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'An Awful, Unseen Visitant': The Return of Burdwan Fever

This essay does not probe why there was a malarial epidemic in Bengal in the 19th century, instead it explores how a series of dispersed and dissimilar debilities came to be represented as a single, continuous epidemic of malaria in Bengal and beyond for over most of the 19th century. The making of the Burdwan fever epidemic can hardly be ascribed to conveniently traceable intentions or a straightforward series of causes. The history of the unfolding of the epidemic hints at a "game of relationships".

EPIDEMICS IN SOUTH ASIAN HISTORYEconomic & Political Weekly EPW march 22, 200863Rajputana.2 He wrote in justification of funds sought to collect a “vast mass of unrecorded experience and unrecorded facts” involving malaria, which was in the possession of the medical department in India. The letter summarised the contradictory ways in which malaria was understood in contemporary medical thought. He suggested “although so much has been attributed to malaria, the actual existence of the poison has never been demon-strated. It is invisible, imponderable and unrecognisable by any known method. The most advanced chemistry has failed in detecting its presence even in localities where it is supposed to be produced in greatest abundance. All that we know of the charac-teristics and habitat of malaria has been deduced by inference from the presumed consequence of its presence.” Moore went on to mention some of the mutually “opposed and irreconcilable statements” on malaria that had been at different times “received and taught as facts”. …Thus by some the origin of malaria has been presumed to be from decaying vegetation; and a writer of repute (Rankin) has gone so far as to express the conviction that every tree is a “malaria trap” and that “every blade of grass in its decomposition vitiates the atmosphere”; – others again (as Fergusson), finding malarious diseases prevalent in dry and parched localities, here there was no vegetation, have referred to malaria to exhalation from ferruginous soils; (Martin) to decaying granite; (Dolimien) to emanations from drying soil of any description; (Parkin) to cells or spores originating from certain species of algoid plants; (Salisbury) to low vegetable organisms floating in the atmos-phere…Hutchinson to carbonic acid…Lawson argues for pandemic waves; Home refers it to lunar influence; Bascomb to hygrometric in-fluence, atmospheric pressure and electrical tension…3 Moore referred to an extensive range of accounts to say that the presence of malaria had been “deduced” in the vicinity of fresh-water marshes and swamps, the embouchures of many tropical rivers and irrigated rice-yielding land and soil saturated by salts. However, he pointed out, an equally elaborate corpus of medical topographies disagreed with such impressions. He concluded by mentioning that malaria could “kill at once”, recall-ing how medical authors in “India, China and elsewhere” had recorded instances of collapse and death, presumably because of malaria. Malaria could cause anything from heat apoplexy, cholera, dysentery, diarrhoea and epileptic seizures to a very “slight effect on the system” marked by only “the most trivial deviations from health”.4 In the late 1870s, the idea that malaria could mean anything, that it could be present anywhere and that it could cause many forms of physical unease was a medical axiom. Such an understanding of the contemporary theories on malaria encourages a return to the history of Burdwan fever. ‘Malarial Subjects’5Contemporary sources often portrayed the epidemic as a specta-cular disruption of the prevailing ways of life. It provided an occasion for dramatic lamentation, for a world that was lost. Its ravages have not yet been repaired, the ruined villages have not been yet rebuilt, jungle still flourishes where populous hamlets once stood, and many of those who fled before the fever have not returned…6 Rev Neale’s school numbering 130 boys is now deserted…7 …the rich and the poor of all ages and castes have suffered alike; con-sequently, dwelling houses of all descriptions in equal proportions are to be seen in various stages of decay and ruin…many large barees [houses] in which there were formerly 30 and 40 residents, have now been left with perhaps one solitary occupant; whole mohullahs and streets have been deserted, and large villages which formerly told their residents by thousands can now almost number them by hundreds…8 Ironically, the language of reporting different aspects of the epidemic used a vocabulary that described daily bodily niggles. These reports were frequently couched in a language endorsed by institutional science. Hence, they looked convincing, respect-able and legitimate. In these reports, expressions of physical unease figured as necessary preconditions, symptoms and sequels or simulations of a collectively experienced malady. Yadunath Mukhopadhyay narrated cases of patients who had been diagnosed to be suffering from malaria in successive medical texts in Bengali published through the 1870s.9 He suggested that malariadid not necessarily express itself through a fluctuating fever or by assuming a contagious character. Instead, its impact on the body, he believed, could make one feel “not sick, but out of sorts”. Malaria did not necessarily cause illness but “a slight deviation from health”.10 Malaria therefore figured as an onerous agent that could be cited to explain a wide variety of maladies. Such maladies ranged from diarrhoea, nausea, headache, infection of the eyeball, abscesses on the female breast or in the ear and secretion of pus or a general unlocatable malaise.11 Malaria also figured as a cause of cardiovascular arrests that could endanger one’s life. The series of cases that appeared in Mukhopadhyay’s texts involved his own experience of suffering from what he thought to be “malaria”. He identified a general lassitude, repeated yawning, the need to stretch oneself, a painful ankle, wind formation, intense, regular sluggishness and irritation and pain around the ear as inevitable preconditions to another attack of malarial fever.12In this way, the epidemic offered medical practitioners an opportunity to itemise sensations such as these as objects of medical knowledge. As items of medical knowledge, they appeared as predictable, manageable and curable categories. Gopal Chander Roy’s extensively cited account on the “epidemic” corroborates this. He listed frequent drying up of the tongue, accumulation of brown sores on the teeth and lips, a bloated face, oedematous limbs, oral ulcers, inflammation of the mucous struc-ture of the teeth, loose teeth and swollen or bleeding gums as probable symptoms of malaria in the body.13 Such associations inspired suspicions about the “malarial character of the epidemic” within the medical bureaucracy. The doubts were, however, carefully resolved. Certain government reports on the epidemic said that in its “worst aspects” it varied vastly from what medics had been accustomed to observe in the fevers that were supposedly caused by malaria. In its milder forms, however, it was suggested, the epidemic differed little from the “ordinary remittent and intermittent fevers, aggravated by local circumstances”.14 Many commentators on malaria in the 1870s, including Joseph Fayrer, Roy, C F Oldham and his anonymous reviewer in the Indian Medical Gazette,15 had definedmalarious diseases in terms of their periodicity. Prevailing histories have exaggerated this rigidity in the rhythms of recurrence, which is implicit in the
