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annotated bibliography summary on the book below ” race, science, and medicine” with key quotations on how it connects to “the effects that race have on medicine”. i will have an example below along with the book.

Race, Science and
Medicine, 1700–1960
Studies in the Social Histor y of Medicine
Series Editor: Bernard Harris
Life, Death and the Elderly
Edited by Margaret Pelling and Richard M. Smith
Medicine and Charity Before the Welfare State
Edited by Jonathan Barry and Colin Jones
In the Name of the Child
Edited by Roger Cooter
Reassessing Foucault
Power, Medicine and the Body
Edited by Colin Jones and Roy Porter
From Idiocy to Mental Deficiency
Edited by David Wright and Anne Digby
Nutrition in Britain
Edited by David F. Smith
Health Care and Poor Relief in Protestant
Europe 1500–1700
Edited by Ole Peter Grell and Andrew Cunningham
Migrants, Minorities and Health
Historical and Contemporary Studies
Edited by Lara Marks and Michael Worboys
Midwives, Society and Childbirth
Edited by Hilary Marland and Anne Marie Rafferty
The Locus of Care
Edited by Peregrine Hordern and Richard Smith
Insanity, Institutions and Society
Edited by Joseph Melling and Bill Forsythe
Illness and Healing Alternatives in Western Europe
Edited by Marijke Gijswit-Hofstra, Hilary Marland and
Hans de Waardt
Race, Science and
Medicine, 1700–1960
Edited by W altr aud Er nst
and Ber nard Harris
London and New York
First published 1999
by Routledge
11 New Fetter Lane, London EC4P 4EE
Simultaneously published in the USA and Canada
by Routledge
29 West 35th Street, New York, NY 10001
Routledge is an imprint of the Taylor & Francis Group
This edition published in the Taylor & Francis e-Library, 2001.
© 1999 selection and editorial matter, Waltraud Ernst and Bernard Harris; individual
chapters, the contributors
All rights reserved. No part of this book may be reprinted or reproduced or utilised in
any form or by any electronic, mechanical, or other means, now known or hereafter
invented, including photocopying and recording, or in any information storage or retrieval
system, without permission in writing from the publishers.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloguing in Publication Data
Race, science and medicine, 1700–1960 / edited by Waltraud Ernst and Bernard Harris.
Includes bibliographical references and index.
1. Medicine–Social aspects–History. 2. Colonization–Health aspects–History.
3. Imperialism–Health aspects–History. 4. Science–Social aspects–History. 5. Social
medicine–History. I. Ernst, Waltraud, 1955– . II. Harris, Bernard, 1961– .
R133.R33 1999
98–55200
610′.9–dc21
CIP
ISBN 0-415-18152-6 (Print Edition)
ISBN 0-203-02542-3 Master e-book ISBN
ISBN 0-203-17335-X (Glassbook Format)
Contents
Notes on contributors
1 Introduction: historical and contemporary
perspectives on race, science and medicine
vii
1
WALTRAUD ERNST
2 Western medicine and racial constitutions:
surgeon John Atkins’ theory of polygenism and
sleepy distemper in the 1730s
29
NORRIS SAAKWA-MANTE
3 From the land of the Bible to the Caucasus and
beyond: the shifting ideas of the geographical
origin of humankind
58
H.F. AUGSTEIN
4 Colonial policies, racial politics and the
development of psychiatric institutions in early
nineteenth-century British India
80
WALTRAUD ERNST
5 Racial categories and psychiatry in Africa:
the asylum on Robben Island in the
nineteenth century
HARRIET DEACON
101
vi
Contents
6 ‘An ancient race outworn’: malaria and race
in colonial India, 1860–1930
123
DAVID ARNOLD
7 Tuberculosis and race in Britain and its empire,
1900–50
144
MICHAEL WORBOYS
8 Changing depictions of disease: race, representation
and the history of ‘mongolism’
167
MARK JACKSON
9 Pro-alienism, anti-alienism and the medical
profession in late-Victorian and Edwardian Britain
189
BERNARD HARRIS
1 0 A virulent strain: German bacteriology as scientific
racism, 1890–1920
218
PAUL WEINDLING
1 1 ‘Savage civilisation’: race, culture and mind in Britain,
1898–1939
235
MATHEW THOMSON
1 2 ‘New men, strange faces, other minds’: Arthur Keith,
race and the Piltdown affair (1912–53)
259
JONATHAN SAWDAY
Index
289
Contributors
David Arnold is Professor of South Asian History at the School of Oriental
and African Studies. His publications include Colonizing the Body:
State Medicine and Epidemic Disease in Nineteenth-Century India
(Berkeley: University of California Press, 1993) and The Problem of
Nature: Environment, Culture and European Expansion (Oxford:
Blackwell, 1996). He has recently completed a volume for the New
Cambridge History of India on Science, Technology and Medicine in
India, 1760–1947, and is currently conducting research into the issue
of ‘tropicality’.
Hanna Franziska Augstein studied history at Berlin, Bielefeld, and the
University of Sussex. In 1996 she completed her Ph.D. dissertation at
the Wellcome Institute for the History of Medicine, London, on the
Bristol doctor and anthropologist James Cowles Prichard (1786–1848)
which was subsequently turned into a book focusing on Prichard’s
unique concept of mental illness and the development of ethnological
and racial theories from the late eighteenth century to the middle of the
nineteenth. Currently she is an editor at the Feuilleton of the Frankfurter
Allgemeine Zeitung.
Harriet Deacon is a historian currently employed at the University of Cape
Town, South Africa, writing computer-based history courseware for
university students. She did her Ph.D. in History at Cambridge University
(1994, on the history of the Robben Island hospitals in the nineteenth
century) and subsequently completed a three-year Junior Research
Fellowship at Queen’s College, Oxford, where she researched the medical
history of the nineteenth-century Cape Colony.
viii
Notes on contributors
Waltraud Ernst is a Lecturer at the Department of History, University of
Southampton. She is the author of Mad Tales from the Raj (London:
Routledge, 1991), and has published widely on the history of psychiatry
in British India. She is currently working on a comparative study of
colonial psychiatry in British India and New Zealand.
Bernard Harris is a Senior Lecturer in the Department of Sociology and
Social Policy at the University of Southampton. He is the author of The
Health of the Schoolchild: A History of the School Medical Service in
England and Wales (Buckingham: Open University Press, 1995), and
has published widely in the areas of anthropometric history and the
history of British social policy. He is currently writing a general history
of social welfare provision in England and Wales from 1800 to the present
day.
Mark Jackson trained in medicine before completing his doctoral work on
the history of infanticide. His publications include New-Born Child
Murder, a monograph published in 1996, and a range of articles on the
histories of infanticide and mental deficiency. A further monograph, The
Borderland of Insanity, is to be published in 2000. Currently a Senior
Lecturer at the University of Exeter, he is developing a new research
project on the history of allergy and asthma.
Norris Saakwa-Mante is researching a Harvard University Ph.D. thesis,
‘Medicine and the construction of race in Britain, c. 1660–1800’. He is an
Honorary Research Associate at the Wellcome Institute for the History
of Medicine, London. His interests include the History of Tropical
Medicine and the Social History of Medicine.
Jonathan Sawday is a Senior Lecturer in the Department of English at the
University of Southampton. He is the author of The Body Emblazoned:
Dissection and the Human Body in Renaissance Culture (London:
Routledge, 1995), and co-editor of Literature and the English Civil War
(Cambridge University Press, 1990). He is currently working on a study
of attitudes towards race at the time of the Piltdown ‘discoveries’ in the
early part of the twentieth century.
Mathew Thomson lectures in the Department of History at the University
of Warwick. He is the author of The Problem of Mental Deficiency:
Notes on contributors
ix
Eugenics, Democracy and Social Policy in Britain, 1870–1959 (Oxford,
1998). He is currently researching the impact of psychology within British
society during the first half of the twentieth century.
Paul Weindling is Wellcome Trust Research Professor in the History of
Medicine at Oxford Brookes University. His research interests cover
international health organisations, eugenics and Social Darwinism, and
medical refugees in Britain from the 1930s. His publications include
Health, Race and German Politics Between National Unification and
Nazism (1989), and Epidemics and Genocide in Eastern Europe (1999).
Michael Worboys is Head of Research in the School of Cultural Studies at
Sheffield Hallam University. He has worked on the history of tropical
medicine and colonial science. Recently he has been working on the
history of bacteriology and his book on germ theories of disease in
British medicine will be published by Cambridge University Press in
2000.
Chapter 1
Introduction
Historical and contemporary
perspectives on race, science and
medicine
Waltraud Ernst *
During the last two decades the study of race and ethnicity as an important
independent academic specialism has become well established within a range of
social science disciplines such as sociology, political sciences, anthropology, cultural
studies and geography.1 This ‘explosion of academic interest in the subject of
race’2 does, however, not suggest an agreement on the conceptualisations most
adequate to explain the category of race. On the contrary, among academics the
concept of race remains a controversial and contested one.3
Traditionally most historians have been careful to distance themselves from the
moral and political implications of biological definitions of race; they have referred
to it as a given (albeit characteristic and problematic) preoccupation of certain
periods during the last two centuries. The interactions of particular colonial and
migrant communities were conceived of as mere manifestations of the frictions of
cultural contact. Racial attitudes and behaviours came to be viewed as but constitutive
elements of particular groups’ traditions and folklore, of the same order as ethnic
idiosyncrasies, national costumes, food preferences and other cultural practices.
Such historical accounts tended to remain almost at the anecdotal level and tended
to ignore the wider power structures within which these episodes were embedded.
As recent authors of the postcolonial and subaltern4 schools of thought have
shown, the writing of colonial histories has had an enduring effect on representations
of race, in the popular media as well as the scientific community. Notwithstanding
honourable exceptions, such as V.G. Kiernan and Eric Hobsbawm, the tendency to
* I would like to express my thanks to the Wellcome Trust for financial support and to B. Harris and M.
Williams for helpful comments and proof-reading.
2
Waltraud Ernst
relegate the analysis of race to a realm beyond historical research, and to provide
instead collections of variably amusing or sinister historical vignettes, has in itself
contributed to the reification of race.5 Whether historians see their role as
unavoidably political or not, writing about race in history cannot merely involve a
dispassionate assessment of historical evidence: it provides the basis for the
construction of historical – and thus necessarily also for present-day – political
discourse.6 As the historian D.A. Lorimer put it: ‘the subject of race is at root a
question of power and is, therefore, whether we like it or not, profoundly political’.7
Historians write history (and get their work refereed and published) within the
constraints and preoccupations of present-day political and academic contexts.
