This article is a study of Zhongshan in South China, which took on the responsibility for modernizing its public health system after it was promulgated as a model county by the Nationalist government in Nanjing in 1929. However, the county was not ready to become a model. Insufficient budget, lack of experience, medical skills and directions limited the scope of the enterprise and its chances to succeed in a number of projects. Zhongshan's urban residents, on the other hand, were going through a transition from traditional to new public health practices. There were widely divergent views on the subject. For instance, some did not only accept the authorities interfering in and controlling their personal and environmental hygiene, but regarded this role as their right. Yet, many others did not see the need for changes. Ultimately, Zhongshan was caught between pressure exerted by Nanjing and the social tensions created by reform programmes that the authorities failed to implement properly.