Bringing together historians of science and medicine with environmental historians, and adding more contemporary vantage points from geography, anthropology, and sociology, Osiris Volume 19: Landscapes of Exposure offers an unprecedented interdisciplinary depiction of how, over the nineteenth and twentieth centuries, scientists and lay people have generated methods for connecting health and place, disease and ecology, calculation and risk.

Osiris, Volume 19

The University of Chicago Press

Contents

LANDSCAPES OF EXPOSURE: KNOWLEDGE AND ILLNESS IN MODERN ENVIRONMENTSGREGG MITMAN, MICHELLE MURPHY, CHRISTOPHER SELLERS: Introduction: A Cloud over History.........................................................................................................1ECOLOGY AND INFECTIONHELEN TILLEY: Ecologies of Complexity: Tropical Environments, African Trypanosomiasis, and the Science of Disease Control Strategies in British Colonial Africa, 1900-1940.....................21WARWICK ANDERSON: Natural Histories of Infectious Disease: Ecological Vision in Twentieth-Century Biomedical Science...........................................................................39NICHOLAS B. KING: The Scale Politics of Emerging Diseases......................................................................................................................................62ECONOMY AND PLACECONEVERY BOLTON VALENCIUS: Gender and the Economy of Health on the Santa Fe Trail..............................................................................................................79GREGG MITMAN: Geographies of Hope: Mining the Frontiers of Health in Denver and Beyond, 1870-1965..............................................................................................93GIOVANNA DI CHIRO: "Living is for Everyone": Border Crossings for Community, Environment, and Health...........................................................................................112MATERIAL FLOWS AND PUBLIC HEALTHSUSAN D. JONES: Mapping a Zoonotic Disease: Anglo-American Efforts to Control Bovine Tuberculosis Before World War I...........................................................................133HAROLD PLATT: "Clever Microbes": Bacteriology and Sanitary Technology in Manchester and Chicago During the Progressive Age.....................................................................149SCOTT KIRSCH: Harold Knapp and the Geography of Normal Controversy: Radioiodine in the Historical Environment..................................................................................167CRISTOPHER SELLERS: The Artificial Nature of Fluoridated Water: Between Nations, Knowledge, and Material Flows.................................................................................182EXPOSURE AND INVISIBILITYLINDA NASH: The Fruits of Ill-Health: Pesticides and Workers' Bodies in Post-World War II California...........................................................................................203LUISE WHITE: Poisoned Food, Poisoned Uniforms, and Anthrax: Or, How Guerillas Die in War.......................................................................................................220RONNIE JOHNSTON AND ARTHUR MCIVOR: Oral History, Subjectivity and Environmental Reality: Occupational Health Histories in Twentieth-Century Scotland...........................................234ADRIANA PETRYNA: Biological Citizenship: The Science and Politics of Chernobyl-Exposed Populations.............................................................................................250MICHELLE MURPHY: Uncertain Exposures and the Privilege of Imperception: Activist Scientists and Race at the U.S. Environmental Protection Agency...............................................266KIM FORTUN: From Bhopal to the Informating of Environmentalism: Risk Communication in Historical Perspective...................................................................................283NOTES ON CONTRIBUTORS..........................................................................................................................................................................297INDEX..........................................................................................................................................................................................299

Chapter One

ABSTRACT

Tropical Africa was one of the last regions of the world to experience formal European colonialism, a process that coincided with the advent of a range of new scientific specialties and research methods. The history of British attempts to understand and control African trypanosomiasis (sleeping sickness in humans and nagana in cattle), following the intense human epidemics that broke out between 1895 and 1910, reveals hitherto ignored scientific research in the fields of ecology, epidemiology, and tropical medicine that helped produce a new understanding of the "ecology of disease." Often generated within a transnational and interdisciplinary context, this knowledge increasingly assumed that vector-borne diseases in tropical environments were highly complex, dynamic, and interrelated phenomena. Thus while many people continued to hope that trypanosomiasis could be eradicated, research results made this prospect seem unlikely, if not impossible.