Any historical account of race – as much as any present-day study of racism –
therefore needs to be created in awareness of its own specific political and academic
context. The political positions and strategies that may be encoded in it need to be
made explicit. Long before the advent of postcolonial, postmodern and subaltern
studies, Gunnar Myrdal expressed this point succinctly in the (German) introduction
to his Asian Drama, appropriately subtitled ‘the mote in one’s own eye’:8
The issue of objectivity in research cannot simply be sidestepped by striving
to exclude value judgments. On the contrary; the investigation of any social
problem is, and has to be, affected by value judgments. There never was such
a thing as ‘disinterested social science’ and there never will be. The attempt to
run away from value judgments is futile and even harmful. Value judgments
are in us – however much we try to repress them – and they direct our work.9
Contributors to this book share an ambition to break away from and to expose
some of the ‘dangerous and destructive patterns that were established when the
absurdity of “race” was elevated into a central political, cultural and economic
concept and endowed with a power to both determine and explain the unfolding of
history’.10 That these ‘dangerous patterns’ have been persistent and enduring is
evidenced by the current academic revival and general popularity of writing based
either on socio-biological theories11 or on ideas that encode and legitimate racial
discrimination in terms of ‘culture’.12
Introduction
3
Opinions diverge as to the extent to which post-Enlightenment thinking and the
various responses to and extensions of it (such as Romanticism) were inherently
flawed.13 Some believe that the categories themselves, although laying claim to
universal truth, were part of but one particular philosophical mind-set that came to
prominence already inherently implicated with racial ideology. Others hold that
Enlightenment traditions projected the possibility of human emancipation, yet
were limited in the expression of their emancipatory potential by social and political
circumstance, and economically based class interest during the emergence of
capitalism.
According to the former view, the elevation of scientific discourse to a major
component in the project of modernity and the Eurocentrism inherent in the Western
scientific enterprise has aided both the development of racial hierarchies and the
creation of the long-enduring myth of science as an impartial, pure and value-free
endeavour, superior to other peoples’ modes of thinking. Alternatively it could be
argued that it is one thing to ‘discover’, identify, categorise and classify plants,
beetles as well as peoples, but quite another to transform such categories and
classifications into hierarchies that suggest stratification in terms of social and
moral inferiority. The process of categorisation would then not in itself be normative,
but rather evaluative attributions would be based upon moral and social preferences,
subjective value judgements and the striving for political power. The unfounded
transformation of a statement about perceived difference into one about social or
moral desirability and thence political dominance is starkly illustrated by Disraeli’s
well-known proclamation that ‘race implies difference, difference implies
superiority, and superiority leads to predominance’.14
The conundrum of the conceptual status and the socio-political consequences
of the Enlightenment has not been resolved satisfactorily. Yet there now exists
agreement on some parameters. The consensus is that scientific racism, racial
medicine and colonial rule were for a time closely linked, variously reinforced and
justified each other. Claims to racial superiority and Western scientific and medical
hegemony are seen to have emerged alongside each other in the wake of the
Enlightenment, culminating eventually not only in scientifically based racism in
the nineteenth and racial medicine in the twentieth century, but also in the perceived
enhancement and legitimisation of colonial expansion by reference to medical and
4
Waltraud Ernst
scientific progress. Lyautey’s dictum that ‘medicine is the only excuse of
colonialism’15 vividly encapsulates this. The interrelatedness of race, science and
medicine, and its extension to the colonial realm during the nineteenth century, in
particular, therefore constitutes one major focus for this book.
Taking issue with the Enlightenment roots of hierarchical racial thinking and
with Western scientific and medical hegemony is, however, vital not only for
colonial history. Debates on the ontological status and political implications of
ideas such as freedom, equality and individual rights on the one hand, and of claims
to difference and particular group rights on the other, are also central to Western
theories of decolonisation and multiculturalism in the twentieth century. The
tendency to transform questions of politics, rights and morals into questions about
nature, biology and culture has persisted. Immigrants and minority groups in
Britain and elsewhere in Europe have been caught up in the tension between claims
to equal rights and citizenship on the one hand, and to difference and the rights to
cultural and political self-expression on the other.
Historically, the conflation of ideas of racial difference with moral values and
political rights was facilitated during the nineteenth century by newly emerging
biological and anatomical frameworks that constructed the qualities of particular
peoples as fixed and transhistorical, thus quasi-naturalising social and political
formations in terms of a racial logic of belonging. As a critical historian of ‘scientific
racism’ put it: ‘In effect, a theory of politics and rights was transformed into an
argument about nature; equality … was taken to be a matter not of ethics, but of
anatomy’.16 In the early twentieth century, in contrast, important changes occurred
as race was increasingly encoded not only as biologically determined but also as
culturally based. Since then equality has become more a matter of culture than of
biology alone.17 It is this shift in conceptual emphasis that is at the centre of the
essays on aspects of early twentieth-century racial theories and medical practices
in Britain itself.
Research on the crucial role of the Enlightenment in the creation of a racialised
science and in the scientific and cultural justification of racism has also alerted us to
the dangers of overgeneralisation and homogenisation of historical perspectives.
Despite the value of critical analyses of the all-pervasive and powerful
Enlightenment and post-Enlightenment gazes and discourses, not least in the eminent
Introduction
5
tradition of Foucault, many authors have pointed out that we also need to see the
great variety and plurality, not to say ambiguities, of these discourses. These argue
that the attribution of any singular train of thought and intention to Enlightenment
or post-Enlightenment thinkers is misleading – in regard to racial theories as well as
medical practices.18
Much recent literature on the link between science and race suggests that Western
science and its representatives assumed a preeminent role in the invention,
justification and dissemination of ideas of racial hierarchies as part of the project of
the civilising mission and the universal spread of Western scientific knowledge.
This led, first, to the formation of nineteenth-century ‘scientific racism’ and,
subsequently, to the ‘retreat of scientific racism’ between the World Wars, when
the definition of race as a biological concept was complemented by cultural notions
of race. Arguably, we then witnessed the unravelling of the post-war scientific
consensus on race, signalled by the ‘return of racial science’.19 These whole-scale
characterisations of particular historical periods in terms of the varying ways in
which science and race are thought to be intertwined constitute an important
challenge to positivist thinking and are useful for the purposes of conveniently
clear-cut classification and accentuation of long-term historical trends. At the same
time they are problematic precisely on account of the generalisation on which they
are based. They might therefore more appropriately be taken as the starting point
for, rather than the conclusion of, further debate and in-depth probing of the
historical evidence.
The concept of ‘scientific racism’, for example, rightly highlights the point that
from the early nineteenth century to the present day the various branches of
science and their representatives have not simply been involved in the pursuit of a
socially and politically disinterested and objective enterprise, but have, to various
extents, been implicated in the justification and construction of racist categories. In
the main, ‘scientific racism’ has become synonymous with ‘biologistic’ racism as it
emerged alongside evolutionary and Social-Darwinist ideas. Yet in-depth studies
of particular strands of late nineteenth- and early twentieth-century medical and
psychological theories of racial difference (see Harris, Sawday, Thomson and
Worboys in this volume) suggest that such an equation may be too simplistic.
‘Scientific racism’ was variously and diversely refashioned during this period in
6
Waltraud Ernst
biologistic as well as cultural terms. As Harris shows, medical observers in the late
nineteenth and early twentieth centuries interpreted differences in the health status
of Jews and Gentiles in cultural rather than biological terms. Worboys suggests
that, contrary to general trends, commentators on tuberculosis favoured biological
explanations from 1914 onwards. Thomson discerns a move away from biology to
culture within the discipline of psychology in the period between the World Wars
and suggests that different scientific disciplines produce or favour different sorts
of scientific racism, as in the case of psychology which seems to have shifted away
from biology-based conceptualisations to a cultural emphasis under the influence
of anthropological ways of thinking.20
These findings indicate first of all that, once we look at the historical evidence of
racism in science and medicine in more detail, we may be confronted with diverse
strands and complex configurations of ‘scientific racism’ within particular scientific
disciplines and in relation to different medical syndromes and socio-political settings.
‘Scientific racism’ presents itself in cultural as well as biologistic guise. Further,
even when expressed in the language of ‘culture’ , a biologically based perspective
may, in the last instance, still be at work, as when ‘culture’ is evoked as if intrinsically
linked to the biological inheritance of a race. Unlike earlier debates on the role of the
environment (in contrast to a people’s constitution and character) that predate the
advent of scientific racism (see essays by Saakwa-Mante and Augstein in this
book), the cultural coding of race rose to prominence once it was realised, from
around the late nineteenth century onwards, that biological differences between
‘races’ were in themselves not very significant. Cultural differences were referred
to as quasi-inherited – as if culture was ‘in the genes’. The move between, and
conflation of, biological and cultural definitions of race still haunts present-day
debates and popular conceptions. The long-standing debates on the status of
‘biology’ and ‘culture’ (progressing from previous ones about the role of
‘constitution’ and ‘environment’) raise the further important question as to whether
binary distinctions, such as those of notions of racial difference based on biology
and those based on culture, can legitimately be sustained.
As has been shown in earlier post-World War II methodological debates,
researchers have indeed a tendency to iron out evidence of inconsistency and to
smooth over ambiguities that might distract from the perceived desirability of
Introduction
7
arriving at unequivocal statements and clear-cut dichotomies. In addition, historians
make allowance for what are seen as the exuberant style and lack of logical
consistency in much Victorian writing, for example, and dismiss these as
idiosyncratic contingencies, not relevant to the core arguments. By so doing, an
important point in regard to the way in which racialised discourses strengthen their
hegemony may be overlooked. In fact, the ambiguities, contradictions and
discrepancies manifest within particular racial theories and racialised medicine are
more likely to strengthen than weaken racial discourses. Racial discourses work
well not despite their logical inconsistencies, ambiguities and mixing up of premises
but because of them. They are destructively all-pervasive precisely because they
are overdetermined and multivariant, creating the possibility for different arguments
or perspectives (moral, biological, cultural, etc.) to be accentuated within different
contexts and depending on the aims pursued.
