Everyone is watched, but not everyone is monitored in the same way. Contagion and the threat of contagion elicits medical surveillance in port cities through monitoring, regulating, quarantining goods and people. In the late nineteenth century, Alexandria, Tripoli, and Tunis were commercial zones where episodic plague and cholera epidemics proliferated causing commercial and mortuary crises. Independent of these outbreaks, constituents such as the International Sanitary Conference (1851) enacted policies to standardize quarantine measures at an international level, which was contested and repackaged in non-Western contexts. How these epidemics were understood and framed was part and parcel of ongoing nationalist and in Mediterranean port cities and beyond. This paper examines the ways that three North African cities—Alexandria, Tripoli, and Tunis—operated as sites of medical surveillance during the late nineteenth century. It does so by showing how indigenous and foreign merchants and medical practitioners defined and regulated goods and people. Starting from the vantage point of the port, the research shows how human and nonhuman entities, whether they were perceived to be infectious or not, were part of a process of globalizing medical surveillance. The port’s physical landscape operates as a case study for understanding how surveillance and sanitation were intimately tied to shifting notions of disease, medicine, and therapeutics in late nineteenth-century North Africa.

Throughout much of the nineteenth-century
in Ojibwe communities in the western Great Lakes of the United States,
community members participated in a medically plural environment, seeking
medical care from within their own communities as well as from French and
Scots-Irish fur traders, New England Protestant missionaries, and
federally-affiliated physicians at forts.  Medical care circulated between
settlers, traders, and Ojibwe communities, both instantiating social bonds and
inflaming epistemic and religious differences.


This paper argues that while often overlooked in the historiography of nineteenth-century Native spaces in the Midwest, health and healing were central material concerns in these mixed colonial spaces, and as such health and healthiness became slippery frameworks for power relationships between Ojibwe community members, missionaries, traders, and Indian agents. Chronic and acute illnesses and injuries brought these diverse social groups into intimate contact and shaped their political, economic, and religious ventures.  The entanglement of physical health with both material and cosmological consequence framed which practices and whose labor qualified as medical and whose body qualified as healthy.  This paper draws from nineteenth-century economic claims on land-cessation treaties from 1837 and 1855 to examine how various claimants, including white and mixed or married-in families, scripted medical care as superstitious, scientific, or social, operationalizing medical care as an economic and political good while simultaneously attesting to the social malleability of medical caregiving.

The medical career of Mississippi native Andrew Bowles Holder (1860-1896) began inauspiciously. After receiving his medical degree, he obtained his first post thanks to his father’s letter to the Office of Indian Affairs, which resulted in Holder’s appointment as physician to the Crow Agency in Montana. Holder began his medical career far from home, facing a set of unusual healthcare challenges amongst a new, untrusting patient population. Holder confronted two challenges on the reservation. First, as an Agency physician, Holder faced outbreaks of pneumonia, diphtheria, malaria, dysentery, measles, and cholera, obstetrical cases, and the occasional gunshot wound. But Holder also experienced challenges to his ideas about normative behavior and bodies, particularly through his encounters with the Bote, individuals he described as “not men, not women,” and in his observations of indigenous health practices, which continued even in the face of the “civilizing” efforts of the Agency.

Holder’s manuscript and published writings on Native American health and bodies reflect four modes of knowledge production: ethnography, experiment, bibliography, and clinical observation. I use Holder’s career to explore the complexity of conceptions about embodiment at the end of the nineteenth century, and the extent to which first-hand experiences with non-white patients could reinforce or transform theoretical, philosophical, and political ideas about race, gender, sexuality, and health. In particular, I explore the extent to which medicine was perceived to be civilizing force, and the limits of this process in the face of intransigent native health practices and bodies.

 
By the 1950s it was well understood that concussions could result in brain changes and degenerative nervous diseases. Yet where many experts saw an immediate, widespread public health problem, their warnings exercised limited influence in American culture. Why? Such ignorance, historian Robert Procter has argued forcefully for other historical episodes, is hardly accidental. Indeed the story of that ignorance as applied to concussions forces historians to confront a startling array of contexts, conceits and victims: fast cars, suburban masculinity, pro-segregationist rhetoric, the popularity of violent sports, boxers, and battered women and children. Meanwhile psychological theory cast the need for spectacles of public violence in sports arenas or on the silver screen as a necessary controlling force for the sublimation of internal drives. Underpinning such theories were different historical valences: ones sometimes engineered by scientific experts and at other times manufactured by the wellsprings of naïve faith in the universality of domestic tranquility, the necessity of racial segregation, and the naturalness of gender norms. Grounded in a rich archive of scientific and cultural sources, this story about the cultural history of head injury thus seeks to make an immediate and urgent contribution to social medicine today. In so doing, this paper shows how head injuries became a public health epidemic, how that fact was recognized by experts, and how, nonetheless, it remained a fact without an audience.