EPIDEMICS IN SOUTH ASIAN HISTORYmarch 22, 2008 EPW Economic & Political Weekly64distinction between intermittent malarial and remittent malarial fevers or between malarial and other diseases. Careful analysis of the caveats, the qualifications and the variations that accom-panied these discussions suggests that intermittent and remittent fevers were not rigid categories. By substantially accommodating exceptions and variations in the expected rhythms of recurrence of these fevers, 19th century texts flexed the malarial identity of maladies and extended it to fevers with various symptoms and diverse rhythms.16 For instance, in the book entitledQuinine by Mukhopadhyay, the logic of periodicity was made flexible and extended to fevers that recurred after days, weeks, months or even years.17 These recurrences were believed to be continuations of a malarial attack that had once taken place. This explains how the individual-body that had once suffered from fever became a “malarial subject”,18 who apprehended a relapse at expected periods of time and took precautions to resist it. Who then could be defined as a “malarial subject” in Bengal in the 1870s? Roy said that unexceptional attacks of “malaria” seldom deterred its victims from eating, drinking and bathing as usual.19 The unhappy effects of “malaria” became a natural phenomenon, a part of how the body tended to behave. Most of the patients would remain without fever for months or years and yet the slightest cause would upset the balance of health. Thus malarial subjects, or individuals caught in “the vortex of disaster”, could be those suffering from pigmentation of the skin, bleeding from the nose or rectum, mental inaptitude, rheumatism, night-blindness and impotency. They also included pregnant women weakened by the embolism of the heart and women suffering from menstrual flux.20‘Cinchona Disease’Surgeon Major Albert M Vercherie left a tour diary that described his visits to inspect reported “malarial” cases in Burdwan town in September 1873. He talks of a dhobi’s daughter whom he confronted in the bazaar. She was the patient of a local physician named Dina Bondhu Dutt. She was recorded in the official regis-ters as a case of “malaria”. In the 14 days Vercherie kept track of her, it was found that she was diagnosed successively with the following maladies: typhus, enteric fever, cholera and relapsing fever. “I heard from Dr French that the case became complicated by pleuro-pneumonia about 13 or 14 days of the disease”.21 Thus detailed individual case histories reveal that those who were labelled as suffering from “malaria” could be diagnosed with different diseases in different phases of the same continuous course of illness. The above example also reveals some of the words other than “malaria” that medical science had at its disposal to explain a similar set of symptoms. How could such confusion, presented in an abundance of closely simulating diagnostic tropes, be resolved? Mukhopadhyay reported a similar experience while attending to a little girl eight to 10 years old. She was initially diagnosed as suffering from cholera at the “collapse stage”. When the relevant fever mixtures and stimulants failed and the physician was about to give up, he decided to gamble with quinine. The girl gradually recovered. Mukhopadhyay narrated this to suggest how the malarial identity of a particular form of physical unease could be determined byhow the body reacted to quinine.22 A careful study of the individual case histories recorded during the “epidemic” reveals that such examples can be multiplied. Quinine was frequently invoked as a diagnostic tool. Thus cases labelled as “malarial” well into the third quarter of the 19th century owed their identity to the expertise of individual physicians, not laboratory tests. When all else failed, quick-fix pharmacological tests determined the fate of the patient. In many more ways, the “malarial epidemic” owed its identity to quinine. Decades before little debilities in various parts of Bengal began to be written about as diverse manifestations of a single, continuous malarial epidemic, quinine had been convinc-ingly advertised as the quintessential remedy for every form of malarial disease. Such advertisements were vigorously reiterated in the official registers at various times in the 1850s.23 Quinine was confidently acknowledged not merely as a febrifuge, but also as a prophylactic. This appeared firmly entrenched in the militaryfiles of the government. In certain regiments in British India, consuming a certain dose of quinine with breakfast was mandatory.24 Even travelling officials like lieutenant G S Hills, who doubted the labelling of the epidemic as “malarial”, were found to take daily preventive doses of quinine. The more I saw of the district the less competent did I feel to deter-mine upon any one particular cause for this dreadful scourge…I no-ticed in villages recently attacked, that a hot steamy atmosphere seemed to pervade the village, the nauseating and depressing effects of which were almost intolerable. I also experienced a cold chilly feel-ing creep over me in spite of the hot close atmosphere in the village…This sensation in my case was never followed by any pernicious ef-fects, which may be attributed to taking quinine daily…25As late as 1874, a considerable number of colonial officials sounded unsure about the malarial character of the many maladies. For instance, Vercherie, a member of the Indian Medical Service, was convinced that it was typhus.26 Lieutenant governor Richard Temple, writing a decade after Hills, seemed equally hesitant to attribute the series of maladies in contem-porary Bengal to “any particular cause”. But whether this fever arose from any particular cause or causes, or why the causes, whatever they were, should have come into operation during particular years, are questions which cannot be answered medically or scientifically. There are things unknown, just as the ori-gin of cholera is unknown…and if ignorance exists, it ought to be fully and frankly acknowledged … I cannot suggest any measures…in con-tending with an awful unseen visitant, whose origin, advance and end no man could know.27 Doubts persisted into the 1870s among some of the highest officials about the precise causes of fever, ill health and death. Or whether they all ought to be considered as expressions of a single general outbreak. However, there seemed to be a consensus that quinine could be the unquestionable remedy for it. Years before doubts about the “malarial” character of the epidemic could be conclusively resolved, quinine had made its way into the interior of Bengal.28 The indiscriminate use of quinine was even being condemned in some government correspondences.29 Through most of the 1860s
