Medicine, Empire, and Disease in 19th-Century Colonialism

Introduction: Technology, Disease, and Imperial Expansion

This paper examines medicine, science, and empire, with particular reference to malaria, the plague, and tuberculosis, in Great Britain, Africa, and India in the nineteenth century. The impact these diseases had on the imperial effort and the medical profession will also be discussed. The paper draws on the following main texts: Colonizing the Body by David Arnold; Contagious Divides by Nayan Shah; Curing Their Ills: Colonial Power and African Illness by Megan Vaughan; Tools of Empire by Daniel Headrick; Warm Climates and Western Medicine by David Arnold; and Machines as the Measure of Men by Michael Adas.

In most reviews of the technologies of nineteenth-century imperialism, three technologies are identified as having given the imperialists their decisive edge: the steamship, advanced military weaponry (such as rifles), and quinine. These technologies allowed the imperialists to gain ground over new territories, to conquer the peoples of those territories, and to consolidate control through mapping projects and the building of, for instance, hill stations in India, which helped the British monitor their new territory and suppress plots to overthrow them. Headrick divides imperial technology into three main categories: tools of penetration, tools of conquest, and tools of communication.

It is telling that Headrick labels some of the imperialists' technologies as "tools of penetration," given that the tropics — Africa and India in particular — were considered the "white man's grave," on account of the many diseases that befell imperial troops. Until the advent of quinine, used against malaria, hundreds of thousands of imperial troops died from the disease. Headrick was therefore most astute in labelling quinine a "tool of penetration." It has been said that India would not have fallen to the British had quinine not been available, since prior to its use, losses to malaria were too great for the British to sustain.

As Elizabeth Scott writes in her review of Headrick's Tools of Empire, the book "adds a new dimension to the lengthy debate on imperialism — [Headrick] argues that technological advances changed both the motives and means for imperialism, and thereby caused imperialism. By focusing on three periods of imperialist development (penetration, conquest, and consolidation), Headrick narrows the approach by concentrating on the technology that made the most significant impact: it 'made imperialism possible where it was otherwise unlikely.'" This is certainly the case for malaria: prior to quinine, it would not have been possible for the British to enter India or Africa, nor for the French or Portuguese to enter Africa. History would have been very different indeed had quinine not been discovered and deployed by these conquering nations.

Malaria and the Role of Quinine in Colonialism

Malaria is a dangerous parasitic disease common in tropical and sub-tropical areas (Siddiqui, 2002). It is caused by protozoans called Plasmodia and is transmitted by the bite of the female Anopheles mosquito (Siddiqui, 2002). There are four types of malaria, each caused by a different species of Plasmodium, all of which produce dangerous fevers that can be fatal if left untreated (Siddiqui, 2002). Physicians diagnose malaria by identifying Plasmodia in a sample of the patient's blood, and most cases can be treated with two drugs, chloroquine and primaquine (Siddiqui, 2002).

Both chloroquine and primaquine are derived from quinine, which is itself derived from the bark of a South American tree, the cinchona. The bark of the cinchona has long been chewed by Andean Indians to ward off malaria, and was also used by Hernán Cortés' troops during his colonial invasion of South America. This remedy was "discovered" by Victorian botanists — reportedly the Frenchman Pierre Joseph Pelletier — in the nineteenth century.

Quinine was used by the French in their conquest of Algeria throughout the 1830s, and it has been argued that the French colonization of Africa would have been impossible without it. The cinchona tree was later transplanted to Asia so that plantations could be developed there, allowing quinine to be produced locally for use by British troops stationed in India.

Tropical Medicine and the Fusion of Western and Non-Western Knowledge

It has been argued — particularly by Arnold in Warm Climates and Western Medicine — that tropical medicine emerged as a stand-alone discipline as a direct result of such colonial adventures in the tropics. Arnold argues that Western medicine offered little defense against unfamiliar tropical diseases, and that, as a consequence, non-Western medicine — specifically tailored to combating such diseases as malaria — began to be introduced into the Western medical canon and slowly incorporated into Western medical practice.

Arnold contends that this fusion of non-Western ideas into Western medical practice arose from the particular imperatives imposed by "imperial diseases" such as malaria, which needed to be cured quickly if the colonialist mission was to proceed. But it also arose as a response to the West's encounter with non-Western cultures and practices. He suggests, therefore, that tropical medicine as a discipline emerged not only in response to the crisis of malaria, but also out of the imperialists' broader search for medical truth and progress.

This theme is replicated in Vaughan's Curing Their Ills: Colonial Power and African Illness, which argues a similar point but from a perspective more sympathetic to African society and more critical of the colonial powers. Vaughan's book traces specific encounters between Western medicine and African medicine and society, arguing that in Africa, medicine itself was used as a tool with which to exert colonial power. By denying African communities access to Western medicine, she argues, colonial powers could impose their will on these societies; medicine thus became a political instrument of colonialism.

Conclusion: The Colonial Legacy of Modern Medicine

Through this study of medicine as related to empire, it becomes clear that medicine — that resource we in the West take for granted as available to us in times of illness — is not a gift bestowed solely by Western scientists. Medicine as we know it today in the West is a fusion of Western and Eastern thought, infused with the knowledge of indigenous peoples across the globe, particularly in an era when multinational pharmaceutical companies engage in bioprospecting in the Amazon and elsewhere.

Modern medicine owes a great deal to those who were colonized, and this debt should be remembered when reading accounts such as those provided by Shah and Vaughan, and when confronting the ongoing reality of millions dying from AIDS in Africa today. The colonial legacy of medicine is not merely historical: it shapes the distribution of medical knowledge, treatment, and power in the present, and understanding that legacy is essential to any serious engagement with questions of global health justice.

Bibliography

Adas, M. (1995). Machines as the Measure of Men.

Arnold, D. (1993). Colonizing the Body.

Arnold, D. (1996). Warm Climates and Western Medicine.

Headrick, D. (1981). Tools of Empire.

Perry, R. D. and Featherstone, J. D. (1997). Yersinia pestis — etiologic agent of the plague. Clinical Microbiology Review 10(1): 35–66.

Shah, N. (2001). Contagious Divides.

Siddiqui, R. (2002). "Malaria" in World Book Encyclopaedia for Macintosh.

Vaughan, M. (1991). Curing Their Ills: Colonial Power and African Illness.