Leprosy in Colonial South India: Medicine and Confinement (review)

In her study on nineteenth-century India, Jane Buckingham examines how sufferers of leprosy experienced colonial power as it was expressed through public health laws to control the disease and through western medical practices used to treat those confined to asylums or prisons. Buckingham explores what it meant for patients to live with a chronic, degenerative disease. She devotes the better part of two chapters to the confinement of leprosy sufferers, describing to good effect the institutions in which they found themselves living. She examines which patients were outpatients and why, and which lived as inpatients. She argues convincingly that, before 1860, confinement was more similar to a hospital stay for those leprosy sufferers with families and homes, whereas for those without home or families confinement was in effect a prison sentence.

In discussing treatments for leprosy, Buckingham argues that, throughout the century, British doctors used both indigenous and western remedies. She details the use of external treatments, including massage with neem leaves, as well as those treatments taken internally. She describes the mercury and arsenic treatments and the fumigation recipes that included zinc, copper, and powdered cobra meat as well as one with carbolic acid. In one of the most compelling sections, she focuses on one doctor at Port Blair, an island penal colony, who settled on gurjon oil, a wood sealant, which had been used for treating gonorrhea and perhaps as an indigenous treatment of leprosy. She also discusses the increasing use after 1870 of another indigenous remedy, chaulmugra oil, though in general she finds that, in this period, British doctors borrowed fewer remedies from indigenous practitioners. According to Buckingham, western doctors picked and chose treatments, using what was available and adjusting treatment regimens used in Britain and Europe.

Buckingham is least successful in her analysis of medical research and the exchange of scientific theories about leprosy. The chapter “Concepts of Leprosy” gives an overview of European and Indian medical and scientific theories about leprosy, followed by individual chapters devoted to these theories and treatment for the disease. Although she returns to the theories she catalogs at the start, they seem to be unmoored, floating free from any social, cultural, or intellectual context. It helps that she provides short biographies of those who practiced medicine among lepers, and those who theorized about the disease, or drafted policies to control it. The biographies are far too brief, however, and are inconveniently placed at the end of the book. They belong in the text where they might provide some insight into why particular policies on the control of the disease were put in place. The organization of the book makes it difficult to piece together the connections—weak or strong—between theories on the etiology of leprosy and medical practices to treat it, or public health policies to control it.

Questions of theory and practice aside, the book’s greatest strength is Buckingham’s ability to summon “the essential humanity of the leprosy sufferer” (p. 191). She succeeds admirably, with an attention to leprosy sufferers that is unflinching, a result of her careful research on the experience of the disease in its different forms and stages.