Empire of the Doctors

C.A. Bayly

  • Colonising the Body: State Medicine and Epidemic Disease in 19th-Century India by David Arnold
    California, 354 pp, £40.00, September 1993, ISBN 0 520 08124 2
  • Public Health in British India: Anglo-Indian Preventive Medicine 1815-1914 by Mark Harrison
    Cambridge, 324 pp, £19.95, March 1994, ISBN 0 521 44127 7

On the outskirts of most Indian cities you still encounter the war graves of imperialism: the melancholy, unvisited Christian cemeteries which contain the serried ranks of monuments commemorating British subjects and their children buried there during the days of the Raj. Perhaps it is not surprising, or particularly shocking, that it was fear for European rather than Indian lives which drove the growth of tropical medicine in India. Mortality among British troops and civil servants remained appallingly high well into the later 19th century. Nor is it surprising that for the European mind, India was the seat of global infection. After 1818, cholera, the terrible ‘westering’ disease, moved out of its endemic haunts in Bengal and north India in the wake of British armies of conquest. Striking overland and along the sea lanes, it became the chief public health problem for 19th-century European governments and a potent source of popular fear and potential disorder. It seemed as if the horrid filth and turbulence of the Orient had infected the seamy underworld of the European city. In the 1890s, bubonic plague appeared in Bombay and threatened to slip into the commercial arteries of the world’s greatest trading nation, arousing archaic panics about Black Death wherever it appeared. This theme of fetid disease and corruption stealing in from the East often surfaced in 19th-century literature – Dr Watson, an Indian Army doctor, first met Sherlock Holmes while he was convalescing from Indian enteric fever, which had caused his ‘life to be despaired of’. In our century, only anxiety about Aids and social disintegration in Africa has brought a comparable merging of physical and political terror with fear of the Other.

The history of science and the history of medicine have been late developers in colonial historiography, and India has even lagged behind Africa. But now there is a considerable spurt of interest, partly as a spin-off from developments in European history. Scholarly attention has been focused by the enlightened patronage of the Wellcome Trust and historians whose fear of the sciences dates back to schoolboy cuffings by the biology master have realised they can do medical history without knowing much medicine. Even better, Michel Foucault has seemed to suggest that colonial medicine was not so much a bounty conferred on the least advanced parts of humanity by the more advanced, but a discourse deployed by governing powers to aid them in ruling.

These themes strike a particular chord in colonial history. Along with canals and railways, the introduction of Western medicine was one of the proudest boasts of the Raj. In 1901, the Director General of the Army Medical Service credited British doctors with stopping the ravages of cholera in India and ‘improving the whole condition there’. Naturally, Indian nationalists have taken the opposite view. For them, British medicine was deployed only in small enclaves of colonial power; no money was spent to improve the health of the mass of the population. Where sanitary measures were introduced it was with such spectacular clumsiness and insensitivity that they sparked public disturbances, as in the riots which followed the imposition of plague regulations in Bombay and Cawnpore in the late 1890s. In such accounts medical history merges into the history of popular resistance to alien rule.

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