ForKevin Oneofthefewtoremainloyal
Acknowledgements
Thisbookowesitsexistencetoanumberofpeopleandcircumstances. Thechaptersincludedherewereoriginallypublishedin2011asthe secondsectionof TheOxfordHandbookoftheHistoryofMedicine.The suggestionthattheymightworktogetherinamorefocusedvolumeon theglobalhistoryofmedicinecamefromCathrynSteeleatOxford UniversityPress.Thetimingwasapposite:Ihadjustcompleteda largeeditedvolumeonthehistoryofdiseaseandwasincubatingmy nextbookonthemidlifecrisis,leavingmewithasuitabletemporal windowwithinwhichtoconcentrateonbringingthechapters togetheras AGlobalHistoryofMedicine.IamgratefultoCathrynfor herinitialpropositionandforhersupportthroughthereassuringly smoothandswiftprocessofproduction.Ofcourse,thevolumewould nothavematerializedwithoutthecommitment,knowledge,andskill ofthecontributors,whohaveprovidedup-to-daterevisionsofthetext andfurtherreadingswiththeircustomarycombinationofpromptness andgenerosity.Ithasbeen,asever,apleasuretoworkwiththem.
WhenIwaslanguishinginsouthLondonthirtyyearsago,having leftmedicineandwaitingtostartaPhDinmedico-legalhistory,it wouldhavebeendifficulttoimaginethatIwouldnowbemarried withthree(nearly)grown-upchildrenandacareerthathaschallenged andfulfilledmeinequalmeasure.Andyet,attheageof fifty-eight, hereIamwithafamily fillingmyheart.Siobhán,Ciara,Riordanand Conallconstitutemyworld,myhealth,myhistory.Withouttheirlove andsupport,neithermylifenormyworkwouldpossessmeaningor momentum.Thisbookistheirsasmuchasitismine.
Listofcontributors xi
1.OneWorld,OneHealth?TowardsaGlobal HistoryofMedicine1 MarkJackson
2.ChineseMedicine19 VivienneLoandMichaelStanley-Baker
3.MedicineinWesternEurope44 HaroldJ.Cook
4.MedicineinIslamandIslamicMedicine69 HormozEbrahimnejad
5.HistoryofMedicineinEasternEurope,IncludingRussia96 MariusTurda
6.PublicHealthandMedicineinLatinAmerica118 Anne-EmanuelleBirn
7.ScienceandMedicineintheUnitedStatesofAmerica149 EdmundRamsden
8.MedicineandColonialisminSouthAsiasince1500173 MarkHarrison
9.HistoryofMedicineinSub-SaharanAfrica195 LynSchumaker
10.HistoryofMedicineinAustraliaandNewZealand220 LindaBryder
11.GlobalandLocalHistoriesofMedicine:Interpretative ChallengesandFuturePossibilities243 SanjoyBhattacharya
Listofcontributors
SanjoyBhattacharya isProfessoroftheHistoryofMedicineand DirectoroftheCentreforGlobalHealthHistoriesattheUniversityof York,UK.Sanjoy’sworkexploresthehistoryofglobalandinternationalhealthprogrammesinSouthAsiaandbeyond:hiscurrent researchdealswiththeeradicationofsmallpoxinBangladeshand Afghanistan.SanjoyleadstheWorldHealthOrganization’sGlobal HealthHistoriesinitiativeandhasanactiveinterestinglobalhealth policyassessment:heisinvolvedinassessingthesocialdeterminantsof vaccine-preventablediseasesinthedevelopingandlessdeveloped world.Sanjoyiseditorofboththejournal MedicalHistory andanew monographseries GlobalHealthHistories,andheco-edits,withDr.Niels BrimnesandDr.NitinSinha, NewPerspectivesinSouthAsianHistory,a seriesofmonographspublishedbyOrientBlackswanIndiaLtd.
Anne-EmanuelleBirn isProfessorofCriticalDevelopmentStudies andGlobalHealthattheUniversityofToronto.Sheistheauthorof numerousbooksandarticlesonthehistoryofpublichealthinLatin America,internationalhealthpolicyandpolitics,andwomenand internationalhealth,including: MarriageofConvenience:RockefellerInternationalHealthandRevolutionaryMexico (UniversityofRochesterPress, 2006); ComradesinHealth:USHealthInternationalists,AbroadandatHome, co-editedwithTheodoreBrown(RutgersUniversityPress,2013);and leadauthorofthe TextbookofGlobalHealth,3rdand4theditions (OxfordUniversityPress,2009;2017).
