The Politics of Medical Topography

Harriet Deacon, “The Politics of Medical Topography: Seeking healthiness at the Cape during the nineteenth century,” 279-297, in Pathologies of Travel eds. R. Wrigley and G. Revill (Amsterdam: Rodopi, 2000).

Deacon focuses primarily upon the imperial, moral, and economic reasons that Cape Town faded as an important health resort spot in the 19th century. It was longer on an important trade route and was unable to compete with Mediterranean or, more significantly, European health resorts in society and status.

I didn’t find a whole lot useful here, mostly because the focus was not on the role that science played in the Cape’s downfall (and attempts to remain relevant). Deacon spends a lot of time fleshing out the moral implications that the developing city with few aristocratic or other high-ranking imperial officials seemed to have for some of those who commented on it. While its climate was originally held to be quite healthful, the discourse on climate and its deterministic role in the making of the individual increasingly cast doubt onto the location’s healthfulness. Deacon argues that this change was one explained better by imperialistic and economic motives than medical or scientific ones.

In her brief description of the state of the environmental understanding of medicine (neo-Hippocratism) is interesting. It reinforces the assertion I have seen elsewhere that, contrary to some more teleological narratives of the making of modern bio-medicine, the germ theory of disease did not overtake or even hinder a more holistic understanding of health and disease prevention. “Environmental disease aetiologies, in both meteorological and sanitary forms, were so powerful that they were able at first to incorporate, and later exist alongside, germ theories of disease, especially in popular culture.” (281)

Deacon does describe an attempt by the Cape Government to legitimize its value as a health-resource through the collection of information about the climate and its “beneficial effects in many complaints.” (290) Unfortunately, she does not go into any depth; I wonder who collected the statistics, if they were gathered together and republished by an agency, and if any sort of marketing occurred. Did the marketing rely on the gathered information? In any case, the government and medical board turned to scientific, quantitative methods in the latter half of the 19th century to try and keep their resort relevant in a medical world increasingly dominated by a new, scientific epistemology.


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