in what is today Xiamen, discovered that the disease — filaria — was caused by a parasitic roundworm transmitted by mosquitoes. The infection would eventually lead to tumor formation. He named the disease lymphatic filariasis.
What does this tell us? That the advancement of European medicine depended not only on local research and innovation, but also on a vast reservoir of diseases and medical data sourced from beyond Europe — from Africa, Asia, and other parts of the colonized world. Viewed in this light, the globalization of medicine was not a one-way export from the West, but a process rooted in cross-cultural encounters and often asymmetrical exchanges.
As historians of medicine, we must confront the realities of colonial power and the inequalities it produced. At the same time, we should not lose sight of the professional integrity and humanitarian impulses that motivated many physicians of the era. Above all, we must remain vigilant against the reduction of complex historical events to ideological narratives. All the nuances of history — no matter messy, human, and irreducible — are worthy of our attention and understanding.
(Header image: Visuals from Wellcome Collection, Bridgeman Ary Library and VCG, reedited by Sixth Tone)
