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Medical Anthropology, Subaltern Traces, and the Making and Meaning of Western Medicine in South Africa: 1895–1899*
Published online by Cambridge University Press: 13 May 2014
Extract
All things in nature are interesting to study, and especially humanity. The different phases in the different classes of life cannot fail to be interesting, and a medical man can gain a far greater insight through such study into the domestic life of his fellow creatures than anyone else.
The word “progress” has its true meaning and significance in the higher walks of medicine. It does not mean a mere improvement in the principles and art of healing. It means a practical victory and conquest over nature by man. Now the greatest of all the aims of civilisation is the acquisition of natural knowledge, the conquest and subdual of nature to the service of the happiness of man.
The aim of the present paper is to examine the concept of western medicine in South Africa by exploring the forms through which its authority was established. The paper is based on an analysis of the South African Medical Journal (SAMJ), which resurfaced after 1893 as a monthly publication. Rather than seeing the SAMJ as a documentary source, I consider it to be a powerful representation of the making and meaning of western medicine and an indicator of the ascendancy and limits of western medicine. Most importantly, the SAMJ illustrates the intersection between an emergent western medical episteme and a larger colonial discourse of race and sexuality.
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- Copyright © African Studies Association 1998
Footnotes
The financial assistance of the Center for Science Development (South Africa) and the MacArthur Program (University of Minnesota) is hereby acknowledged. I would like to thank Jean Allman, Allen Isaacman, David Roediger, Adam Sitze, May Fu, Heidi Gengenbach, and Vivienne Mentor for comments on an earlier draft. They, however, do not share responsibility for the argument or conclusions drawn here.
References
1 “The Medical Professional and the Bedside Manner,” South African Medical Journal (hereafter SAMJ) 7/1 (May 1899), 14.Google Scholar
2 “The First Medical Peer,” SAMJ, 4/12 (April 1897), 255.Google Scholar
3 For a criticism of David Arnold's analysis of perspectives on the Indian plague see Das, Veena, “Subaltern as Perspective,” Subaltern Studies VI (Delhi, 1989), 317.Google Scholar Das suggests that colonial medicine is often studied in terms of its consequences rather than “the forms through which its authority is established.”
4 For an example of this approach see Burrows, Edmund H., A History of Medicine in South Africa: Up to the End of the Nineteenth Century (Cape Town, 1958).Google Scholar
5 van Heyningen, Elizabeth, “Public Health and Society in Cape Town 1880-1910” (Ph.D., University of Cape Town, 1989).Google Scholar This study builds on Maynard Swanson's earlier examination of the sanitation syndrome and urban segregation. See Swanson, M., “The Sanitation Syndrome: Bubonic Plague and Urban Native Policy in the Cape Colony, 1900-09,” JAH, 18 (1977), 387–410.CrossRefGoogle Scholar
6 Dubow, Saul, Scientific Racism in Modern South Africa (Cambridge, 1995).Google Scholar
7 These studies also draw on other medical sources such as the South African Medical Record. Dubow's study draws on the SAMJ mainly for the period after 1902.
8 In this essay, I am employing the word “native” neither in the derogatory manner in which it was used by colonialists nor in the way it is used by racists in contemporary South Africa. While conscious of the pitfalls of nativism, I am instead contesting a strand of postcolonial theory which only sees the native as a product of colonialism. In reading colonial medical documents I have seldom included the names of local medicines or the names of subaltern healers. To that extent I am aware that the production of knowledge is stacked against me. The designations “kaffir,” “native,” “Hottentot,” “Bushman,” and “coloured” are both symptoms of a colonial discourse and constitutive of the rules of that discourse. Basically, I am interested in the ways in which race and sex articulate with discourses of medicine. I therefore seriously consider the racial signifiers deployed in the medical journals as an effect of medical discourses.
