In the Blood: Sickle Cell Anemia and the Politics of Race (review)

Melbourne Tapper. In the Blood: Sickle Cell Anemia and the Politics of Race. Philadelphia, University of Pennsylvania Press, 1999. 163 pp. $22.50.

For more than fifty years the dominant view among anthropologists and geneticists has been that there is no “reality” to race; yet race persists in our culture as an axis of social stratification, and many people (scientists among them) unthinkingly continue to believe that visible racial differences reflect an appropriate biological categorization of human beings. Science studies scholars who address the question of race often do so out of admirable political commitment: a desire to understand the tenacity of this bizarre notion in order to contribute to its abolition.

Melbourne Tapper is an anthropologist interested in sickle cell anemia as an aid in explaining twentieth-century views of race. He bases his discussion in discourse network analysis, a methodology that declines to assume the prior reality of the topic of any discourse. This approach should find some sympathy among historians of medicine who understand the malleability of disease concepts and recognize that scientific knowledge is socially constructed. Tapper does not say so explicitly, but not assuming the reality of a thing need not mean denying that it exists. Thus readers of this bookcan feel comfortable accepting that sickle cell anemia is a particular disease entity, while understanding that race exists only because it is the subject of discourse.

In the Blood consists of an introduction in which Tapper lays out his theoretical biases, followed by four somewhat independent essays and a short coda. The four main chapters explore how doctors and medical scientists have used sickle cell anemia—and the sickled cell itself—to reify the quality of being black. Chapter 1 deals largely with the 1920s and 1930s, when sickle cell came to be seen as evidence of black African ancestry. Cases that appeared among seemingly white people led to genealogical studies intended to find either evidence of “race-mixing” in recent generations or reason to believe that populations had intermingled in the more distant past. Chapter 2 looks at the “anthropathology” of the American blacks, a concept originated by the African-American physician Julian Lewis, author of The Biology of the Negro (1942). Here Tapper concentrates on comparative studies that tried to establish incidence of sickle cell anemia as the result of hybridization in the Americas absent among “pure Negroes” living in Africa. Chapter 3 analyzes work done in the 1940s and 1950s whose object was to trace common racial origins of populations with a high prevalence of sickling, and thus to substitute a biogenetic understanding of ethnic differences in place of cultural explanations. The last chapter examines sickle cell anemia in 1970s United States as a component of the political redefinition of blackness in terms of “personal conduct and social formation” (p. 94).

How well, then, does Tapper use the history of sickle cell anemia to explore the idea of race in our culture? Perhaps out of fear that it would imply a positivistic approach, Tapper seems reluctant to tell the scientific story as a series of events in chronological sequence, and without landmarks sometimes his point gets lost. Part of the discourse whose network he is analyzing is Victor Emmel’s invention in 1917 of a test for sickle cell. Tapper discusses testing programs extensively but barely mentions Emmel. James V. Neel is a major actor in chapter 2, yet Tapper makes very little of his role in demonstrating that sickle cell anemia patients must be homozygous for the sickle cell trait. Tapper several times brings up the discovery of the balanced polymorphism (the fitness advantage that heterozygotes experience in malarious districts), but he gives short shrift to the role of population genetics in providing a new way to look at the demographic distribution of sickle cell or to ecologists’ theorizing about how...