EPIDEMICS IN SOUTH ASIAN HISTORYEconomic & Political Weekly EPW march 22, 200865and the early 1870s, government files in Bengal reveal organised efforts to procure additional quinine from Madras and Bombay Presidencies to combat the “outbreak”.30 They also reveal obsessive efforts in indenting quinine from England31 and tracking the details of its journey from there,32 in frequently measuring its stock in medical stores33 and in requesting the military depart-ment to spare some quinine for the civil department.34 It is very difficult not to notice the voluminous correspondence among officials at different levels: the districts, the subdivisions and the divisions, supervising and instructing panchayats about the distribution of quinine in the villages. Such correspondence almost suggests how the units of revenue extraction began to be projected as units of affording relief. Since the 1850s, the careers of malarial diseases and quinine were repeatedly written about as integral parts of a single, shared history. Reports in medical journals,35 stories narrating the glories of the Jesuit Bark,36 reports on journeys into the Peruvian forests37 and the statements of the early managers of cinchona plantations in India38 informed official under-standing. This resulted in the impression that quinine and malarial diseases were inseparably linked. The presence of one seemed to imply the presence of the other. At a time when the official characterisation of dispersed debilities and deaths in Bengal suffered from imprecision, government alacrity in distributing quinine contributed to reinforcing the malarial identity of the epidemic. An impression that the introduction of quinine to Bengal had immediately preceded the outbreak of the epidemic was reflected in certain publications in the late 19th century. In an editorial of the homeopathic journal entitledThe Calcutta Journal of Medicine, the epidemic was seen as a consequence of introducing quinine to Bengal. Its editorial characterised the epidemic as a cinchona disease, which was born of consuming regular doses of quinine to stave off intermittent fever. It argued that while quinine relieved the body from mild and temporary forms of intermittent fever, it plagued the body with a worse and enduring disease: cinchona disease. If the homeopathy law be correct, which is the case; if it be a truth founded in nature that diseases can only be safely and permanently cured by remedies the pathogenetic (sic) symptoms of which are simi-lar to those of the disease, then quinine shares its pathogenetic traces with malaria…has not their original disease been converted to a worse one, which does not, indeed return at separate periods of an equal du-ration but which is continuous, though more concealed?… Behold how asthmatic they are; behold their hard and distended abdomen, the hard swelling of their loins, their lost appetite, their repulsive taste, the oppression which every nourishment produces in their stomachs; behold their undigested and unnatural stools, their anxious, unre-freshing sleep, interrupted by all sorts of dreams! See, how they crawl about, as it were faint, joyless, desponding, susceptible out of humour and stupid, tormented by a greater quantity of ailments than was caused by their intermittent fever! How long does such a cinchona dis-ease frequently last, which can only be relieved by death! Is that health? It is not intermittent fever, I grant, but I say, and I challenge contradiction when I say so, it is not health; on the contrary, it is another and worse disease than intermittent fever; it is a cinchona-disease worse than intermittent fever…If then cinchona be continued in larger doses in order to prevent future attacks in this case a chronic cinchona cachexia is formed…39 Such impressions survived well into the last decade of the 19th century. Fuelled by revivalist flames, the Bengali journal Chikitsa Sammilani blasted the government policy of distributing quinine at cheap rates through post offices, saying it had caused general sickness and fever in rural Bengal since 1893.40 ‘…Opportunity of the Epidemic…’The malarial epidemic and quinine in 19th century Bengal were caught in a symbiotic relation. It has been indicated how quinine was invoked to add weight to the malarial identity of the epidemic. The epidemic was thought to have unleashed itself at a time when the credibility of quinine was being called into question. It proved to be an occasion when the usefulness of quinine as an effective drug could be tested once again, for commentators inside and outside state medicine had begun doubting its potential, both as a febrifuge and a prophylactic.41 The distribution of quinine, it was alleged, fell into the hands of “unqualified impostors” and “mischievous quacks” who frequently tampered with its purity, producing adulterated forms. Quinine gave them access to quick, easy money despite its lukewarm success as a cure. The Sanitary Commissioner of Bengal himself in a letter written in June 1869 expressed concern about the falling faith in quinine because corrupt forms of it circulated in the market. Under the existing circumstances, when a villager himself, or a mem-ber of his family, is weakened by fever in a malarious district, it is cus-tomary for him to purchase what is called quinine from some village apothecary who deals in medicines, which he sends for to Calcutta. In many instances I have examined and tasted the so-called quinine mix-ture of the Bengal villages, and often found it be an altogether spuri-ous and useless remedy; and yet for a small quantity of this and simi-lar preparations, it is common for a villager to give two or three rupees at a time, the consequence being that the poor man remains uncured, whilst at the same time he is being beggared.42 How could a supply of pure quinine endorsed by the state be ensured? It was suggested that the government could depend on “reliable agents” at the village level. A small medical store might be made over to some trustworthy