Imperial Bodies in London

Empire, Mobility, and the Making of British Medicine, 1880–1914

Kristin Hussey, Kristin D. Hussey

• Publisher: University of Pittsburgh Press
• Year: 2021
• Topic: History
• eBook ISBN:
  9780822988441
• Subtopic: Science History
• Index: History

Winner, 2022 Whitfield Prize for First Monograph in the Field of British and Irish History

Since the eighteenth century, European administrators and officers, military men, soldiers, missionaries, doctors, wives, and servants moved back and forth between Britain and its growing imperial territories. The introduction of steam-powered vessels, and deep-docks to accommodate them at London ports, significantly reduced travel time for colonists and imperial servants traveling home to see their families, enjoy a period of study leave, or recuperate from the tropical climate. With their minds enervated by the sun, livers disrupted by the heat, and blood teeming with parasites, these patients brought the empire home and, in doing so, transformed medicine in Britain. With Imperial Bodies in London, Kristin D. Hussey offers a postcolonial history of medicine in London. Following mobile tropical bodies, her book challenges the idea of a uniquely domestic medical practice, arguing instead that British medicine was imperial medicine in the late Victorian era. Using the analytic tools of geography, she interrogates sites of encounter across the imperial metropolis to explore how medical research and practice were transformed and remade at the crossroads of empire.

PART I

DISEASE, ENVIRONMENT, AND THE EX-COLONIAL AT HOME

But in all this jam of work done or devising, demands, distractions, excitements, and promiscuous confusions, my health cracked again. I had broken down twice in India from straight overwork, plus fever and dysentery, but this time the staleness and depression came after a bout of real influenza, when all my Indian microbes joined hands and sang for a month in the darkness of Villiers Street.

—Rudyard Kipling, Something of Myself

FAMOUS FOR HIS SHORT STORIES ABOUT LIFE IN THE BRITISH RAJ, THE poet and author Rudyard Kipling (1865–1936) is a classic example of the imperial career of an Anglo-Indian of his class. Born in India to European parents, following the prevalent medical advice of the day, young Rudyard was dispatched to Britain for his health and education at the age of five. Twelve years later, following boarding school at the United Services College, widely acknowledged to be the best preparation for a lucrative Indian Army posting, he returned to India to work as a journalist at the age of seventeen. After what he described as “seven years hard” labor at the Civil and Military Gazette in Lahore, recurring bouts of dysentery and a local outbreak of typhoid sent Kipling to London in 1889, where he resided on Villiers Street just off the Strand. In his autobiography Something of Myself (1937), Kipling described life in Soho as dark and noisy, replete with music halls and brothels. After several months in the metropolis, Kipling fell ill, observing that his health was strained from the Indian “fever and dysentery” he had contracted during his journalistic apprenticeship, which seemed to return to him in times of stress. This vision of the clinging Indian microbes, passengers in Kipling’s own body, set loose in the dark streets of London, provides a striking image of the experience of chronic and recurrent disease which seemed to follow ex-colonials wherever they traveled.

The chapters that follow explore the intersections of environment, disease, and race through the experiences of ex-tropical residents in London in the late nineteenth century. They join a much broader literature that has explored the ways in which the climates of the British imperial territories, in particular India, and Britain itself were co-constituted.¹ Following in the tradition of the new imperial history, scholars across disciplines have interrogated how the formation of colonial power structures were buttressed by the dichotomies of colonized and colonizer, ruled and ruler, female and male, hot and cold, metropole and colony.² Ann Laura Stoler and Frederick Cooper have argued that the culture of empire must be expanded to view metropolitan British and colonial spaces side by side.³ They are interested in the “contingency of metropolitan-colonial connections” and the ways in which European nations, and indeed colonial territories, could be understood only in conversation with each other.⁴ In so doing, the dichotomies of imperial discourse become destabilized and the tensions of the colonial project are revealed. This move to question these dualities, and the power structures they engender, is central to these chapters.

As we have just seen, debates around human acclimatization placed the body at the center of a dense web of political, social, and economic concerns. The European body was at once a strong, masculine, colonizing force, and at the same time also fragile and at risk from its surroundings: human, animal, and environmental. White colonists developed a wide array of practices to help protect their physical health in this pathogenic environment, including particular forms of dress, bathing, diet, medical regimes, and protocols for social engagement. Environmental anxieties and their relation to bodily practices are an essential theme for historians of colonial medicine who have tackled the question of climate and health, especially with reference to British-controlled India and Africa.⁵ These practices formed a specialist medical knowledge which came to be known as “tropical hygiene.” While the exact suggestions of what this hygiene involved varied across the period, physicians were central to the development of a set of behavioral and bodily practices which helped to codify a distinct form of embodied “Britishness” in the Empire.⁶ From the solar topi hat to tinted glasses and spine pads, the physical manifestations of anxieties over the tropical climate marked out the distinctiveness but also the frailty of white colonizers in the tropics.⁷

