Okay, thought for the day time - let's talk about disease hierarchies and empire (long thread, mostly to help me organise my own thoughts)

One of the little theories I am currently developing is that you can tell a lot about a society's priorities by the diseases its doctors see as most worthy of their attention, and who they are percieved to affect

I study, amongst other things, Guinea Worm, which causes a disease known by at least 50 names, the most well-known of which are dracunculiasis and dracontiasis

This is an ancient disease, known since antiquity, and referenced in many ancient texts from Plutarch to Ibn Sina to the Bible (yes, really)

But European physicians only really started to take note of it in the 18th C, when they found it afflicted Enslaved Africans trafficked from West Africa (hence the name Guinea Worm - commonplace from the 1720s, contrary to popular belief)

And these European physicians found it weird, they'd never seen anything quite like it before, and so in 18th C medical dictionaries it ends up being given short entries. But it is always presented as a curiosity

Throughout the 18th C, Guinea Worm is given cursorary treatments in medical texts, but the authors aren't very interested in it, they give it a couple of pages at most, explaining the essentials, and then move on to diseases more worthy of their time. Why?

Because they'd decided it is something which affects Africans, particularly Enslaved Africans. Guinea Worm became racialised as an African disease. It did still affect Europeans - I have the case notes to prove that - but it was thought of as African and a problem for Africans

Because of who it affected. Enslaved Africans were expected to suffer through disease. Diseases percieved by European doctors as African (or Black) weren't thought of as a problem, and so weren't much studied

Contrast Scurvy. Scurvy, which affected African and European alike, was thought to be a European disease, was thought to be a threat, particularly to European sailors

Sailors had military value. The strength of the Empire depended on healthy sailors, so 18th C physicians wrote reems and reems on Scurvy, even after James Lind found a cure. Fighting scurvy was a worthy challenge for European physicians

Fighting scurvy was a way of making a patriotic contribution to the Empire. Fighting Guinea Worm, which (contra reality) was not seen as a threat to Europeans and sailors, was only seen to help people who weren't seen as important

But in the 19th C., this changed. With the rise of tropical medicine and parasitology, Guinea Worm became a problem, something scientists and doctors could devote whole textbook chapters to - and frequently did. What caused this?

India. Increasing British presence in India meant that Royal and East India Company (EIC) troops were starting to contract Guinea Worm. Soldiers with manifesting worms couldn't march, and they couldn't fight. Guinea Worm was now, like scurvy, a military problem

EIC surgeons started to notice this, and set about solving the problem. Some of them got in touch with Colin Chisholm, who had briefly studied Guinea Worm in Enslaved Africans in Grenada. The ball of research got rolling. Guinea Worm was now a worthy challenge

All because of who it affected. Physicians didn't care about plantation labourers half as much as they cared about imperial troops. Now Guinea Worm was a problem for 'valuable' tools of the empire, they could devote their energies to solving it

And eventually, they did. Through microscopes and experiments, science discovered the exact causes and life cycle of Guinea Worm (though much of the credit goes to a Russian, Alexei Fedchenko) - 120-ish years after they worked out how to cure scurvy.

The point I want to make here is how utilitarian the Empire was. It cared - doctors serving it cared - primarily about how much use you were to it. It was racist and white supremacist, but it was happy to let white people die when they weren't useful to it

Europeans soldiers who couldn't fight were a huge problem for the Empire, and for physicians. Europeans dying in slums, less so. Indians dying in Bengal, even less. Africans dying on plantations, less again. The racial hierarchy was intertwined with a utilitarian hierarchy

Value was determined only by what you could do for the Empire. Working-class English, Welsh and Scots, even Irish were despised, yes, but a pool of them (us) needed to be preserved for use as soldiers, sailors, millworkers and labourers

This is what I hate most about Empire glorification - the Empire turned us all into tools, parts in a machine. Some parts were maintained more carefully than others. Some parts were entirely disposable. But everyone was used by a machine that did not care about them

It was a hierarchy. The message to Europeans was "wave your flags and parade your whiteness, feel superior to the Indians and Africans, and ignore that you are being used. And the moment you are not worth the effort to save, the Empire will let you die"

The point, always, was that the Empire allowed those it exploited to benefit, just a little, from it in order that they would serve it. And every rung of that ladder would focus on despising the rungs below and ignore the fact that they were being exploited by the rungs above