INTRODUCTION

In August 1939, Kenneth Morris, a young entomologist employed in Britain's Gold Coast medical department, wrote two articles for The Times (London) on his experiences "fighting a fly." Morris had worked in West Africa since the late 1920s and was one of the first entomologists there to undertake systematic field investigations of the various tsetse flies in the region, adopting what was then called a "bionomic," or environmental, approach. Morris's preoccupation with understanding life from the fly's point of view was evident in his articles. "This small grey insect ... which dominates so much of Africa's most fertile land," he told his audience, "is an aristocrat of the insect world.... [H]e is quick and sly in his habits and is remarkable among insects in possessing so few natural enemies. And in the wild untouched bush of his natural home he exists in millions." Much as it was for aristocrats in Britain, one of the fly's main occupations was the hunt for prey. At this point, Morris's admiration for the tsetse fly was superseded by his allegiance to his own species, for among the fly's prey were humans. "[E]very one of the tsetse is a potential carrier of trypanosomiasis," the parasitical disease that causes the fatal illnesses of sleeping sickness in humans and nagana in cattle. "Civilization," the entomologist concluded, "is incompatible with the presence of the tsetse fly."

For Morris, hope for future progress in tropical Africa lay "[o]nly in the quiet persistence of science in discovering and exploiting [the tsetse's] weaknesses." Researchers were subjecting to scientific scrutiny all facets of the fly's breeding grounds, including soil and climate, its means of securing blood meals, its digestive processes, its manner of infection by the trypanosomes, its affinity with particular flora and fauna, and even its "activity from hour to hour throughout the day." From his experience in the field, Morris felt that "tackling the problem from one aspect only, is bound to be a failure." What was needed was a comprehensive approach, which "combined the forces of entomology and medicine, veterinarians and agricultural experts," to reclaim land where humans, animals, and tsetse flies came into contact. "This study of the fly's relationship to its environment, known as ecology, is the very keystone," assured Morris, "to an understanding of the problem of extermination. A full knowledge of the fly's habits and of the complexities of his environmental requirements may make it possible to determine how the alteration of some small factor will lead to the disappearance of the pest.... This highly involved study must be carried out on the spot, in the fly's own home."

Luise White, in an innovative article on the social dimensions of African trypanosomiasis research and control in the interwar period, has argued that efforts in East and Central Africa "to study specific relationships-human to landscape, human to animal-that might cause or limit the disease gave way to the study of a vector alone, abstracted into the 'fly.'" On one level, she is absolutely correct: British academics, colonial officials, and technical research officers often tended to organize their observations about trypanosomiasis under the heading of "the tsetse fly." Yet as Morris's comments should suggest, for the researchers themselves this was less an abstraction than a shorthand designation to represent the full spectrum of issues related to the disease they wanted to stem. By following the fly, they could consider particular dynamics both in isolation and in relation to one another: fly to climate, fly to fauna, fly to flora, fly to parasite, fly to human. Yet the fly was never the sole point of entry for such studies. Researchers often chose to stress those realms for which their scientific training prepared them: parasitologists looked at trypanosomes, botanists studied vegetation, veterinarians explored cattle and game, physicians concentrated on humans, and entomologists, not surprisingly, dwelled on the fly.

The history of British efforts to understand African trypanosomiasis provides a useful lens to explore the dynamic interplay between ontology and epistemology, tropical and temperate environments, and colonies and the metropoles. In what ways was tropical Africa a significant site for ecological investigations regarding disease? How did studies undertaken there affect the thinking of practitioners in British institutions? Were there parallel trends elsewhere that fed into and reverberated with these new conceptual and methodological developments?

