Abstract
Locating the Medical is one of the few edited volumes on the theme where the introduction and the individual articles coherently pursue a given set of arguments and observations. At the outset, this is a volume dealing in large part with colonial medicine in India, yet it is different from the conventional colonial histories. Instead of the question, ‘what is colonial about colonial medicine?’ which directs attention to the colonial aspect in the enquiry, the editors of this book ask ‘what is medical about colonial medicine or, for that matter, indigenous medicine?’ bringing the medical into focus.
The objective of the volume is to trace the manner in which ‘medical’ as a category emerges in the discourses of from eighteenth to twentieth century South Asia. The editors state that they are not starting with a given definition of the medical, rather they would like to explore the different ways in which the objects, events and processes that go by the name medical are produced, enacted and delineated in the South Asian context. In short, they are challenging the ‘out there-ness’ of medicine as something ready and clearly evident and try to locate the medical at the many sites of its emergence.
Clearly, this is a Foucauldian enterprise, and the editors draw on the work of Ian Hacking who has renamed it as ‘historical ontology’. For Hacking, historical ontology represents the combined strength of history and philosophy in the analysis of concepts, their emergence, the sites where they are deployed and the authorities that use them in given institutional settings. Rather than searching for the unfolding of the medical in the hospital and the lab, the volume focuses on the concept of the medical as it is set out in various contexts by the different kinds of experts at the mortuary, the prison, the highway, the shrine, the street and the tribal reserve and the volume covers material over two centuries.
There are eleven essays in the volume, organised in four sections: ‘Production of the Medical’, ‘Enactments of the Medical’, ‘Rethinking Disconnections and Continuities’ and ‘Contours of the Medical’, apart from the editors’ introduction and an afterword by Mark Harrison. The first section consisting of three essays is quite effective in showing how the sociological is so intimately intertwined with the medical. The description of women’s bodies in forensic medicine, especially those of women subject to abortion and rape or those of prostitutes, seem to rely on a host of circumstantial information and they make explicit pronouncements on female sexuality. The second essay presents two cases of human experimentation by colonial officers—finger printing and mesmeric surgery—that invoke quite opposite views of the Indian mindset: mendacity and passiveness. The third essay traces how the spleen among the body organs comes to occupy a seminal position in human pathology and how this truth of the inherently weak and enlarged spleen of the colonised body becomes an excuse to condone British officers who beat their servants to death. All the three essays in the section are very well written and do offer insights into the intricate interplay of truth, knowledge and ethics, as Foucault would have it. In the second section, consisting of two essays, the first shows how non-medical officers enquiring into a mysterious disease at the Thayetmyo Prison in Burma end up making recommendations to address the outbreak whose cause could never be found by the medical teams. The next essay, based on the writings of a Bengali doctor posted as medical officer in the Jarawa reserve in the Andaman Islands in the late 1990s, describes the process by which biomedicine is introduced among the reserve tribes, highlighting the ambivalence of the independent Indian state towards ‘primitive’ populations. Both the essays make the best of the case study at hand in conveying how the medical and non-medical, in fact, alternate their roles.
In the third section, there are three essays: one dealing with the archives of a British surgeon-general who during the 1840s conducted several experiments using eclectic medicine among the prison inmates and among the troops and who, despite writing 461 volumes on the subject, never finds mention in the history of medicine. The second essay pertains to Sowa Rigpa, the traditional medicine of Ladakh which is transformed drastically due to one major event: the construction of a highway connecting Leh to Srinagar in 1962. Hitherto scarce herbs and medicinal ingredients in the Ladakhi region which had to be acquired through long-distance travel and social networks become easily available with the road and transport, opening the era of commodification of Sowa Rigpa drugs. The next essay traces the trajectory of Cannabis, an Asian plant with known usage in traditional medicine coming to the attention of the British in the 1840s. But the medical and therapeutic significance of Cannabis for the British is overshadowed by its chequered career involving Victorian moral reservations about opium use to issues of excise regulation; thus, some plants like Cannabis from the colonies face an unstable therapeutic career at the colonisers’ end. Together, the three essays in this section draw the much needed attention to the experiments in eclectic medicine and traditional medicine.
The first essay in the last section demonstrates how the borders between medical and non-medical are constantly breached by oscillation on the part of health seekers. The second essay proposes how the concept of political medicine from Europe gets ‘vernacularised’ in the writings of two contemporary Bengali figures in the late nineteenth century: a doctor and a writer. However, the process of vernacularization, also referred to as domestication and indigenization in the colonial histories of science, focuses on one way cultural processes flowing from the colonizer to the colonized, without of any mention of reverse flows from the colonized. The last essay on technology and health describes the interface between technology and the colonial subjects in the street, factory and the home dealing with phenomenon of accidents with the advent of motorised vehicles, machines and mills. The afterword offers an overview of the volume showing how the category of the medical in this period lacked precise definition and certainty and, more often than not, was dependent on the authority or discretion of non-medical actors.
But even as the historical narrative is tightly woven, we are left wondering where the ‘philosophical’ is to be found in the volume which introduces itself as evincing ‘historical ontology’. There is not much of an engagement with the category of ‘medical’ in the introduction, as much as repeated reiteration that the ‘medical’ is not out there or self-evident. Whom or which viewpoint this assertion directed at is not clear. There is no reference to who could be arguing today that the medical is given out there and what their basic premise is. Some substantive remarks or statements about the very concept of the medical and a self-conscious distinction between nascent disciplines of the nineteenth century like biomedicine to which Foucauldian methods apply and the long standing medical traditions like Sowa Rigpa to which it may not apply would have added philosophical insight to the discussion. This philosophical oversight is also reflected in the passing remark made by Harrison in the afterword about the use of the suffix ‘systems’ for indigenous medicines in India which he considers to be misleading. This is a contentious issue in historiography of medicine in India because the concept of system that underlies such assertions has not been subject to interrogation. It is assumed that their borders were porous and so they could only be regarded as practices. Such assumptions are based on the premises of exclusively expert-centred knowledges like biomedicine. Porousness of border could be an intrinsic characteristic of these systems, something that philosophical understanding of their premises would have revealed.
The volume is, however, refreshingly different from conventional histories of colonial medicine, with a mix of history, social history and anthropological studies, drawing upon not just imperial archives but also Bengali literary writing, ethnographic notes of a doctor and fieldwork in a shrine. It will be of interest to anthropologists, historians and sociologist although I should say that the essays are quite readable and rich in detail for any informed reader.