Concerns about acclimatization contributed to the social construction of white bodies as “out of place” in colonial environments. The perceived inter-actions of climatic and disease environments with racialized bodies served to mutually reinforce and sustain ideas of difference. Historians have argued that one of the key differences between colonial medicine and domestic medical practice in the age of empire was the emphasis placed on race and racial ideas in the colonies.⁸ However, the concept of “race” changed and developed over the course of the nineteenth century, often in close conversation with ideas about human acclimatization.⁹ Developments of ideas about disease and environment did not simply focus on the European, that is “white,” body but also created understandings of foreign bodies, often described as “black” or “native” bodies. The concept of racial immunity developed over the nineteenth century: that native bodies were immune to climatic influences or tropical diseases of the environments in which they were born.¹⁰ These perceived differences assisted in the construction of a racial hierarchy, which allowed disease susceptibility or immunity to be used as a factor for putting local peoples in what Nancy Stepan has called their “proper place.”¹¹

The following chapters consider what happened when Europeans returned “home” to temperate climates to recover their health, and how their relocation from tropical environments to their “native air” was seen to affect their bodies and minds. In contrast to the wide literature on European bodies in colonial spaces, scant attention has been paid to ex-colonial health in Britain. By focusing on “reacclimatization,” I suggest that following mobile “tropical invalids” can shine a light on the tensions of race, environment, and health in domestic spaces. Like Kipling, these tropical “valetudinarians” may have returned to the capital for work, for education, for furlough or for health reasons, but all found themselves irrevocably changed by their exposure to tropical climates. In practice, life in temperate environments was not as salubrious as patients or many physicians may have expected. Instead, many “tropical” complaints continued or even worsened after their return to England—with former imperial residents representing a particularly vulnerable community, especially in terms of mental health and risk of suicide. To study reacclimatization at home in London is to reveal the heavy toll of empire on the bodies and minds of its “builders”—and the inherent fragility of a political system which depended on continued circular traffic between metropolitan and colonial spaces. At the same time visitors, migrants, and students from the colonies experienced their own health challenges in the temperate climes of Britain—the cold, damp, and stresses of the city resulting in many finding their way into London’s asylums.

Part I will argue that the health concerns of returning tropical invalids to London served to construct the white body as fragile and easily influenced by climatic factors, even in temperate environments. Just as defining bodies as “other” in colonial spaces served to justify and reinforce the necessity of imperial control of lands and peoples, the colonizing process produced a dynamic and changeable definition of whiteness.¹² As many authors have acknowledged, whiteness as a category was flexible and adaptable, often shifting in particular times and places.¹³ Disease susceptibility was one key factor understood to differentiate white and black bodies, with Europeans being depicted as at once strong, hearty colonizers ready to conquer the globe and as highly at risk from the insidious effects of tropical environments. Disorders like “tropical liver” or “sunstroke insanity” were cocreated by white imperial patients and their physicians in British hospitals and in consulting rooms, these categories serving to explain the long-term breakdown in health experienced by many tropical invalids years and even decades after their return.

1

THE TROPICAL INVALID’S LIVER

Climate, Health, and Reacclimatization

IN 1884 THE COLONIAL PHYSICIAN PATRICK MANSON REMARKED TO HIS audience at the Hong Kong Medical Society that “anyone who has been through the Suez Canal is assumed in London consulting rooms to have an enlarged or otherwise diseased liver; that he eats and drinks too much; and that he stands in need of blue pills, nitro-muriatic acid and quinine.”¹ While Manson may have been put off by this old-fashioned view of imperial bodies, it nevertheless provides a helpful snapshot of the perception of “tropical invalids” returning from periods of service in the Empire in the late nineteenth century. Since at least the late eighteenth century the ability for “tropical valetudinarians” to resettle at home in Britain after their imperial service represented a considerable challenge for domestic practitioners of medicine. Nineteenth-century physicians used different phrases to describe this unique patient group: “those who have returned from tropical climates,” tropical valetudinarians, or more succinctly, tropical invalids.² From London to Bath and Bristol, surgeons and physicians found their practices populated with “Indian invalids”—famously hypochondriacal and seeking help for health problems unique to former imperial residents.³ Europeans who had inhabited the warm climates of empire, whether temporarily or for the majority of their lives, believed themselves to have been inextricably changed by their encounter with imperial environments. As Manson astutely observed, the source of the problem tended to coalesce around one particular internal organ—the liver—and its associated digestive system. It was a belief which prevailed well into the twentieth century, as captured by a satirical cartoon in Punch (fig. 1.1) in which an aggressive (and well-heeled) Anglo-Indian demands that his terrified London physician must “overhaul” his liver—probably with the same mercurial remedies bemoaned by Manson decades before.

