Ludwig Edinger: Hirnanatomie und Psychologie

Lyons persuades us that sleeping sickness was indeed the disease of colonialism. Although endemic in small, isolated foci in the early colonial period, it increased in incidence around the turn of the century, becoming epidemic in some regions over the next decades. As in other parts of Africa, the upheavals and social disruptions accompanying colonial conquest produced ecological crises which affected all aspects of life. Central to her interpretation is the contention that these events disturbed the delicate ecological relations among humans, vectors and disease-causing pathogens and thus constituted the determining factor of the epidemic. Sleeping sickness was also a colonial disease in the sense that the colonial state's incessant demands for labour and tax and its drive to restructure African society through a series of restrictive administrative measures, undermined the health of Africans in a variety of related ways. Labour migration, for example, introduced Africans to new diseases, while time spent labouring on mines and plantations resulted in a decline in food production and thus in nutritional levels within African societies. This in turn exacerbated existing stresses and impaired resistance to disease. Political and social disruption in some regions also contributed to the disturbance of a complex cluster of beliefs and practices which had constituted a pre-colonial "public health" system. As Lyons shows, many Africans' first encounters with Europeans and colonial medicine were in the form of military-style sleeping sickness campaigns. The "manhunts", the surveillance of African villages, enforced isolation, and the ineffective chemotherapy that characterized the early campaigns, evoked intense distrust from Africans. Not surprisingly these campaigns were often perceived as aggressive expressions of colonial power and as a kind of biological warfare. Even after public health reforms were instituted to ensure African cooperation after 1910, these measures were coupled with increasing controls over a wide range of African social and economic activities. For many Africans, thus, the campaigns were indistinguishable from other measures of social engineering. Lyons situates sleeping sickness research and the "medicalization" of the region within the wider history and politics of international tropical medicine. She also traces the influences of nineteenth-century European epidemiological theory and public health practices and the way in which these were hybridized in a colonial context. African attitudes to disease and curative procedures and their responses to the campaigns were equally salient, she argues, in the shaping of the much vaunted public health system. She takes care, however, to indicate …