Table Of ContentWESTERN MEDICINE AS
CONTESTED KNOWLEDGE
EDITED BY ANDREW CUNNINGHAM AND BRIDIE ANDREWS
general editor John M. MacKenzie
When the ‘Studies in Imperialism’ series was founded by
Professor John M. MacKenzie more than thirty years ago,
emphasis was laid upon the conviction that ‘imperialism
as a cultural phenomenon had as significant an effect on
the dominant as on the subordinate societies’. With well
over a hundred titles now published, this remains the
prime concern of the series. Cross-disciplinary work has
indeed appeared covering the full spectrum of cultural
phenomena, as well as examining aspects of gender and
sex, frontiers and law, science and the environment,
language and literature, migration and patriotic societies,
and much else. Moreover, the series has always wished to
present comparative work on European and American
imperialism, and particularly welcomes the submission of
books in these areas. The fascination with imperialism, in
all its aspects, shows no sign of abating, and this series
will continue to lead the way in encouraging the widest
possible range of studies in the field. Studies in
Imperialism is fully organic in its development, always
seeking to be at the cutting edge, responding to the latest
interests of scholars and the needs of this ever-expanding
area of scholarship.
AVAILABLE IN THE SERIES
Propaganda and empire
The manipulation of British public opinion, 1880–1960 John M. MacKenzie
Imperialism and popular culture
ed John M. MacKenzie
‘At duty’s call’
A study in obsolete patriotism W. J. Reader
Images of the army
The military in British art, 1815–1914 J. W. M. Hichberger
The empire of nature
Hunting, conservation and British imperialism John M. MacKenzie
Imperial medicine and indigenous societies
ed. David Arnold
Imperialism and juvenile literature
ed. Jeffrey Richards
Asia in Western fiction
ed. Robin W. Winks, James R. Rush
Empire and sexuality
The British experience Ronald Hyam
Imperialism and the natural world
ed. John M. MacKenzie
Emigrants and empire
British settlement in the dominions between the wars ed. Stephen Constantine
Revolution and empire
English politics and the American colonies in the seventeenth century Robert M. Bliss
Air power and colonial control
The Royal Air Force, 1919–39 David E. Omissi
Acts of supremacy
The British Empire and the stage, 1790–1930 J. S. Bratton et al.
Policing the Empire
Government, authority and control, 1830–1940 ed. David Anderson, David Killingray
Policing and decolonization
Nationalism, politics and the police, 1917–65 ed. David Anderson, David Killingray
Popular imperialism and the military, 1850–1950
ed. John M. MacKenzie
The language of empire
Myths and metaphors of popular imperialism, 1880–1918 Robert H. MacDonald
Travellers in Africa
British travelogues, 1850–1900 Tim Youngs
Unfit for heroes
Reconstruction and soldier settlement in the empire between the wars Kent Fedorowich
Colonial masculinity
The ‘manly Englishman’ and the ‘effeminate Bengali’ Mrinalini Sinha
Geography and imperialism, 1820–1940
ed. Morag Bell, Robin Butlin, Michael Heffernan
‘An Irish Empire?’
Reading colonialism through children’s books and magazines Keith Jeffery
Britannia’s children
Aspects of Ireland and the British Empire Kathryn Castle
Western medicine as
contested knowledge
edited by Andrew Cunningham
and Bridie Andrews
MANCHESTER UNIVERSITY PRESS
Manchester
Copyright © Manchester University Press 1997
While Copyright as a whole is vested in Manchester University Press,
copyright in individual chapters belongs to their respective authors, and no chapter
may be reproduced wholly or in part without the express permission in writing of
both author and publisher.
Published by MANCHESTER UNIVERSITY PRESS
ALTRINCHAM STREET, MANCHESTER, M1 7JA, UK
www.manchesteruniversitypress.co.uk
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
Western medicine as contested knowledge / edited by Andrew Cunningham
and Bridie Andrews
p. cm. — (Studies in Imperialism)
ISBN 0–7190–4673–4
1. Public health—Political aspects—Developing countries.
2. Imperialism. 3. Traditional medicine—Developing countries.
4. Social medicine—Developing countries. 5. Medicine—Political
aspects—Developing countries. I. Cunningham. Andrew, Dr.
II. Andrews, Bridie. III. Series: Studies in imperialism
(Manchester, England)
RA441. 5. W47 1997
306. 4(cid:31)61—dc20 96–34392
CIP
ISBN 0 7190 4673 4 hardback
The publisher has no responsibility for the persistence or accuracy of URLs for any
external or third-party internet websites referred to in this book, and does not guarantee
that any content on such websites is, or will remain, accurate or appropriate.
CONTENTS
General introduction — page vii
The contributors — page viii
Acknowledgements — page ix
Introduction: Western medicine as contested
knowledge
Andrew Cunningham and Bridie Andrews page 1
1 WHO and the developing world: the contest for
ideology
Sung Lee 24
2 AIDS from Africa: Western science or racist
mythology?