LindaBryder isProfessorofHistoryattheUniversityofAuckland andFellowoftheRoyalSocietyofNewZealandandholdsan HonoraryChairattheLondonSchoolofHygieneandTropical Medicine.Shehaspublishedwidelyinthehistoryofpublichealth inthetwentiethcentury,including: BelowtheMagicMountain:ASocial HistoryofTuberculosisinTwentieth-centuryBritain (1988); AVoicefor Mothers:ThePlunketSocietyandInfantWelfare,1907–2000 (2003); Women’sBodiesandMedicalScience:AnInquiryintoCervicalCancer (2010); WesternMaternityandMedicine,1880–1990,editedwithJanetGreenlees,
(2013);and TheRiseandFallofNationalWomen’sHospital:AHistory (2014).Sheiscurrentlyontheeditorialboardof MedicalHistory and HealthandHistory andisamemberoftheCounciloftheAustralianand NewZealandSocietyoftheHistoryofMedicine.
HaroldJ.Cook isJohnF.NickollProfessorofHistoryatBrown University.Hehaspreviouslytaughtandheldadministrativepositions atHarvard,theUniversityofWisconsin-Madison,andtheWellcome TrustCentrefortheHistoryofMedicineatUCL.Hepublishes mainlyonmedicineinearlymodernEurope,particularlywithattention toEnglandandtheNetherlandsandwithaninterestinunderstanding howthescientificrevolutionwasshapedbythemedicalcommunity. Hehelpedtopioneerthemethodofstudyingthemedicalmarketplace andhaspublishedanaward-winningbookonmedicine,science,and commerceentitled MattersofExchange:Commerce,Medicine,andScienceinthe DutchGoldenAge (YaleUniversityPress,2007).
HormozEbrahimnejad isaLecturerinHistoryattheSchoolof Humanities,UniversityofSouthampton.Hisdoctoralresearch focusedonpowerstructuresineighteenth-andnineteenth-century Iranandhisworkinthehistoryofmedicinecontinuestoexplorethe relationshipbetweenmedicineandpower,theimpactofinstitutions onscientificdevelopments,theemergenceofthemedicalprofession andhospitalinstitutions,andtheirrelationshipwithmedicalknowledgeinboththemedievalandmodernperiods.Hispublications include: Medicine,PublicHealthandtheQâjârState:PatternsofMedical ModernizationinNineteenth-CenturyIran (2004);and TheDevelopmentof ModernMedicineinNon-WesternCountries:HistoricalPerspectives (ed., 2008).Heiscurrentlyworkingonthetransitionfromtraditionalto modernmedicineinnineteenth-andtwentieth-centuryIran.
MarkHarrison isProfessoroftheHistoryofMedicineandDirector oftheWellcomeUnitfortheHistoryofMedicineattheUniversityof Oxford.Heistheauthorofmanybooksandarticlesonthehistoryof disease,medicine,andcolonialism,including: PublicHealthinBritishIndia (1994); ClimatesandConstitutions (1999);withSanjoyBhattacharyaand MichaelWorboys, FracturedStates:Smallpox,PublicHealthandVaccination Policy1800–1947 (2006); TheMedicalWar:BritishMilitaryMedicineinthe FirstWorldWar (2010) winneroftheTemplerMedalBookPrize;
MedicineintheAgeofCommerceandEmpire:BritainanditsTropicalColonies, 1660–1830 (2010);and Contagion:HowCommerceHasSpreadDisease (2013). WithBiswamoyPati,heiseditorof Health,MedicineandEmpire:Perspectives onColonialIndia (2001)and TheSocialHistoryofHealthandMedicineinBritish India (2009),andwithMargaretJonesandHelenSweet,of FromWestern MedicinetoGlobalMedicine:TheHospitalBeyondtheWest (2009).
