Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-23T20:59:51.183Z Has data issue: false hasContentIssue false
  • English
  • Français

Tropical medicine in nineteenth-century India†

Published online by Cambridge University Press:  05 January 2009

Mark Harrison
Mark Harrison
Affiliation:
Wellcome Institute for the History of Medicine, 183 Euston Rd., London NW1 2BN.
Rights & Permissions [Opens in a new window]

Extract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

It is customary to regard ‘tropical medicine’ as a product of the late nineteenth century, ‘its instrument the microscope, its epistemology the germ theory of disease’. The accepted interpretation is that tropical medicine was a European concept: originating in Britain and France and exported to the colonies by pioneering medical scientists. This interpretation is useful inasmuch as ‘tropical medicine’ as a discipline with its own journals, institutions, qualifications, and an exclusive discourse did not emerge until the last decade of the nineteenth century, and partly in response to metropolitan imperatives. But the European perspective of existing histories of ‘tropical medicine’ has obscured important developments in the understanding of diseases in the tropics which took place prior to 1890; most of which occurred in the colonies themselves – and especially in India. In order to distinguish this body of knowledge from its later, institutional incarnation, it will be referred to here as ‘tropical hygiene’: the term most commonly used by medical men in India until the 1890s.

Type
Research Article
Information
The British Journal for the History of Science , Volume 25 , Issue 3 , September 1992 , pp. 299 - 318
Copyright
Copyright © British Society for the History of Science 1992

References

1 MacLeod, R. M., ‘Introduction’, Disease, Medicine, and Empire. Perspectives on Western Medicine and the Experience of European Expansion (ed. MacLeod, R. M. and Lewis, M.), London, 1988, 7.Google Scholar

2 Sir Patrick Manson and others held that ‘tropical medicine’ came into being with Laveran's identification of the parasite causing malaria. See Manson, , ‘Address to BMA tropical diseases section’, Journal of Tropical Medicine (hereafter JTM) (08 1898), 22Google Scholar; JTM (02 1906), 38, editorial.Google Scholar

3 The current tendency is to view ‘tropical disease’ as an artificial categorization, imposed by colonial medical men on diseases which, in reality, bear more relation to poverty than to geographical location. See, for example, Patterson, K. D., Health in Colonial Ghana: Disease, Medicine and Socio-Economic Change, 1900–1955, Waltham, Mass., 1981.Google Scholar

4 Worboys, , ‘Science and British Colonial Imperialism, 1895–1940’ (University of Sussex D.Phil, thesis, 1979), 83–128Google Scholar; Worboys, , ‘The emergence of tropical medicine: a study in the establishment of a scientific speciality’, in Perspectives on the Emergence of Scientific Disciplines (ed. Lemaine, G. et al. , The Hague, 1976, 76–98Google Scholar; Worboys, , ‘Manson, Ross, and colonial medical policy: tropical medicine in London and Liverpool, 1899–1914’Google Scholar, in MacLeod, and Lewis, , op. cit. (1), 21–37.Google Scholar

5 For example: Scott, H. H., A History of Tropical Medicine, London, 1939–1942Google Scholar; Manson-Bahr, P. E. C., Patrick Manson: the Founder of Tropical Medicine, London, 1962.Google Scholar

6 Worboys, , ‘British colonial imperialism’, op. cit. (4), 85–7.Google Scholar

7 Ibid., 414. A similar argument is advanced by Macleod, R. in ‘Scientific advice for British India: imperial perception and administrative goals, 1898–1923’, Modern Asian Studies (1975), 9, 343–84.CrossRefGoogle Scholar

8 Grove makes a similar case for botany in India prior to 1857: see Grove, R. ‘Conservation and Colonial Expansion: A Study of the Evolution of Environmental Attitudes and Conservation Policies on St. Helena, Mauritius, and in India, 1660–1860’ (University of Cambridge Ph.D. thesis, 1988)Google Scholar. Geology in early and midnineteenth-century India, however, provides a classic instance of a science directed almost entirely from the metropolis. See Stafford, R. A., The Empire of Science: Sir Roderick Murchison, Scientific Exploration and Victorian Imperialism, Cambridge, 1989.Google Scholar

