The Emergence of Tropical Medicine in France by Michael Osbourne (review)

In this volume, Michael Osbourne traces the entangled histories of naval and colonial medicine in France from the Napoleonic era through to World War I. Weaving together the biographies of key doctor-reformers with major shifts in naval regulatory regimes, Osbourne examines how the ‘‘life worlds’’ of port cities and their inhabitants shaped the production of knowledge about health and hygiene in ways that were highly localized. This book therefore serves as a useful contribution to the historiography of nineteenth century French medicine, not least because it privileges the ‘‘periphery’’ of maritime France over Paris as the primary site of inquiry. It also turns the history of tropical medicine on its head, focusing on the field’s development in France rather than in the colonies. In doing so, however, it develops an uneasy relationship with the recent historiography, which has largely moved beyond hagiographies of white men to consider the local developments of knowledge across cultures and within burgeoning international scientific networks as a way of resisting the metropole and nation as the dominant frame of analysis. This book is really about one specific variant of tropical medicine in France as understood and practiced by medical naval officers, and therefore provides a valuable but only partial view of the field’s development.

The book begins with the birth of the French navy via the 1689 ordinance that formalized its separation from the civil sphere and led to the creation of dedicated naval hospitals, medical schools, prisons, and arsenals. These new institutions clustered in the port cities of Brest, Rochefort sur Mer, and Toulon, which were marked by rich and variant regional medical traditions. While the navy was in charge of colonial medicine for much of the nineteenth century, reforms inaugurated under the Third Republic eventually yielded precedence to civilian and army medicine. Naval medical activities accordingly shifted to the cities of Bordeaux, Marseille, and Paris, marking a new moment in the history of French imperialism as well as the emergence of a new ‘‘universal tropical medicine’’ (10). Many of these transformations are tracked through the naval careers of doctors like Raphaël Blanchard and Félix-Alexandre Le Dantec, whose experiences point to the tensions that existed both within and across the various branches of the French bureaucratic state.

Perhaps the most novel contribution of the book concerns the importance of place, defined here as ‘‘not only a point on a map. . . also a site of meaning and attachment, one to which value is assigned, often through the textured facts of experience and memory’’ (4). For Osbourne place as a mode of analysis operates on two registers. The first is the distinctive social and disease ecologies of port cities and the ships that moved in and out of them. The second refers to the experience of living in these places, including the interactions of naval doctors with bureaucratic regulations that drove disparities in salary and opportunities for advancement. Part of what made port cities so distinctive was their role in the colonial economy that generated new demands for labour in the form of large public works. These projects relied on an influx of French migrant labour to coastal towns as well as the impressment of prisoner-labourers attached to the bagnes. From the ensuing ‘‘squalor, social dislocations and disease’’ (17) of urban living emerged a unique laboratory ripe for naval doctors who used their experiences abroad to bear on their investigations of ‘‘tropical diseases’’ back home.

For naval healers, the ‘‘implacable situatedness of morbidity and mortality’’ (7) — a phrase borrowed from Charles Rosenberg — served as powerful reminders of the usefulness of hygiene and medical geography even after the acceptance of the germ theory of disease and medical parasitology. A particular strength of this book is its focus on the institutional, social, and disease environments that structured the production of knowledge about tropical medicine. From the curriculum of naval medical schools to the standardization of information collected on...