It is not least this chameleon-like versatility of racialised discourses, their facility
in shifting from ethical norms to biological arguments or to those of cultural identity,
that has proved so painfully overpowering to those victimised by it.21 The insistence
that the presumption of ‘a single monolithic racism’ needs to be replaced by
context-specific analyses of the multifarious historical formulations of particular
‘racisms’ has rightly led to an increased awareness of the multidimensionality of
racial discourses, encouraging a focus on the variable spatial and temporal contexts
within which particular discourses are articulated.
A number of chapters in this collection look at how the heterogeneity of racial
discourses manifests itself. They deal with aspects such as the diversity of thinkers
in any particular period (e.g. Augstein); the variety of perspectives employed in
any one particular thinker’s writings (e.g. Saakwa-Mante, Thomson); differences
of outlook and opinion present in scientific and philosophical, in contrast to
public, discourses and practices (e.g. Jackson, Sawday, Worboys); differences in
the tenor of scientific debates in the colonial and metropolitan intellectual
environments (e.g. Deacon on psychiatry in Africa, and Thomson on psychology
in Britain), and, finally, the different social and political forces that influence
particular strands of thought (e.g. Arnold, Ernst, Harris, Weindling).
8
Waltraud Ernst
The move away from overly generalising accounts that only stress the allpervasiveness of racial domination has to some extent been due to the recognition
that they contributed to the reification of the very structures they intended to
expose. An exclusive emphasis on specific contexts rather than universal forces
might on the other hand merely constitute another ploy in the politics of difference
that not only produces new kinds of thinking about race, ethnic strife, body and
mind, but promotes with it also new kinds of intolerance.22 While it is vital to
contextualise racialised medical theories and practices, we should not lose sight of
the wider structures of political and economic power within which these are situated.
Furthermore, the current proliferation of histories that focus exclusively on cultural
and literary representations invites us to ask whether we really could write a social
history of the interrelationship of race, science and medicine from contextualised,
self-contained case-studies, travellers’ diaries and cultural forms alone. In order to
avoid the Scylla of conceptual fragmentation and the Charybdis of essentialist
homogenisation, work on race and medicine will have both to situate itself within
specific contexts and to proceed to relocate itself within the wider structures of
political discourse and global power relationships.23
Current writing insists that race needs to be looked at in combination with the
other categories that feed into it. As Solomos and Back have argued, ‘racist discourse
needs to be placed in the conditions surrounding the moment of its enunciation.
This means irrevocably crossing the analysis of racism with other social relations.’24
The aim is to do justice to complex realities by ‘complicating the categories’.25
Gender and class messages as well as discourses of nationhood and citizenship
have been focused on as vitally informing and intersecting with racial discourses.
Even before the heyday of postmodern and feminist writing, historians
highlighted the conflation of race with class in the West’s construction and
categorisation of colonial peoples. Take, for example, Kiernan’s important
observation in his classic The Lords of Human Kind: ‘Discontented native in the
colonies, labour agitator in the mills, were the same serpent in alternate disguises.
Much of the talk about the barbarism or darkness of the outer world … was a
transmuted fear of the masses at home.’26 Arguments such as these evolved, of
course, during a period when the concepts of race and gender still coexisted in
uneasy relationship with social class, as questions of explanatory primacy were
for a time the dominant theme in academic discourse.27 More recently, in contrast,
Introduction
9
a pronounced shift has occurred, not only away from simplistic, determinist models
that attribute conceptual precedence to one particular factor, but also from more
sophisticated dialectical thinking. However, there exists as yet no agreement on the
precise relationship between these various analytical categories in social and
historical analysis, and the relative weight to be attributed to each of them. The
common ground currently appears to be that the major categories need to be
assessed in their interconnectedness. As Brah expressed it, emphasis is on the
‘gendered racialisation of class’ as constitutive in the rise of Europe.28
While issues of social class have been somewhat neglected by many academics
during the last two postmodernist decades, work on the intersection of race and
gender in particular has made considerable progress. Both race and gender have
come to be seen as based on a number of similar principles: the locking of particular
groups of people into fixed and quasi-transhistorical identities, for example, which
enable some to lay claim to positions of power and to the right to self-determination,
while excluding others. As pointed out by O’Hanlon in connection with Asian
communities, the principles of their representation within Western Orientalist
writing from the late eighteenth century were based on the ‘persistent reference to
the effeminate sensuality of Asiatic subjects, their inertia, their irrationality, their
submissiveness to despotic authority, the hidden wiles and petty cunning of their
political projects’.29 Lewis therefore further expanded Said’s pathbreaking work
on ‘Orientalism’ by not only exposing the flawed construction by the West of
peoples in the East in racialised terms, but also by ‘gendering Orientalism’.30 In a
similar vein, Sinha exposed the case of the ‘effeminate Bengali’ – the crude
stereotypical image of one particularly important group of Britain’s colonial peoples
in India, in which gender and race amalgamate to evoke the negative connotations of
both the allegedly ‘weak sex’ and the ‘weak native’.31
As well as race and gender, here, too, other concepts such as class, nation and
nationalism are vitally implicated. The image of the ‘effeminate Bengali’ is a
particularly good case in point, as it became increasingly popular during a period
when members of the Bengali elite in British India had not only proved to be
eminently able competitors in trade, industry and the civil service, but had also
become active in anti-British, nationalist movements. The image of the ‘effeminate
Babu’ suggests easily enforced domination and relegation to the supposedly minor
10
Waltraud Ernst
concerns of the private and cultural spheres of a group of people not only competing
for but also challenging political and economic power. It therefore resonated
especially well with, and boosted, self-confidence among the British during a
period when colonial rule became increasingly contested in a structured and
organised, and thus threateningly potent, way.
Yet gender stereotypes need not be female. The grand-scale ‘feminisation of the
Orient’ was complemented by the ‘masculinisation’ of some selected colonial
communities – singling them out as ‘martial’, ‘noble’ and ‘warrior-like’. These
groups were assigned stereotypical images such as the loyal and proud native or
the fierce fighter and good sport. The latter constituted a challenging match for the
European soldier in the battle- as well as the sports field – although he, of course,
remained inferior in character to the superior English prototype.32 Both constructs
shared a reference to quasi-scientific and, in particular, biologically, anatomically
and medically grounded frameworks.
The projects of ‘gendering’ race and of ‘race-ing’ gender have developed alongside
research on the gendered racialisation of colonial people (and, to a lesser extent,
migrant communities) as a means of political and cultural subjugation. They also
support the view that stereotypical images and representations are usually actively
responded to, resisted and even turned against those who create them. Here
emphasis has shifted away from an exclusive focus on the process of imposed
negative identity-ascription and the disabling consequences of stigmatising
discourses. As pointed out, not least by Foucault himself, ‘power implies resistance’:
those apparently subjugated by discourses of power might resist and even reframe
them in positive and empowering terms, and ultimately achieve access to the very
resources and spheres of power from which they were intended to be excluded.
This defiant response to Western attempts at ‘othering’ and subjugation is manifest
in the expropriation for their own political purposes of racialised concepts by the
social elite of disadvantaged groups. A striking example is the Bengali elite’s attempt
to make use of the racial ideologies associated with British medical theories on
malaria by emphasising the prospect of a regeneration of the Bengali race by means
of suitable (namely middle-class Bengali) leadership (see Arnold’s contribution to
this book).
Introduction
11
An emphasis on ‘complicating the categories’ is relevant not only in regard to
colonial formations. The delineation of different groups of peoples within Europe
itself has become an equally important focus for historical and conceptual analysis.
Anderson’s earlier book on the construction of ‘imagined communities’ has helped
to highlight the social fragmentation and elusive, if not illusory, boundaries around
allegedly clearly delimited communities that underscore the Western dogma of a
‘unitary self’.33 The salience of the colonial project rested for a time to a great
extent on the ideological premise of this undivided Western ‘self’, united not least
by the spirit of Reason. Colonial historians and anthropologists in particular for a
time fell prey to the implicit suggestiveness of an unproblematic ‘Western self’ and
to its extension into a unified and unifying ‘whiteness’ that required no probing and
problematising. But in fact, British society itself has been characterised not only
by divisions of gender and class but also by the uneasy relationship of the English
with peoples of Scottish, Welsh, Irish or Southern and Eastern European background.
Nineteenth-century gentlemen such as Charles Kingsley, for example, held that
they were ‘haunted’, during travels to Ireland, ‘by the human chimpanzees’ they
saw ‘along that hundred miles of horrible country. … To see white chimpanzees is
dreadful; if they were black, one would not feel it so much.’34
The dehumanisation and quasi-‘Orientalisation’ of the Irish, for example, is mirrored
by early twentieth-century perceptions of particular immigrant communities as
implicitly ‘other’ or ‘non-European’ (see Harris, Worboys, Weindling). The
persistence of such transposed images and their shifting boundaries, as ‘when the
Irish became white’,35 has rightly been a focus of recent research that aims at
exposing the processes by which whiteness is constructed as both unity and norm.
A number of essays (Harris, Sawday, Thomson, Weindling) take issue with the
ways in which medical science, supported by the newly emerging disciplines of
anthropology and psychology, gave credence to and supported the racialised
construction of boundaries between different white communities, as well as between
groups of immigrants from other European countries.36
It would be futile to pretend that a selection of historical essays could possibly
touch upon the whole range of issues relevant to the interconnections between
race, science and medicine. There are obvious omissions, arising more from the
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practicalities of editing and the limitations imposed by the necessities of academic
specialisation, than as a consequence of deliberate disregard or studied negligence.
In fact, some of the themes left out of this collection had originally vitally informed
the discussion of the individual papers first presented at the conference on Race,
Science and Medicine in Southampton, in September 1996. Literary and visual
representations of race in science and medicine, for example, played a major part in
the conference debates, even though they unfortunately do not figure in the present
volume.37 Neither do accounts of the eugenics movement in Britain and abroad, or
of some of the most traumatic moments in the recent history of race that affected
Europe and Northern America: transatlantic slavery, the Nazi genocide and ‘ethnic
cleansing’ in the former Yugoslavia. Despite the inclusion of accounts that focus on
locations outside Europe, the ‘comparative perspective’ also remains restricted –
with the exception of Weindling’s chapter – to an almost exclusively British view
of race within Britain and its empire. There is little engagement with the way in
which racial categories impacted on science and medicine within other than British
and British colonial national settings, nor have any contemporary Continental
conceptualisations of ‘race’ or American preoccupations been referred to. Recent
studies in the emerging subdiscipline of ‘Science, Technology and Medicine Studies’
have scarcely been touched on, and the intersection of race with gender and with
class, in particular, would merit further elaboration. However, despite these lacunae
it is hoped that this volume will further a critical engagement with issues of race in
the history of science and medicine.
