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

In Leprosy and Empire, the example of leprosy in the decades between 1840 and 1920 enables the author to consider wide-ranging practices of exclusion, separation, and isolation in different parts of the imperial world and across many colonial territories. Edmond states that his intention is to situate leprosy “within the entangled relations of metropole and colony” (p. 17).

The dawning awareness of the possibility that leprosy threatened to “return” to the heart of empire and the mid- to late nineteenth-century debates about the nature of the disease are the starting points of Edmond’s discussion. This discussion centers on the 1867 Report of the Royal College of Physicians and the unremitting, rather dogged but liberal, defense of its findings by the honorary secretary of the College’s Leprosy Committee, Gavin Milroy. He held fast to the report’s conclusions that leprosy was a hereditary disease not requiring any special conditions of isolation and containment. In the face of the discovery of the bacillus Mycobacterium leprae as the causative agent of leprosy in 1873 and the death of Father Damien in the leprosy colony of Molokai, in Hawaii, in 1889, as well as the vividly reported examples of the random and difficult-to-explain contagiousness of the disease in the colonies and in Britain, leprosy became a topic of public discussion, and the “fear of return” ramified in the public imagination. Edmond then describes the development of tropical medicine and its incorporation of leprosy as a tropical disease and the island colonies of Robben Island, at the southern-most tip of South Africa; Kalapaupa, on Molokai, in Hawaii; and several islands off the coast of Australia, as well as Quail Island, in New Zealand, which were established in the high imperial period for the purposes of segregating and isolating leprosy sufferers.

This leads to a broader discussion of colonies of detention and incarceration such as the concentration camps of the Anglo-Boer war, the Native American Reservation system, and Indigenous Australian Reserves. These places are also seen in the context of nineteenth-century metropolitan forms of quarantine and segregation such as the agricultural colony of Mettray for adolescents in France, the lock hospitals, the smallpox isolation ships, tuberculosis sanatoria, and finally the Essex Leprosy colony. Both colonial outpost and metropolitan center exercise the same techniques of detention and separation. Out of these, Edmond concludes that “practices brought home and turned on pariah groups within Europe itself” (pp. 22 and 185) extend the idea of the colony to elements of the national population. The discussion concludes with the examples of writers who “transgress” the boundaries of the colony. Charles Warren Stoddard, Robert Louis Stevenson, Jack London, Graham Greene, and Paul Theroux go beyond the boundaries of the leprosy colony, either physically or sexually, risking contamination and writing about it.

Rod Edmond has done a service by documenting this phase of the history of leprosy, and he has thoughtfully and provocatively extended the discussion to the broader social landscape. This work can stand beside those that have discussed the nineteenth-century debates around contagion and heredity¹ and those that have discussed the leprosy colony as a microcosm of the colonial project.² It would have been another book, but more historical detail about leprosy in the period for this study could add layers of complexity and reinforce Leprosy and Empire’s argument. The leprosy colony of the nineteenth and twentieth centuries, even if only the island colony, still needs to be differentiated as a site historically, geographically, and in different empires. Not all leprosy colonies were the same; some were termed asylums, others were hospitals, and others were indeed colonies or settlements. Toward the end of this period, the agricultural leprosy colony was increasingly popular in India, in particular, but also in Brazil, and especially along the lines of the Mettray experiment.