A story this complicated-involving two continents, dozens of individuals, and multiple research institutes-requires a multifaceted approach, one that jumps back and forth between the local and individual, whether in England or Africa, and the international and institutional. What unites the narrative are a set of conditions-epidemics, colonial rule, and the fear that trypanosomiasis might pose permanent obstacles to the (European) development of Africa-and a range of ideas, about natural complexity, infectious disease, ecological interrelationships, and even disciplinary reconfigurations. Above all, the story explores some of the epistemological and epidemiological consequences of imperial conquest.

COLONIZATION, EPIDEMICS, AND THE GROWTH OF AFRICAN MEDICAL DEPARTMENTS

The intensive colonization and territorial demarcation of tropical Africa occurred between 1880 and 1920, coinciding with a period in human history marked by rapid changes in bioscientific theory. As disciplines proliferated so, too, did new ideas: the germ theory of disease, hypotheses concerning a genetic basis of life, the advent of ecological studies, and advances in, among other fields, immunology, bacteriology, psychology, and neurology. In important respects, these changes were themselves an outgrowth of colonial encounters, yet their development and application across the European empires proved simultaneously uneven and sporadic. To capture this unevenness with respect to administrative concerns, imperial protagonists often likened their empires to organisms, suggesting both an "infinite variety of conditions" and an unpredictability with respect to their control. As technical and scientific work took root across the African continent, such metaphors were extended to African environments and their human populations.

One of the most unsettling experiences the French, British, German, Belgian, and Portuguese powers faced in the first decade of the twentieth century, following the "Scramble for Africa," was the outbreak of sleeping sickness epidemics across the continent's tropical territories. Although the actual mortality rates will never be known for certain, scholars conservatively estimate that between 750,000 and one million Africans died in this period. Even before the scope of the catastrophe was understood, scientists and financiers in the various metropoles mobilized to send research commissions to the territories to determine the disease's etiology. Between 1901 and 1913, fifteen such commissions were completed (eight under the auspices of Britain). While the immediate priority was understanding and stemming the epidemics, two underlying imperatives concerned interimperial competition and colonial development. No nation wanted to be trumped scientifically or otherwise by one of its rivals. More to the point, however, the colonial powers believed that, until the epidemics could be stopped, tropical Africa's economic future hung in the balance.

From these on-the-ground investigations, scientists offered new explanations of the disease phenomena they observed. In a preliminary report from 1903, the second Sleeping Sickness Commission of the Royal Society reported two findings: the animal disease, known by its Zulu name nagana, was in fact related to sleeping sickness, and "trypanosoma fever" and sleeping sickness were considered to be the same disease in humans. Its research in Uganda, the commission concluded, offered "proof" that "the trypanosome when it finds its way into the cerebro-spinal fluid produces sleeping sickness, and that the parasite is carried to man by a biting fly which is a species of the same genus, Glossina, as that which carries the trypanosome of nagana to cattle." Many questions remained, however, and these continued to preoccupy researchers in the years to come: Was there more than one species of trypanosome that caused sleeping sickness? What was the extent and duration of trypanosomal pathogenicity? What was the geographic distribution of the disease(s)? How was infection transferred between animals and humans? Did a kind of "racial" immunity to the disease exist? What types of tsetse fly species were responsible for carrying trypanosomes? What were the causes of different epidemic outbreaks? Finally, could the disease spread to other parts of the world, particularly British India? Though a disease agent, the trypanosome, and a vector, the tsetse fly, had ostensibly been identified, many scientists remained skeptical that the relationship between the two was fully understood.

Scientific uncertainty notwithstanding, colonial administrations were forced to take action to control the epidemics and, as several historians have noted, often did so with haste and considerable coercion. Colonial officials concentrated their attempts to manage epidemic outbreaks, with erratic success, on four methods: relocating populations from infested to noninfested areas; increasing population densities in lightly infested rural settlements; developing prophylaxis and chemotherapy treatments; and controlling, albeit on a variable scale, tsetse fly populations by clearing bush and vegetation, trapping flies, and killing game.

