Historical analysis shows epidemics hindered inland development in Taiwan, indicating health challenges profoundly affected the Qing dynasty's progress.
During the early Qing dynasty, Taiwan remained largely undeveloped, with vast areas covered in dense wilderness and forests. The terms zhangli and zhangyi, which appear frequently in historical documents, most likely cover a variety of epidemic diseases such as malaria, dysentery, cholera, and scarlet fever. Following the Opium Wars, as Western powers increased pressure on Taiwan, the Qing government sought to intensify inland development. However, persistent epidemics in the mountainous regions hindered efforts to “open the mountains and pacify the aborigines.” These health challenges significantly affected Taiwan’s development during the Qing dynasty, experiences which share many similarities with the history of South America.
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Huang et al. (2025) studied this question.
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