MarkJackson isProfessoroftheHistoryofMedicineandDirector oftheWellcomeCentreforCulturesandEnvironmentsofHealthat theUniversityofExeter.HehasservedasChairoftheWellcome TrustHistoryofMedicineandResearchResourcesfundingcommittees,asSeniorAcademicAdvisor(MedicalHumanities)totheWellcomeTrust,andasamemberoftheHistorysub-panelforREF2014. Hehastaughtmodulesinthehistoryofmedicineandthehistoryand philosophyofscienceforoverthirtyyearsatundergraduateand postgraduatelevelstobothmedicalandhistorystudents,andhas beeninvolvedinteachingmedicalhistorytoGCSEandAlevel students.Hisbooksinclude NewbornChildMurder (1996); TheBorderland ofImbecility (2000); Infanticide:HistoricalPerspectivesonChildMurderand Concealment1550–2000,(ed.,2002); Allergy:TheHistoryofaModernMalady (2006); HealthandtheModernHome (ed.,2007); Asthma:TheBiography (2009); TheOxfordHandbookoftheHistoryofMedicine (2011); TheAgeof Stress:ScienceandtheSearchforStability (2012); StressinPost-WarBritain, 1945–85 (ed.,2015);and TheRoutledgeHistoryofDisease (ed.,2016).Heis currentlywritingabookonthehistoryofthemidlifecrisis.
VivienneLo isDirectoroftheChinaCentreforHealthandHumanityatUCL.ShehasbeenteachingthehistoryofAsianmedicineand classicalChinesemedicineatBScandMAlevelinUCLsince2002. Herresearchconcernsthesocialandculturaloriginsofacupuncture andtherapeuticexercise.Shetranslatesandanalysesmanuscript materialfromearlyandmedievalChinaandthetransmissionof scientificknowledgealongtheso-calledSilkRoadsthroughtothe modernChinesemedicaldiaspora.SheistheeditorwithChristopher Cullenof MediaevalChineseMedicine (2005),andwithWaltraudErnstof thejournal AsianMedicine:TraditionandModernity.Forthcomingpublicationsinclude: PotentFlavours:AHistoryofNutritioninChina (Reaktion Press,2017);andwithM.S.B.Stanley-Baker(eds), RoutledgeHandbook ofChineseMedicine (Routledge,2017).
EdmundRamsden isaWellcomeTrustUniversityAwardLecturer atQueenMaryUniversityofLondon.Hiscurrentresearchisfocused ontheinvolvementofsocialandbehaviouralscientistsinarchitecture, planning,anddesigninthepost-warUnitedStates,soastoimprove mentalhealthandsocialwell-being,particularlyinrelationtoinstitutionalenvironmentsandpublichousing.Otherkeyareasofresearch includethehistoryofexperimentalpsychiatryandpsychologyin relationtoneuroses,emotionaldisorders,addiction,andsuicide;the historyofeugenics,populationscience,andpolicy;socialsurvey methodsinrelationtohealth,growth,andintelligence;andtherole ofanimalsinscienceandmedicine.Heistheeditor,withDavid Cantor,of Stress,ShockandAdaptationintheTwentiethCentury (University ofRochesterPress,2014).
LynSchumaker completedherPhDinhistoryandsociologyof science,technology,andmedicineattheUniversityofPennsylvaniain 1994,withprevioustraininginanthropologyandAfricanhistoryat MichiganStateUniversity.Herbook, AfricanizingAnthropology:Fieldwork,Networks,andtheMakingofCulturalKnowledgeinCentralAfrica,was publishedin2001byDukeUniversityPress.Sheworkedatthe WellcomeUnitfortheHistoryofMedicineatManchester,1994–2009,receivingaWellcomeTrustUniversityAwardin1999for researchinthehistoryofindigenous,mission,andminingmedicine onZambia’scolonialCopperbelt.Herworksituatesanti-retroviral therapyinthehistoryofWesternpharmaceuticalsandindigenous medicinesinZambiaaswellasexploringAfricanperspectiveson privatelyfundedmedicalphilanthropy,suchastheBillandMelinda GatesFoundation ’sfundingofmalaria,tuberculosis,andHIV/AIDS researchandminingmagnateA.ChesterBeatty’sfundingofearly malariaresearch.
MichaelStanley-Baker isapractitionerandhistorianofChinese medicine.HavingreceivedhisDiplACatRusetoCollegeinBoulder, Colorado,helaterwentontopursuegraduatestudiesinDaoist historyintheEastAsianlanguagesandculturesatIndiana,University Bloomington,andreceivedhisPhDinmedicalhistoryfromUCLin 2013.Heisatwenty-yearpractitionerofyoga,taiji,andmartialarts. Hisresearchisconcernedwiththebroadertherapeuticcultureof medievalChina,especiallythatwhichisrecordedintheDaoistCanon.
