This study of leprosy in colonial south India investigates indigenous and British medical and legal systems and their impact on the person suffering from leprosy, from the 1800s up until 1898, specifically before the missionary period. The study claims that because leprosy was “a slow degenerative disease”, initially believed by the British to afflict Indians and Eurasians, it offers a unique perspective on colonial power and colonial medical intervention and provokes a “reconsideration” of accepted models of colonial medical relationships. In the process, it takes issue with assumptions of a coherent and dominating exercise of colonial power and colonial medical intervention, reassessing the use of British medicine as a tool of empire, the contribution of law to colonial authority, and the role of confinement as an expression of British power. This analysis emphasizes the interplay of class and financial imperatives in determining the management of leprosy, with socio-economic status having the most profound impact on the leprosy sufferer.
The medical investigation of leprosy in this period marks a shift to a rational and secular European medical system, yet a selective appropriation of indigenous remedies. Neither indigenous nor British medical traditions could offer a specific cure for leprosy. Local British medical officers explored remedies such as fumigation, gurjon oil, chaulmugra, and marotty oil. They sought the most effective remedies available at the time, and were less interested in any assertion of superiority of British over Indian treatments or medical systems.
The politics of leprosy control shows how information and research into leprosy was deployed with specific agendas, and how medicine was used by the colonizers to dominate each other. The Royal College of Physicians' Report (1867) was not only formulated to investigate the prevalence of leprosy in the colonies, but also to establish the credibility of the medical profession and the role of the College. The struggle between the Sanitary Commission and the Indian Medical Service over who would serve as government adviser on leprosy, and debates over segregation and the formation of leprosy policy, demonstrate differing political agendas.
This period was also characterized by negotiation between the government of India, the presidency governments, and public opinion represented by the Indian middle class around the 1889 Leprosy Bill, the 1896 Leprosy Bill, and the 1898 Lepers Act. Class interests, concern about resentment towards any British interference, and a desire to protect local trade resulted in legislation that targeted vagrants and avoided dealing with workers and home dwellers with the disease. The study concludes that at each remove from Britain, at the level of the government of India, the presidency, and local levels of medical authority, the exercise of power became increasingly diffuse and subject to negotiation and opposition. At the local level of direct contact between doctor and patient “British medicine was ultimately subordinate to the wishes of the leprosy patients, the majority of whom were Indian” (p. 191).
This is a valuable study that provides a foundation for understanding the culture of medical research into leprosy that is still characteristic of south India to the present. The study does overstate the agency of the leprosy sufferer. Those most likely to be constrained by measures against leprosy emerge as the least powerful members of society, yet both resistance and co-operation are attributed to them. Co-operation was necessary for confinement to be effective and co-operation with treatment was essential for British medical claims to superiority. So it would seem that leprosy sufferers had the power of subversion, and evidence of this is offered in their resistance to the institutional diet, subversion of the working regimens, and avoidance of treatment. Yet the conclusion states that “the medical, legal and cultural structures of their own communities and of British India impacted profoundly on their lives” (p. 191). In the face of this, the refusal to eat boring food or be productive seems both ineffectually the most and the least that could be done.