agent…Zamindars would, I dare say, consent to appoint their reliable agents for the sale of government medicines…supervised at time by the head-masters of village schools. These men, as a rule, take an interest inthe physical welfare of the people; they are an intelligent class; and in many instances I believe they would be willing to undertake such a duty…43 The resolve to distribute “pure quinine” through headmasters has been indicated in other contemporary sources as well.44 What was this quinine that the state was keen on marketing as “pure”? Government factories had repeatedly failed to produce “pure quinine” in India till then. The factories managed to make several quinine substitutes such as quinovium, quinidine, cincho-nidine and cinchonine. The government was keen on endorsing these substitutes as acceptable variations of “pure quinine” though they were often regarded as “adulterated quinine”. Quinine continued to be advertised as a distant drug, which was very difficult to produce and procure but, said the government, its virtue could be sensed from the healing qualities of its substitutes.I had frequently been told that sulphate of quinine sold by native druggists in Calcutta and mofussil was largely adulterated by mixing it with flour, magnesia, arrowroot and other articles. I was therefore agreeably
EPIDEMICS IN SOUTH ASIAN HISTORYmarch 22, 2008 EPW Economic & Political Weekly66surprised to find that after analysis… were not adulterated by any foreign substances, but were either pure cinchonidine, or contained cinchonine, which are alkaloids found in the cinchona bark, and which cannot be distinguished from quinine by the naked eye or unless by analysis …45 In a letter in July 1872, the lieutenant governor instructed the inspector general of civil hospitals to use the opportunity of the epidemic to test the capabilities of the cinchona bark:The lieutenant governor desires that opportunity may be taken of the epidemic fever in Burdwan to test the use there of the cinchona bark which has already been ordered to be sent, in order to ascertain the capabilities of the bark when used as a simple infusion with boiling water. His Honour would like to find out whether a simple infusion of the bark is a really reliable febrifuge. Taking 500 patients suffering from the normal low miasmatic fever how many pounds of barks will approximately be expended in treat-ing them. It has been suggested to his Honour to put a special officer in charge of a certain amount of the bark at a certain place, with ordersto use only the simple infusion; the details of this proposition the lieutenant governor will leave to you to settle …46The epidemic thus became an occasion to test the medical efficacy of different extracts from the cinchona bark or the raw bark itselfafter it had been dissolved in water. Through such tests, the reliability of the quinine substitutes could be assured even if “pure quinine” had to be indented from England. ‘Local’Ordering myriad experiences of physical unease into a particular epidemic in 19th century Bengal was conditioned by and contin-gent upon an emerging culture of bureaucratic correspondence. The acts of reporting the epidemic, recording it and recapitulating it were shaped by the colonial medical bureaucracy and the intri-cate network of correspondences sustained by it.47 These converged at different times with blame games stoked by a nation-alist press, reports in medical journals, opinions solicited from people who supposedly had local or subdivisional knowledge, retrospective literary works and post-colonial histories to provide credible contours to the story of the “malarial epidemic”. The bureaucratic correspondence reveals an intimate, detailed engagement with the geography of rural localities. Almost coincid-ing with the first Census Report of 1871, the desire to know what caused the epidemic converged with an increased desire for know-ledge of the localities it was found in. The causes of the epidemic, it was argued, were inherent in “the numbers and the classes of the population, of tenures and rents, rates of wages and prices of food”. A series of 12 questions was circulated from the office of the governor general in council and “local officers” were “specially desired to give in their periodical reports all they know…”48 Knowledge of the locality soon went beyond the living conditions of the people to the landscape and the vegetation. Baboo Sunjeeb Chunder Chatterjee, a magistrate from Cantalpara, in an official letter to A Eden, secretary to the government of Bengal, pointed out the difficulties there were in gathering authentic knowledge of the localities. The magistrate was expected to personally carry out “detailed and careful inspection of each of the infected villages”. This being impossible, he often divided the burden among the police “darogahs” under him. Overburdened with assignments, the police darogahs ended up deputing their “fareedars” and “barkundauzes” to execute the magistrate’s orders. Chatterjee added that the fareedars and barkundauzes would inevitably prove incapable of exercising the required discretion when judging if certain trees and plants close to human habitations affected public health. The mass of people on the one hand are ignorant of the malarious in-fluence of the jungles, and on the other hand regard them as particu-larly useful in screening their zenanas from exposure to the public gaze, and especially in supplying their kitchen with vegetables, fruits and fuel. Therefore they would not miss an opportunity to induce the fareedars to pass over unnoticed such portions of the jungles as lie be-hind their houses, and have on that account little chance of being dis-covered from the principal road of the village if ever the magistrate should happen to pass along it.49 To avoid disputes, Chatterjee recommended the appointment of three special officers with sufficient penal authority to keep the fareedars and the villagers “under control”. It is not very clear from the records whether his recommendation was implemented. However, from the mid-1860s, one notices that special engineers were deputed to the “affected districts”. They were entrusted to “examine and collect information” on any specific “local works” that might be required for the “sanitary improve-ment” of particular villages.50 C Ducas was one such special engineer for the fever district in Burdwan division, entrusted with the job of locating the causes for the “epidemic” and remedies for it in September 1864. He reported after having visited the villages of Tribeni and Mugrah: The Kutchoo andOle, both bulbous plants, thickly cover the village land, so much so that village roads have disappeared under them, and the ditches have been choked with them. The slopes of tanks are also covered with