Leprosy and Empire: A Medical and Cultural History (review)

Leprosy's complexity and elusiveness to modern medical and cultural analysis is precisely the problem that Edmond successfully, if narrowly, addresses in this book. His case studies are primarily British but also include the Molokai leper colony in Hawaii. What is missing are French and other imperial experiences with leprosy, or how lepers themselves shaped their identities. Silla's superb, recent study of leprosy and identity in colonial and postcolonial Mali, which is completely absent from the bibliography, would have helped to provide a better grasp of the impact of this acute disease.¹

Even today, debates still linger about leprosy's unknown mode of transmission, its low level of infection, long latency, uncertain onset, and prolonged duration. The bacillus, first isolated in 1873 by Armaeur Hansen, a Norwegian scientist, has unfortunately demonstrated an alarming resistance to dapsone, once hailed as the wonder drug that would eradicate this ancient scourge.

The book's strengths are its thorough and thoughtful analyses of literary references to leprosy from the Bible through the works of Romantics like William Blake, Samuel Coleridge, and Mary Shelley to twentieth century observers who spent time inside leper colonies. The list of those who mention leprosy includes such diverse writers as Robert Louis Stevenson, Jack London, Graham Greene, and Paul Theroux. Edmond shows how leprosy has crossed or blurred the boundaries imposed on it, which might explain its past link to diet and food, especially exotic products that are neither ªsh nor fowl, such as breadfruit, which has the same capacity to cross or blur boundaries. It has also been tied to race—to Africans in the era of slavery, to Jews, and to other "aliens"—without lasting success, and even to sex. In a brilliant section, Edmond draws multiple meanings from leper colonies as an extreme example of "boundary thinking," making salient comparisons with other ways of isolating "others," including concentration camps, Native American reservations, lock hospitals, and tuberculosis sanatoriums.

This book will interest those who are concerned with the emergence of international public health. Like bubonic plague and cholera, both of which earned major scientific and diplomatic gatherings during the late nineteenth century, leprosy also received attention, especially at the Berlin conference of 1897 attended by such medical luminaries as Rudolf Virchow, Robert Koch, Gerhard Hansen, and Albert Neisser.