FIG. 1.1. “Doctor, overhaul my liver!” A Punch cartoon from 1926 showing an Anglo-Indian Colonel “fiercely entering Doctor’s consulting-room.” Wellcome Collection. Attribution 4.0 International (CC BY 4.0).

The return of these troublesome imperial bodies to Britain and their need for care by domestic medical practitioners prompted new challenges and opportunities for the medical marketplace in London. Many of the city’s leading physicians and surgeons made names for themselves treating this special class of patients in their private practices. Speaking to the students of the Charing Cross Hospital in 1884, former Indian physician Joseph Fayrer advised medical students to take a keen interest in the tropical diseases that they would undoubtedly encounter in domestic practice, given “our rapidly extending intercommunication with India, China, the colonies and other foreign, tropical or subtropical countries.”⁴ Empire builders also had an opportunity to take their health into their own hands. The increased traffic of tropical returners facilitated a booming market for medical self-help —patent medicines marketed themselves as cures for stubborn imperial ailments.

Just as a thriving marketplace peddled advice literature for new emigrants departing for India, a flurry of publications appeared for the medical and lay reader aimed at addressing the special concerns of those returning from tropical to temperate climates.⁵ By interrogating medical guides written by colonial physicians, patent medicine advertising materials aimed at tropical invalids, and the sale of life insurance to imperial servants, this chapter aims to unpack the complexities and power structures surrounding coming “home” from empire and the limits of the ability of the temperate environment to heal imperial bodies. It reveals the prevalence of medical concerns around rapid movement, reacclimatization, and the influence of these ex-colonial patients on domestic discourses around disease and climatic change. While of course many different types of people moved between London and the British Empire, this chapter will focus on the somatic experiences of white returners from the tropics.

By the last decades of the nineteenth century, prevailing medical opinion argued that sustained exposure of European bodies to heat would result in certain deterioration of the body and mind.⁶ Overstimulated by the tropical climate, organs would become overwrought and congested, typically resulting in sallow skin, disturbed digestion, and mental and physical exhaustion. Fayrer, a highly regarded authority on European health in India and president of the India Office Medical Board, advised his readers that “the European does at length become debilitated, and needs to change to a cooler climate, which he should take, if he can, after six or seven years.”⁷ In order to sustain the viability of the imperial project, the colonial government created mechanisms for its servants to return periodically to cooler climates like the Indian hill stations or ideally to Britain itself.⁸ As the social evolutionist Benjamin Kidd (1858–1916) remarked in 1898, “In the tropics the white man lives and works only as a diver dives and works under water”—they needed to come up for air.⁹ Central to this framework of climatic disease was the establishment of a discursive paradigm which equated the tropics with illness and temperate climates with healing.¹⁰ Defined in contrast to the dangerous heat of the tropics, Britain’s climate was depicted as “relaxing, sedative and bracing,” temperate quite literally meaning mild and clement.¹¹

While return to the “bracing air of England” was construed as necessary for the health of Europeans, physicians were keenly aware of the complex climatology of Britain and its potential risks to tropical invalids—not to mention the hazards of a journey home which itself traversed numerous different climatic contexts.¹² In the opinion of many practitioners like Edward J. Waring, return to the supposedly temperate climate of Britain was hardly “the great panacea for all ills of tropical life” that many mistakenly believed.¹³ For Waring the variability of the climate at home “present[ed] more of a dark than of the bright side” for returning ex-colonials.¹⁴ How to stay well during and after the journey home required careful consideration, with any misstep in diet, dress, or exercise likely to result in disease or even death.¹⁵ A “temperate hygiene” needed to be adopted with equal strictness as the “tropical hygiene” to which Europeans in the colonies had become accustomed.

The focus of this anxiety around disease, climate, and movement between extremes of temperature centered on the liver. In the 1870s George Yeates Hunter (1794–1866) observed that liver disorder was “one of the most common and intractable sources of danger, and, if not the most fatal disease in the tropics, is probably the most widespread.”¹⁶ Not only was it prevalent among Europeans in the Empire, Hunter believed that liver disorders were “certainly that from which the returned Tropical most frequently suffers.”¹⁷ Medical writers in Britain and in India identified the liver as the seat of tropical complaints and the organ most likely to be put “out of order” by exposure to hot climates.¹⁸ Along with its associated digestive organs, the liver and viscera of ex-colonial...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Dedication
• Contents
• Acknowledgments
• Prologue. Imperial Bodies in the Museum
• Introduction. Medicine and Empire in London
• Part I. Disease, Environment, and the Ex-colonial at Home
• Part II. Networks, Mobility, and Knowing Medicine at a Distance
• Conclusion. The Cosmopolitanism of Imperial Disease
• Notes
• Bibliography
• Index