Suchergebnisse

This article is a history of the last stage of the global smallpox eradication programme, christened in India as the National Smallpox Eradication Programme (NSEP). Here I have attempted to show how the Intensive Campaign of the NSEP was forced to abandon its erstwhile language of targets and returns, whose acme was the mass vaccination strategy of the 1960s, and switch instead to a language of crisis and cases. It instituted a new practice where vaccination once again became a moment in a larger armamentarium, though not in quite the same way that variolation was a moment in a larger therapeutic structure in the eighteenth century. Unlike variolation, where it was self-imposed, the eradication campaign's rediscovery of individual segregation as a necessary tool, and village and community as hallowed space, were coupled with an imagery of the kill. In this imagery, smallpox had been radically transformed from a goddess to a demon that was no longer to be solicited and purged but fought against and vanquished. This leads us to two models of consecration and healing in the movement from the eighteenth to the twentieth century: from Sitala and the self to body populations and the state.

This essay is to be conceived in two parts. The first part is an exegesis of an eighteenth-century tract on the practice of smallpox inoculation in Bengal written by a Scottish medic. Cited repeatedly in the contemporary history and anthropology of smallpox in India, it has been invariably used to highlight the
technique
of inoculation in eighteenth-century India. Caught in disciplinary cleaving between anthropology and history, its original import has not been addressed. The exegesis in restoring the text to its intended import, argues that it offers a
theory
of smallpox, and in this theory the technique of inoculation is a moment in larger therapeutics. The latter-day privileging of this moment has resulted in seeing the nineteenth-century as a standoff between variolation (smallpox inoculation) and vaccination. The exegesis, however, recasts this as a passage from a therapeutics to a pure prophylactics that caccination represents. Having restored what I think is the central concern of the essay, I then begin to ask whether the essay is actually about the manner of inoculating for the smallpox in Bengal as Holwell says it is or is it actually about its practice in Britain. It is this very restoration, when we locate the essay in 18th century Britain, that allows us, in the latter part of the essay, to to see that not only is the theoretical articulation "induced" by his audience, but also every detail of the
description of the practice
, which has hitherto been seen as a description determined by his experience in India, is equally induced and
determined by his location in Britain
. While this could lead me to argue that Holwell's essay has nothing to do with India, I suggest that what the text effects, if not represents, is a kind of
translation
: one that is both possible and enabled by the fact that the kind of medical theory and practice that underlies disease and its cure is similar - not identical - in India and Britain.

This paper attempts to reconstruct the debate that marked the advent of vaccination in the 19th century. Having to contend with the ongoing practice of variolation, backed by professional variolators and a presiding deity, advocates of vaccination sought to portray the practice as a form of treason that needed to be outlawed on the ground that it provoked epidemics and hence was a public threat. The paper recasts the encounter by arguing that the preference for variolation may actually have been based on the continuous failure of vaccination, making it a risky venture for individual patients. Variolation, on the contrary, invariably 'took', and as part of a therapeutics ensured individual care and safe passage to patients. In the light of this, the paper examines the record of vaccination practices in the 19th century. Proffered with fanfare under the sign of individual safety and public welfare, the reach of vaccination was limited. But the rhetoric that sustained it was clearly constitutive of both a European self and a state in the making. As the prototype prophylactic it heralded the insinuation of the state between variolators and their erstwhile clients: a sign of the state's attempt to appropriate the right to be the sole addressee between state and citizen. More fundamentally, it was constitutive of the very terms 'state' and 'citizen', and their mutual relations.

This paper attempts to problematise the founding of 'Tropical Medicine' in the late 19th century as a classificatory act by posing a question: why was the discipline founded when it was and not earlier? In the process, it offers an alternate genealogy of its advent by arguing for a mid-19th century episteme, in terms of fevers, the constitution of the body, and the weather-in originating fevers and in predisposing the body towards disease—both in the temperates and the tropics, as being crucial to an understanding of the discourse on the tropics.

Ideas about health are reinforced by institutions and their corresponding practices, such as donning a patient's gown in a hospital or prostrating before a healing shrine. Even though we are socialized into regarding such ideologies as ""natural"" and unproblematic, we sometimes seek to bypass, circumvent, or even transcend the dominant ideologies of our cultures as they are manifested in the institutions of health care. The contributors to this volume describe such contestations and circumventions of health ideologies, and the blurring of therapeutic boundaries, on the basis of case studies

Frontmatter -- Table of Contents -- List of Tables -- 1 Global Mental Health -- Critical Histories -- 2 Mental Ills for All -- 3 Schizoid Balinese? -- 4 Misdiagnosis -- The Limits of Global Mental Health -- 5 Jinns and the Proletarian Mumin Subject -- 6 Psychedelic Therapy -- Alternatives -- 7 The House of Love and the Mental Hospital -- 8 Ayurvedic Psychiatry and the Moral Physiology of Depression in Kerala -- 9 Global Mental Therapy -- Afterwords -- 10 Global Mental Health -- 11 "Treatment" and Why We Need Alternatives -- Index