MariusTurda isDirectoroftheCentreforMedicalHumanitiesand ReaderinCentralandEasternEuropeanBiomedicineatOxford BrookesUniversity.Heistheauthorof ModernismandEugenics and EugenicsandNationinEarly20thCenturyHungary (2010),andtheeditorof TheHistoryofEugenicsinEast-CentralEurope,1900–1945 (2017).His mainareasofinterestincludethehistoryofeugenics,racism,anthropology,andmedicineinEast-CentralEurope,withaparticularfocus onHungaryandRomania.Hehasjustcompletedabookonthe historyofracetobepublishedin2018.
OneWorld,OneHealth?
TowardsaGlobalHistoryofMedicine
MarkJackson
InOctober2010,Haitiexperiencedthe firstoutbreakofcholerain thecountry’shistory.Overthenextfouryears,approximately 700,000Haitianscontractedthedisease,over8,000peopledied, andcholeraspreadacrosstheCaribbeanregion,withcasesreported intheDominicanRepublic,Cuba,andMexico.Thecausesofthe epidemiccanbetracedtoanumberofinterlockingsocial,economic, andenvironmentalfactors.AdevastatingearthquakeinJanuary2010 hadkilledover300,000people,displacedcommunities,exacerbated poverty,anddisruptedsanitation,providingtheconditionsforthe rapiddiffusionofdiseasethroughvulnerablepopulations.Atthesame time,evidencethatthestrainofcholerainHaitiresembledstrains prevalentinAfricaandSouthAsiawasusedtosuggestthatcholera hadbeenintroducedtotheCaribbeanbyNepalesetroopsservingas partofaUnitedNationspeace-keepingforce.Itwouldappearthat theorganismhadhitchhikedacrosstheworldtoinfectanation alreadyrenderedsusceptiblebyecologicaldisasterandsocioeconomicconditions.1
ItistemptingtointerpretthetrajectoryoftherecentHaitian choleraepidemic,aswellastheoutbreakandspreadofotherdiseases suchasMiddleEastRespiratorySyndrome,asacontemporaryphenomenon,asaproductofthewaysinwhichmodernglobalizationhas acceleratedthecirculationofpeople,commodities,andorganisms aroundanintegratedandinterconnectedworld.Thereissome merittothisargument.Whetherweregardglobalizationintermsof
theglobaleconomy,thetransferofinformation,orculturalexchange, thereisnodoubtthatrecentandrapidglobalchangehastransformed thewaysinwhichweinteractwitheachotherandwithourenvironmentsacrosswhathadpreviouslyseemedtobenaturalboundariesof spaceandtime.Increasinglyconnectednetworksoftrade,travel,and technologyhaveservedtorealizeMarshallMcLuhan’svisionofa ‘globalvillage’,aworldinwhichlocalculturesandpracticesalways interactwithglobaleconomic,political,andculturalforces,reshaping notonlyprocessesofproductionandconsumption,butalsopatterns ofhealthanddiseaseandapproachestohealthgovernance.2
However,itisalsoclearthatglobalizationisnotanewphenomenon.Placesandpopulations,aswellaseconomiesandcultures,have alwaysbeenconnectedtosomedegree.Diseaseshavetravelledand beentransmittedthroughthemovementofpeopleandproduce, leadingtothefearofmigrantsandtradersandtothecreationof publichealthpoliciesdesignedtoseparateorquarantineinfected animalsandhumans.Medicalknowledgeandpracticehavebeen communicatedandexchangedacrossspatialandtemporalborders, helpingtoproducenewunderstandingsofthebodyandnewformsof healing.Historicalexamplesoftheimpactofglobaltransactionson patternsandexperiencesofhealthanddiseasearenotdifficultto identify.Theopeningin1914ofthePanamaCanal,theconstruction ofwhichhadresultedinmanythousandsofdeathsfrommalariaand yellowfever,raisedthespectreoffreshepidemics,includingcholera andplague,astraderoutesbecameshorter.3 Thecholerapandemicof 1865–66originatedinanoutbreakofthediseaseinMeccaapparently importedbypilgrimsfromIndia.4 Evenearlieroutbreaksofcholera andotherinfectiousdiseasesinJapanandChinaweresimilarly patternednotmerelybylocaltopographicalandsocio-economic conditions,butalsobythemovementsofboatmenanddocklabourers alongcanals,theopeningoftraderoutesforteaandopium,and interactionsbetweenhumansandnon-humananimals.5
