A sword of empire?: Medicine and colonialism at King William's town, Xhosaland, 1856-91

Medicine and Colonial Identity

Volumn , Issue , 2003, Pages 41-60

  Gordon, David ^a  

^a UNIVERSITY OF MARYLAND   (United States)

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[No Author keywords available]

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EID: 4544342815     PISSN: None     EISSN: None     Source Type: Book    
DOI: 10.4324/9780203522318     Document Type: Chapter

References (55)

1. South African Library, Cape Town (henceforth SAL), MSB 223 B(10), Grey Collection, 21-2, Fitzgerald's manuscript "The Witchdoctors of South Africa"; Fitzgerald, A Short History of the Native Hospital and Permanent Canvas Marquees (King William's Town, 1885), 16; King William's Town Gazette, 10 Jan. 1857, 3.
2. Fitzgerald listed most of his African patients as "Xhosa," followed by "Fingo" (Mfengu). These ethnic distinctions do not faithfully translate social realities in the nineteenth century. Yet it is useful to distinguish Xhosa from Mfengu. In 1853 the Xhosa had only just been conquered and the colonial authority in Xhosaland was tenuous; by contrast, the Mfengu collaborated more closely with the colonial regime. For a history of Xhosa/Mfengu relations see Les Switzer, Power and Resistance in an African Society: The Ciskei Xhosa and the Making of South Africa (Madison, WI: Univesity of Wisconsin Press, 1993).
3. In 1888 the hospital was named the Grey Hospital after its most important sponsor. Here I retain the name King William's Town Hospital. The following article does not attempt to be a history of the hospital but an analysis of the political forces, ideologies, and cultural prectices in which it was immersed. Those interested in a general history should consult BKM Box W6940, A. W. Burton, "A Brief History of the Grey Hospital,"
4. Fitzgerald, A Short History of the Native Hospital and Permanent Canvas Marquees (King William's Town, 1885).
5. Jeff Peires, The Dead Will Arise: Nongqawuse and the Great Xhosa CattleKilling Movement of 1856-7 (Johannesburg: Ravan Press, 1989), 60.
6. Influenced by Michel Foucault, such scholars view the development of European medical institutions as being integral to the construction of colonial power. For example, see Timothy Mitchell, Colonising Egypt (Berkeley, CA: University of California Press, 1991). For cases that deal specifically with medicine in the colonies
7. see David Arnold, Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-Century India (Berkeley, CA: University of California Press, 1993);
8. Megan Vaughan, Curing their Ills: African Power and Colonial Illness (Cambridge: Cambridge Universitry Press, 1991).
9. Arnold, Colonizing the Body, 292-3.
10. John M. Janzen, The Quest for Therapy in Lower Zaire (Berkeley, CA: University of California Press, 1978). On the relationship between "modern" and "traditional" medicine also
11. see Murray Last and G. L. Chavanduka, The Professionalisation of African Medicine (Manchester: Manchester University Press, 1986).
12. For the relationships between the Xhosa and the land and labor requirements of settler farmers and miners see Colin Bundy, The Rise and Fall of the South African Peasantry (Berkeley, CA: University Of California Press, 1979);
13. Clifton Crais, The Making of the Colonial Order: White Supremacy and Black Resistance in the Eastern Cape, 1770-1865 (Cambridge: Cambridge University Press, 1992).
14. The rise of therapeautic certainty in Western medicine and its cultural impact is best described in Edmund D. Pellagrino, "The Socio-cultural Impact of Twentieth-Century Therapeutics," in Charles Roseburg and Morris Vogel, eds, The Therapeutic Revolution: Essays in the Social History of American Medicine (Philadelphia, PA: University of Pennsylvania Press, 1979), 245-66.
15. The seminal anthropological work is Victor W. Turner, The Drums of Affliction: A Study of Religious Process Among the Ndembu of Zambia (Oxford: Oxford University Press, 1968).
