One of the explicit goals historians of colonial medicine often profess to having, is the desire to demonstrate the ways in which the colonies constituted medical knowledge and practice in Britain. However, histories that reveal the full extent of exchanges between Britain and its colonies have been few and far between. Mark Harrison’s latest book, Medicine in an Age of Commerce and Empire: Britain and its Tropical Colonies, 1660–1830, achieves this difficult task through a meticulous reading of over three hundred medical tracts and pamphlets penned by European and British practitioners.
The book spans the period of Britain’s Atlantic empire to the rise of the second empire and ‘swing to the east’. The primary motivation propelling Britain’s imperial endeavours throughout this period – perhaps with the exception of the American colonies – was the cultivation and protection of lucrative trade networks in the Atlantic and Indian Ocean arenas. Therefore, Harrison appropriately follows the ebb and flow of therapeutic knowledge and practice between Britain, the West Indies and India, through natural historians, surgeons and physicians attached to the Army, Navy and East India Company. While he divides the book into three distinct parts, his argument remains the same throughout: that you cannot understand developments and changes in British and European medical knowledge and practice between 1660–1830 without taking into account the work of practitioners plying their trade in the tropical colonies.
Through what can be described as an impressively descriptive and evidence-packed prosopography, Harrison, in the first two sections especially, convincingly demonstrates the ways in which tropical practitioners impacted therapeutic practices in Britain and Europe. Given the degree of professional freedom and autonomy they possessed in the colonies, alongside their often-dissenting backgrounds, these practitioners devised, tested and advanced many novel therapeutic and anatomical practices. In this case, Harrison’s scholarship further shifts the historiography away from a bias towards Paris medicine and Europe as the originating point of ‘modern’ medical practice. While not denying the importance of Paris medicine, Medicine in an Age of Commerce and Empire is the first full-length study revealing just how important physicians practising in the colonies, and their distinctive ‘tropical’ therapeutics, were to the development of British medicine. Where Harrison particularly shines in this respect is his discussion of morbid anatomy and nervous theories of disease.
Harrison also demonstrates that as they developed their own unique branch of medicine, practitioners in the tropical colonies did not simply alter metropolitan medical practices by introducing therapies pioneered in the colonies or reinvigorating therapeutic agendas in Britain: it was often the case that therapies developed in the colonies did not take hold or further entrenched existing ones. Either way, however, tropical practitioners were transforming metropolitan medical practice. While Harrison could have provided greater analysis of the relationship between commerce, empire, dissenting ideology, and the dizzying number of practitioners the reader is confronted with, the outcome is nonetheless a testament to a long and devoted engagement with the writings of these individuals.
In this case, an easily placed criticism of the book is its lack of engagement with local practitioners and other agents who possibly influenced the many European and British practitioners whose writings Harrison so ably dissects. Harrison notes C.A. Bayly’s observation, that as British rule intensified in India, the British sought to disengage from an information order that was largely mediated by Indian agents; and that this applied equally to British practitioners and medical knowledge. However, as Bayly goes on to argue, despite British desires to become self-reliant in the process of ruling India – and arguably in the creation of medical knowledge – they were never able to do so in practice.
However, dwelling too much on the lack of local agency would be to miss the point of Harrison’s scholarship. There is only so much a single study can accomplish. While this history can never be complete until local agency is assessed in a similarly detailed manner, Harrison has provided a vital new dimension that will undoubtedly change the way historians approach the history of Western science and medicine. In this case, demonstrating how European and British tropical practitioners were pivotal to the development of ‘modern’ British medicine is perhaps enough of an achievement for the time being.
