Leprosy and Empire: A Medical and Cultural History.
Article Type: Book review
Author: Parle, Julie
Pub Date: 03/22/2009
Publication: Name: Journal of Social History Publisher: Journal of Social History Audience: Academic Format: Magazine/Journal Subject: History; Sociology and social work Copyright: COPYRIGHT 2009 Journal of Social History ISSN: 0022-4529
Issue: Date: Spring, 2009 Source Volume: 42 Source Issue: 3
Topic: NamedWork: Leprosy and Empire: A Medical and Cultural History (Nonfiction work)
Persons: Reviewee: Edmond, Rod
Accession Number: 197666906
Full Text: Leprosy and Empire: A Medical and Cultural History. By Rod Edmond (Cambridge: Cambridge University Press, 2006. ix plus 255 pp.).

In his Introduction to Leprosy and Empire: A Medical and Cultural History, Rod Edmond, Professor of Modern Literature and Cultural History at the University of Kent explains that he is not a "historian of medicine, but a literary-cumpostcolonial critic of strongly historicist bent." His study of the modern history of leprosy (1) is situated in the "new imperial history" which seeks to show how metropole and colony were "mutually constitutive" [p. 17]. What follows is a series of chapters which, in varied ways, explore how responses to leprosy in the nineteenth and twentieth centuries may illuminate important aspects of imperialism in the colonies as well as how the colonial experience fostered--or rekindled--concerns of contamination, contagion, infection and degeneration within the metropolitan powers themselves.

Edmond argues that despite the now known fact that leprosy is not a readily communicable infection, it has long been so stigmatized in Judeo-Christian cultures because "the leprous body challenges the fundamental distinction between life and death, putrefying and decomposing while alive and still able to reproduce" [p.3]. In the Western European Middle Ages, lepers were stigmatized, banished and on occasion persecuted. Leprosy however appears to have been less of a concern in the sixteenth and seventeenth centuries when, as Foucault has famously argued, "the leper"--as a target of disciplinary regimes of exclusion--was succeeded by "the lunatic" and "the criminal." Edmond, following Zachary Gussow, shows that in the era of high imperialism leprosy resurged as a matter of medical, sanitary and cultural anxieties. It was "retainted" with a new sexualised and racialised metaphorical language which associated the source of the bacillus with the tropics and especially with Africans and indentured workers from India and China [p. 6]. The new age of scientific medicine did not offer immediate answers either. Instead, as Laura Otis has argued, the development of germ theory in the 1870s meant that there was widespread anxiety that "[I]mperial cell bodies might be in danger from colonized ones, even in the metropolitan centres, and there was concern about the health and the integrity of the national body at home and the imperial body overseas" [p. 11].

Conceding that medical historians are more likely to date the impact of the concept of "invading germs" until later in the 1800s, Edmond readily acknowledges that there are significant difficulties in the trans-disciplinary approach he takes which draws from a wide variety of (mostly secondary) sources and perspectives. More conventional social and medical historians, for instance are likely to be intrigued, but somewhat wary, of Edmond's theoretical trajectory which, via the lens of leprosy, includes the work of Paul Gilroy on "camp-thinking" in which the social order wrought in the colonies fed into racialised nationalisms and models of "inclusion and exclusion which were eventually brought home to Europe in the form of Nazi genocide" [pp. 12-13]. Edmond draws too on Giorgio Agamben's analysis of the biopolitics of modernity which reduce some to "bare life" in order to keep them outside the camp of civilized humanity. In the chapters which follow Edmond seeks to interrogate these ideas so as to "... historicise the processes that Foucauldian cultural history and theory conceptualise, and to suggest that they were not always as totalitarian and clear-cut as Gilroy and Agamben ... assume." Instead, Edmond wants to suggest "a more conflicted genealogy and a more nuanced history." He is attempting, he says, a "kind of medico-cultural history" [p. 14] which "trace(s) the interconnections between empire and nation in respect of leprosy, and which "demonstrate[s] the involvement of literary culture in this process ..." [p. 18]

Chapters One and Two both focus on nineteenth century medico-scientific attempts to identify and understand the cause of leprosy; whether it was hereditary or contagious; and whether the threat of its return came from within Europe or from the colonies. These chapters show the contested nature of medical science as well as illustrating the variance within nineteenth century liberal thought. If leprosy were not contagious, as the 1867 Report of the College of Royal Physicians found, then confinement was inhumane and inconsistent with mid-nineteenth century universalism and liberalism. However, after the discovery in 1874 by Hansen of the Mycobacterium leprae bacillus, the widening acceptance of germ theory, and--interestingly--the insistence of colonial medical doctors and administrators that leprosy was contagious, this view came under attack, with accompanying implications for debates about the confinement and seclusion of lepers.

