The Caribbean and the Medical Imagination, 1764–1834: Slavery, Disease and Colonial Modernity by Emily Senior (review)

An explosion of interest in illness and health converged around the transatlantic slave trade, the growth and prosperity of Britain’s sugar islands, the Seven Years’ War, the American War of Independence, the Haitian Revolution, and abolitionists’ debates over the use of biological reproduction to supply bonded laborers for North American and Caribbean plantations. From the hiring of doctors to ply the Middle Passage and ensure healthy cargo to the conducting of experimental treatment by plantation and military doctors to secure healthy soldiers, sailors, and slaves, preventing illness and restoring health were central concerns of colonial life. Exploring colonial medical practices, historians examine European and Afro-Caribbean approaches to health and healing and the knowledge and conflicts produced when these two distinct medical traditions came into contact. Similarly interested in how the mass movement of populations out of Europe and Africa into the Caribbean created medical vulnerabilities and health crises that resulted in the development of medical knowledge and methods, Emily Senior’s richly researched book draws attention to how medical texts and medical ideas also drew upon literary concerns and literary forms. Medical knowledge not only relied on language for articulation; indeed, as Senior so thoughtfully shows, Romantic literary forms and themes also influenced medical knowledge production at the same time that illness and death shaped literary production. The georgic poetry, gothic fiction, pantomime, and melodrama of such physicians as James Grainger, John Gabriel Stedman, and George Pinckard, exemplify the synergy among illness, health, literature, and culture.

Weaving together classic topics in colonial history with newer concerns of medical history and literary studies, Senior examines themes of citizenship, creole identity, violence, and obeah, offering fresh perspectives on the exercise of imperial power and the contested relations of colonial domination. By arguing that European physicians’ agricultural verse—georgic poetry—sought to “‘transform the savage face of things,’ rendering the West Indian landscape audible and aesthetically pleasing to the European ear” (p. 52), Senior’s superbly written first chapter expands the classic colonial history metaphor that frames colonial agriculture as symbolic of Europeans imposing their sense of order on the New World. Poetic verse also sought to flatten the menacing threats of the tropics. Yet, as Senior illustrates in a provocative final chapter that rethinks conventional analyses of obeah and slave resistance, the imposition of European order was hardly unchallenged. Obeah gave cultural significance to matter Europeans discarded as mere filth or waste, or minimized in elevating agential power to climate and geography in causing diseases. Discussing the use of dirt as an ingredient obeah transforms to cause the illness and death of scores of enslaved people, Senior argues, “While the climatic and geographic understandings of diseases emphasized the agency of matter—of dirt—in its theory of noxious effluvia, obeah marshaled the power of dirt in ways that opposed European models of medicine and knowledge by calling upon the ideas of transformation which elide post-Enlightenment divisions of organic and inorganic, animate and inanimate” (p. 185). Obeah’s alchemy diverged from air’s inherent miasmatic quality.

The Caribbean and the Medical Imagination is as imaginative as it is thoughtful in its analysis of how medicine and literature offer new understandings of Creole identity and colonial modernity. Analyzing the concept of Creole through medical literature reveals a more complex picture beyond the commonly portrayed loss of Englishness. Medical creolization, as Senior proposes, captures the possibilities afforded colonizers in the tropics as they suffered disease and death and experimented with various methods of recovering health. The resulting “Creole epistemology” (p. 136) developed from the crucible of tropical illness and Afro-Caribbean medical methods held corrective potential for metropolitan learning. The colonial experiences of Creoles produced new knowledge and new perspectives that reshaped medical practices and literary culture. “Embodying the synthesis of old knowledge and new world” (p. 153), Senior concludes, Creole embodies connections between...