Medical Geography in Historical Perspective (review)

Medical Geography in Historical Perspective. Edited by Nicholas A. Rupke (London, Wellcome Trust Centre for the History of Medicine at University College London, 2000) 227 pp. $50.00

As the title promises, most of the chapters in this volume (originally issued as Medical History, Supplement No. 20, [2000]), comprise a wide-ranging, essentially historiographical, treatment of medical geography. Predictably, the focus is on the nineteenth century when medical geography (as we understand it) originated and on the influence of both Alexander von Humboldt and August Hirsch, although a search for ancestors invariably reaches back to the Hippocratic corpus (On Airs, Waters, and Places).

Historians predominate among the contributors; they range from senior scholars to doctoral candidates. An introductory chapter on the "Histories of Medical Geography" is followed by five essays subsumed under the heading "European National Practices"; another two chapters under the heading, "Colonial Discourses"; three more under "Cartographic Representations"; and two final essays comprising a section called "Epilogues." No explanation is offered for why chapters on both India and the Dutch East Indies are subsumed under "European National Practices" and another dealing with Arkansas and Missouri during the first half of the nineteenth century under "Colonial Discourses."

Geographically, much of the focus is on the tropics. In fact, terms like "medical geography" and "medical topography" were often used synonymously with "tropical medicine"—the often racial (and racist) preoccupations of the latter constituting a ready-made rationale for slavery and a handy tool of nineteenth-century imperialism. As a consequence, additional essays might have provided more completeness—perhaps one or more on the Caribbean islands, another on tropical Africa, and still another on the "regional" or "states rights" medicine of the United States in the decades immediately prior to the Civil War.

The aim of the authors and editor was to showcase something (not everything) of the recent resurgence of interest in medical geography, and in this goal they have succeeded. They make the point many times that the field-oriented, empirical observations of geographical medicine—so important to nineteenth-century medicine—were relegated to the ash heap of history by the birth of scientific medicine late in that century. But, in the words of Ronald Numbers that close out the work, "Nicolaas A. Rupke and his collaborators in this volume go a long way toward restoring medical geography to its rightful place in the history of medical science" (220). This book is an apt place to start for scholars interested in exploring the field. The contributors have provided copious bibliographical information, and the value of the work is enhanced further by an index of all authors mentioned in both text and notes.