Disease and Empire: The Health of European Troops in the Conquest of Africa (review)

Philip D. Curtin. Disease and Empire: The Health of European Troops in the Conquest of Africa. Cambridge: Cambridge University Press, 1998. xiii + 256 pp. Ill. $64.95 (cloth), $19.95 (paperbound).

Few "real" historians have better demonstrated the recent integration of medical history into general historical enquiries than the distinguished Africanist Philip Curtin. More than three decades ago, his book The Image of Africa contained much on health and disease on the Dark Continent. More recently, his Death by Migration revealingly exploited the fact that military records often contain fuller statistics of morbidity and mortality than do their civilian counterparts. In that monograph, he examined the transplantation penalty paid when troops were moved from one tropical disease basin to another, or from the temperate home base to a tropical climate.

The present volume extends the method and narrows the focus. Curtin concentrates on Africa, but his concern is as much with military campaigns as with troop movements between disease ecologies. He convincingly argues that improvements in the control and prevention of disease in military circles between the 1840s and the 1860s provided the background for the scramble for Africa that so featured in European imperialism during the last third of the nineteenth century. These improvements were more consistently achieved in stationary barracks life than they were during campaign and battle conditions, but they did make possible a permanent military (and civilian) presence in areas that previously malaria, yellow fever, and other diseases had rendered virtually uninhabitable for Europeans. Death rates even in the 1870s and beyond could still be horrendous, and in most campaigns, deaths from disease far outnumbered casualties from enemy action.

Curtin has selected for closer scrutiny about a dozen British or French campaigns, in each case for which reasonable contemporary medical records survive. They range geographically from the north (Egypt, Tunisia) to the south (South Africa), not omitting the equatorial middle (Madagascar, several encounters with the Asante). Except for a brief mention of the first, disastrous Asante campaign of the 1820s, where the British lost from disease more than fifty men per thousand per month, they fall into the last third of the century. In general, British armies fared better than their French counterparts, with most British losses contained in single figures per month and most French reaching double figures.

Three diseases accounted for most of the disease mortality among Europeans and their African, West Indian, or Indian troops: malaria and yellow fever were long associated with the White Man's Grave, but in the northern and southern extremes of the continent, and especially in the latter decades of the century, typhoid also took a large toll. Although the mode of transmission of malaria and yellow fever was not elucidated until the end of Curtin's period, water was implicated in the spread of typhoid as early as mid-century, and its causative organism was demonstrated by Carl Eberth in 1880, the very year that Laveran observed the organism of malaria in blood smears of soldiers in North Africa. Effective water-filtering apparatus, such as the porcelain Pasteur-Chamberlain system, became available in the mid-1880s, and systems based on sand or charcoal were around much earlier. Quinine had been long known as both a cure and a prophylactic against malaria, and it was used periodically by the military from the 1850s.

Curtin shows that these "tools of empire" did affect troop mortality and morbidity; he also shows that they were neglected as often as observed, especially during marches and engagements. On occasion, he is forced to attribute some of the significant differences in campaign mortality to good fortune. Planning, medical management, and, above all, discipline did matter, however, even before germ theory provided a rationale for "modern" hygiene. Yet the home judgment of the success or failure of a campaign always had more to do with...