Maladies of Empire: How Colonialism, Slavery, and War Transformed Medicine Jim Downs Belknap (2021)
“History performs a social task,” wrote George Rosen in his classic 1958 book A History of Public Health. “It may be regarded as the collective memory of the human group and for good or evil helps to mold its collective consciousness.” Rosen’s book grounded modern US public health in the experiences of European immigrants in urban areas. It scarcely mentioned ill health among enslaved or formerly enslaved people — but his words were prescient.
Historian Jim Downs has now given global context to nineteenth-century advances in medicine and public health, beyond the dominant histories rooted in Western Europe and the ancient world. In Maladies of Empire, he centres slave ships, people living in colonized countries, prisoners and wars in the narrative of medical discovery, at the foundation of epidemiology. He barely mentions what is often cited as the field’s origin story, when British doctor John Snow removed the handle from a London water pump and ended a cholera outbreak in 1854.
Downs’s first goal is to “make visible” how epidemiological thinking emerged from imperial conquest and the exploitation of enslaved people. He delves into archival records to recount how Western medical men — they were nearly always men — drew on the transatlantic slave trade. These researchers studied the health consequences of enslavement and thence began to understand disease transmission. For example, the study of ventilation emerged from the holds of slave ships and crowded prison cells. British and other European doctors observed and discussed cholera outbreaks in the Caribbean and elsewhere before Snow stopped one in London.