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Introduction British Medicine as Imperial Medicine 2 INTRODUCTION T HIS book is about the role of British imperialism in the making ofVictorian medicine and science. The career ofPatrick Manson, the "father" of the modern study of tropical medicine, serves as the point of departure for an exploration ofthis relationship from the mid-nineteenth century until the early twentieth century. Why Manson? He is worthy of a book-length study not least because of his pioneering research into the role of the mosquito in the development and spread ofthe Plasmodia protozoa (the cause of malaria disease) and other human pathogens. As medical adviser to the Colonial Office (18951911 }, Manson also played a critical role in the domestication of research into the diseases ofthe tropical empire at the London School of Tropical Medicine, which was founded in 1898 and continues to operate. Moreover, in the wake of decolonization, Manson's reputation has provided a contested ground for specialists and historians alike who are engaged in forging an understanding of the place of Western medicine and science in European imperialism and its lingering consequences. This study is by no means the first. There have been two earlier biographies ofManson. The first, coauthored by Col. Alfred Alcock and P. H. MansonBahr (Manson's son-in-lawandlater research protege), appeared in 1927, some five years after Manson's death. In 1962, Manson-Bahr was the sole author of Patrick Manson: Father of Tropical Medicine.1 Each biography reflects the affection of Manson-Bahr and Alcock for Manson based on their long professional association and personal ties. As patron, Manson was instrumental in the appointment ofAlcock, a retired member of the Indian Medical Service, to the London School as medical entomologist in 1905, where he remained a fixture for over a decade.2 Manson-Bahr married Manson's daughter Edith Margaret in 1909 and in 1921 assumed the editorship of the textbook Tropical Disease, which Manson first published in 1898.3 After Manson died in 1922, Manson-Bahrbecame his most devotedmemorialist. In articles, addresses, and books, he singlehandedly established Manson's reputation as the founder of tropical medicine.4 Manson's reputation is not simply a product of the intersection of personal and professional relationships. More important, it forms a discursive site for locating the place of British medicine and science in society and the wider world. As a self-made man from a commercial family in Aberdeenshire, Scotland , Manson had a career that epitomized the openness of medicine and affirmed the "lad ofparts" national myth in which social mobilitywas the reward for the ambitious and resourceful aspirants of the middle and upper classes.5 After receiving his medical degree at Aberdeen University in 1866, Manson yielded to "an urge to travel" or "adventurous spirit" and launched his career INTRODUCTION 3 as a port surgeon for the Imperial Chinese Customs Service.6 For Manson-Bahr, this impulseprovided a fortuitous opportunityfor the diffusion ofwestern medicine . Over nearly twenty-five years, Manson's effectiveness as a surgeon and practitioner among the inhabitants of south China enriched him while confirming the superiority of Western medicine as a system of healing? Indeed, the College of Medicine of Hong Kong, which Manson helped found in 1887, continued the process of modernizing China by training future generations of practitioners in Western medicine long after he had returned to Britain in 1889.8 Manson's reputation derives in large part from his scientific endeavors in the tropical periphery. Pride of place is given to his 1877 discovery of the role of the mosquito in the development of the filaria worm.9 (The presence of this worm in the human bodycauses a range ofdiseases alongthe lymphaticvessels and extremities chiefly by disrupting the flow of fluids in the body.) The importance of this discovery rests not so much on filaria disease-which affected primarily the indigenous inhabitants-as on Manson's later application of the mosquito-parasite relationship to the problem of the transmission of malaria. In practical and cultural terms, malaria posed the single greatest challenge to the expansion of European colonies. The wide swaths of the tropics, rangingfrom Africa to South America to China, designated as the "white man's grave" testified to stubbornly high levels of mortality and morbidity among European imperial servants. In defining the boundaries of European civilization , this designation defined its comparative absence as well. Manson's 1894 mosquito-malaria theory turned the tables on the tropical natural world, however . In four years, Manson and his collaborator, Ronald Ross...


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