9 Grove, , op. cit. (8), 186–7, 262, 291Google Scholar; Chitinis, A. C., The Scottish Enlightenment, a Social History, London, 1976, 124–87Google Scholar; Riley, J. C., ‘The medicine of the environment in eighteenth century Germany’, Clio Medico (1983), 18, 167–78.Google ScholarPubMed

10 For a discussion of Burkean philosophy and Company administration see Bearce, G. D., British Attitudes Towards India, 1784–1858, London, 1982, 14–33Google Scholar. Respect for indigenous cultures, however, was by no means a universal feature of the ‘Enlightenment’ as a whole. Turgot and Smith, for example, viewed most indigenous societies as being in a state of barbarism compared with European society, while Rousseau and Herder were far more critical of the idea of history as progress. See Meek, R. L., Social Science and the Ignoble Savage, Cambridge, 1976.Google Scholar

11 Rather, L. J., Mind and Body in Eighteenth Century Medicine. A Study Based on Jerome Gaub's ‘De Regimine Mentis’, Berkeley, 1965.Google Scholar

12 Playfair, G., Taleef Shereef, Calcutta, 1832Google Scholar. It appears to have been common practice for medical men, prior to the 1830s, to discard western therapeutic practices in favour of indigenous remedies. Patterson, T. J. S., ‘The relationship of Indian and European practitioners of medicine from the sixteenth century’, in Studies in Indian Medical History (ed. Meulenbeld, G. J. and Wujastyk, D. D.), Groningen, 1987, 119–29Google Scholar; Patterson, , ‘Science and medicine in India’, in Information Sources in the History of Science and Medicine (ed. Corsi, P. and Weindling, P.), London, 1983, 457–75Google Scholar. For a comparison with the experiences of Portuguese medical men in Brazil see dos Santos Pereira, R., Piso e a Medicine Indigena, Pernambuco, 1980.Google Scholar

13 Jaggi, O. P., Indian System of Medicine, Delhi, 1973, 118–21Google Scholar; Basham, A. L., ‘The practice of medicine in ancient and medieval India’Google Scholar and Burgel, J. C., ‘Secular and religious features of medieval Arabic medicine’Google Scholar, both in Asian Medical Systems: A Comparative Study (ed. Leslie, C.), Berkeley, 1976, 18–43 and 44–59 respectivelyGoogle Scholar; Bala, P., ‘State and Indigenous Medicine in Nineteenth- and Twentieth-Century Bengal: 1800–1947’ (Edinburgh University Ph.D. thesis, 1987), 27–9.Google Scholar

14 Pelling, M., Cholera, Fever and English Medicine 1825–1865, Oxford, 1978, 15–16Google Scholar. Cullen, however, was critical of Galen's fluidist pathology, stressing instead the importance of the nervous system in the maintenance of physical and mental health. See Bowman, I. A., ‘William Cullen (1710–90) and the Primacy of the Nervous System’ (Indiana University Ph.D. thesis, 1975).Google Scholar

15 Maclean, C., Results of an Investigation Respecting Epidemic and Pestilential Diseases; Including Researches in the Levant Concerning the Plague, London, 1817, i, 4–5Google Scholar. On the advice of the orientalist William Jones, the EIC's Court of Directors came to recommend that its surgeons make a study of indigenous medicinal herbs and drugs, and suggested that they would benefit from a closer association with indigenous practitioners. These convictions led to the establishment in 1822 of a Native Medical Institution in Calcutta, for the instruction of Indians (in their vernacular languages) in indigenous and western medicine. See Bala, , op. cit. (13), 6, 70.Google Scholar

16 Maclean, , op. cit. (15), 11, 21.Google Scholar

17 DNB. Maclean, Charles (1788–1824)Google Scholar, began his medical career as a surgeon on an East-Indiaman. In 1792 he settled in Bengal, taking charge of a hospital in Calcutta.

18 This is the argument of Cooler, Roger: ‘Anticontagionism and history's medical record’, in The Problem of Medical Knowledge, Edinburgh, 1982 (ed. Wright, P. and Treacher, A.), 96–7Google Scholar. In a general sense, he suggests that there was a connection between anticontagionism and political radicalism, ‘anticontagionism’ offering a kind of ‘un-fixing solvent’ in which traditional ideas were dissolved.