The amount of attention devoted to describing these endeavors in Britain itself was sufficient to inspire the novelist John Masefield to write Multitude and Solitude, in which the protagonist decides to abandon his career in the arts for a career in science. "Art seemed to him to be taking stock of past achievement, science to be on the brink of new revelations. He knew so little of science that his thought of it was little more than a consideration of sleeping sickness." The disease was "an almost human thing, a pestilence walking in the noonday.... It fascinated him." In this, he was not alone.

The period between the two world wars marked an important turning point in colonial governments' attempts to study and control diseases of all kinds. Not only were the new schools of tropical medicine and the newly established African medical departments augmenting and expanding their own capacities, but these changes were overseen and, in some respects, coordinated by Britain's Colonial and Foreign Offices and by the new intergovernmental Health Organisation of the League of Nations. The periodic international and interimperial conferences held in London, Paris, South Africa, and across the dependent territories (see Table 1) provided important vehicles for such coordination. In this way, with almost equal emphasis on African trypanosomiasis and general health care, the imperial powers rapidly built up an infrastructure for research, experimentation, and biomedical provision.

ECOLOGY INTO MEDICINE AND MEDICINE INTO ECOLOGY: DISCIPLINARY DEVELOPMENTS

In an important article on German and English epidemic theories in the interwar period, Andrew Mendelsohn opened with the question, "[W]here did the modern, ecological understanding of epidemic infectious disease come from?" While he writes that the "obvious answer would seem to be that it came from ecology," he rejects this explanation. "How indeed is one to imagine that the fledgling ideas and methods of upstart population ecology, or the premises of parasitology, which were of uncertain relevance to bacterial and viral disease ... could have conquered bacteriology?" He goes on to argue that, in fact, epidemics "became complex," and epidemiology more syncretic, through intellectual currents within the discipline of bacteriology itself. He locates this development in the decade following the First World War, a time when the influenza pandemic called into question existing explanations on the "causes and nature of [human] epidemics."

The full story behind the question Mendelsohn posed, however, remains untold. As he acknowledged, in the interwar period there were a "diversity of sciences" affected by such concepts as "holism," "complexity," "equilibrium," "web of causes," and "system," suggesting there had been "a broad intellectual transformation" among many scientific disciplines and their adherents, not just one. The evidence supports this interpretation and even pushes Mendelsohn's periodization back in time. Ecological ideas, principles, and research, fragmented though they may have been, clearly did have an effect on medical researchers, including epidemiologists, bacteriologists, and public health officials. Yet the converse was also true: adherents to ecology, in particular those concerned with questions of disease and health, drew upon the work of medically trained researchers, not least because such arguments bolstered the formers' evidence. A strong case could be made that the "new epidemiology" being promoted in Britain, which supported the idea that epidemics should be examined from the "bird's eye view of all from an aeroplane," was in many respects an organic bedfellow to that other synthesizing and "aerial" science, ecology.

There was a third dimension to this picture: tropical medicine. Historians have already made the point that this young discipline emerged equally from the biological and the medical sciences. "Structured around the life-cycle of parasites," writes Michael Worboys, "tropical medicine required detailed knowledge of the taxonomy of vector species and ecological management, which found application in the tropical environment." However much the different European powers saw each other in a competitive light at the turn of the twentieth century, their experience of sleeping sickness epidemics was a shared one. All classified the disease as endemic to "that portion of the African continent lying between the Tropics of Cancer and Capricorn," and all devoted considerable resources to its study in their respective institutes of tropical medicine. By the twentieth century's second decade, tropical medicine itself was undergoing key changes, shifting gradually away from a narrow and linear understanding of disease causation, in which microbes alone were targeted as the culprit, toward a more integrated and comprehensive approach. "[T]ropical medicine," noted Britain's Medical Research Council in 1925, "is no separate branch of medicine but touches all the fields of medicine and needs the services of all the medical sciences."

(Continues...)

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