Cambridge University Press, 2017. 332 pages.
Malaria has long garnered no shortage of interest among global health experts and the medical anthropologists periodically at their sides. The sustained concern owes in one part to the fact that malaria remains a major threat, and in other to the devilish assemblage of insects, microbes, pharmaceuticals, poverty, and power the disease entails. This assemblage constitutes fertile ground for a 21st century medical anthropology increasingly affected by conversations arising from attention to ontology, multi-species studies and the field of new materialisms. Yet, even as these ongoing conversations train our ethnographic attentions to the more-than-human dimensions of health and medicine, the ways that history—and particularly, the history of medicine—might inform and/or alter these debates remains underexplored.
Rohan Deb Roy’s Malarial Subjects:Empire, Medicine and Nonhumans in British India, 1820–1909 steps into this breach with considerable acumen. Meticulously researched and elegantly written, the book does not present a history of malaria per se, but rather offers an investigation of the various subjects—human and otherwise—that historically co-constituted the disease in India and beyond. From the outset, Malarial Subjects forces us to dispense with our present-day sureties of what malaria is. Well before the disease’s etiology came into focus at the turn of the 20th century, ‘malaria’ circulated throughout the colonial world as an amorphous category indexing a broad range of ailments including fevers, eye infections, diarrhea and so on. Along the way, the diagnosis engendered what Roy terms ‘malarial subjects’ – a range of associated phenomena that shaped the disease’s protean ontology. Malarial Subjects excels at bringing into view these multiple subjects that together made malaria a focal-point of colonial medicine. Roy shows in vivid detail how, even in its most acute expressions, malaria was always a “game of relationships’ (153), involving plants, pharmaceuticals, land, bodies, insects, bureaucracy, and other actants. The beauty of the book lies in the analytic agility with which it tracks these many moving parts.
Indeed, as Roy’s analysis makes clear, one cannot apprehend malaria in 19th century India without paying its subjects due attention. Among Roy’s malarial subjects are: the chemistry of quinine; the botany of the cinchona tree from which it was harvested; the designs of colonial bureaucracy and its curious relationship to pharmaceutical capital; and geographies of medical expertise, spanning continents and empires. The six chapters of Malarial Subjects walk readers through these and other elements of malaria’s assemblage. We learn first of the botanical networks that brought cinchona, the fabled ‘fever tree’, from South America to India and the subsequent struggles of the British to establish cinchona plantations on the subcontinent. The book’s early focus on plants necessarily transitions to the fascinating chemical history of quinine, where Roy marshals diverse archives to bring readers into the labs of European chemists who attempted to isolate and capitalize on the quinine alkaloid, and concludes in the Indian factories where the drug was manufactured. In tracing out this history, the book also animates everyday colonial medical practices to show how the relationship between malaria and quinine disrupts the conventional sequencing of medical knowledge production. Typically, we think of a disease as precipitating its treatment. But in an era when malaria’s mosquito-borne etiology wasn’t yet known, the treatment, quinine, became a means to identify the disease. Thus, the “knowledge about a cure and a disease-causing entity,” as Roy notes, “to a considerable extent, shaped one another” (276). In describing malaria’s slippery ontology, Malarial Subjects joins a number of contemporary studies troubling the standard epistemologies of medical science—Sophia Roosth’s work on synthetic biology (2017), being a particularly recent and compelling example.
Yet, as Roy keenly demonstrates, however slippery malaria’s ontology was, it brought with it palpable exercises of power. For example, if cinchona/quinine was a “tool of empire,” as historians like Headrick (1981) and Brockway (1979) have suggested, Roy takes us into the malaria-ridden districts of colonial India to show how the British impulse to simultaneously combat malaria and open new markets for its drugs enabled deeper and deeper penetration into Indian bodies and territory. To compliment a rigorous engagement with the colonial archive, Roy’s readings of vernacular Bengali literature further afford the reader a medical “history from below.” Indeed, sensibilities of postcolonial critique sharpen Roy’s arguments throughout the book. More broadly, Malarial Subjects does important work to decenter Euro-centric geographies of medical expertise by chronicling how India emerged as a front-runner of malarial and pharmaceutical science. Importantly, Roy’s interrogation of malaria and power does not stop with the humans on various ends of the disease. Instead, the book closes with a provocative conceptualization of non-human empire—an analytic born of history but fit for our more-than-human present.
Malarial Subjects will be of great interest to medical anthropologists looking to bring history into their reckonings of ontology, multi-species studies, and new materialisms. Like the subjects of the malarial assemblage it unpacks, the book’s chapters work best as an interlocking set. That said, it may be productively broken down into shorter sections for teaching at the undergraduate and graduate levels. Pedagogically, the book grounds recent treatments of malaria in deeper histories of science and colonialism. Particularly when paired with recent ethnographies, it is sure to prompt excellent discussion of methods. By bringing historical analysis to the fore, Malarial Subjects serves, on final analysis, not so much as a rejoinder to the more-than-human attunements of medical anthropology, but rather as a catalyst for broader re-examination of methods, ontologies, and materialisms, new and old.
L. H. Brockway, Science and Colonial Expansion: The Role of the British Royal Botanic Gardens (New Haven: Yale University Press, 1979/2002).
D. R. Headrick, The Tools of Empire: Technology and European Imperialism in the Nineteenth Century (Oxford: Oxford University Press, 1981).
S. Roosths, Synthetic: How Life Got Made. Chicago: University of Chicago Press, 2017
Townsend Middleton is an Associate Professor of Anthropology at the University of North Carolina at Chapel Hill, who specializes in the political culture and history of South Asia. He is the author of The Demands of Recognition: State Anthropology and Ethnopolitics in Darjeeling (2015) and co-editor of Limn Ten-Chokepoints, as well as Darjeeling Reconsidered: Histories, Politics, Environments (2018). He is currently working on a book, The Quinine Chronicles, examining the afterlives of quinine in India.
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