19 For example Lind, James, Essays on the Diseases Incidental to Europeans in Hot Climates, 1st edn, London, 1768Google Scholar. The publication date of this treatise suggests that it is misleading to credit Maclean, solely, with the introduction of ‘anticontagionist’ theory into Britain.

20 DNB. Johnson, James (1777–1845)Google Scholar, born co. Derry, Ireland. At the age of fifteen became apprenticed to a surgeon-apothecary in co. Antrim, where he resided for two years. After spending a further two years at Belfast, he moved to London to study for the surgeon's examination, which he passed in 1798. Immediately afterwards, Johnson was appointed surgeon's mate on a naval vessel, and sailed to Newfoundland and Nova Scotia. In 1800 he took part in an expedition to Egypt and, in 1803, sailed for India. Johnson returned to England in 1806, where he continued to serve in the Royal Navy until setting up in private practice in 1814.

21 Johnson, J., The Economy of Health or the Stream of Human Life from the Cradle to the Grave, with Reflections Moral, Physical and Philosophical on the Successive Phases of Human Existence, the Maladies to which They are Subjected, and the Dangers that may be Averted, 2nd edn, London, 1837, 81, 119Google Scholar. For a discussion of phrenology as a vehicle of liberal/radical ideology see Cooter, R., The Cultural Meaning of Popular Science. Phrenology and the Organisation of Consent in Nineteenth-Century Britain, Cambridge, 1984.Google Scholar

22 Johnson, J., The Influence of Tropical Climates, More Especially of the Climate of India, on European Constitutions; and the Principal Effects and Diseases thereby Induced, their Prevention and Removal, and the Means of Preserving Health in Hot Climates Rendered Obvious to Europeans of Every Capacity, 2nd edn, London, 1815, pp. ix, 27, 398–400.Google Scholar

23 Ernst, W., ‘Doctor-patient relationship in colonial India: a case of “intellectual insanity”’, History of Psychiatry (1990), 1, 207–22CrossRefGoogle Scholar; Laissus, Y., ‘Les voyageurs naturalistes du Jardin du Roi et du Museum d'Histoire naturelle: essai de portrait-robot’, Rev. Hist. Sci. (1981), 34, 259–317.CrossRefGoogle Scholar

24 Lind, J., Diseases Incidental to Europeans, 6th edn, 1808, 44.Google Scholar

25 Ibid., 226. Lind went on to comment that negro slaves taken from the African coast were ‘dull and stupid, lively and ingenious, sickly or robust, long or short-lived, according to the nature of the soil in the country from where they are brought’.

26 Johnson, , op. cit. (22), 401Google Scholar; Johnson, , A Practical Treatise on Derangements of the Liver, Digestive Organs and Nervous System to which is added an Essay on the Prolongation of Life and Conservation of Health, London, 1818, 11.Google Scholar

27 Johnson, , Derangements of the Liver, op. cit. (26), 3–4.Google Scholar

28 Like most other practitioners at this time, Johnson accepted classification of fevers into ‘remittent’, ‘intermittent’ and ‘continued’: Bynum, W. F., ‘Cullen and the study of fevers in Britain, 1760–1820’, in Theories of Fever from Antiquity to the Enlightenment, Med. Hist. Suppl. (ed. Bynum, W. F. and Nutton, V.) London, 1981, 135–45.Google Scholar

29 Johnson, , op. cit. (22), 88Google Scholar. The notion of lunar influence in fevers was a well-established one among medical men in India. See Balfour, F., Treatise on the Influence of the Moon in Fevers, Calcutta, 1784Google Scholar. Balfour believed that lunar influence on disease was universal, but that it showed itself in the tropics in an ‘uncommon degree’ (p. vi).