theKutchoo.The bulbs of these plants are much used by the natives in daily food. The Kutchoo is used in place of potatoes and the Ole makes nicechutney, which is prepared in mustard oil, much in the same way a mango chutney is prepared in the United Provinces…There is not a single village road to be traced, except by the foot tracks…51After having described his visits to other places such as Balagore, Kanchrapara, Goopteepara and Jerat, the engineer suggested:Where foot tracks exist, regular village roads must be of necessity con-structed…So long as rank vegetation will be promoted, no engineer-ing work can be carried out so as to ensure permanent advances…nothing can be done to assist…theselocalities when the surface of the country is scarcely visible from the covering of undergrowth, and when village paths have disappeared under them in most places…52 How could improvement be guaranteed? Ducas’ solution was simple: denudation of excess, rank vegetation and cultivation of those lands. Chatterjee provided a list of 33 shrubs, creepers and plants, of which 27 had to be burnt as a precaution against malaria. The remaining six had to be rooted out. Among them, plants like ‘Kuchoo’, ‘Mankuchoo’, ‘Laoo’, ‘Shim’ and ‘Koomra’ would be spared if methodically cultivated in the fields while ‘Monsha’ would be preserved for worship.53 Thus a detailed engagement with some aspects of the local vegetation acquired great relevance in Ducas’ narration of the causes of the epidemic. Such details, otherwise quotidian and mundane, emerged as credible inputs in the engineer’s analysis of the locality. Similarly, dispersed, local tales concerning the landscape such as the drying up of rivers, the excessive deposit of silt in some of them, shifting levels in the subsoil and inconsistent rainfall combined with state initiatives at the sub-divisional level that
EPIDEMICS IN SOUTH ASIAN HISTORYEconomic & Political Weekly EPW march 22, 200867had backfired54 and gossip from rural gatherings converged in government reports to produce the impression they could cause another malarial outbreak.55 These various factors spoke to each other in a shared vocabulary as the authors of these reports rearranged the stories by invoking some branch of science. Thus the idea of malarial Bengal as a landscape undergoing many mutations was articulated in a language endorsed by science. The local tales were rewritten as physical changes in the landscape,56 engineering debacles,57 meteorological inconsisten-cies58 and debates concerning contagion.59 The ‘truth’ about the epidemic was expressed in these reliable and credible ways.60 The officials deputed to the interior of Bengal to furnish local knowledge were uniquely placed. They could dip into the profes-sional world of natural and engineering sciences while claiming to provide exotic local details. By claiming to know a locality and its inhabitants, they provided coherence to different experiences of unease in distant regions, which could all be seen as variations of one commensurate malady: malaria. They were agents, unaware or unintended, of a “larger pathologisation of space”, a trend reflected in medical writings across local, regional and national contexts.61 Thus the start of studying the interior of the body through dissec-tion and post-mortem converged with trends in framing knowledge about the “local” in British India, deepening the possibilities of construing medical and geographical stereotypes. Did such narrations inevitably converge into yet another condescending colonial statement on the poor levels of native sanitation? George Campbell concluded his minute on the Hooghly fever in August 1873 by quoting Haig, who had charac-terised lower Bengal as a “hollow in which the water stagnates and a mass of decaying vegetation festers in it; where noxious fumes exhale in the hot weather; while the damp of the raw cold weather render it still more unwholesome”.62 Malaria was imagined in contemporary sources as a mobile, peripatetic agent. Therefore it is hardly surprising that neither Haig nor Campbell attributed malarial fevers to unsanitary localities alone. Let us stay with Campbell for another moment: “All sanitary science notwithstanding…Colonel Haig truly observes that up to this time there has been much less fever in these reeking swamps than in the higher parts of Burdwan and Hooghly, where there is a sensible natural drainage…”63‘Travelling Epidemic’ Some of the prevalent histories on the subject tend to organise contending explanations offered for the epidemic in contempo-rary sources into a debate between two opposite positions. It has been suggested that while the emergent nationalist press, keen on resisting policies of improvement conceived by the colonial state, were explaining the epidemic in terms of the new channels of communication such as the construction of railway tracks and embankments and renovated roads, the colonial officials attrib-uted the epidemic to “indigenous” sanitary practices.64 However, the fragmented nature of the official explanation for the epidemic is seen in statements such as this in the files of the colonial medical bureaucracy: The history of the epidemic itself is equally strange. It is shown to havebeenunaccountably capricious and fitful in its incidence, seizing indiscriminately on towns whose sanitary arrangements were the best, and others where sanitation was quite neglected, and entirely over-leaping tracts which there was every reason to suppose most liable for to its attacks.65 The colonial medical bureaucrats frequently explained the epidemic by invoking the logic of communication. In the process, they often distinguished between communication and contagion. Such distinctions figured in an extensive range of official reports.66 … it progresses steadily although slowly, it has followed, like a rolling wave, the chief roads or means of communication and there was no evidence that sanitary conditions had changed to any extent during or shortly before the epidemic.67 In contemporary bureaucratic reports, “malaria” surfaced as that onerous entity that could communicate itself across distant regions. The word “communication” in these medical bureau-cratic reports had a different set of connotations than what it had in nationalist tracts. In medical bureaucratic imagination, “malaria” could travel even when agents of development such as renovated roads or railway tracks were not communicating it. As adoctor named Jackson wrote: “I regard the supposition that a line of railway embankment could, under any circumstances, originate a travelling epidemiclike that in Burdwan as ridiculous and unworthy of serious consideration.”68What communicated malaria was in dispute, but there seemed to be agreement across different sections of the medical bureau-cracy that “malaria” was travelling and carrying the epidemic along with it. When these medical bureaucrats referred to “lines of communication”, they were not necessarily subscribing to the anti-developmentalist positions articulated by the likes of Digam-bar Mitra.69 On the contrary, they were implicitly referring to, and drawing from, imaginings of malaria as a mobile category in the medical journals. In correspondences, malaria was imagined as a mobile entity that could travel like invisible waves across districts and provinces; that could remain latent in the body and could travel with it across continents;70and that “could drift up the ravines”.71 One account said “it moves like mist and rolls up the hill sides, and may travel with the wind for miles…”72 The transit of malarious particles, Massy of the Army Medical Depart-ment in Jaffna believed, was resisted by certain trees and their leaves were eventually stained with black rust.73 It is in the light of such imaginings that one has to read the charac-terisation of the “malaria fever epidemic” as a “travelling epidemic”.That the fever did travel is no matter for doubt. Like the waves of a flow-ing tide it touched a place one year and receded, reached it again next year with greater force and again receded, repeating this process until the country was wholly submerged and the tide passed further on…74 Its main feature is, as we have shown already, that it is travelling, slowly indeed, but, as some have remarked, yet travelling.75 Unlike the sweeping but uncertain marches of cholera and small pox, its progress has been slow but sure…76 Such widely circulated stories about travel fed into the idea of malaria as an ordering principle. These imaginings-bound diverse symptoms of physical unease dispersed across time and space into a coherent, continuous and single malarial epidemic. This explains how as late as 1899 Rogers could suggest “Burdwan fever” had a lifeline spanning half a century. He extended Burdwan fever’s life back and forth by weaving in “outbreaks” in
EPIDEMICS IN SOUTH ASIAN HISTORYmarch 22, 2008 EPW Economic & Political Weekly68Jessore in 1824, Nuddea in 1862, Mauritius in 1869, Burdwan in the 1870s and Assam and Rangpur in the late 1890s as different expressions of the same unending epidemic.77 A close reading of the bureaucratic correspondence reveals how the distances covered by the epidemic were put into quanti-fiable terms. “We have found it in our time to have travelled in 13 years from Nuddea to Hughly.”78 “From Jessore it spread slowly (from 5 to 10 miles per year) from one district to another for a period of over 20 years.”79 Rogers quoted the sanitary commissioner of Burdwan suggest-ing in 1874 that the epidemic followed a repetitive pattern until it left one locality for another: During the fourth, fifth and sixth years – six years being the average duration of the fever in any place – there was a general and slow re-covery, the fever in each successive year attacked fewer persons, was of a less fatal type, and prevailed for a shorter period, finally disap-pearing altogether in the seventh year.”80 Conclusions The making of the Burdwan fever epidemic can hardly be ascribed to a straightforward series of causes or conveniently identifiable intentions. The unfolding of the epidemic hints at a “game of relationships”: between medicine and governance; medical and natural sciences; patterns of bureaucratic reporting and diagnostic methods and the pharmacy industry; the desire for “improvement” harboured by the British government in India and the reactions of the “local proprietors”; and the tensions among different layers of local proprietors.81 Gleaning contemporary advertisements and medical manuals in Bengali help us to locate ‘others’ operating in the medical marketplace besides those who were blending diverse expressions of physical unease into a continuous epidemic. This alternative, “other” archive suggests how dissimilar ordering principles could be used to account for the ailments that were being explained through the metaphor of malaria. Practitioners who contributed to this “other” archive were often, with some exceptions, treated with condescension. G C Roy in his report on the Burdwan fever spoke of “a band of lawless resolute…whose prototypes we observe in quacks and empirics. These infest the country like locusts, and cause more devastation amongst humanity than the diseases which they pretend to combat.”82 A popular healer, Karal Chandra Chattopadhyaya, attributed his skills to divine benevolence and his medical recipes to the extensive travels he had undertaken through what he called “Bharatbarsha”. In his booklet entitledVividha Mahaushadh83 he does not acknowledge a debt to any individual or medical tradi-tion. He rarely met his patients in person, interacting with them through the post. Though this gave him little scope for diagnosis, his patients wrote to him about their complaints: various pains, bleeding from the rectum, impotency, infirmity, gonorrhoea, ulcers and fevers of all sorts among them. Such “complaints”, as we have already noted, were otherwise seen as symptoms of a single malarial malady. Chattopadhyaya wrote back to his patients, enclosing the required medicines without forgetting to mention the dosage and, of course, the price with postage, which varied from ailment to ailment. His patients came to know of him through advertisements he placed in the Calcutta and Bombay newspapers and also from testimonials that acknowledged his abilities in local newspapers. These were published in dailies from as far away as Dinajpur, Benaras and Lahore. A study of the advertisements published in Bengali newspapers in the late 1870s suggests that Chattopadhyay was not alone in his silence on the “malarial epidemic”. Nor was he the only self-proclaimed healer in Bengal to prescribe generic medicines other than quinine, or to exploit the emerging postal network to foster his trade.84 However, one has to be careful before over-reading these apparently “exotic” sources as a “counter-discourse” to that of the epidemic. While studying the epidemic as an epistemological construction, it is but natural that one encounters other modes of ordering diseases, alternative cosmologies and patterns of cure, often addressing overlapping markets. It is equally natural for these different modes to be locked in a relationship of mutual dismissal and condescension. Indifference to and disinterest in the language of the malarial epidemic – its aetiology and its management – were seen even within “medical science”. The Indian Medical Gazette published a series of editorials in different volumes through the course of 1873 on the topic “Prominent Fallacies in Epidemiology” which challenged the idea of “general” epidemics. These editorials described epidemics as