Chapter Three--"The fear of degeneration: leprosy in the tropics and the metropolis at the fin de siecle"--shows how, in the heyday of imperial scientific racism, leprosy's long history in the West was forgotten or ignored. It came, instead, to be associated with "the tropics" which were as much--if not more--a discursive construct that a climatic or geographic space. Theories of contagion and of hereditary were no longer antagonistic, but complementary as specific groups of people came to be regarded as pools of infectious disease. As many scholars have noted, this "served the ideological function of associating these diseases with natural rather than social, economic or political factors" [p. 117] and so provided a justification for segregation and, in the case of those identified as lepers, confinement at lazarets, leper colonies, or banishment to off-shore islands.

In the late nineteenth century, leprosy and its association with decay and defilement also became a European literary trope, which Edmond explores in several "literary embediments" [p.18]. For instance, in Chapter Three he describes the fear of leprosy and degeneration in Victorian literature and poetry, with examples from Wilde, Carlyle, George Elliot, Gaskell, Kipling and Conan Doyle.

Banishment to a leper colony could be a "life sentence" and in Chapter Four, Edmond examines some of the places to which sufferers were sent in the late 1880s to mid-twentieth century. He focuses particularly on a number of island leper colonies off the coasts of the colonial towns of Australia, New Zealand, South Africa, and in Hawaii. Arguing that these were often "island grave yards", Edmond nonetheless points out that they were not "total institutions" and were in some cases supported by indigenous elites.

Chapter Five returns to the notion of "camp practice" and links together a variety of institutional forms of seclusion and discipline--Australian Aboriginal and North American Native reservations, concentration camps in South Africa, lock hospitals and TB Sanatoria in Britain--to argue that "behind the proliferating uses of 'colony' ... there was the same need to enclose and isolate the primitive, the diseased, and the backward ..." [p. 217]. For Edmond, leprosy was "an exemplary disease for an era in which contact--both literal and cultural--marked and defined European expansion across the globe" [p.219]. Thus, by the early twentieth century, the notion of "bare life" that would become so horrifyingly extended and implemented and "camp practice" in metropolitan European nations, had been rehearsed in colonial projects which had successfully witnessed and practiced forms of segregation, including that of lepers.

Chapter Six is an analysis of a number of traveller-writers of the late nineteenth and twentieth centuries--including Robert Louis Stevenson, Jack London and Graham Greene--whose "leprosy stories" continued to reflect the conventional tropes of contamination, decay and revulsion. The most recent writer considered is Paul Theroux who, in "The Leper of Moyo" (1994) describes a willing sexual encounter between the protagonist and a young woman in Malawi. In Edmond's view, "... by normalising this sexual encounter, Theroux brings to an end a very long and old chapter in the history of writing about leprosy" [p. 23].

Probably best approached as a collection of essays rather than a linear disquisition, Leprosy and Empire does not claim to be a definitive social or medical history of leprosy in the modern era. It does however succeed in being a thought-provoking volume which has much of relevance for historians of disease and medicine, of imperialism and culture, and for those who are especially interested in exploring the theoretical and methodological benefits, as well as the constraints, of trans-disciplinary studies.

ENDNOTE

(1.) See pp. 17--18 for Edmond's defence of his retention of the term "leprosy" over the scientifically preferred "Hansen's disease". For this reader, one of the pleasing features of this publication--one of the Cambridge Social and Cultural Histories series--is the return of the footnote. Here they are helpful and unobtrusive. Less happy, however, is the absence of a bibliography, surely part of the necessary apparatus of any academic book?

University of KwaZulu-Natal

Julie Parle
Gale Copyright: Copyright 2009 Gale, Cengage Learning. All rights reserved.