Thesespecificexamplesofglobalconnectionsandcontinuities revealanotherdimensionofthehistoryandgeographyofmedicine, namelytheparallelimportanceofunderstandingthelocaldeterminantsofhealthanddisease.Althoughwecandiscernglobalpatterns linkedtotheinterconnectednessofregionsandnations,personal experiences,professionaldiscourses,andstateinterventionshave
alwaysbeendependentonlocalsocial,political,cultural,environmental,andbiologicalcontexts.Forexample,whiletherisinglife expectancyanddecliningmortalityratesassociatedwiththemodern epidemiologicalanddemographictransitionareevidentinmany partsoftheworld,developmentshavenotbeenevenlydistributed acrosspopulationsandplaces.Historicalevidencesuggeststhatthe Westernmodelofmortalitydeclinecannotbereadilytransposedto othercountriesandcontinents.In1901,malelifeexpectancyatbirth inBritainwasintheregionofforty-fiveyears;amongstIndianpopulationslifeexpectancyonlyreachedthatlevelinthe1960s.6 As historians,epidemiologists,andmedicalgeographershavepointed out,neithercanweassumethatmortalityratesamongstparticular communitiesorgroupswerereflectedintheexperiencesofothers: inthetwentiethcentury,maternalmortalityratesvariedwidely acrossEnglandandWales;andintheUnitedStates,maternaldeaths followeddifferenttrajectoriesamongsturbanandrural,whiteand black,andrichandpoorpopulations.7 Byaccentuatingeconomic disparities,measuredintermsofGrossDomesticProduct(GDP), morerapidglobalizationmayhaveamplified,ratherthanmitigated, healthinequalities:in2015,aWorldHealthOrganization(WHO) surveyrevealedthataveragelifeexpectancycontinuedtovarywidely acrosstheworld,rangingfrom83.7yearsinJapanto50.1yearsin SierreLeone.8
Understandingthehistoryofmedicinethereforerequiresattention tobothglobalandlocaldimensionsofhealthanddiseaseor,asthe anthropologistsAkhilGuptaandJamesFergusonpointedoutmany yearsago,remainingsensitiveto ‘locallylivedlivesinaglobally connectedworld’ 9 Ofcoursethiscommitmenttoexploringfullythe complexrelationsbetweenplace,space,andtime,aswellastracing thepathwaysalongwhichpeople,animals,germs,food,ideas,norms, standards,practices,anddiseaseshavetravelled,raisesmethodological,conceptual,political,andethicaldifficulties.Theaimofthis volumeistoequipscholarswithsomeoftheknowledgeandtoolsto confrontthosechallenges.Inthe firstinstance,thefollowingchapters introducethehistoryofhealthandillness,ofmedicalknowledgeand practice,acrossdifferentperiodsandlocations.Althoughstructured largelyaroundcontinentsandregions,theseoverviewsdonot reinforcesimplisticnotionsofdistinctandstaticmedicaltraditions
orculturesassociatedwithparticularplaces.Insteadtheyrevealthe pluralityandporosityofpractices,experiences,andknowledge,as wellasthedynamicsocialstructuresandpoliticalprocessesthathave shapedthemanifestationanddistributionofdisease,andthemanner inwhichindividual,professional,state,andinternationalresources havebeenmobilizedinordertomaintainorrestorehealth.
Secondly,contributorsreflectonhowtoresearchandwritehistoriesofmedicinethataresensitivetopromiscuouslinkagesbetween global,regional,andlocaldimensionsofhealthanddisease.What sources,skills,andmethodsarerequiredtoconnecthistoriesconvincinglyacrosstimeandspace?Howcanwechallengetenaciouspreoccupationswiththe ‘rise’ ofWesternbioscienceasthedominant modelfornarratingthehistoryofmedicine?Howcanwerevealand resisttheasymmetriesofpowerthatareconcealedwithinthebinary analyticalframeworksthatoftenstructureandconstrainourhistories, lives,andpractices:local/global;centre/periphery;state/voluntary; population/individual;East/West?Canweedgetowardsaglobal historyofmedicinethatdoesnotsuper ficiallyreducespace,place, andculturetocountriesandcontinents,butinsteadconsiderstheways inwhichmigration,commerce,war,andtravel,amongstother humanandnon-humanfactors,haveenabledhealingpracticesto beconstructedandreconstructedacrossborders,communities,and identitiesthatarebothrealandimagined?Howcanweimpartially navigatethealwaystangledrootsandcontoursofmedicineinthepast andacknowledgetheirenduringpulseintothepresent?