16. John M. Janzen has three important books: The Quest for Therapy in Lower Zaire (Berkeley, CA: University of California Press, 1978);
17. Lemba 1650-1930: A Drum of Affliction in Africa and the New World (New York: Garland, 1982); and Ngoma: Discourses of Healing in Central and Southern Africa (Berkeley, CA: University of California Press, 1992). A valuable work in the Nguni (Zulu) context is Harriet Ngubane, Body and Mind in Zulu Medicine: An Ethnology of Health and Disease in Nyuswa-Zulu Thought and Practice (London, 1977). In the Nguni (Pondo) context, Monica Hunter, Reaction to Conquest, 2nd edn (Oxford: University Press, 1961).
18. A valuable section on healing among the Nguni (Xhosa) is in J. H. Soga, The Ama-Xosa: Life and Customs (Lovedale: Lovedale Press, 1931), 145-82.
19. Janzen identifies this collective feature of Ngoma as "therapy group management." Janzen, The Quest for Therapy, 51, 73.
20. Soga, The Ama-Xosa, 160, 171;
21. Monica Hunter, Reaction to Conquest, 337-9;
22. Ngubane, Body and Mind, 102;
23. Janzen, Ngoma, 123.
24. SAL, MSB 223 B(10), Fitzgerald's manuscript, 29-64. There was some overlap; for example, a refusal to obey a calling would invoke ancestral wrath. Patients with a calling could also be "eaten" by the river-spirit (a form of possession). My account has been enriched by the anthropological works listed in note 15 and by Monica Hunter's work on the nearby Pondo, Reaction to Conquest, 320-48, 496-502.
25. Jeff Peires claims that cases were rare between 1853 and 1856, The Dead Will Arise, 62. In 1846 Kona, son of Chief Maqoma, allegedly burnt and strangled to death a senior counselor. He later told the story to Fitzgerald. Fitzgerald's manuscript, 1-6. In 1859 four men were found guilty by the Criminal Court of British Kaffraria of torturing a women to death by tying her up and lighting a fire under her arms and legs after accusing her of bewitching a child. These cases were collected by Grey to justify expenditure on the new hospital. SAL, MSB 223 B(9), Copy of the Proceedings of the Criminal Court of British Kaffraria, King William's Town, 12 April 1859. Also see Soga, The Ama-Xosa, 180-1.
26. For example see Fitzgerald, A Short History of the Native Hospital, 4.
27. Soga, The Ama-Xosa, 160, 171;
28. Hunter, Reaction to Conquest, 337-9.
29. For a discussion of these issues and a cautionary note regarding the tendency of anthropologists to reduce African medicine to the equivalent of biomedicine see Robert Pool, "On the Creation and Dissolution of Ethnomedical Systems in the Medical Ethnography of Africa," Africa 64(1) (1994): 1-20.
30. Quoted in Robert Donaldson, "Dr John Patrick Fitzgerald: Pioneer Colonial Doctor, 1840-1860," MA thesis, University of Waikato, 1988, 23.
31. R. J. Towers, "Dr John Patrick Fitzgerald," New Zealand Hospital, Sept. 1964: 7-10;
32. Robert Donaldson, "Dr John Patrick Fitzgerald," 1-138.
33. This is implied in some of the letters Fitzgerald sent to George Grey. Fitzgerald had a deep affection for Grey who cared for him after the death of his wife. In these letters Fitzgerald also implies that the Cattle-Killing episode may have been an outcome of Grey's attack on the amagqirha or a deliberate plot by Grey. While I remain skeptical, this does seem to provide the strongest evidence behind the "Grey's plot" theory of the Cattle Killings popular among Xhosa. See SAL, Grey Collection, 2(61), Fitzgerald to Grey, 16 July 1885, 10 April 1886, 19 July 1891, 30 Jan. 1893, 24 Dec. 1895. For an account of the "Grey's plot" theory, see Peires, The Dead Will Arise, x.
34. Peires, The Dead Will Arise, 71.
35. Fitzgerald, The King William's Town Hospital Reports: No. 1 (King William's Town, 1858), 10; King William's Town Gazette, 10 Jan. 1857, 3; BKM, Fitzgerald's Letter Book, Fitzgerald to Maclean, 19 May 1856; Fitzgerald to Maclean, 1 Feb. 1861.