9 Michel Foucault as cited in Stoler, Anne, Race and the Education of Desire (London, 1995), 3.Google Scholar
10 Burrows, , History of Medicine, 354.Google Scholar
11 The formation of the SAMA was proposed at the Fourth South African Medical Congress held in Graham's Town in December 1896. “Editorial,” SAMJ, 4/9 (January 1897), 224.Google Scholar
12 The BMA only accounted for one third of the total of about 800 doctors in South Africa (including Rhodesia). In 1896 its total membership was 102. “Annual Report of the BMA,” SAMJ, 4/7 (November 1896), 175.Google Scholar
13 Beck cited in Burrows, , History of Medicine, 354.Google Scholar
14 “On the Formation of the South African Medical Association,” SAMJ, 4/6 (October 1896), 145–48.Google Scholar
15 See for example “Notes,” SAMJ, 4/7 (November 1896), 175Google Scholar, which carries a notice from the Natal Branch of the BMA, rejecting the motion to form a South African Medical Association.
16 “The First South African Medical Association Conference, Johannesburg,” SAMJ, 6/7 (November 1898), 154.Google Scholar
17 “Editorial: The Fourth South African Medical Congress,” SAMJ, 4/8 (December 1896), 199.Google Scholar
18 DrAnderson, G.E., “Presidential Address to the Cape of Good Hope Branch of the BMA,” SAMJ, 4/7 (November 1896), 149.Google Scholar
19 “The First Reading of the Draft Constitution of the South African Medical Association,” SAMJ, 6/7 (November 1898), 154.Google Scholar
20 DrFernandez, H. E., “The Extraordinary Vitality of the Native Under Serious Injuries,” SAMJ, 4/2 (June 1896), 34.Google Scholar
21 Long, E.C., “A Wonderful Cure in Basutoland,” SAMJ, 4/8 (December 1896), 198–99.Google Scholar
22 DrDarley-Hartley, W., “Medical Ethics in South Africa,” SAMJ, 5/2 (June 1897) 31.Google Scholar
23 “Debate on Medical Ethics,” SAMJ, 5/2 (June 1897), 32.Google Scholar
24 DrHeath, T.H.L., “Medical Ethics,” SAMJ, 5/5 (September 1897), 115–16.Google Scholar
25 Ibid.
26 Andrew Smith was attached to the Native Institute at Lovedale in the Eastern Cape, where he conducted his research on locally used drugs.
27 See for example “Matters of Current Interest,” SAMJ, 4/2 (June 1896), 41.Google Scholar
28 Railing, Ernest, “Review of Smith's Contribution,” SAMJ, 4/1 (May 1896), 22–24.Google Scholar
29 Pappe was a Professor of Botany at the South African College.
30 Railing, , “Review,” 23.Google Scholar
31 For a synthesis of this view see Dr.Maberly, John, “Notes on the Pharmacology of Some South African Drugs,” SAMJ, 7/6 (October 1899), 123.Google Scholar
32 Railing, , “Review,” 22.Google Scholar
33 Ibid.
34 “Reports of Medical Meetings,” SAMJ, 4/1 (May 1896), 27.Google Scholar
35 Dr.Scholtz, W.C., “London Notes,” SAMJ, 5/3(July 1897), 67.Google Scholar
36 Dr.Maberly, J., “Notes on the Pharmacology of Some South African Drugs,” SAMJ, 7/6 (October 1899), 123.Google Scholar
37 Ibid.
38 Dr.Blaine, Ben, “A Case of Anthrax Treated by Blepharis Capensis,” SAMJ, 5/5 (September 1897), 122.Google Scholar
39 Maberly, , “Notes on the Pharmacology,” 123.Google Scholar
40 “Proposed South African Addendum to the British Pharmacopoeia,” SAMJ, 7/1 (May 1899), 18.Google Scholar
41 Ibid.
42 Railing, Ernest, “Suggested Colonial Addendum to the British Pharmacopoeia,” SAMJ, 7/1 (May 1899), 19.Google Scholar
43 An alternative account of the dispersed nature of South African pharmacology should consider other strategies by which black practitioners denied white practitioners access to their knowledge. The examples provided here are the only ones that I have been able to glean from the SAMJ.
