中国是1918年大流感的主要受灾国，但史学界对中国疫情的研究非常薄弱。既有关于中国疫情的研究，所依据资料均较单一，不能反映疫情全貌，且存在明显误判。故需要结合当时中外报道、医官报告、海关史料、日记、地方志等材料，重建疫情在华传播图景。整体上，中国经历春秋季两波流感疫情，其传播路径主要依赖铁路、航道和驿道系统，京津、沪汉等重要城市是疫情向全国扩散的中心，而其他交通沿线的主要城市则是疫情在本区域内的扩散中心。其中，第一波疫情自北向南扩散，通过南满、京奉、京汉和沪宁等铁路线迅速传播，将疫区由点串成线，同时借由内河航道和驿道将疫区由线而织成网。幸运的是，第一波疫情并未波及重庆以西地区，且程度较轻，死亡率较低，惟因症状"新""奇"而备受舆论关注。相较之下，第二波疫情则自南向北传播，疫情范围远超第一波，甚至深入云南、甘肃和新疆等内陆省份；同时，第二波疫情的疫势亦明显较第一波严重，各省均有大量死亡病例报道，且呈现乡村疫势远甚于城市的特点，两者粗死亡率相差近十倍之巨。整体上，第二波疫情导致全国死亡人数的保守估算至少在360万至450万之间。值得注意的是，考察1918年两波流感疫情在华传播亦需考虑到各种国内外因素的实际影响。事实上，此类变动的因素极大地加剧了疫情在华传播的复杂性。在国际因素上，俄国革命与黑龙江、新疆等省份的疫情传播关系密切，日本远征军的军事调动则是东三省疫情传播的关键因素，而中越、中缅间的跨国贸易网络则是云南疫情的主要源头；在国内因素上，南北交战和山东匪患加剧了政局不稳和社会动荡，并大大提升了湖南、湖北、陕西和山东等省的人口流动频率，从而增加了疫情传播的速度和范围。文章深入挖掘和全面梳理了1918年中国流感疫情的各类中外史料，详细地考辨了两波流感疫情在华传播的具体路径和范围，重估疫情严重程度，并着重考察各种变动的国内外因素对疫情在华传播的复杂影响，进而勾勒出一幅较为完整的1918年流感疫情在华传播图景。通过文章的梳理和考辨，希望能为1918年大流感的全球性比较和中国国内的区域性研究提供扎实可靠的基础。

China was among main countries affected by the 1918 influenza pandemic, but the study of China's pandemic is very weak. Existing researches on this issue are based on flimsy historical records, which cannot reflect the whole picture of 1918 pandemic, also there are obvious misjudgments. Therefore, it is necessary to combine both Chinese and foreign newspaper reports, medical officer reports, customs materials, diaries and gazetteers in order to reconstruct the whole picture of 1918 influenza pandemic in China. Overall, China experienced two waves of influenza in spring and autumn, and their transmission paths rely on railways, waterways and post road systems. In this case, central cities such as Beijing, Tianjin, Shanghai and Hankou are the centers of the spread of the epidemic to the outside world, while other major cities along the line are the regional center for the spread of the epidemic. The first wave of the influenza spread from north to south, and spread rapidly through railway lines, through which the epidemic area was strung into lines. Later, the inland waterways and post road system woven the epidemic area from the line into a net. Fortunately, the first wave of outbreaks did not spread to areas beyond Chongqing, and is relatively mild. However, it caused public attention because of "new" and "peculiar" symptoms. In contrast, the second wave spread from south to north, and the scope far exceeded that of the first wave, even reaching inland provinces such as Yunnan, Gansu and Xinjiang. At the same time, the mortality of second wave was far beyond the first wave, many deaths have been reported in various provinces, especially the influenza in rural areas is far greater than that in city. On the whole, the conservative estimate of the number of deaths caused by the second wave is at least 3.6-4.5 million. Meanwhile, domestic and foreign situations such as the civil war, banditry, Russian revolution and Japanese expeditionary army also add complexity to the spread of influenza. Taking international factors into consideration, the Russian revolution is closely related to the spread of the epidemic in Heilongjiang and Xinjiang, and the military mobilization of the Japanese army is a key factor in the spread of the epidemic in northeast China, while the transnational trade network between China, Vietnam and Myanmar is the main channel for the epidemic to enter Yunnan province. In terms of domestic factors, the civil war and banditry have aggravated social unrest, and greatly increased the frequency of population movement in Hunan, Hubei, Shanxi and Shandong provinces, thereby increasing the speed and scope of the epidemic. The paper focuses on the issue of the spread of the pandemic influenza in China in 1918, especially focuses on the complex effects of various changing domestic and foreign factors on the spread of the pandemic. It discusses in detail the routes of the two waves of 1918 influenza in China, re-evaluating the scope and severity of the pandemic, and reconstructs a relatively complete picture of the spread of 1918 influenza in China.

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