Not of Parochial Interest Only: Imperial Connections and the Production of Knowledge about Tuberculosis in East Africa
UCLA and Cedars-Sinai Medical Center
In 1960 Arthur Williams, a physician working in Uganda, justified the testing of new tuberculosis drug regimens in East Africa, claiming, "By studying under African conditions the application and adaptation of advances made in western countries, knowledge can be gained that is relevant to both." Williams' centering of East Africa as a site of global knowledge production about tuberculosis control marked a distinct change from the first half of the twentieth century, when colonial medical authorities considered "African tuberculosis" a distinct pathology linked to differential racial immunity. They considered tuberculosis in East Africa much more like tuberculosis among black populations in South Africa or the American south than among populations in the British metropole. By the 1960s, however, the testing of drugs in white British and black African bodies had illustrated for them the irrelevance of race for tuberculosis control. As such, researchers like Williams considered "African conditions" of resource scarcity and dispersed populations a perfect backdrop in which to find cheap, easy to administer drug regimens that could benefit populations around the world. This paper tracks how colonial medical authorities repositioned East Africa as a site of global knowledge production about tuberculosis control over the first half of the twentieth century, and the role that local circumstances in East Africa played in this shift. Despite this repositioning, it argues, colonial knowledge about tuberculosis in East Africa had always been formed by drawing on observations from elsewhere in the world; the places deemed relevant to this knowledge production simply changed.
This Formidable Foe Now Has a Conqueror: Patent Medicine Advertising in British Guiana, 1880-1920
Icahn School of Medicine at Mount Sinai
British Guiana, at the turn of the century, was a country in flux. Previously disenfranchised ethnic groups were gaining economic and civic power, social strata were evolving, and rapid changes in the structure and composition of the medical system led to fierce professional rivalries among different practitioners. Newspapers were sites where health culture was debated, and advertisements framed those debates by redefining diseases themselves. Tracing the influence of patent medicine advertisements across time, in this context, provides insight into evolutions of key concerns and values of the Guianese, including worries about motherhood and infant mortality, as well as anxieties regarding the strength and reach of the British Empire and whether individuals had the energy levels to preserve and expand it.
By analyzing the role that patent medicines played in elite medical discourse (Part I) and the role that such discourse played in advertisements (Part II), I show how patent medicine advertisements were sites in which discursive ideologies, value-systems, and models of authority were propagated and manipulated. Such semiotic analysis is not equipped or intended to measure the effect advertisements had on readers: rather, I wish to reconstruct and understand the "text" which readers would have faced. The third and final part of this essay analyzes the rhetorical structures and strategies of patent medicine advertisements in an effort to excavate the professional rivalries and the ideologies that advertising companies used to carve themselves a niche within which they might sell their products. This paper reframes advertisements, these so-called 'lower rungs' of cultural production, as sites of transmission and negotiation of contemporary elite discourse surrounding colonial breakdown, neurasthenia, and the shaping of the colonial body, arguing that these advertisements were deeply implicated in the establishment of medical authority.
With Maps Illustrative of the Disease: Medical Cartography in Late Nineteenth-Century Colonial India
Lauren Bouchard Killingsworth
University of Cambridge
From the late 1860s, sanitary commission reports in colonial India consistently included fold-out maps to "illustrate the prevalence of cholera." Here, I document the medical cartography initiative in colonial India by examining over 250 annual sanitary reports across 1868 to 1911 containing over 400 maps from the sanitary commissions of Bengal, Bombay, Madras, Assam, Burma, Central Provinces, Coorg, Eastern Bengal and Assam, Hyderabad, North-Western Frontier Provinces, Oudh, Punjab, and Rajputana.
I trace the origin, evolution, and reception of disease maps across India, examining sanitary commission proceedings, government records and correspondence, academic journals, and newspapers. Significant resources were expended on the design and implementation of cholera maps. Government officials touted cholera maps as instrumental in elucidating the origin and transmission of cholera, but there is little evidence that they enhanced understanding of disease. Rather, they aimed to enforce hierarchies between the British and their colonized subjects and within the British bureaucracy, and to reify administrative borders. The cholera mapping initiative contributed to the collection of medical statistics, and maps helped establish "mortuary circles"- units of surveillance.
Cholera maps were designed to project control, but the map-making process exposed unreliable statistics and a reliance on indigenous knowledge. Disdain for the mapping initiative grew into concerns that extended beyond public health administration. Sanitary commissioners disparaged the prioritization of bureaucratic tasks over rigorous scientific inquiry. Resistance took the form of new disease mapping approaches that directly countered imperial motives. Though the mapping initiative intended to enforce compliance at all levels of governance, it ultimately raised tension and resistance amongst colonial administrators, exposing the weaknesses of the colonial system of knowledge and surveillance.
The Lungs of a Ship: Labor, Medicine and the Maritime Environment, 1740-1800
Paul E. Sampson
University of Scranton
I propose to present a chapter from my dissertation, "Ventilating the Empire: Environmental Machines in the British Atlantic World, 1700-1850." My overall project investigates the pre-industrial origins of efforts to improve air quality as a measure for preventing the spread of contagious disease. The chapter I will present examines attempts to ventilate and reform the "close, confined, putrid air" on Royal Navy ships during the mid-eighteenth century. Alarmed at the high mortality rates of sailors, British experimenter and clergyman Stephen Hales (1677-1761) invented new "ventilators": hand-or-wind-powered bellows constructed to mimic the action of the human lungs.
Required on all Navy ships after 1756, these machines were unpopular with captains and seamen, but Hales' theories deeply influenced the work of maritime medical experts James Lind, John Pringle, and Gilbert Blane, who viewed ventilation as a vital necessity to be cultivated through hygienic discipline. Management of the shipboard environment was fiercely debated in moral terms that cast the clean, well-ventilated ship as the "nursery" of sailors and guardian of national glory, and the dirty ship as a "pestilential maw" - an appellation most frequently applied to slave ships during late eighteenth-century debates over the regulation of the slave trade.