a fallacy within medical understanding. Another usage of epidemiologists, which leads to most unfounded conception, and encourages wild and unprofitable speculation, con-sists in the mixture of the term “general” as applied to epidemics. A few cases of some epidemic diseases appear simultaneously, or at short interval, in different parts of a wide area, and the epidemic is without hesitation pronounced to be a “general” one. The human mind is, moreover incessantly hankering after causes, and the error of pronouncing a sprinkling of some epidemic disease to be a general phenomenon leads naturally to be facile, but absurd, conclusion that this must be due to some general influence or cause ... An abstract term “climate” or “epidemic influence” is invented or utilised, and made to do as a substantive “theory” of a more occult or quasi learned description…We have every right to reason that each instance is due to an identical cause or set of causes, but we have no right to conclude that it is due to the same cause or same set of circumstances. The whole process is a melancholy exhibition of false generalising.85 This questioning of the idea of epidemics as a general, widely dispersed, homogeneous phenomenon converged with consider-able scepticism expressed in some contemporary medical texts about the existence of malaria itself. Wrapping up, we return to Moore’s letter again:…it is probably the uncertainty and difficulty in accepting seemingly opposed facts which have caused a minority among eminent medical observers both in this country and in other parts of the world, to doubt, or altogether deny the existence of any such poisonous agent as malaria. In France and Algeria Dr Burdel regards marsh poison as “a myth’; Armam entirely rejects it as a figment of the brain. Among Anglo-Indian officers, Renine writing of China says: ‘Let mud and ma-laria alone, it will give no one the ague’… Hutchinson thinks malaria will be ‘only an old friend: Carbonic acid’; Dr Knapp, the President of the Iowa University, regards malaria as a ‘hypothetical cause’ that could never be empirically verified, which some practitioners were us-ing as ‘cloaks for ignorance’ that would eventually ‘hinder the progress of medical science’.86
EPIDEMICS IN SOUTH ASIAN HISTORYEconomic & Political Weekly EPW march 22, 200869Notes 1 For instance, see Arabinda Samanta,Malarial Fever in Colonial Bengal, 1820-1939, Social History of an Epidemic, Kolkata, 2002. 2 Dr Moore’s, ‘Proposed Inquiry into Malaria’, home department, Medical Branch, January 1877, File number, 47-48 B. For a discussion of the differ-ent 19th century theories about malaria, see Rohan Deb Roy, ‘Mal-areas of Health: Dispersed Histories of a Diagnostic Category’,Economic & Political Weekly, January 13-19, 2007, Volume XLII, No 2. 3 Ibid. 4 Ibid. 5 One finds this expression in Joseph Fayrer, ‘First Croonian Lecture on Climate and the Fevers of India’,Lancet, March 25, 1882, pp 423-26.6 Leonard Rogers, ‘The Lower Bengal (Burdwan) Epidemic Fever Reviewed and Compared with the Present Assam Epidemic Malarial Fever (Kala-Azar)’, Indian Medical Gazette, November 1897, p 401. 7 ‘Origin or Cause of the Fever’, General Department, Medical Branch, File 6, Prog-34-36, July 1873 (West Bengal State Archives, hereafter WBSA). 8 Home department, Public Branch, May 7, 1870, pp 65-71 A (National Archives of India. Hereafter NAI). 9 Yadunath Mukhopadhyay was a medical practi-tioner with the Subordinate Medical Service. Be-tween 1872 and 1880, he published at least eight medical manuals in Bengali. Mukhopadhyay and his works await more intense and detailed atten-tion from historians. His manuals includeVisuchi-ka Roger Chikitsa (Treatment of Asiatic Cholera) 1872, Quinine Prayog Pranali (A Treatise on the Use of Quinine for Treating Malarial Fevers) 1873, Parimitisutra (The Elements of Mensuration)1876, Chikitsakalpadruma (The Cyclopaedia of the Prac-tice of Medicine) 1877-78, Sarirpalana (Preserva-tion of Health) 1878, Sarala Jvara Chikitsa (On Bengal Fevers and Their Treatment) 1880, Chikitsa Darpana (Practice of Medicine for Practitioners) 1880), and Quinine 1893. 10 Yadunath Mukhopadhyay, Saral Jvara Chitiksa, Prothom Bhag (Curing Fevers, Part I)Calcutta, 1878. It would be misleading to suggest that such trends were unique to Bengal or to Burdwan fever. Mukhopadhyay’s understanding was shared and articulated across contexts. See the letter written by Arthur Christie on latent malarial disease to the editor ofMedical Times and Gazette London, May 11, 1872, p 550; ‘Papers by Ewart, Medical Charge Mewar Bheel Corps, on the Prophylactic Powers of Quinine’, home department, Medical Board, October 21, 1814 (NAI); Dr Moore’s, ‘Proposed Inquiry into Malaria’, home department, Medical Branch, January 1877, File number 47-48 B (NAI); See the definition of the categories ‘masked and pernicious malaria’ and ‘malarial cachexia’ in Joseph Fayrer, ‘Second Croonian Lecture on Climate and the Fevers of India’, Lancet, March 25, 1882, pp 426 and 467-70. 11 Yadunath Mukhopadhyay, Saral Jvara Chitiksa, Prothom Bhag (Curing Fevers, Part I)Calcutta, 1878, Yadunath Mukhopadhyay, Quinine, Calcutta,1893. 12 Yadunath Mukhopadhyay, Saral Jvara Chitiksa, Prothom Bhag (Curing Fevers, Part I)Calcutta, 1878, pp 39, 49, 50, 67.13 Gopaul Chandra Roy,The Causes, Symptoms and Treatment of Burdwan Fever Or the Epidemic Fever of Lower Bengal, Calcutta, 1876, pp 84 and 98-100. Roy’s work was widely circulated and reviewed. For a brief overview of the ways in which it was received in theLancet, Medical Times and Gazette, Medical Press and Circular andThe Doctor see, Ap-plication from Dr Roy, Civil Surgeon of Beerbhoom, for the patronage of the Secretary of State for his work on Burdwan Fever published in 1876, home department, Medical Branch, File 1-5 A. (NAI). 14 Home department, Public Branch, May 7, 1870, File 65-71 A (NAI). 15 Anonymous review of C F Oldham’s What Is Malaria? And Why Is It Most Intense in Hot Climates? Indian Medical Gazette, May 1, 1871, pp 99 and 100. 16 For instance, see, Staff Assistant – Surgeon Wm. Hensman, Remarks on Malaria, Appendix No L. Army Medical Department Report for the Year 1866, Volume viii, Harrison and Sons for Her Majesty’s Stationery Office, 1868, pp 505-11; Joseph Fayrer, ‘Second Croonian Lecture on Climate and the Fevers of India’,Lancet, March 25, 1882, pp 467-70. 17 Yadunath Mukhopadhyay, Quinine, Calcutta, 1893.18 One finds this expression in Joseph Fayrer, ‘First Croonian Lecture on Climate and the Fevers of India’,Lancet, March 25, 1882, pp 423-26.19 Gopaul Chandra Roy,The Causes, Symptoms and Treatment of Burdwan Fever Or the Epidemic Fever of Lower Bengal, Calcutta, 1876, p 75. 20 Ibid, pp 84 and 94-105. 21 Albert M Vercherie, ‘Extracts from a Diary Kept during a Visit to Burdwan in September 1873’, Indian Medical Gazette, November 1, 1873,pp 287-89. 