華人「不衛生」是近代以來常被中外人士提及，且在各方之間引發頗多碰撞、交集和爭議。本文試從三個方面展開討論：一、華人「不衛生」被定義為瘟疫之源和近代細菌學理論的傳入；二、租界衛生景觀的改善和華人社會的變革維新；三、文化優越感、民族主義訴求和主權之爭。本文認為，自租界開闢之後，居高不下的患病率和死亡率讓外人深感不安，通過職業醫生的科學觀察，生命統計學方法的採用和近代細菌學理論的傳入，華人的生活習俗和居住環境被外人視為「不衛生」，致使租界疫病頻繁發生。通過公共衛生改革，外人管理的租界與華人社會形成了潔淨∕汙穢的巨大反差，促使華人菁英反省自身的落後，鼓吹仿效租界衛生管理制度，並大力推動變法維新和文明開化。在那個殖民主義、帝國主義世界體系擴張的年代，關於華人「不衛生」的講述體現外人的強烈文化優越感，同時也激發華人菁英的民族主義情緒；再加上外人市政當局借公共衛生之名，乘機攫取華界市政管理權，華人社會為捍衛主權而注重公共衛生事業的推展。在這個意義上，關於華人「不衛生」的講述的歷史複雜性和多面性，體現在外人方面，雖有明顯的文化歧視、種族壓迫，但由此引入西方近代公共衛生理念，改善在地衛生狀況；體現在華人菁英方面，雖接受外人關於華人「不衛生」的講述，卻非簡單重複西方的霸權話語，或將之內在化為自身的文化設定，而是由此形成對自身社會及對殖民主義、帝國主義的再認識、再反省、再批判，其中當然包括對新文化的接受、引進和想像。所以，圍繞著華人「不衛生」的講述，中外雙方雖各有不同的考量和投射，並常以衝突和競爭的形式展開，卻共同開創和推動上海公共衛生的現代性發展。

The “unsanitary Chinese” was a topic widely discussed by both Chinese and foreigners in modern times, and was subject to constant debate. This paper revolves around three aspects of the topic. First, the “unsanitary Chinese” seen as the origin of the plague and the introduction of modern bacteriology. Second, the amelioration of unsanitary sights in the foreign Settlement and the reform of Chinese society. And third, the feelings of cultural superiority, nationalistic claims, and struggles for sovereignty that appeared during these debates. From the opening of the treaty ports in 1842, foreigners were deeply worried about the high rate of disease and mortality among foreigners in China. Through the scientific observations of professional doctors, the application of demographic research, and the introduction of the modern bacteriology, the foreigners believed it was the “unsanitary Chinese” who caused epidemics, and Chinese elites subsequently accepted this view. With the development of urban public sanitation reform in the International Settlement, a sharp contrast emerged with the “unsanitary” Chinese communities, which stimulated Chinese elites to contemplate the backwardness of their own society, advocate the emulation of foreign sanitary institutions, and promote the political reform and enlightenment of Chinese communities. 　　In the context of an expanding system of colonialism and imperialism, foreign narratives of “unsanitary Chinese” and related notions cultural superiority also provoked a sense of nationalism among Chinese elites. In addition, the foreign municipality sought to assert authority over sanitation in the Chinese-run parts of Shanghai in the name of good hygiene, which further prompted Chinese leaders to emphasize the development of hygiene to maintain Chinese sovereignty. In this sense, narratives related to “unsanitary Chinese” were complex and diverse. Although it was a product of cultural discrimination and national oppression, the foreigners’ narrative promoted the introduction of Western and modern concepts of public hygiene into China and helped to improve local sanitary conditions. However, the Chinese elites’ acceptance of the narrative of the “unsanitary Chinese” was not a simple internalization and regurgitation of the hegemonic colonial discourse but rather involved a re-cognition, re-meditation, and re-criticism of their own society as well as of colonialism. The Chinese narrative thus inevitably included the introduction, acceptance, and imagination of a new culture. Although differences between Chinese and foreigners often resulted in competition and conflict, the historical intertwining of foreign and Chinese narratives also initiated and promoted the modern development of Chinese hygiene.