- Western Medicine and Public Health in Colonial Bombay: 1845–1895
Mridula Ramanna’s Western Medicine and Public Health in Colonial Bombay: 1845–1895 is a welcome addition to a growing body of literature on colonial medicine. During the past two decades historians have revised an earlier picture of colonial medicine as benevolent in monographs on tropical medicine, medical practitioners, disease and public health, colonial discourse, and gender issues. In most of these studies medicine is seen as the handmaiden, although often a hesitant and confused handmaiden, of imperial policy. In a review essay critiquing the direction of this work, Warwick Anderson bemoans the fact that so much of it looks at how Western medicine differs in each setting rather than asking “what is colonial about Western medicine in any setting.” He urges historians to study the “global circulation” of Western medicine as well as its reception, to attempt to understand “migrancy as much as situatedness.” (“Where Is the Postcolonial History of Medicine?” Bulletin of the History of Medicine 72.3 (1998) 522–530). It is colonial medicine’s situatedness that Ramanna has tackled in this case study of British policy and Indian reactions in nineteenth century Bombay, the largest city in the British Empire.
This book covers a wide range of topics from medicine, medical practitioners, and medical institutions to disease, public health, and politics. In seven meticulously researched thematic chapters Ramanna presents colonial ideas and policies and Indian reaction and response. In each section she clearly demonstrates that Indians were largely responsible for the acceptance of Western medicine among the population.
The book begins with a detailed look at the state of native practitioners who continued to coexist with Western-trained doctors despite rhetoric denouncing them as quacks and legislative proposals to dislodge them. Ramanna tells us a great deal about the problems faced by Indian doctors, as well as their involvement in social reform and local politics. Turning to hospitals and dispensaries, and later in the book to facilities for women, she underscores the essential role of Indians in setting up and running medical institutions often without much help from the government.
If anyone still holds the illusion that the British brought scientific medical knowledge to India, they must read Ramanna’s chapters on ‘Sanitary Policy’ and ‘Coping with Diseases.’ While the British boasted about their civilizing mission and higher knowledge, for example, Lord Curzon said British medical knowledge in India was “built on the rock-bed of pure and irrefutable science,” ( The Indian Lancet, VIII (March 16, 1899): 248–249) the reality was quite different. What Ramanna documents is the incredible muddling of the British authorities confronting Bombay’s high death rate. Arguing among themselves about causation and cure, they were nevertheless certain they understood (and had good reason to despise) Indian society and culture. This made them unbelievably arrogant as they mismanaged situation after situation. No, it wasn’t polluted water that caused disease, it was miasma. No, it wasn’t hunger that caused the death of famine victims, it was fever. No, it was not overcrowding and poverty per se that accounted for the high death rate, it was Indian fondness for festivals and feasting!
Ramanna’s chapters on the Contagious Diseases Act and Facilities for Women both make it clear that women were of little importance to imperial administrators unless they threatened the health of the troops. The regulation of prostitutes in Bombay was only half-heartedly enforced, between 1870–1872 and again 1880–1888, and touched only a few of the women involved in this work. Indians, prostitutes, and even a number of British doctors found the acts absurd but the government clung to the belief that compulsory examinations and lock hospitals were the way to keep the army and navy healthy. Indian women were also wary of the benefits of Western medicine and especially suspicious of hospitals. While Indian men were keen to have women doctors provide medical care for their families, British prejudice against women professionals worked to hamper their careers. Grant medical college was opened to...