Individual contributions to this book have been arranged chronologically to
enable readers to follow the sequential development and diverse historical
manifestations of racial concepts from the eighteenth century onwards, right through
to the nineteenth and the early twentieth centuries. Overlaps of time spans are, of
course, unavoidable as some authors focus on the development of particular racialised
disease categories and medical approaches over an extended period whilst others
examine in more detail evidence for ‘scientific racism’ across a shorter interval.
The opening chapters by Saakwa-Mante and Augstein provide the early context
on which a deeper understanding of some of the issues raised in subsequent
contributions needs to be based. They also cover new ground in their assessment
of the multiple conceptual considerations and geopolitical constellations that fed
Introduction
13
into eighteenth-century ideas of the origins of perceived racial difference and the
construction of newly discovered diseases in the wake of the slave trade and
European expansion.
In his analysis of the ideas of an early eighteenth-century naval surgeon (John
Atkins) on sleepy distemper (‘sleeping sickness’ or trypanosomiasis), SaakwaMante shows that Atkins subscribed to an idiosyncratic brand of ‘constitutional
polygenism’, anticipating developments more commonly associated with racial
science only from the late eighteenth century onwards. Atkins argued that external
differences (e.g. the dark skin and ‘woolly hair’ of African slaves) were markers and
signs of hidden, inner difference (e.g. the ‘constitutional immaturity’ and ‘natural
weakness’ of the African brain), so that particular kinds of bodies were prone to
developing particular kinds of disease. Sleepy distemper therefore represented a
disease category that was properly applied only to people of non-European racial
backgrounds. The link between this disease and race was also made by subsequent
generations of medical practitioners right up to the beginning of the twentieth
century when the ‘real’ cause of sleeping sickness, a parasitic pathogen, was
discovered. At that juncture medical practitioners began to see the European body,
too, as potentially capable of harbouring a disease that had previously been
conceptualised as intrinsically and exclusively bound up with particular racial
populations. The linking of race and disease categories, and then the decoupling of
this tie, suggests not only that racial preconceptions can inform and deform medical
observations and practices, but it also constitutes evidence that medical theories
are vitally implicated in the construction of ideas of race.
Saakwa-Mante highlights another important point that has been central to recent
controversies on the periodisation and classification of various strands of racial
thinking and the, at times, oversimplifying generalisations on which these are
based. He traces the medley of factors, constitutional as well as environmental,
that were characteristic of Atkins’ construction of ‘constitutional polygenism’. As
Atkins suggested that cultural resources such as art and science have an impact on
a people’s constitution, the boundaries between ‘constitution’ and ‘environment’
became blurred in his writing. This suggests that historical accounts of ‘scientific
racism’ that juxtapose arguments of ‘constitution/heredity’ with those of
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‘environment/culture’, as if these were part of two opposed and irreconcilable sets
of ideas, are too static and simplistic.
In a similar vein Augstein shows that monogenist and polygenist arguments
developed alongside each other, not necessarily as a strict dichotomy. She focuses
on the eighteenth century, when ideas on the geographical origins of humankind
were for a time at the centre of controversy among physiologists, biologists and
anatomists in Germany, France and Britain. The hypothesis of Europeans’ Caucasian
origin exemplifies a concept of racial origin that was based on a plethora of vague
and shifting assumptions and speculative ideas and lent itself well to being
incorporated into, and to giving credence to, diverse strands of ideas about race. As
pointed out by Augstein, the Caucasian hypothesis ‘spread precisely because it
was unlikely, part of an imaginative geography rather than informed by solid
factual knowledge, and hence open to all sorts of association of ideas, none of
which had much to do with the original purpose of the concept: to elucidate the
historical or geographical make-up of the human physique’ (p. 59).
Augstein’s perspective is wide-ranging in its emphasis on different national
settings and she draws attention to the various scientific and philosophical traditions
within Europe and to the ways in which these impacted in various different ways
on the discussions about the geographic origin of the human and, more specifically,
the European-born ‘race’. She also traces the popularity and the appropriation of
the term ‘Caucasian’ for racist causes in the United States, when it was variously
used in support of segregation policies that privileged ‘whites’ over ‘blacks’. In
Europe, in contrast, the concept was less easily adapted to societies that were keen
on finer distinctions among Europeans themselves – between Celts and AngloSaxons, Germans and Slavs, Gauls and Franks. Augstein’s contribution underlines
the importance of rigorously situating racial theories and terminologies not only
within the contexts of their origins but also in relation to subsequent social and
political appropriations and applications.
The issue of the spatial as well as temporal specificity of ideas of ‘race’ is at the
centre of my own contribution on the development of psychiatric institutions in
early nineteenth-century British India. The ‘British Raj’, with all its profusion of
connotations of heat and dust, colourful indigenous diversity and splendid imperial
glamour, has become synonymous with the supreme unifying imperial and military
spirit and the monolithic force and rational efficiency of British colonial
Introduction
15
administration. Yet a far less monolithic picture in fact characterised the situation
in the various areas under British rule: in regard to lunacy policy and related healthand population-control measures a variety of administrative approaches and views
of racial identity prevailed. These developed in response to, and in support of,
diverse colonial and indigenous power structures and ethnic stratification in specific
localities.
I show that psychiatric approaches and institutional policies developed both in
unison with the powerful global discourse of race and in response to heterogeneous
local racial discourses and indigenous social and political power structures. I conclude
that it is important to pay attention to the various locale-specific manifestations
and variations of ‘colonialisms’ and the particular ‘racisms’ going along with these.
However, it is equally important to acknowledge the globalising and universalising
tendencies inherent in Western colonising strategies and concomitant racial
conceptualisations.
Deacon assesses the development of colonial psychiatry within the social and
political context of the first British settler colony, the Cape. As in British India,
here, too, the broader socio-economic and political contexts need to form the major
setting for the study of racism and psychiatry. However, Deacon stresses that it is
too simplistic to assume a straightforward translation of racist ideas and policies
within colonial society at large into psychiatric theories and practices within
institutions for the insane. In the Cape, measures such as the racial segregation of
patients in the asylum preceded the formulation of racist psychiatric theory. In
regard to institutional and psychiatric practice, therefore, ‘scientific racism’ appears
to have lagged behind the popular racist and segregationist ideology within broader
society.
Despite a high level of social stratification among European settlers as well as
indigenous groups, ethnic, religious and status categories tended to be collapsed
into a dichotomous racist framework which divided ‘European’ from ‘coloured’,
‘civilised Christians’ from ‘savage heathens’. Throughout the nineteenth century
the idea prevailed that ‘coloured people’ did not require the same sort of refined
treatment and ‘moral management’ techniques as Europeans. According to Deacon
this view echoed the stereotype of the ‘coloured as savage’, rather than expressing
any particular conception of ‘coloured insanity’. Yet, despite its apparent
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prescriptiveness, segregation on the basis of race alone was not always considered
practical and hence less strictly applied in the day-to-day management of institutions.
Deacon suggests that the liberal roots of medical universalism opened up the
space for a culturally based racism – rather than a biologically grounded racist
science – to develop within Cape medicine during the course of most of the nineteenth
century. It was only from the 1880s onwards that discriminatory attitudes, born
out of a hardening racism among the English and the Afrikaners, came to rely on the
discourse of scientific racism. Deacon concludes that ‘it was not racist psychiatry
or racist science more generally which formed the basis for theorising racial
segregation in Cape asylums like Robben Island, but the liberal tenets of moral
management which permitted the expression of racism by white staff, patients and
officials in the space created by class differentiation’ (p. 118).
In his chapter on malaria in colonial India, Arnold challenges some of the
assumptions on which much previous research into scientific racism has been
based. Arnold acknowledges that some high-profile scientific figures such as H.H.
Risley did indeed promulgate a hierarchical-determinist and biologistic view of
race. Yet, among the wider scientific and medical communities, as well as among the
European public in British India, a number of less narrowly focused ideas on race
prevailed that were more commonly based on a wide-ranging mixture of cultural
and moral, as well as physical, factors. Arnold’s evidence puts into question whether
the commonly assumed universal shift away from cultural towards biological
conceptions of race, during the period from the late nineteenth to the early twentieth
century, was equally characteristic of the situation in British India.
Arnold focuses on malaria and malaria prevention as an example of a disease
category that on account of its symptom-profile lent itself particularly well to
developing ideas of racial decay, enfeeblement and racial regeneration. He finds that
ideas of race were not exclusively confined to the British but also played a profound
role in the self-perceptions and social attitudes of the European subject people. In
Arnold’s reading of the evidence in Bengal ideas of race and visions of racial
regeneration were part of an interactive process in which not only various groups
among the European communities but also Indian people were involved. The
Bengali Hindu intelligentsia played a crucial role in the appropriation of particular
Introduction
17
strands of culturally based ideas of race, reinterpreting these on their own terms
and for their own purposes, projecting themselves as the vanguard of Bengal’s
social and political regeneration, especially during a period of a heightened sense of
demographic and political rivalry with Bengali Muslims. Ideas of race within
colonialism, a powerful tool of stereotyping and stigmatisation in the hands of the
Western colonisers, lent themselves also to appropriation by particular strata
within colonial societies in search of their own political and social empowerment.
European ideas of Bengali effeminacy had been well entrenched in colonial
discourse since the beginning of the nineteenth century. As many among the Bengali
elite and the medically informed European public believed that the weakness and
feebleness attributed to Indian people were not immutable, inherited characteristics
of their race, but contingent upon poverty, deprivation and a malarious environment,
Arnold concludes that medical and sanitary science ‘held out the possibility of
contesting the more biologically determinist interpretations of race’ (p. 141).
In his chapter on ‘Tuberculosis and Race’, Worboys investigates the extent to
which ideas of race are linked to the changing epidemiological and pathological
understanding of a particular disease. He finds that concepts such as ‘racial
immunity’ and ‘primitive TB’ were conflated with biological and physical, as well
as social and cultural, assumptions about racial difference. He assesses in depth the
reception of epidemiological evidence from a wide range of areas in Britain, North
America and various colonies by Lyle Cummins, a leading authority on TB.