EntangledHistories
Emergingattheintersectionofglobalhistoryandpostcolonialstudies, ‘entangledhistory’ constitutesanapproachthatchallengesthewaysin whichhistorianshaveuncriticallyembracednations,empires,and civilizationsas ‘theexclusiveandexhaustiveunitsandcategoriesof historiography’ . 10 AccordingtoSönkeBauckandThomasMaier,the notionofentanglementenableshistorianstoadoptatrans-cultural perspectivethatforegrounds ‘historicpowerstructuresandtheirconstitutioninspace’ andmorecarefullyexamines ‘themultidirectional characteroftransfers’ . 11 Thisformofhistoriographicalrenewalnot onlyprioritizeslocal,regional,andtrans-nationalconnectionsand
exchangesbetweenpopulations,institutions,andpractices,butalso questionsthe ‘hegemonyofEurocentricteleologies’ ofglobaldevelopmentandmodernization.12
Historiansofmedicinehavesometimesmobilizedtheconceptof entanglementtocapturethecomplexityofinterdependencies andexchangesbetweendisciplinesandculturesinthepastandpresent,ortoexploreinteractionsbetweenhumans,animals,andtheir environments.13 Throughtheirworkoncolonialandpostcolonial medicine,inparticular,historianssuchasWarwickAnderson,Mark Harrison,andAlisonBashfordhavealsocontributeddirectlytothe historiographicalandpoliticalaspirationsofentangledhistory,helpingtodecentretheglobalWestandtheNorthAtlanticfromhistorical narrativesandtracingthenetworksofpowerthatsustainhealth inequalities.14 However,attemptstowriteentangledhistoriesofmedicinealsorevealthedifficultiesofpursuinghistoricalanalysisofthis nature.Atapragmaticlevel,asMariusTurdapointsoutinhis chapterinthisvolumeonthehistoryofmedicineinEasternEurope, theydemonstratehowconvincinglydisentanglingscrambledhistories ofhealthanddiseaserequiresmulti-lingualandmulti-disciplinary expertise.15 Theyalsoillustratehowevenempiricalstudiesofmedical knowledgeandpracticethatjuxtaposedifferentnationalcontextsin ordertodevelopcomparativeanalysestendtoreproducefamiliar temporalandgeographicaldivisions,simplifythedirectionof flow betweenWesternandEasternformsofhealthcare,andconsolidate overlyrigiddistinctionsbetweenglobalandlocalsitesofinnovation andintervention.16 Comparativestudieshavecertainlyopenedup newquestionsaboutthecirculationofinformation,experience,and practiceandoftenmovewellbeyondhabitualpreoccupationswith Westernbiomedicine,butmanyofthemhavecontinuedtonarrate nationalexperiencesasparallel,ratherthanentangled,occurrences and,indoingso,tostrengthenratherthantroublethebinaryanalyticalcategoriesthathavesustainedbothmedicalandhistoricalprofessionalhegemony.
Goingglobalinthesewaysalsoraisesuncomfortablequestions aboutthepotentialforcollusionbetweenhistoryandthepoliticsof globalization.AsSarahHodgeshaspointedoutinadiscussionof whatshetermsthe ‘globalmenace’,thereisatensionbetween ‘the globalasdescriptorandananalyticsoftheglobal’.Atbest,sheargues,
thetermglobalhassimplyreplaced ‘international’ , ‘world’ ,or ‘colonial’ asadescriptionofthegeographicalrangeofaparticularhistoricalstudy.Atworst,however,framingthehistoryofmedicinein globaltermsthreatenstoreinforcethenotionofuniversalityand commonality(orcontext-neutralobjectivity)thatcharacterizes bothWesternmedicalscienceandeconomicglobalization.Inthis way,globalhistoriesofmedicinecancompressandobscurethe unevennessandheterogeneityofplacesandperiodsandreproduce ratherthancritique ‘globalisationasasetofinstitutions,discourses andpractices’ . 17
Hodges’ cautionabouttheperilsofglobalizingthehistoryof medicine,andheradvicetohistoriansofmedicinetoengagemore effectivelywithpostcolonialstudiesandenvironmentalhistory,has notbeenignoredbyotherscholarsseekingtocolonizenewhistorical andhistoriographicalterritories.Inhisrecentreflectionsonglobal healthhistory,WarwickAndersonhashighlightedhowpostcolonial analysiscanenablehistorianstogenerate ‘criticalandrealistichistoriesofscalemakinginbiomedicine,oftheconfiguringofthelocaland globalinglobalhealth’ inwaysthatresistthehydraulicmetaphorsof circulationand flowthattendstilltoprivilegetheglobalNorth.18 As Anderson’sownworkonbiomedicineandbiotechnologydemonstrates,apostcolonialperspectiveallowshistorianstoholddifferent contextsandtrajectories ‘withinthesameframe’;to ‘interrupta globalisationthatlackshistoryorpolitics’;to ‘recognisetheentanglementsofmultipleagents’;toreveal ‘themutualreorganisationofthe globalandthelocal’;andtotrackthe ‘increasingtransnationaltraffic ofpeople,practices,[and]technologies’ . 19