30 Lind, , op. cit. (24), 155.Google Scholar

31 Ibid., 171–2.

32 Johnson, , op. cit. (22), 2–3.Google Scholar

33 On classification see Foucault, M., The Order of Things. An Archaeology of the Human Sciences, London, 1970.Google Scholar

34 Johnson, , op. cit. (22), 32, 416–17.Google Scholar

35 Ibid., 422.

36 Ibid., 437.

37 Ibid., 456–7.

38 Johnson, , op. cit. (21), 8–9.Google Scholar

39 Johnson, , op. cit. (22)Google Scholar; Durey, M., Return of the Plague: British Society and the Cholera 1831–2, Dublin, 1979, 105–18.Google Scholar

40 Twining, W., Clinical Illustrations of the More Important Diseases of Bengal with the Results of an Enquiry into their Pathology and Treatment, Calcutta, 1835, 53–287Google Scholar. This is the second and an extended edition; the first being published in 1823. See also Annesley, C. A., Researches into the Causes, Nature, and Treatment of the More Prevalent Diseases of India, Calcutta, 1828.Google Scholar The first dissection of a human body performed in India with official sanction took place at the Calcutta Medical College in 1836: Centenary of the Medical College of Bengal, Calcutta, 1935, 13.Google Scholar

41 Pelling, , op. cit. (14), 15Google Scholar; Bynum, , op. cit. (28), 137–9.Google Scholar

42 Twining, , op. cit. (40), 1.Google Scholar

43 Ibid., 31–2, 297.

44 Ranken, J., ‘On public health in India’, Transactions of the Calcutta Medical & Physical Society, Calcutta, 1836, 300–50.Google Scholar

45 Twining, , op. cit. (40), 44–5.Google Scholar

46 Ibid., 420.

47 William Bentinck, Governor-General of India 1828–35, implemented a series of reforms which applied the Benthamite principles of efficiency to most aspects of administration in India. For the first time, the Company began to interfere directly in the cultural and religious practices of the Indian people. There were attempts to abolish sati (the cremation of Hindu widows) and other customs, which were now regarded as medieval superstition. See Bearce, , op. cit. (10), 69–78Google Scholar; Stokes, E., English Utilitarians and India, Oxford, 1959.Google Scholar

48 See Patterson, , ‘Science and medicine in India’, op. cit. (12)Google Scholar; The Centenary of the Medical College, Bengal, op. cit. (40), 1–9.Google Scholar

49 DNB. SirMartin, James Ranald (1793–1874)Google Scholar. Son of a minister on the Isle of Skye. Admitted as a student at St George's Hospital, London in 1813 and MRCS in 1817, whereupon he joined the Bengal Medical Service. After three years in Orissa he began civil practice in Calcutta. Martin left India in 1843 and was admitted FRCS in the same year; in 1845 he was elected FRS. He was knighted in 1860.

50 Martin, J. R., Notes on the Medical Topography of Calcutta, Calcutta, 1837, 45.Google Scholar

51 Ibid., 43.

52 Ibid., 24, 27–8.

53 Cf. Douglas, M., Purity and Danger. An Analysis of Concepts of Pollution and Taboo, London, 1966, 2Google Scholar: ‘In chasing dirt… we are not governed by anxiety to escape disease, but are positively re-ordering our environment, making it conform to an idea’. Curiously, Martin's respect for his mentor, James Johnson, was such that he did not erase Johnson's references to indigenous hygiene from his re-writing of Johnson's classic text in 1856. See Martin, J. R., The Influence of Tropical Climates on European Constitutions, including Practical Observations on the Nature and Treatment of the Diseases of Europeans on their return from Tropical Climates, London, 1856.Google Scholar

54 Martin, , op. cit. (50), 43, 45, 52.Google Scholar

55 Martin, , op. cit. (53), 35.Google Scholar

56 E.g. de Montesquieu, Baron, The Spirit of the Laws (tr. Nugent, T., ed. Neumann, F.), New York, 1949Google Scholar. Montesquieu's own ideas about climate and human character were, themselves, derived from eighteenth-century medical texts.

57 Martin, , op. cit. (53), 38–49Google Scholar; op. cit. (50), 99.Google Scholar

58 Martin, , op. cit. (50), 94.Google Scholar

59 See Balfour, , op. cit. (29), 48.Google Scholar

60 Martin, , op. cit. (53), 114–15.Google Scholar

61 Murchison, Charles's classic Treatise on the Continued Fevers of Great Britain, 1st edn, London, 1862Google Scholar, bears many resemblances to Martin's Medical Topography in terms of its historical approach and its quantification of medical, geographical, and meteorological phenomena. Murchison, a graduate of Edinburgh University, had, like Martin, served in the EIC's medical service in Bengal and Burma. Murchison's explanation of the causes of continued fevers also owed much to observations he had made in India. See Pelling, , op. cit. (14) 288–9.Google Scholar