The collection of incidence and mortality rates for different social and cultural
groups became a priority issue for public and industrial health policies during a
period when immigrant groups in the United States became more visible and when
contact and conflict between ‘primitives’ and ‘civilisation’ increased considerably
in the wake of European imperial expansion and exploitation of African and Indian
labour power. The collected data provided highly diverse and contradictory incidence
and mortality rates for different groupings of people, and could thus easily be
drawn on to support a wide range of different and at times conflicting views on TB.
For example, data that showed that differences in mortality within the white
population were as great as those between whites and non-whites were used to
promulgate the view that environmental and social improvements were vital in the
reduction of TB, and that TB immunity was acquired rather than racially based.
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Statistics collected among South African mining communities, in contrast, were
interpreted as supportive of views that put emphasis on racial susceptibility –
thus enabling the South African mining companies (who had commissioned the
collection of statistics and medical expert advice on how to optimise labour costs)
to be excused any responsibility for the high incidence of TB amongst their workers.
Worboys’ study highlights the various ways in which different national and
geographic contexts, and the political and economic interests within these, together
with practitioners’ shifting political and professional allegiances, informed and
shaped the ways in which the conceptualisation of a specific disease was imbued
with biologically and/or culturally based racial ideas. Worboys concludes that,
before World War I, the idea that ‘primitive people’ were ‘virgin soil’, lacking
immunity to TB because they had not been exposed to this disease before, seemed
‘not only to make sense of the experience of disease in colonial medicine, but also
was a resource in the debates about eugenics and immune theories. Between the
wars, the racial theory of tuberculosis went against the wider trend in the biological
sciences to question the validity of “race” as a scientific category’ (p. 161).
Jackson’s paper highlights the effects that racial stereotyping had not only on
‘other’ people ‘out there’, in the British Empire, but also on particular groups of
people within Western societies. He discusses the changing representations and
medical discourses surrounding that group of people who were for nearly a century
referred to as ‘mongols’. Jackson shows that in a way similar to how people in
colonial countries were represented as ‘having degenerated from the Caucasian
pinnacle, mental defectives were frequently portrayed as the primitive products of
a process of atavistic degeneration from a mental and physical norm’ (p. 167). The
prevalence of ‘mongolism’ lent itself to substantiate theories of race that suggested
a link between physical form and appearance on the one hand and mental ability
and state of development on the other. The concept of ‘mongolism’ drew on and
gave credence to ideas that constructed racial hierarchies, and passed judgement on
their mental abilities and stage of development on the basis of people’s physical
difference alone.
Jackson also investigates whether a change of medical terminology, towards
seemingly purely clinico-technical terms, is bound to result in a dissociation of the
clinical category from any racial allusions. He shows that the racial stereotyping of
people with learning difficulties persisted even with the recognition that ‘mongolism’
Introduction
19
was due to a genetic specificity subsequently referred to as ‘congenital acromicria’
or ‘trisomy 21 anomaly’. Despite substantial variations in appearance, organic
pathology and intelligence, this group of people was still regarded as different and
deviant from the norm – now by virtue of their shared genetic constitution. Jackson
concludes that ‘novel understandings and depictions of disease failed to shake off
racial assumptions evident in earlier representations, although those assumptions
were now recast in the language of genotypes’ (p. 183). This indicates the continuing
effect and endurance of racial discourse even in the face of new gene-oriented or
genomic constructions of ‘race’ and their apparent distance from eighteenth- and
nineteenth-century scientific racisms.
In Harris’ chapter the focus is on the medical profession’s response to the
immigration of Eastern European Jews into Britain during the late nineteenth and
early twentieth centuries. Although Harris places the different ways in which
racial thinking influenced debates on public health measures in relation to Jewish
immigration at the centre of his analysis, he stresses that ‘race was only one of the
factors to influence intellectual debate at the end of the nineteenth century’ and
that ‘we also need to examine the persistence of liberal ideas about freedom of
movement, the right of asylum and free trade, together with the broader links
between Jewish immigration and the politics of public health reform’ (pp. 189–90)
in order to understand the full range of medical responses to Jewish immigration.
Although the extent of immigration from Eastern Europe was relatively
insignificant in terms of the numbers involved, East European Jews in Britain
were regarded as being especially ‘visible’ as they tended to be geographically
concentrated in particular areas of cities such as London, Manchester and Leeds.
Harris argues that in late Victorian and Edwardian Britain older stereotypes of
the Jewish people as Christ-killers and plain anti-Semitism still persisted, but
were gradually being superseded by newer economic, moral and health-related
concerns – by factors such as the perceived decline of British economic wealth
and the erosion of its imperial power in the face of German and American economic
competition and the early defeats of the Boer War, compounded by fears about
physical degeneration, fuelled by Social Darwinism and fears that immigration
put pressure on the scarce resources of a nascent welfare state.
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Although there is evidence in the debates on Jewish immigration and public
health that substantiates the prevalence of anti-Semitism and middle-class distaste
for the poor and destitute, Harris notes that discussions were far more complex
and some important factors, such as the twin principles of free trade and free
movement of people, as well as liberal beliefs in the right to asylum, tended to
challenge the hardening of racial attitudes and growing hostility to non-native and
non-white groups.
He also highlights evidence collected by Medical Officers of Health that goes
against the grain of common pre-perceptions. Harris argues: ‘medical writers believed
that Jews were at least as healthy as the population around them, and often more
so’ (p. 195). Jewish people appeared to experience higher rates of some physical
and mental diseases, and tended to live in extreme squalor and insanitary conditions
on arrival in Britain – factors that seemed to give credence to the belief in Jewish
degeneracy and ‘racial’ susceptibility to disease. Some advocates of Jewish
immigration countered this view by insisting that a ‘racial habit of body’ may well
be implicated in regard to Jewish people – yet this did not express itself in
susceptibility, but rather in ‘racial immunity to disease’. Others focused more on
Jewish cultural and dietary habits (such as good parenting skills, careful and
abstemious diet) to explain statistical trends that affirmed that urban areas with a
high percentage of resident Jewish people tended to show a more favourable health
and mortality profile even than areas with more affluent, ‘native’ populations.
In his contribution on ‘German Bacteriology as Scientific Racism’, Weindling
sets out to challenge the view that bacteriology, as a laboratory-based offshoot of
biology, is immune to social and racial ideologies. He explores the close link between
public health and sanitary policies in response to typhus, and immigration and
population control procedures in Germany during the 1890s and in occupied
Poland and Serbia during World War I. Weindling shows that, although towards the
close of the nineteenth century anti-Semitic notions of the Jew as parasite deployed
the language of bacteriology and parasitology, such rhetoric did not yet pervade
bacteriology itself. This changed during the time of World War I when intolerance
and apprehension towards Eastern European Jewish people changed to outright
anti-Semitism. The bacteriological cleansing, segregation and hygiene measures
recommended by bacteriologists in the prevention and eradication of typhus were
Introduction
21
based on centralised, authoritarian and interventionist approaches, and could
therefore – in particular historical circumstances – easily be integrated into and
lend credence to racist rationales. Although there was no intrinsic link between
bacteriology and racial ideas, within the economic and socio-political context of
Germany in the early decades of the twentieth century, a racist bacteriology could
easily be elicited. Weindling concludes that at that period bacteriologists ‘stood on
the threshold of eradicating epidemics by eliminating the presumed carriers of the
disease’ (p. 231).
In his contribution on ‘Savage Civilisation’, Thomson assesses the
reconfigurations in theories of the mind between 1898 and 1939 within the new
academic discipline of psychology in response to anthropological findings that
cast doubt upon the supposed link between race and mental ability. The
anthropological experience (particularly in the wake of the expedition to the Torres
Straits in 1898) and its reconfiguration in psychological theories appeared to
demonstrate the importance of culture and the persistence of archaic mental
structures, of ‘savage’ instincts and of the ‘primitive’ even within the ‘civilised’.
During the era leading up to and following World War I, when issues of national
identity were to the fore and Britain and other nations were struggling to come to
terms with the horrors and ‘barbarism’ of trench warfare, the idea of the omnipresence
of the ‘savage’ captivated academic and popular thought.
Thomson raises doubts about the assumed hegemony of biologically based
scientific racism in turn-of-the-century Britain, suggesting instead that culture
evolved alongside biology in a more complex way during this period. He looks at
popular and influential psychologists, such as McDougall, who argued that innate
racial differences manifested themselves in culture over a long period, leading to
distinctive national cultures that developed in harmony with a people’s innate
national character. This line of thinking fuelled the racialisation of national identity,
as ‘Englishness’ and ‘English character’, for example, were seen to be based on
innate national characteristics as well as national culture – or, as McDougall
expressed it, ‘the “culture species” replaced the race’ (p. 244). The individual mind
became a repository for a racialised national history which was both biological and
cultural.
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Thomson argues that as the unity and common life of all humankind were
recognised, this culturalised vision of race harboured the potential to lead to the
subversion of race as a category of difference. Nevertheless it could also perpetuate
a racist scientific justification for colonialism as colonial subjects continued to be
portrayed as childlike and driven by instinct, and therefore in need of moral guidance
and civilised culture.
In his chapter on ‘Arthur Keith, Race and the Piltdown Affair’, Sawday invites
us to unravel the story of a scientific fraud committed in 1912, by considering its
importance in the construction of racially fraught scientific theories and cultural
perceptions within the context of the changing political and nationalistic agenda in
Britain. When the skull of a human, with an ape-like jaw, was found in a Sussex
gravel-bed in 1912, British scientists were jubilant as the bones seemed to present
hard evidence for the hitherto speculative Darwinian assumption that modern
humans and modern apes shared the same origin. It also provided relief for those
who disliked the idea of a shared origin of the human race and, in particular, the
suggestion that in evolutionary terms Africa constituted the cradle of humankind.
Yet Piltdown Man remained entirely out of conformity with the fossil evidence
available from all over the world for about four decades. Sawday shows that while
it may indeed be intriguing to expose the perpetrator(s) of the initial fraud and their
particular motives, the question of why the planted evidence was accepted for so
long – some forty years until the belated detection of the swindle in 1953 – is
equally politically revealing and historically instructive. In fact, the importance of
Piltdown Man varied over the decades with the changing scientific preoccupations
and political agendas with which high-profile and public figures such as Arthur
Keith, one of the protagonists in the Piltdown affair, were affiliated.
At the time of the discovery of the curious skull in 1912, when the British, like
other European nations, were in pursuit of territorial expansion and still vitally
implicated in the scramble for Africa, Piltdown Man bolstered the colonial disdain
for ‘primitive peoples’ by lending credence to theories of two widely divergent
branches of human lineage, and thus of different racial origins of the white and the
coloured races, and the separation of the modern races in prehistoric times.