36. Arnold Fischer, E. Weiss, S. Tshabe, E. Mdala, English-Xhosa Dictionary (Cape Town, 1985);
37. J. McLaren, A New Concise Xhosa-English Dictionary (Cape Town, 1963 [first 1915]). A comparison with Zulu, the closest language to Xhosa, is instructive. Zulu medicine also employs the vuma chant which also means consent. However, there is no special name for opthalmia, and the noun imvuma is listed by Colenso as the animal slaughtered when a marriage is agreed upon.
38. J. W. Colenso, Zulu-English Dictionary (Natal, 1905), 649.
39. J. McLaren, A New Concise Xhosa-English Dictionary; C. M. Doke, D. M. Malcolm, J. M. A. Sikakana, and B. W. Vilakazi, Zulu-English Dictionary (Johannesburg, 1990).
40. Robin Horton, "African Conversion," Africa 41 (1971): 57-108.
41. Franz Fanon, Studies in a Dying Colonialism (New York: Grove, 1989), 45.
42. Fitzgerald, A Short History of the Native Hospital, 16.
43. Fitzgerald, A Short History of the Native Hospital, 8-9.
44. He called this the "dry earth system," see Fitzgerald, Sanitation, or Scavenging Simplified: The Method Adopted at the Native Hospital, King William's Town, South Africa (King William's Town, 1886), 1-30.
45. S. Marks, Divided Sisterhood: Race, Class and Gender in the South African Nursing Profession (London: Macmillan, 1994), 80.
46. Calculated from CA, HGK 6/2-3 Dispensary Book; CA, CCP 1/2/1/18 A16-67, Hospital Reports. For account of primary stage syphilis see Fitzgerald, The King William's Town Hospital Reports, 19. For both syphilis and respiratory complaints, African and settler infection and fatality seem to have been of a similar nature, although fatality for respiratory complaints among Africans was slightly higher than for the settlers and settlers suffered from more enteric complaints.
47. The first detailed records of a smallpox epidemic are from the 1713 epidemic which supposedly decimated the Khoi. The effects of this epidemic are still being debated. Andrew Smith, "Khoikhoi Susceptibility to Virgin Soil Epidemics in the Eighteenth Century," South African Medical Journal, 75(1) (1989): 25-6.
48. The spread of disease in the wake of famine may be due to both a tendency to migrate to find food, thus spreading disease or becoming susceptible to new diseases, and weakened resistance due to under nourishment. For study in the Southern African context see Elizabeth Eldredge, "Drought, Famine and Disease in Nineteenth-Century Lesotho," African Economic History, 16 (1987): 61-93.
49. He distributed vaccine to nearby missionaries and within King William's Town he supervised the vaccination of around 600 people every week. For the smallpox campaign, see G. S. Hofmeyr, "King William's Town and the Xhosa: The Role of a Frontier Capital," MA thesis, University of Cape Town, 1981: 128-32; Also King William's Town Gazette, 26/06/1858, 1/10/1858, 23/10/1858.
50. Mortality rates for all hospital cases between 1867 and 1877 calculated from CA, CCP 1/2/1/19 to 35. For comparative material on hospitals in England and the "hospital debate" surrounding their efficacy see S. Cherry, "The Hospitals and Population Growth: The Voluntary General Hospitals, Mortality and Local Populations in the English Provinces in the Eighteenth and Nineteenth Centuries," Population Studies, 34 (1980): 59-75, 251-65.
51. Peires, The Dead Will Arise, 245.
52. Peires, The Dead Will Arise, 241-72.
53. Fitzgerald, The King William's Town Hospital (1864), 5-8; BKM, Fitzgerald's Letter Book, Fitzgerald to Colonial Secretary, 31 Aug. 1868.
54. CA, HGK 2/4 Blaine to Colonial Office, 3 March 1892. Catherine Burns argues that the 1928 Medical, Dental and Pharmacy Bill finally solidified state control over the right to heal and undermined the legitimacy of more informal healers. Catherine Burns, "Louisa Mvemve: A Woman's Advice to the Public on the Cure of Various Diseases," Kronos, 23 (1996): 108-34, 121.
55. Marks, Divided Sisterhood, 80.