62 Pelling, , op. cit. (14), 113–45Google Scholar. See also Morrell, J. B., ‘The chemist breeders: the research schools of Liebig and Thomas Thompson’, Ambix (1972), 19, 1–46.CrossRefGoogle Scholar

63 See, for example, Reports of the Sanitary Commissioner with the Government of India.

64 Snow, J., On the Mode of Communication of Cholera, 2nd edn, London, 1855Google Scholar, On Continuous Molecular Changes, more particularly in their relation to Epidemic Diseases, London, 1853Google Scholar; Stewart, A. P. and Jenkins, E., The Medical and Legal Aspects of Sanitary Reform, 1866–69, London, 1869, 10.Google Scholar

65 Watkins, D. E., ‘The English Revolution in Social Medicine, 1889–1911’, (University of London Ph.D. thesis, 1984) 347–57Google Scholar; Curtin, P. D., Death by Migration: Europe's Encounter with the Tropical World in the Nineteenth Century, Cambridge, 1989, 59, 105.CrossRefGoogle Scholar

66 Parkes, E. A., Manual of Practical Hygiene. Prepared Especially for Use in the Medical Service of the British Army, London, 1864, eg. pp. xvi, 437Google Scholar. DNB. Parkes, Edmund Alexander (1819–1876)Google Scholar, educated at Christ's Hospital, London and University College London. Graduated MB and admitted MRCS in 1840. In 1842 joined the Army Medical Service and served for three years in India. There, he gained experience of dysentery, hepatitis, and cholera. In 1845, Parkes retired from the army and went into private practice in London. In 1846 he graduated MD from London University, with a thesis on dysentry and Indian hepatitis. From 1852 to 1855 Parkes edited the Medico-Chirurgical Review, and in 1860 was appointed professor of hygiene at the newly-founded Army Medical School, Chatham. The school was transferred to Netley in 1863. At Netley, Parkes carried out important research in several branches of medicine and imparted his views to successive generations of Indian, Army and Naval Medical Service recruits. See also Pelling, , op. cit. (14), pp. 70–4.Google Scholar

67 Parkes, (1864), op. cit. (66), 431, 437.Google Scholar

68 Ibid., 21–2, 36, 47–8, 158, 432. However, acceptance of specific modes of putrefaction did not necessarily entail the implementation of more specific preventive measures. As Christopher Hamlin has put it, ‘The zymotic analogy made it plausible to think of the entire insanitary environment as contributing… [to epidemic disease], while the perpetual threat to health of putrefaction was the basis on which Simon and his medical inspectors harried local officials into removing filth’: Hamlin, C., ‘Providence and putrefaction: Victorian sanitarians and the natural theology of health and disease’, in Energy and Entropy. Science and Culture in Victorian Britain (ed. Brantlinger, P.), Bloomington, Indiana, 1990, 93–123.Google Scholar

69 Parkes, Practical Hygiene, op. cit. (66), p. xvi.Google Scholar

70 Ibid., 132–6. A small minority continued to believe that the Hindu diet was the diet best suited to life in tropical climates. See Fink, G. H., ‘Food of the natives of India’Google Scholar, JTM (10 1906), 310–12Google Scholar. But Fink wrote as a retired medical man, a representative of an out-moded viewpoint. In the 1860s nutrition was becoming an important area of chemical research, a consequence of the perception that there was a common ground between the organic/inorganic, animate/inanimate realms.

