On April 16, 1841, the first large-scale outbreak of Canton Madness occurred in Canton, China. The city was under multiple influences at the time and was ripe for the spread of an infectious disease; the Opium War, the British and Merchants were all coming and going from Canton. It is believed that this outbreak catapulted the disease from Canton to the rest of the world, making it one of the most important outbreaks
Destroying Chinese war junks, by E. Duncan (1843)

Chaos in Canton Harbor, April 18, 1841

in history.

The Outbreak

Very few official documents survive; the Commander of the British Forces in Canton, Hugh Gough seems to have attempted a hasty coverup of the infection, referring to it in all official documents as "the Insurrection". From the personal accounts of the British troops, Cantonese residents, and foreign merchants in the city at the time, the events of April 16-19 have come to light. It is believed that the infection started among the richer residents of Canton; the rich paid bribes to both the British and Chinese authorities on April 14 in order to keep their lapdogs; sometime on April 15th the Pekingese of a prominent local family became infected, possibly from eating the body of a rat carrying the illness. The Pekingese, "went mad", and promptly attacked three members of the housekeeping staff and the family's Patriarch before being put down. The head of the family died in the evening of April 15 from massive hypertension; as he raged and became violent preceding the full force of the infection, the family's eldest son and one of their butlers managed to hold him down long enough to force-feed him a strong Ma-Huang Tincture, to, "clear his thoughts". The ephedrine in the Ma-Huang tincture worsened his condition; they were barely able to keep the "raving lunatic" confined to his chambers as the stimulant drove him into a frenzied rage and eventually killed him as his extreme body temperature and blood pressure destroyed those organs necessary to live.

The family's servants, however, returned to their own families on April 15, and without the resources to calm them from their rage, two of the servants set upon their families (the exception being Shi Changzhou, who was calmed and restrained with the aid of Laudanum). Over the night of the 15-16, the infected ran wild through Canton, killing and infecting others.

As dawn approached, the British were alerted of the impending dangers by patrolmen who'd happened upon "a group of Cantonese ... devouring their own kin". Rioting begins as Cantonese civilians flood the streets in an attempt to flee the city. Many British soldiers mutiny as the infected overwhelm the crudely fortified docks; four ships are sunk as mutineers attempt to flee the burning city. Commander of the British forces in the city Hugh Gough orders the port to be burned down on April 18, leading the massive withdrawal of the British from the city and destroying many official documents about the infection. Hugh Gough would commit suicide during his retreat from Canton.

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