With the competing geopolitical claims of rival European powers in the colonial
sphere, the focus of politics, as well as science, came to be on ‘territoriality’ and
Introduction
23
racial origin – of the empire as much as of evolution. In the wake of World War I,
when issues of dominance and competing races at war in Europe were to the fore,
Piltdown Man was at the centre of debates about racial variation within one branch
of human lineage and the interrelationship of different populations belonging to the
same species of men. During the 1930s the rise of fascist and eugenics movements
facilitated an interpretation of the Piltdown ‘evidence’ both in terms of culture and
biology, in the conception of race as a distinction of the spirit as much as a physical
characteristic, of races struggling and fighting to preserve an archaic emotional
bond to ‘soil’ and ‘blood’. As a bearer of a biologised notion of culture, Piltdown
Man became in a complex way representative both of ‘Britishness’ (in reference to
‘race’) and ‘Englishness’ (in reference to locality) – until discovered to be a fraud.
Although the file on Piltdown Man is not yet closed, as the identity of its creator
remains obscure, the fraud exerted a genuine influence on British anthropology and
ideas of race, representing an example of how scientific, cultural and political
assumptions may be made on the basis of what appears to be ‘hard’ scientific
evidence.
Notes
1. J. Donald and A. Rattansi (eds), Race, Culture and Difference, London, Sage,
1992. F. Anthias and N. Yuval-Davis, Racialised Boundaries: Race, Nation,
Colour, Class and the Anti-Racist Struggle, London and New York, Routledge,
1992. P. Jackson and J. Penrose (eds), Constructions of Race, Place and Nation,
London, University College London Press, 1993. J. Rex and D. Mason (eds),
Theories of Race and Ethnic Relations, Cambridge, Cambridge University Press,
1986. D.T. Goldberg, Anatomy of Racism, Minneapolis, University of Minnesota
Press, 1990. D.T. Goldberg, Racist Cultures: Philosophy and the Politics of
Meaning, Oxford, Basil Blackwell, 1993. R. Young, Colonial Desire: Hybridity
in Theory, Culture and Race, London and New York, Routledge, 1995. J.
Fabian, Time and the Other: How Anthropology Makes its Object, New York,
Columbia University Press, 1983. L.M. Alcoff, ‘Philosophy and Racial
Identity’, Radical Philosophy 75 (Jan./Feb. 1996): 5–14. P. Gilroy, There Ain’t
No Black in the Union Jack: The Cultural Politics of Race and Nation, London,
Hutchinson, 1987. P. Gilroy, The Black Atlantic: Modernity and Double
Consciousness, London, Verso, 1993. D. LaCapra (ed.), The Bounds of Race:
Perspectives on Hegemony and Resistance, Cornell University Press, 1991.
H.L. Gates (ed.), Race, Writing and Difference, Chicago, University of Chicago
Press, 1986.
2. S. West (ed.), The Victorians and Race, Aldershot, Scolar Press, 1996, p. 1.
24
Waltraud Ernst
3. J. Solomos and L. Back, ‘Conceptualising Racisms: Social Theory, Politics and
Research’, Sociology 28, 1 (1994): 143–61, esp. p. 143. A. Brah, ‘Time, Place
and Others: Discourses of Race, Nation and Ethnicity’, Sociology 28, 3 (1994):
805–13. L.M. Alcoff, ‘Philosophy and Racial Identity’. L. Lieberman, B.W.
Stevenson, L.T. Reynolds, ‘Race and Anthropology: A Core Concept Without
Consensus’, Anthropology and Education Quarterly 20, 2 (1989): 67–73.
4. Work in the postcolonial tradition is by now too numerous and well known to
be cited. See for references to and a summary of the subaltern premises, G.C.
Spivak, ‘Subaltern Studies: Deconstructing Historiography’, in R. Guha (ed.),
Subaltern Studies IV: Writings on South Asian History and Society, Delhi,
Oxford University Press, 1985.
5. See, for example, on the danger of reifying race or ‘race’, and on its shadowy
companion, ‘whiteness’, Goldberg, Racist Cultures. V. Dominguez (ed.),
‘(Multi)Culturalisms and the Baggage of “Race” ’, Identities: Global Studies in
Culture and Power, 1, 4 (1995), special issue. Gilroy, The Black Atlantic. K.
Mercer, Welcome to the Jungle: New Positions in Black Cultural Studies, New
York, Routledge, 1994. R.W. Allen, The Invention of the White Race, London,
Verso, 1994. D.R. Roediger, The Wages of Whiteness: Race and the Making of
the American Working Class, London, Verso, 1991. R. Young, White
Mythologies: Writing History and the West, London, Routledge, 1990. V. Ware,
Beyond the Pale: White Women, Racism and History, London, Verso, 1992. C.
Hall, White, Male and Middle Class: Explorations in Feminism and History,
New York, Routledge, 1992.
6. A number of authors have argued against attempts to depoliticise race and have
critiqued in particular race- and ethnic-relations studies and authors who insisted
on the separation of research process and political action. See, for example, R.
Miles, Racism, London, Routledge, 1989. Centre for Contemporary Cultural
Studies, The Empire Strikes Back, London, Hutchinson, 1982. M. Banton,
Racial Theories, Cambridge, Cambridge University Press, 1986. J. Rex, Race
Relations in Sociological Theory, London, Weidenfeld & Nicolson, 1970.
7. D.A. Lorimer, ‘Race, Science and Culture: Historical Continuities and
Discontinuities, 1850–1914’, in S. West (ed.), The Victorians and Race,
Aldershot, Scolar Press, 1996, p. 12. See also Miles, Racism; Gilroy, Black
Atlantic.
8. G. Myrdal, ‘Der Balken in unserem Auge’, Asiatisches Drama: Eine
Untersuchung ueber die Armut der Nationen, Frankfurt, Suhrkamp,
1973, p. 13.
9. Myrdal,AsiatischesDrama,pp. 26–7.
Das Problem der Objektivitaet in der Forschung laesst sich nicht einfach
dadurch umgehen, dass man Wertungen auszuschalten versucht. Im
Gegenteil; jede Untersuchung eines sozialen Problems ist und muss
durch Wertungen bestimmt sein. Eine ‘interessenfreie Sozialwissenschaft’
hat es nie gegeben und wird es nie geben. Der Versuch, sich Wertungen
Introduction
25
zu entziehen, ist vergeblich and sogar schaedlich. Die Wertungen sind in
uns, auch wenn wir sie verdraengen, und sie leiten unsere Arbeit.
See also, for similar arguments, Solomos and Back, ‘Conceptualising Racisms’;
R. Miles and A. Phizacklea, Racism and Political Action in Britain, London,
Routledge, 1979; Gilroy, Black Atlantic; Centre for Contemporary Cultural
Studies, The Empire Strikes Back.
10. P. Gilroy, ‘Race Ends Here’, paper presented at Rethinking Ethnic and Racial
Studies, the Ethnic and Racial Studies Twentieth Anniversary Conference in
London, May 1997.
11. See, for example, the discussion surrounding the ‘bell curve’. S. Fraser (ed.),
The Bell Curve Wars: Race, Intelligence and the Future of America, New York,
Basic Books, 1995. S. Jones, In the Blood: God, Genes and Destiny, London,
HarperCollins, 1996. D. Nelkin, ‘The Politics of Predisposition: The Social
Meaning of Predictive Biology’, in A. Heller and S. Puntscher Riekmann (eds),
Biopolitics. The Politics of the Body, Race and Nature, Aldershot, Avebury,
1996, pp. 133–43.
12. See, on the coding of race as culture, discussion and references on pp. 6–7 of
this chapter.
13. See, for example, T. Todorov, On Human Diversity: Nationalism, Racism and
Exoticism in French Thought, Cambridge, MA, Harvard University Press,
1993. W. Kymlicka, Multicultural Citizenship, Oxford, Clarendon Press, 1995.
K. Malik, The Meaning of Race: Race, History and Culture in Western Society,
London, Macmillan, 1996. Goldberg, Anatomy of Race.
14. House of Commons Speech (1 February 1849), quoted in H. Odom,
‘Generalizations on Race in Nineteenth-Century Physical Anthropology’, Isis
85 (1967): 9, and in M.D. Biddis (ed.), Images of Race, Leicester, Leicester
University Press, 1979, p. 16.
15. D. MacDonald – a former member of the Indian Medical Service and author of
Surgeons Twoe and a Barber: Being Some Account of the Life and Work of the
Indian Medical Service (1600–1947), London, Heinemann, 1950 – placed in
the front pages of his book Marshal H. Lyautey’s epigram that ‘La seule
excuse de la colonisation c’est le médecin’.
16. N. Stepan, ‘Race, Science and Medicine: Citizenship and the Natural’ (p. 8),
paper presented at the conference on Race, Science and Medicine in
Southampton, September 1996. See also Section 2 (entitled ‘Science Constructs
“Race” ’) in Sandra Harding’s recent edited book, The ‘Racial’ Economy of
Science: Towards a Democratic Future, Bloomington and Indianapolis, Indiana
University Press, 1993.
17. See, for an analysis of the conflation of race and ethnicity in regard to citizenship
and nationship, and for debates about new racism in Britain, Gilroy, Black
Atlantic, There Ain’t No Black in the Union Jack and ‘Race Ends Here’. Donald
and Rattansi, Race, Culture and Difference. M. Guibernau and J. Rex (eds),
26
Waltraud Ernst
The Ethnicity Reader: Nationalism, Multiculturalism and Migration, Cambridge,
Polity Press, 1997.
18. As Porter pointed out in respect to the case of history of medicine: ‘the terrain
of healing has always been characterized by great diversity’; R. Porter (ed.),
The Popularization of Medicine, 1650–1850, London, Routledge, 1992, p. 1.
See also R. French and A. Wear (eds), British Medicine in an Age of Reform,
London, Routledge, 1991; W.F. Bynum, Science and the Practice of Medicine
in the Nineteenth Century, Cambridge, Cambridge University Press, 1992; R.
Cooter (ed.), Studies in the History of Alternative Medicine, Houndsmill,
Macmillan, 1988.
19. N. Stepan, The Idea of Race in Science, London, Macmillan, 1982. E. Barkan,
The Retreat of Scientific Racism: Changing Concepts of Race in Britain and the
US between the World Wars, Cambridge, Cambridge University Press, 1992.
