Medicine in an Age of Commerce and Empire: Britain and Its Tropical Colonies 1660–1830 (review)

The title of Harrison’s latest contribution to the history of medicine shines with promise. The combination of commerce, tropics, colonies, and medicine suggests the possibility of a multidisciplinary approach to the wider topic that would enrich our understanding of the dynamic, entrepreneurial British world of the long eighteenth century. The geography of commerce and colonialism/empire, and of medical locations, networks, and institutional structures; the anthropology of cultural and commercial interaction and exchange between indigenous and British medicine; the economics and business practices of medicine overseas; demography and statistics—all of these fields could be utilized to explore British medicine’s encounter with the “warm climates” of the tropics and the ways in which it informed, instructed, or influenced the medical men whose careers took them into the unfamiliar and the unknown.

The purpose of Harrison’s book is not, however, to explore the outward exposure of British medicine overseas but to examine the inward dynamic—the effect that the experiences of these medical men had on British medical culture and practice. Harrison’s concerns and methodology belong solidly to the history of professional medicine—an area in which the input of sociology has become so embedded as to be invisible to the interdisciplinary eye. The colonial “legacy” to British medicine was, Harrison argues, transformatory; it had a “formative influence upon the development of what came to be known as ‘Western medicine’” (9).

The views and experiences of individual practitioners, derived from their various writings, constitute Harrison’s source material and dominate his text. He examines medical ideas and practices in detailed case studies that also demonstrate how this medical world operated. It was a web of networks and communication, influenced by political, commercial, religious, and professional considerations. Commerce, however, does not in itself receive much attention. Harrison is less interested in trade and transport than in the military institutions that defended and supported those activities and that employed so many of the British medical men whose careers incorporated experience overseas.

The book falls into three parts. Part 1 considers “medicine as natural history,” as well as the release from cultural constraints that many medical practitioners enjoyed in the colonial context, enabling them to pursue knowledge by any methods deemed appropriate. Dissection, for example, was still relatively rare in Europe, surrounded by cultural taboos; in the colonies, however, postmortem examinations and the study of morbid anatomy became acceptable practice.

Part 2 considers tropical therapeutics. Part 3 examines the “ills of empire” and the perception of colonial commerce and administration as destructive of the very qualities of physical strength and political stability that had enabled and underpinned the enterprise in the first place. Service overseas brought wealth and new opportunities for consumption to Britain; it liberated intellectual inquiry and generated new scientific knowledge; and it helped to set medicine on the road to modernity. But these developments came at the price of death, disability, and identity crisis both at home and abroad. Notwithstanding the considerable benefits of the colonial enterprise—knowledge, material goods, and even wealth—the consequences for individual lives were frequently unhappy, and widely acknowledged to be so.