44 Maberly, , “Notes on the Pharmacology,” 123.Google Scholar For a discussion on Jane Waterston as an “agent of empire” see van Heyningen, E., “Agents of Empire: The Medical Profession in the Cape Colony, 1880-1910,” Medical History 33 (1989), 450–71.CrossRefGoogle ScholarPubMed See also Bean, Lucy and van Heyningen, E., eds., The Letters of Jane Elizabeth Waterston, 1866-1905 (Cape Town, 1983).Google Scholar
45 Burrows, , History of Medicine, 234Google Scholar
46 Dr.Casalis, G., “The Phenomena of Menstruation and Parturition Among the Native Women of Basutoland,” SAMJ, 4/2(June 1896), 29.Google Scholar
47 Ibid., 30.
48 Ibid.
49 Ibid.
50 Ibid.
51 Ibid.
52 Ibid.
53 See “Editorial,” SAMJ, 4/3 (July 1896)Google Scholar, for a vote of thanks to Casalis for his insightful research.
54 George Casalis was the son of Eugene Casalis of the Société des Missions Evangéliques, the person often credited with being the first to “write a full account of the customs and beliefs of the Basuto.” Ashton, Hugh, The Basuto (London, 1952), vii.Google Scholar
55 Eugene Casalis cited in ibid., 55.
56 Casalis, , “Phenomena of Menstruation,” 31.Google Scholar
57 Ibid.
58 Chidester, David, “Mutilating Meaning: European Interpretations of Khoisan Languages of the Body,” in Skotnes, Pippa, ed., Miscast: Negotiating the Presence of the Bushman (Cape Town, 1996), 8.Google Scholar
59 Stoler, Anne and Cooper, Fred, “Between Metropole and Colony: Rethinking a Research Agenda,” in Cooper, and Stoler, , eds., Tensions of Empire: Colonial Cultures in a Bourgeois World (Los Angeles, 1997), 7.Google Scholar
60 Casalis, , “Phenomena of Menstruation,” 32.Google Scholar
61 “Responses to Dr. Wilson's Paper on Phthisical Resorts,” SAMJ, 4/7 (November 1896), 177.Google Scholar
62 Ibid.
63 Ibid.
64 See Swanson, “Sanitation Syndrome,” and Van Heyningen, “Public Health.”
65 “Annual Presidential Address to the Cape of Good Hope Branch of the BMA,” SAMJ, 4/7 (November 1896), 149.Google Scholar
66 “The Fourth South African Medical Congress,” SAMJ, 4/9 (January 1897), 224.Google Scholar
67 “Report on Natal Medical Council Meeting of 10 September 1897,” SAMJ, 5/7 (November 1897), 172.Google Scholar
68 Dr.Egan, C.J., “Presidential Address to the Fourth Medical Congress,” SAMJ, 5/1 (May 1897), 4.Google Scholar
69 Ibid.
70 Dr.Greenlees, D., “Remarks on Lunacy Legislation in the Cape Colony,” SAMJ, 5/9 (January 1898), 228.Google Scholar
71 Ibid.
72 MOH 1/2, Doc 516, State Archives, Cape Town, South Africa.
73 MOH 1/2, Doc 524 (no. 142 H), State Archives, Cape Town, South Africa.
74 Greenlees, , “Remarks,” 228.Google Scholar
75 Ibid.
76 Ibid., 229.
77 Dr.Fuller, , “An Original Research into the Causes of Death from Infantile Diarrhoea,” SAMJ, 5/3(July 1897), 57.Google Scholar
78 Dr.Dodds, , “Presidential Address to the Cape of Good Hope Branch of the BMA,” SAMJ, 7/8 (December 1899), 167.Google Scholar
79 Ibid.
80 Ibid.
81 “Review of Report of the Medical Officer of Health for the Cape Colony, Dr. Turner, for the year 1895,” SAMJ, 4/8 (December 1896), 209.Google Scholar
82 “Minutes of Meeting of Cape Medical Council: 3 March 1899,” SAMJ, 6/12 (April 1899), 255.Google Scholar
83 Ibid.
84 “The Medical and Pharmacy Act: Prosecution at Wynberg,” SAMJ, 7/1 (May 1899), 2.Google Scholar
85 “The Case of False Death Certificates: Dr. Anthony Accused,” SAMJ, 7/2 (June 1899), 22.Google Scholar
86 Ibid.
87 Ibid.
88 “Report of the Registrar of Births and Deaths,” SAMJ, 7/5 (September 1899), 111.Google Scholar
89 Dodds, , “Presidential Address,” 167.Google Scholar
90 Gramsci, Antonio, Selections from the Prison Notebooks (New York, 1992), 416.Google Scholar
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