M. Kohn, The Race Gallery: The Return of Racial Science, London, Vintage,
1995. Much of the impetus for historical reassessments of race is due to the
work of historically grounded as well as theoretically challenging authors such
as H. Bhabha, ‘The Other Question: Difference, Discrimination and the
Discourse of Colonialism’, in F. Barker et al. (eds), Literature, Politics and
Theory: Papers from the Essex Conferences, 1976–84, London and New York,
Methuen, 1986; R. Guha and G.C. Spivak (eds), Selected Subaltern Studies,
New York, Oxford University Press, 1988. They have shown that ideas of race
were created and disseminated by Western nations in the wake of industrial
transformation, colonial expansion and the spread of the ‘project of modernity’.
See also Harding, The ‘Racial’ Economy of Science.
20. Barkan, The Retreat of Scientific Racism. H. Kuklick, The Savage Within: The
Social History of British Anthropology, 1885–1945, Cambridge, Cambridge
University Press, 1991. P. Rich, Prospero’s Return? Historical Essays on
Race, Culture and British Society, London, Hansib, 1994. G. Richards, ‘Race’,
Racism and Psychology: Towards a Reflexive History, London, Routledge,
1997. G. Stocking Jr, Race, Culture and Evolution: Essays in the History of
Anthropology, New York, Free Press, 1969.
21. Furthermore, the ability to fluctuate between different perspectives has also
the effect of increasing the appeal and support-base of racial discourse to a
wider (and variably motivated) spectrum of people. This point is of particular
relevance in respect to political mobilisation along the lines of discourses of
citizenship, nation and nationalism. See, for examples, J. Wrench and J. Solomos
(eds), Racism and Migration in Western Europe, Oxford, Berg, 1993; Gilroy,
There Ain’t No Black in the Union Jack.
22. Heller and Puntscher Riekmann (eds), Biopolitics. See also discussion of the
contention that ‘Race is irrelevant, but all is race’ by Goldberg, Racist Cultures,
p. 6.
23. Attempts by authors in the postmodern tradition to expose as contradictory
and conceptually flawed the essentialism and universalism inherent in
Enlightenment concepts and in theories derived from them, have themselves
Introduction
27
run the danger of over-homogenising and essentialising. See on this point, for
example, the debate between G. Prakash, ‘Writing Post-Orientalist Histories
of the Third World’, Comparative Studies in Society and History 32 (1990):
383–408. R. O’Hanlon and D. Washbrook, ‘After Orientalism: Culture,
Criticism, and Politics in the Third World’, Comparative Studies in Society and
History 34 (1992): 141–67. G. Prakash, ‘Can the “Subaltern” Ride? A Reply to
O’Hanlon and Washbrook’, Comparative Studies in Society and History 34
(1992): 168–84.
24. Solomos and Back, ‘Conceptualizing Racisms’, p. 156.
25. See, for example, the recent call for papers for a special issue of International
Review of Social History Supplement 1999 on the subject of ‘Complicating the
Categories: Gender, Class, Race and Ethnicity in Western and Non-Western
Societies’ (announceh-net.msu.edu).
26. V.G. Kiernan, The Lords of Human Kind: European Attitudes towards the
Outside World in the Imperial Age, Harmondsworth, Penguin 1972, p. 33.
27. Part of the earlier academic controversies between theorists such as Banton,
Miles, Rex and the Centre for Contemporary Cultural Studies, for example,
can be accounted for by the relative importance attributed to class in contrast
to other analytical dimensions.
28. Brah, ‘Time, Place and Others: Discourses of Race, Nation and Ethnicity’, p.
806.
29. R. O’Hanlon, ‘Cultures of Rule, Communities of Resistance: Gender, Discourse
and Tradition in Recent South Asian Historiographies’, Social Analysis 23
(1989): 106.
30. R. Lewis, Gendering Orientalism: Race, Femininity and Representation,
London, Routledge, 1996. E. Said, Orientalism, Harmondsworth, Penguin,
[1979] 1985.
31. M. Sinha, Colonial Masculinity: The ‘Manly Englishman’ and the ‘Effeminate
Bengali’ in the Late Nineteenth Century, Manchester, Manchester University
Press, 1995.
32. See for gendered and racialised representations of non-Europeans in children’s
history textbooks and periodicals, K. Castle, Britannia’s Children: Reading
Colonialism through Children’s Books and Magazines, Manchester,
Manchester University Press, 1996. See for the rationales underlying such
representations, A.L. Stoler, ‘Rethinking Colonial Categories: European
Communities and the Boundaries of Rule’, Comparative Studies in Society and
History 31, 1 (1989): 134–60. B. Anderson, Imagined Communities: Reflections
on the Origin and Spread of Nationalism, London, Verso, 1983.
33. Anderson, Imagined Communities. In regard to colonial psychiatry, see W.
Ernst, ‘Idioms of Madness and Colonial Boundaries: The Case of the European
and “Native” Mentally Ill in Early Nineteenth-Century British India’,
Comparative Studies in Society and History 39, 1 (1997): 153–81.
34. ‘Charles Kingsley: His Letters and Memories of His Life’ (edited by his wife,
1877), vol. 2, p. 107, quoted from M.D. Biddiss, Images of Race, Leicester,
28
Waltraud Ernst
Leicester University Press, 1979, p. 30. See also L.P. Curtis, Anglo-Saxons
and Celts: A Study of Anti-Irish Prejudice in Victorian England, New York,
New York University Press, 1968; S. Gilley, ‘English Attitudes to the Irish,
1780–1900’, in C. Holmes (ed.), Immigrants and Minorities in British Society,
London, Allen & Unwin, 1978; S.B. Cook, Imperial Affinities: NineteenthCentury Analogies and Exchanges between India and Ireland, New Delhi,
Sage, 1993.
35. N. Ignatiev, How the Irish Became White, London, Routledge, 1995.
36. For literature on the later period, when the ‘implosion of Empire’ occurred
(namely when groups from former colonial countries became resident within
the core culture), see W.), The Politics of ‘Race’ and Health, Bradford, Race
Relations Research Unit, University of Bradford, 1992; L. Marks and M.
Worboys (eds), Migrants, Minorities and Health: Historical and Contemporary
Studies, London, Routledge, 1997.
37. For an excellent book that focuses on discourses of race as represented in art
and literature in particular, see West, The Victorians and Race.
Chapter 2
W ester n medicine and r acial
constitutions
Surgeon John Atkins’ theory of
polygenism and sleepy distemper
in the 1730s
Norris Saakwa-Mante *
A new, natural-historical, essentially non-theological conception of race emerged in
Europe and the British Isles from the mid-seventeenth to the mid-eighteenth century.
Three developments at least were responsible for the emergence of this new naturalhistorical conception of race. First, the possibility of truly global travel following
the first circumnavigation of the Earth was a social change with enormous
consequences. Second, a new awareness of the different physical appearance of
the world’s people derived from new transcontinental population movements (e.g.
the Atlantic Slave Trade and European emigration to the New World) had a major
effect. Third, the application of the values and naturalising epistemology of the
seventeenth-century Scientific Revolution (however defined)1 to the different
physical appearance of the human species as a whole, made possible a new
theoretical vocabulary for fabricating race, or gave new meanings to old terms.
These developments, among others, produced the conditions for the emergence of
race.2
Naturalised constructions of race emerged, or were forged, as a product of very
specific interaction and conflict between two intellectual traditions which have
been labelled monogenist and polygenist traditions, beginning in the 1680s and
1690s.3 Monogenism includes and is sometimes identified with the assertion that
all men and women originated from a single couple. Polygenism includes and is
sometimes identified with the assertion that physically diverse groups of men and
women could not have originated from a single couple and that there must have
* I wish to thank Mark Gosbee, Mark Harrison, Christopher Lawrence, Clare Midgley, Roy Porter and
Molly Sutphen for comments on earlier drafts of this paper and for their helpful criticisms.
30
Norris Saakwa-Mante
been multiple original couples, or ‘first parents’, in the formulation sometimes
given. By the second half of the eighteenth century, monogenism had become the
assertion that all humans belonged to a single species and polygenism the assertion
that people of diverse physical appearance belonged to different species. The idea
of using species-difference to represent race is relatively rare in the mid-seventeenthto mid-eighteenth-century period that is focused on here, rare but not unknown.4
Monogenism is the naturalistic version (and genealogical descendant) of the
creation narrative contained in Genesis.5 It is a natural philosophical rather than
(mainly) religious viewpoint, and as such it argues (in the period before the nineteenth
century) that environmental factors cause differences in physical appearance.6
Polygenism is the naturalistic transformation (and genealogical descendant) of the
‘men before Adam’ or ‘pre-Adamite’ thesis.7 As a natural philosophical viewpoint,
polygenism denies environment has the power to cause differences in physical
appearance, and argues that only differential descent from a different ancestor can
account for the bodily differences that come to be called racial difference.
The principal subject of this chapter is the racial and medical theory contained
in the surgical manual of John Atkins (1685–1757). This manual, The Navy-Surgeon,8
is of great interest as one of the few eighteenth-century medical texts with both a
clearly identifiable and formulated conception of race, and a series of ideas about
disease shaped by the built-in conception of race. Atkins’ view of race is a
recognisable part of the polygenist tradition. Eighteenth-century polygenists are
relatively little studied and John Atkins is no exception. Interestingly, this is true
despite the fact that Atkins’ polygenism was flagged as early as 1863–4 by the
Victorian classicist, historian and member of the Anthropological Society of London,
Thomas Bendyshe.9
In this chapter, I do not make claims for John Atkins as a major figure of
eighteenth-century naval surgery/medicine, or as a dominant figure in the early
eighteenth-century medicine of regions outside Europe.10 What I do claim for John
Atkins, however, is that the ideas contained in the relevant section of his surgical
manual are an exemplification of a much wider cultural shift in European attitudes
to race, beginning in the mid-seventeenth century. It is a shift that led to racial
difference being perceived, analysed and constructed as one of the most important
Western medicine and racial constitutions
31
forms of bodily difference by the end of the eighteenth century and into the
nineteenth.11 I suggest that the ideas contributed by The Navy Surgeon are important
for the way they signal the emergence of an independent role played by medicine
in the construction of ideas of bodily difference. Medicine, as a practice and
theoretical field concerned with disease, by this method contributed to constructing
race in the eighteenth century. I also argue that his writing is one of the very few
sites in eighteenth-century medicine where polygenist ideas and a racial
constitution–construct underlying a disease aetiology come together in the same
text and in the same author.