71 IMG (04, 1868), 87.Google Scholar

72 DNB; obituary, Trans. Epid. Soc. (1906–1907), 26, 78–9Google Scholar. SirFayrer, Joseph (1824–1907)Google Scholar, born in Plymouth, the son of a Commander in the Royal Navy. After a brief study of engineering, Fayrer made a voyage to the West Indies and South America as a midshipman on a West Indian steampacket. In 1843 he sailed with his father to Bermuda, where his experience of an outbreak of yellow fever inclined him towards medicine. After entering Charing Cross Hospital in 1844, Fayrer was admitted MRCS in 1847 and gained a commission in the medical service of the Royal Navy. Soon afterwards, Fayrer resigned his commission to travel around Europe in the company of Lord Mount-Edgcumbe. He ended his tour at Rome, where he resumed his study of medicine and, in 1849, obtained its MD degree. In 1850 Fayrer left Europe to take up the post of Assistant Surgeon in the Bengal Medical Service, where he busied himself in medical and cultural activities, becoming President of the Asiatic Society of Bengal in 1867. He was instrumental in setting up a zoological society and the zoological gardens in Calcutta. In 1869 Fayrer became personal surgeon to the new Viceroy Lord Mayo but, in 1872, returned to Britain because of ill health, whereupon he was appointed President of the India Office Medical Board. Fayrer was widely respected in Britain, becoming personal physician to the Prince of Wales and President of the Epidemiological Society in 1879. He was made CSI in 1868 and a baronet in 1896. A prolific writer on medicine, climatology and venomous snakes, Fayrer was one of the last exponents of the ‘universalistic’ approach to medicine which typified the IMS in the first half of the nineteenth century.

73 Fayrer, J., The Natural History and Epidemiology of Cholera, London, 1888, 6.Google Scholar

74 Fayrer, J., Preservation of Health in India, London, 1894, 9.Google Scholar

75 Fayrer, , op. cit. (73), 52–3.Google Scholar

76 Ibid., 36.

77 Bellew, H. H., The Nature, Causes, and Treatment of Cholera, London, 1887, 19Google Scholar. By this time, both ozonic and electrical theories were out of vogue in Britain: see Pelling, , op. cit. (14), 148.Google Scholar

78 Hunter, W. Guyer, ‘The origin of the cholera epidemic of 1883 in Egypt’, Trans. Epid. Soc. (1883–1884), 3, 51Google Scholar. See also, Gordon, C. A., ‘Experiences in relation to cholera in India from 1842 to 1879’, Trans. Epid. Soc. (1895–1986), 15, 48–67.Google Scholar

79 Fayrer, J., On the Climate and Fevers of India. Being the Croonian Lectures delivered at the Royal College of Physicians in March 1882, London, 1882, 59–60Google Scholar. See also Fayrer, J., ‘Enteric fever among British soldiers in India’, JTM (09 1898), 29–31.Google Scholar

80 Report of the Sanitary Commissioner to the Government of India (1877), 24.Google Scholar

81 Report of the Sanitary Commissioner to the Government of India (1870), 1.Google Scholar

82 See for example: on malaria, IMG (03, 1871), 57Google Scholar; and on cholera (William Farr's law of ‘cholera elevation’), Pelling, , op. cit. (14), 89.Google Scholar

83 Curtin, , op. cit. (65), 48.Google Scholar

84 Fayrer, J., European Child Life in Bengal, London, 1873, 30–1.Google Scholar

85 See Livingstone, D. N., ‘Human acclimatization: perspectives on a contested field of inquiry in science, medicine and geography’, History of Science (1982), 25, 359–94CrossRefGoogle Scholar; also Thompson, A. S., ‘On the doctrine of acclimatization’, Madras Quarterly Medical Review (1840), 2, 69–76Google Scholar; Ewart, J., ‘On the colonisation of the sub-Himalayahs and Neilgherries, with remarks on the management of European children in India’, Trans. Epid. Soc. (1883–1884), 3, 96–117.Google Scholar

86 Moore, W., ‘The constitutional requirements for tropical climates, with special reference to temperaments’, Trans. Epid. Soc. (1884–1885), 4, 37–8, 46, 48Google Scholar. See also Moore, 's ‘Is the colonisation of tropical Africa by Europeans possible’, Trans. Epid. Soc. (1890–1891), 10, 27–45Google Scholar. According to Moore, ‘the Anglo-Saxon race, excepting probably the Jews, are perhaps better fitted to brave extremes of climate than any other section of mankind’ (p. 29). An optimistic note about colonization – though confining its attention to the hill stations of India – is struck in Chesson, J.'s Second Report on the Hill-Station of Panchgunny, near Mahableshwar, Bombay, 1862.Google Scholar

87 The parasitologist L. W. Sambon and Robert Koch were two of the foremost exponents of this view. See also Livingstone, , op. cit. (85), 369.Google Scholar