Itisimportanttorecognizethat,inthesecontexts,thetermpostcolonialdoesnotrefermerelytoachronologicalframeworkof analysis.Italsocapturesahistoriographicalapproachthat,asKavita Sivaramakrishnanhasargued, ‘tracesthepersistenceofcolonial powerstructures’ andtheirimpactoncontemporary ‘ideasandpracticesinglobalhealth’ . 20 Asimilarlenshasbeenusedbyenvironmental historians,suchasGreggMitman,MichelleMurphy,andChris Sellers,toscrutinizethelinksbetweenhealthanddisease,onthe onehand,andstructuralandecologicalchange,ontheother.New scholarshipintheseareas,theyarguedintheirintroductiontoa specialissueof Osiris someyearsago,demandsinterdisciplinary
researchpartnershipsthatenableus ‘toexplorethenexusofplace, healthandpoliticaleconomyindiversesitesandtimesaroundthe world’ 21 Byweavingtogetherthemethodsandinsightsofhistory, geography,anthropology,andsociology,itbecomespossibleto developmulti-sitedanalysesthatidentifytherelationalaspectsof health,unravelandconfrontthehistorical ‘tanglesofeconomyand flesh’,andexposethemannerinwhich ‘privilegeandviolence’ are builtintoexposuretodiseases,poisons,andpollutants.22 Herethe conceptualandempiricalworkofscholarssuchasDoreenMasseyon theintimateconnectionsbetweenspaceandtime,MargaretLockon howpathologyandplaceinteracttoproduce ‘localbiologies’,and ArjunAppadurai’sarticulationof fivedimensionsofglobalcultural flowsoffershistoriansofmedicinetheresourcestoavoid ‘grand narratives’ atthesametimeastheyacknowledgetheglobalscaleand complexityofmanythreatstohealthandwell-being.23
Thescholarwhohasarguablydonemosttobringtheseissuestothe attentionofhistoriansofmedicineinthelastfewyearsisMark Harrison,whoseownresearchnotonlychartsthereciprocalrelationshipsbetweencommerce,labourmigration,andwar,ontheone hand,andhealthanddisease,ontheother,butalsoinviteshistorians tofocusonnetworksratherthannations,toadoptlonger-termperspectivesonstructuralandecologicalchange,andtoincludechronic non-infectiousdiseasesofprosperityinourevaluationofhowlocal andglobalfactorsintersect.24 ParticularlyvaluableisHarrison ’ s emphasisonrecognizingtheroleofmoderntradeandwarfarein establishingnewworldorders,markedbydecolonization,theriseof multinationalcorporations,theglobalimpactofneoliberalideologies, andtheemergenceofforeignaidandglobalhealthgovernance especiallyaftertheSecondWorldWar.Inaddition,hisexamination oftheconstructionof,andresponsesto,pandemicsremindsusto situatehistoricalstudiesofmedicineanddiseasewithinwider,and contested,discoursesofsecurity,uncertainty,andrisk.25 AsHarrison pointsout,theaspirationsofinternationalorglobalhealthpoliciesto provideacommonframeworkfordiseasepreventionandhealth promotionareoftenobstructedorfragmentedbytheneedtoprotect nationalsecurityandtrade.26
Harrison ’sprovocationispersuasiveandhaselicitedwarmlycritical responsesfromotherscholars,whohavedrawnonhisworkto
reinforceargumentsforadoptinghistoricalperspectivesthatlink globalandlocal,aswellashumanandnon-human,dimensionsof diseaseandhealthcare.AsJ.R.McNeillhaspointedout,anyglobal historiographicalturnshouldincorporateattentiontothemovement ofanimalsandanimalpathogens,aswellasproductsandpeople, aroundtheworld.27 AlisonBashfordhasencouragedhistoriansof medicinetobroadenHarrison ’svisionbyfocusingonthemannerin whichneoliberalformulationsofproductionandreproductionare gendered.Anewmodeofanalysis,sheargues,wouldbetoidentify issues,suchaschildbirth,thatcanserveaswhatsomescholarshave referredtoas ‘glocal’ objectsofenquiry,thatisthosethatconstitute ‘matterssimultaneouslyintimateandinternational,privateandpublic,individualandaggregate’ . 28 Inproposingthathistoriansofmedicineadopta ‘zig-zag’ perspective,KavitaSivaramakrishnanreminds usthatweneedtoexplorealternativescalesandsequencesinorderto combattheuniversalizingandteleologicalnarrativesofglobalhistory. Newnarratives,heargues,arenecessarytoexposethe ‘regional circuitsofknowledgeandexchangethatoftencircumventedgeopoliticaldichotomies ’ andtodecentretheWest–restdialecticthatshapes ourhistoriesofmedicine.29 Sivaramakrishnan’scalltocomplement historywithethnographies,oralhistories,andthestudyofartefacts, manuals,andmemorieshighlightstheimportanceofassembling multi-disciplinaryteamsofscholarsinordertodeveloprelational approachesthatconnectlargelysynchronousandentangledhistories ofhealth,disease,andmedicine.