In the following section I outline one of the leading eighteenth-century trends –
the neo-Hippocratic revival of environmental medicine – from which John Atkins’
work constitutes a departure. Following this section I discuss in detail Atkins’
polygenist ideas and their possible relationship to concepts of the racial constitution.
In subsequent sections I discuss in detail Atkins’ theory of the causation of sleepy
distemper. I treat first his construction of its non-constitutional cause. I treat
second his construction of its two constitutional causes. A final section considers
John Atkins’ significance for the eighteenth century.
Neo-Hippocratic theory and environmental
medicine to 1730
For the 1730s and within the medical culture of the early eighteenth century more
generally, John Atkins’ ideas have a degree of relative novelty. They stand out and
seem somewhat exceptional. While I do not wish to suggest his ideas were entirely
without precedent in earlier periods, since I have no doubt precedents exist, I do
wish to emphasise that John Atkins’ ideas seem to be part of a new development.
They were, as I have suggested, part of the wider cultural shift that has been
described above, which led to the development of new naturalistic (as opposed to
biblical, theological or mythological) understandings of race.12 Within medicine
itself, taken as a discrete component of intellectual culture and practice, Atkins’
ideas represented a major departure from influential seventeenth-century and early
eighteenth-century currents.
One of the influential currents of seventeenth-century medicine was an emphasis
on environmental factors in the aetiology of disease. James C. Riley has argued that
32
Norris Saakwa-Mante
the Hippocratic view of disease and its relationship to environmental factors has
exercised a large and profound influence over medicine in Western Europe,
particularly since the early modern period.13 According to Riley, in the second half
of the seventeenth century, physicians still adhering to classical insights shifted
emphasis away from Galen and the attribution of disease to disorder within humans,
towards a revived Hippocratic notion of disease as the product of disorder between
humans and their environment.14 This aspect of seventeenth- and eighteenth-century
medicine has been studied by a number of historians and I will here merely allude
to some of the intellectual figures whose work most clearly embodies this
‘environmental medicine’ (the term used by James Riley and Ludmilla Jordanova)
in the period before Atkins’ own publication.15
Two key figures in the development of environmental medicine were Thomas
Sydenham (‘the English Hippocrates’) and Robert Boyle. Boyle, while being a
leading proponent of experimental practice and the mechanical philosophy within
the Royal Society, also had a strong interest in medical cures and understanding the
cause of disease.16 Boyle endorsed the view that epidemics might be caused by
emanations from the earth and from diseased persons, focusing on the idea of
inorganic subterranean corpuscular emanations mixed with other atmospheric
elements. Boyle, Riley argues, more generally aided the focus on the atmosphere as
a possible cause of disease by investigating the properties of the atmosphere,
thereby directing attention to the air as a major realm of scientific inquiry.17
As an admirer of Hippocrates, Sydenham accepted environmental factors as
causal agents behind disease. He affirmed Boyle’s ideas about emanations from the
earth and from diseased persons. Indeed, Riley suggests that Sydenham, like
Hippocrates, identified five phenomena as probably important aetiological elements
behind manifestations of disease: heat, cold, moisture, dryness and emanations
(from the earth and from pathological matter, whether human, animal or inanimate).
He thought that breathing might be the method by which disease-causing agents
entered the body of a healthy individual. He attributed certain diseases, such as
intermittent fever and pleurisy, to climate and weather factors; other diseases, such
as plague, were attributed to emanations from the earth or diseased bodies; yet
other diseases, such as gout, were attributed to humoral imbalance. Riley makes
Western medicine and racial constitutions
33
the further point that there is a good deal of ambiguity about the ideas of the
epidemic, atmospheric and environmental constitutions that are found in
Sydenham’s writings, and a great deal of ambiguity about just how environmental
factors interacted to cause disease.18
Riley makes the point that no coherent statement of the content, aims and
methods of environmental medicine existed in print until the publication of John
Arbuthnot’s An Essay Concerning the Effects of Air on Human Bodies in 1733, the
year before Atkins’ publication of The Navy-Surgeon. I am not arguing that Atkins
read Arbuthnot (although he might have), or that he was steeped in the writings of
Robert Boyle and Thomas Sydenham. Rather I suggest that ideas about the
environmental aetiology of epidemic and endemic disease were extremely widespread
in late seventeenth-century/early eighteenth-century medicine, and that they were
influential both by virtue of presumed derivation from Hippocrates and through
authoritative contemporary exponents. On this basis it seems likely that there
would have been a strong presumption towards, or favouring of, physicians and
surgeons constructing interpretations of disease which drew upon the environmental
medicine developed by Sydenham, Boyle, Arbuthnot and others. John Atkins’
regional medicine, in contrast, does not deploy these resources. It represents a
departure from this framework.
Polygenist constructs and racial
constitutions
John Atkins’ regional medicine forms a part of the literature of pre-Mansonian
tropical medicine which predates the adoption of germ theory and its application
to tropical disease.19 The term ‘warm climates’ rather than ‘tropical’ has been used
recently by historians to designate the tropical medicine of this earlier period,
partly because the phrase ‘warm climates’ had a strong contemporary resonance
and because it underlines the fact that germ theory played no role in warm climate
medical knowledge. The part of Atkins’ surgical manual in which these discussions
occur (to be found in the Appendix to the 1734 edition) is derived from an expedition
to the Guinea Coast near the end of his naval career in 1721–2, on board HMS
Swallow and Weymouth. The expedition’s purpose was to protect British
merchantmen trading in slaves from pirates, and to capture and hang as many of
34
Norris Saakwa-Mante
those pirates as possible.20 The Navy mission was to make the seas off the Guinea
Coast safe for slave-traders. In the course of the expedition, one of the two navy
ships engaged in an action which killed the famous pirate commander, Bartholomew
Roberts. Captain Chaloner Ogle of the Swallow later received a knighthood, partly
as a consequence of this early success. John Atkins published his journals of the
voyage over a decade later, possibly stimulated by the notoriety that attached to
the expedition.21
Atkins’ surgical manual contains discussions of fevers and fluxes of the ships’
crews; these were widely understood to be afflictions of warm climates. He also
discusses diseases he believes to be found uniquely in the eighteenth-century
African constitution or to have unique manifestations within that constitution. In
particular he identifies four diseases: three diseases – yaws, chicoes, croakra – are
given their eighteenth-century African names and a fourth disease – sleepy distemper
– is given an English name.22 This fourth disease he says is ‘called, by Europeans
the Sleepy Distemper’. This is a pointer to the fact that the English name itself
predated his arrival. With all four diseases Atkins offers something new. For each
he describes symptoms, suggests an aetiology and prescribes treatment. All four
descriptions suggest he had direct contact with patients and attempted treatments
himself. They indicate he was not just summarising local African, or locally resident
European knowledge of these diseases. He was presenting knowledge based on
personal experience. Nevertheless it is almost certain that he relied heavily on a
local antecedent knowledge-base for identification of these clinical symptom
patterns. Though some of these diseases had been described earlier, Atkins’
relationship to this earlier literature is unknown.23
The disease we will focus on in this chapter is sleepy distemper. It is here we
will seek the connections between concepts of race and concepts of disease. John
Atkins describes many of the clinical symptoms of sleepy distemper in ways that
are recognisable to modern observers. He also describes the course of the illness,
susceptible age-groups and methods of treatment. His description is fairly full and
detailed by eighteenth-century standards, but he has some of that century’s tendency
to therapeutic optimism. Though he believes the disease is usually fatal, he believes
cure is possible in some cases:
The Sleepy Distemper (common among the Negroes) gives no other previous
Notice than a Want of Appetite two or three Days before; Their Sleeps are
Western medicine and racial constitutions
35
[pro]found, and Sense of Feeling very little; for pulling, drubbing, or whipping,
will scarce stir up Sense and Power enough to move; and the Moment you
cease beating the Smart is forgot, and down they fall again into a State of
Insensibility, driviling constantly from the Mouth, as in deep Salivation;
[they] breath slowly, but not unequally, nor snort.24
And he believes young adults are more frequent victims than the aged:
Young People are more subject to it than the Old; and the Judgement generally
pronounced is Death, the Prognostick seldom failing. If now and then one of
them recovers, he certainly loses the little Reason he had, and turns Ideot.25
He applies the full range of eighteenth-century heroic therapeutics to the
treatment of the disease, including bleeding in the jugular and, interestingly for the
eighteenth century, acupuncture:
The Cure is attempted by whatever rouzes the Spirits, bleeding in the Jugular,
quick Purges, Sternutories, Vesicatories, Acu-Puncture, Seton, Fontanels, and
sudden Plunges into the sea; the latter is most effectual when the Distemper
is new, and the Patient as yet not attended with a driviling at Mouth and
Nose.26
The inner core of Atkins’ thinking about the causation of sleepy distemper is
his view that the production of a superabundance of phlegm is the immediate cause
of the disease. This is basically a traditional humoral approach to disease.27 As we
can see from the passage below, however, Atkins is not satisfied with the humoralist
explanation, as traditionally conceived, and seeks deeper explanations. He seeks
the procatarctic cause (defined by the OED as the cause that begins other causes,
and in this case the cause(s) that begin(s) the immediate cause). It is in seeking
these procatarctic causes that he innovates, going beyond and outside traditional
humoralism.
To return, the immediate cause of this deadly Sleepiness in the Slaves, is
evidently a Super-abundance of Phlegm, or Serum, extravased in the Brain,
36
Norris Saakwa-Mante
which obstructs the Irradiation of the Nerves; but what the procatartick [sic]
Causes are, that exert to this Production, eclipsing the Light of the Senses, is
not so easily assigned.28
Turning to John Atkins’ polygenist construct, it has already been noted in the
introduction how Atkins articulated the doctrine of polygenism, the concept that
different human racial groups, distinguished primarily by colour, have different
origins.29 It is now time to flesh out that general account of polygenism with the
details of Atkins’ specific account. This is how Atkins sets up the problem:
From the River Senega in Africa, 15 [degrees] N. to almost its Southern
Extremity in 34 [degrees] they are all black and woolly, the natural Cause of
which, must ever perplex Philosophers. I know Malpighius, and from him
others, ascribe these different Colours in Men to a Tinge from that reticular or
mucous Substance under the Cuticle, not considering the Question as strongly
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