Rosalind J. Harrison-Chirimuuta 46
3 Elders and experts: contesting veterinary knowledge
in a pastoral community
Richard Waller and Kathy Homewood 69
4 Dances with doctors: Navajo encounters with the
Indian Health Service
Stephen J. Kunitz and Jerrold E. Levy 94
5 What/who should be controlled? Opposition to yellow
fever campaigns in Brazil, 1900–39
Ilana Löwy 124
6 The hook of hookworm: public health and the politics
of eradication in Mexico
Anne-Emanuelle Birn and Armando Solórzano 147
7 Unequal contenders, uneven ground: medical encounters
in British India, 1820–1920
Deepak Kumar 172
[ v ]
CONTENTS
8 Plural traditions? Folk therapeutics and ‘English’
medicine in Rajasthan
Helen Lambert 191
9 The reduction of personhood to brain and rationality?
Japanese contestation of medical high technology
Emiko Ohnuki-Tierney 212
10 Rumoured power: Hong Kong, 1894 and Cape Town,
1901
Mary Preston Sutphen 241
11 Drug-resistant malaria: a global problem and the Thai
response
Helen Power 262
Guide to further reading — page 287
Index — page 291
[ vi ]
GENERAL INTRODUCTION
The symbiotic relationship between imperialism and the development of
Western intellectual disciplines and their practical application in the
nineteenth and twentieth centuries has recently been subjected to increasing
scrutiny. This has been particularly true of medical history, since Western
medicine was both profoundly influenced by, and established hegemonic
relationships through, encounters with the rest of the world during the
imperial era. European medical practitioners, their methodologies still in the
process of formulation, embarked upon their own patterns of social and
scientific dominance. Through medicine and its related disciplines, the West
assured itself that it was capable of diagnosing the bodily ills of the indigenous
peoples of empire as part of its wider cultural, political and economic project.
Such a medical conquest far exceeded the formal boundaries of empire.
Western doctors conceived a mission, scarcely less fervent than that of the
Christian missionaries with whom they were often associated, to take their
insights to the furthest corners of the world. Many missionaries – Livingstone
was perhaps the most celebrated example – adopted medicine as a prime
vehicle for imparting Christian values and ultimately beliefs. Within formal
empire, medicine and its practitioners enjoyed high prestige, soon establishing
powerful administrative networks and close connections with the armed
forces, services associated with the environment, and educational institutions.
It thus became both a significant cultural marker of imperial superiority and
an acknowledged, if often exaggerated, facilitator of the white presence and
dominance in the wider world.
It is, then, not surprising that its pervasive authority should have had little
difficulty in surviving into the post-imperial age. Despite its comparatively
limited focus in the understanding of health, illness, diagnosis and treatment,
despite the modern fascination with alternative medical traditions, it is still
invariably privileged as a superior ‘scientific’ system. This has had a profound
influence on health-related international organisations and the social and
cultural analysis of ‘epidemics’, of which AIDS is perhaps the best example.
This volume examines many of the issues associated with the relationship
of medicine and power, together with the grappling of indigenous and Western
medical systems. The studies that follow extend their concerns beyond the
conventional boundaries of both empire and human medicine. They attempt
some global comparative analysis. They embrace major Asian cultures where
the contest between traditional methodologies and those of the West has been
particularly acute. And they recognise that veterinary science, when applied to
domestic stock, opens up fresh areas of conflict which can profoundly influence
human health. Together they represent a significant stage in the recent highly
rewarding research into the relationship between medicine and imperialism.
John M. MacKenzie
[ vii ]
THE CONTRIBUTORS
BRIDIE ANDREWS, Department of History, School of Oriental and African
Studies, University of London.
ANNE-EMANUELLE BIRN, Department of Health Policy and Historical
Studies at the New School for Social Research in New York City.
ANDREW CUNNINGHAM, Wellcome Unit for History of Medicine,
Department of History and Philosophy of Science, University of Cambridge.
ROSALIND J. HARRISON-CHIRIMUUTA, consultant ophthalmologist in
south-east Staffordshire, co-author of Aids, Africa and Racism (1987).
KATHY HOMEWOOD, Department of Anthropology, University College,
London.
DEEPAK KUMAR, National Institute of Science, Technology and
Development Studies, New Delhi.
STEPHEN J. KUNITZ, Department of Community and Preventative Medicine,
University of Rochester, New York.
HELEN LAMBERT, Department of Anthropology, London School of Hygiene
and Tropical Medicine.
SUNG LEE, Stanford Medical School, Stanford, California.
JERROLD E. LEVY, Department of Anthropology, University of Arizona,
Tucson.
ILANA LÖWY, INSERM, Unité 158, Hôpital des Infants Malades, Paris.
EMIKO OHNUKI-TIERNEY, Department of Anthropology, University of
Wisconsin, Madison.
HELEN POWER, Department of Economic and Social History, University of
Liverpool.
MARY PRESTON SUTPHEN, Department of the History of the Health
Sciences, University of California, San Francisco.
ARMANDO SOLÓRZANO, Department of Family and Consumer Studies,
and Ethnic Studies Program at the University of Utah, Salt Lake City.
RICHARD WALLER, Department of History, Bucknell University, Lewisburg,
Pennsylvania.
[ viii ]
ACKNOWLEDGEMENTS
For advice and assistance we are grateful to David Arnold, C. A. Bayly,
Michael Bravo, Lionel Carter, Arne Hessenbruch, Tamara Hug, Christopher
Pinney and Molly Sutphen. We are particularly grateful to the series editor,
John MacKenzie, for his enthusiastic support of the project from the beginning.
[ ix ]