PatchworksofPractice
Inherwonderfullylucidreflectionsonspace,place,andtime,the geographerDoreenMasseyarguedthatweshouldunderstandplaces notasstatic,boundedunitsthatequateinanystraightforwardwayto communities,whichcanexist ‘withoutbeinginthesameplace’,butas uniquepointsofintersectionbetweensocialrelations,movements, andcommunications:
Insteadthen,ofthinkingofplacesasareaswithboundariesaround, theycanbeimaginedasarticulatedmomentsinnetworksofsocial relationsandunderstandings,butwherealargeproportionofthose relations,experiencesandunderstandingsareconstructedonafar
largerscalethanwhatwehappentodefineforthatmomentasthe placeitself,whetherthatbeastreet,oraregionorevenacontinent. Andthisinturnallowsasenseofplacewhichisextroverted,which includesaconsciousnessofitslinkswiththewiderworld,whichintegratesinapositivewaytheglobalandthelocal.30
Massey’sinsistencethatglobalizationreferstomorethanspatial reach,butthatitalsosignifiesandrealizes ‘thestretchingoutof differentkindsofsocialrelationshipsoverspace’,constitutesafruitful reminderthathistoriansofmedicineneedtocontinuetopuncture nationalnarrativesinfavourofaccountsthatunveilthepluralism, permeability,andpowerthatsaturatemedicalpractice.Atthesame time,itsuggeststhatweneedtoavoidwhatBarbaraWeinsteinhas calledthe ‘assimilationistdiscourseofthepostcolonialera’,which takesforgrantedWesternsuperiority,anddispensewiththenotion ofasingle ‘pointoforigin’ toexplaintheemergenceofdiseases, medicalknowledge,andhealth-caresystems.Rather,Weinsteinhas argued,weshouldthinkintermsof ‘multiple “contactzones”’,where ideas,practices,anddiseasebecomeentangledincomplexways.31 Herethenisamandateforamorevibrantglobalhistoryofmedicine thatfocusesnotonstatictraditionsorgrandnarratives,butinsteadon howthe ‘patchworksofpractice’ thatconstitutemedicinehavebeen variablyconstructed,maintained,transmitted,andtransformed acrossspaceandtime.32
Bychallengingsuper ficialnotionsoftradition,aconceptthattends toclosedownanyawarenessofeitherchanginghistoricalcontextsor thepoliticsofpractice,thisvolumeexploresnotonlyhowmedicine hasbeenpluralandpermeableinthepast,butalsohowithas routinelyreflectedandreinforcedpower.AsthechaptersbyVivienne LoandMichaelStanley-Baker,HalCook,Anne-EmanuelleBirn,and MarkHarrisoninparticulardemonstrate,therehavealwaysbeen ‘pluralhealingenvironments’,inwhichresponsestodiseasevary accordingtothehumanandnon-humanactorsandagentsinvolved. Althoughthesechaptersexplorethehistoryofmedicineacrosslarge countriesandcontinents,theyalsoargueforagreaterawarenessand analysisofregionaldiversity,forrecognizingwhatEdRamsdenrefers toinhischapteronNorthAmericaasthepresenceof ‘nationswithin nations’.Asanumberofhistorianshavepointedout,experiencesof healthandthepracticeofmedicineintheAmericanSouthwere