22 Yadunath Mukhopadhyay, Saral Jvara Chitiksa, Prothom Bhag (Curing Fevers, Part I)Calcutta, 1878, pp 103-06. 23 For instance, A Bryson, ‘Navy Medical Report Number xv on the Prophylactic Influence of Quinine’, Medical Times and Gazette, London, 1854, viii; ‘The Practice of Giving Quinine or Quinine Wine on Distant Expeditions on the West Coast of Africa’, Statistical Report, Health Navy 1857, London, 1859, pp 82-85; Blair D, ‘On the Employment of Quinine on West India Fevers’,Lancet, London, 1848, ii, p 344; S Rogers, ‘The Protective or Prophylactic Pre-ventive, and Some Points in the Curative uses of Quinine, Applicable to Miasmatic Localities and in Miasmatic Diseases’,Transaction of the Medical Society, New York, Albany, 1862, pp 181-202.24 ‘Papers by Ewart in Medical Charge Mewar Bheel Corps on the Prophylactic Powers of Quinine’, home department, Medical Board, October 21, 1814,Octo-ber 28, 1852, December 2, 1858, 1858 (NAI). 25 From Lieutenant G S Hills, executive engineer, Shillong Division, on Special Duty, to H L Dampier, Commissioner of the Nuddea Division, December 31, 1864. home department, public branch, March 7, 1868, File no 140-143 A (NAI). 26 Albert M Vercherie, ‘Extracts From a Diary Kept During a Visit to Burdwan in September 1873’, Indian Medical Gazette, January 1, 1874, pp 8-12. 27 Richard Temple, ‘The Causes of, and Remedies for the Burdwan Fever’, Minute by the Lieutenant Governor of Bengal, August 25, 1875, home department, Medical Branch, File 53-55A, November 1875 (NAI). 28 Result of the Experiment for the Sale of European Medicines in the Mufussil, home department, Public Branch, April 1872, p 508 A (NAI). 29 Free Use of Quinine in Burdwan District, General Department, Medical branch, May 1872, pp 92-93 B (NAI).30 Supply of Quinine for the Relief of the Fever Stricken Localities in Burdwan district, home department, public branch, September 1872, pp 441-44 A (NAI).31 Supply of Quinine from England for Burdwan Fever, home department, public branch, Decem-ber 1872, pp 344-53 A (NAI).32 Supply of Quinine for the Relief of the Fever Stricken Localities in Burdwan district, home department, public branch, September 1872, pp 441-44 A (NAI).33 ‘Immediate Demand for Quinine for Burdwan Fever’, home department, Public Branch, August 1872, pp 574-577 A (NAI).34 ‘Supply of Quinine from England for Burdwan Fever’, home department, Public Branch, Decem-ber 1872, pp 344-353 A (NAI). 35 A Bryson, ‘Navy Medical Report Number xv on the Prophylactic Influence of Quinine’, Medical Times andGazette, London, 1854. ‘The Practice of GivingQuinine or Quinine Wine on Distant Expedi-tionson the West Coast of Africa’, Statistical Report,Health Navy 1857, London, 1859, pp 82-85; BlairD, ‘On the Employment of Quinine on West India Fevers’,Lancet, London, 1848, ii, p 344; S Rogers, ‘The Protective or Prophylactic Preven-tive, and Some Points in the Curative Uses of Quinine,Applicableto Miasmatic Localities and in Miasmatic Diseases’,Transaction of the Medical Society, New York, Albany,1862,pp181-202.36 For instance, Clements R Markham,A Memoir of the Lady Ana de Osorio, Countess of Cinchon and Vice Queen of Peru (ad 1629-39) with a Plea for the Cor-rect Spelling of the Cinchona Genus, London, 1874.37 Clements R Markham,Travels in Peru and India while Superintending the Collection of Chinchona Plants and Seeds in South America and Their Intro-duction to India, London, 1862. 38 For instance, the extensive range of official corre-spondence (home department, Medical Branch) involving the introduction of cinchona plantations in India since the early 1860s preserved in the NAI. 39 Calcutta Journal of Medicine, Volume v-vi, June 1873, p 198. 40 Quinine i malaria, (Quinine is malaria),Chikitsa Sammilani, 9th volume, 9th year, first issue, 1893. Such trends of attributing malarial fever to the intake of quinine have been witnessed in other contexts. For instance, see, W B Cohen, ‘Malaria and French Imperialism’, Journal of African History, 1983, pp 24-29; Aran S Mackinnon, ‘Of Oxford Bags and Twirling Canes: The State, Popular Responses’, and ‘Zulu Antimalaria Assistants in theEarly-Twentieth Century Zululand Malaria Campaigns’, Radical History Review, 80, 2001, pp 76-100.41 For instance, see J Elliot,Report on Epidemic Remittent and Intermittent Fever Occurring in Parts of Burdwan and Nuddea Divisions, Calcutta, 1863. Similar impressions were subsequently elaborated in Bengali medical texts. For instance, see the article entitled ‘Bhati, Anubikkhan’, Calcutta, 1873. 42 From D B Smith, Sanitary Commissioner of Bengal, to A Mackenzie, Officiating Junior Secretary to the Government of Bengal, June 5, 1869, home depart-ment, Public Branch, January 1870, pp 15-29A (NAI). 43 Ibid. 44 ‘Appointment of a Panchayat to Superintend the Distribution of Quinine in Midnapore District’, General Department, Medical Branch, p 192, pp 1-4, July 1873, WBSA. 45 No 1238, dated Calcutta, October 16, 1872, from S Wauchope, Officiating Commissioner of Police, Calcutta, to the Officiating Secretary to the Govern-ment of Bengal, Judicial Department, Sale of Adulterated Quinine in the Bazaar by Native Druggists, General Department, medical branch, Proceedings 6-8, October 1872, WBSA. There were several pieces in the medical journals on adulterated versions of quinine and other abuses of the drug. For instance, see, ‘Adulterated Sulphate of Quinine’,Indian Medical Gazette, Calcutta, 1872, vii, p 187; T Skinner, ‘Toxic Action of Quinine’, British Medical Journal,London, 1870, i, p 103.46 Dated July 6, 1872, from J Ware Edgage, Officiating Junior Secretary to the Government of Bengal, to Inspector General of Hospitals, Lower Prov-inces. Inspector General of Civil Hospitals to take the Opportunity of the Epidemic to test the Capabilities of the Cinchona Bark, General Department, Industry and Science Branch, July 5, 1872, WBSA. 47 Besides, the geographical frames of reference that formed the basis of these reports are those of the revenue extraction units: the presidency, sub-divisions, thanas and districts. These reports show how these divisions were being naturalised as rigid boundaries so that any transgression be-yond the borders of one district was taken note of, written about and accounted for. This led to the reinforcement of revenue generating subdivisonal categories of the colonial presidency as natural entities. It seemed commonsensical that diseases should be confined to one particular division or district. Diseases that spread beyond one district into another were considered to flout some natu-ral principle and were taken note of. For instance, Gopaul Chandra Roy,The Causes, Symptoms and Treatment of Burdwan Fever, Or the Epidemic


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