Colonial Fantasies, Imperial Realities. Lenny A. Ureña Valerio

the 1860s and 1870s. Physicians actively participated in the defining moments of national unification and imperial expansion in German history. They helped shape projects for the new German nation and overseas colonies. Understanding the particularities of diseases and how to control them opened the doors for overt overseas colonialism and tightened national frontiers in the eastern borderlands. At the same time, the establishment of colonies as “laboratories of knowledge” strengthened the experimental movement in the German sciences. However, the emergence of the medical profession did not turn every physician into a state collaborator and enthusiast of an aggressive colonial policy abroad. A study of the period before Robert Koch’s major discoveries on the germ theory helps us to understand better the support that the medical profession gave to the policy of imperial expansion in the second half of the nineteenth century.

      Anticontagionism and the Professionalization of German Medicine

      Up to the late 1860s, anticontagionism was a powerful movement throughout Europe. Medical historian Erwin Ackerknecht claims that it originated in the last decades of the eighteenth century with debates over yellow fever and the ongoing frustrations physicians experienced in trying to contain this disease in colonial realms, the United States, and Europe.⁶ The first anticontagionists were physicians in the English-speaking world, especially in the United States, and the last to convert to contagionism and the germ theory were members of the British medical service in India.⁷ As states in east and central Europe failed to control the cholera epidemic of 1830–1831 by using antiquated methods such as quarantines and cordons sanitaires, the anticontagionist movement grew in influence and gained more followers. Far from stopping the spread of the disease, as many have observed, these techniques only served to exacerbate the poor conditions of people everywhere, contributing to one of the main factors that triggered a series of revolutions across Europe.

      In Ackerknecht’s work, anticontagionism is portrayed as a broad trend in Europe associated with the rise of liberalism. Although the author has been criticized for delineating a too-simplistic, dichotomous model of scientific ideas without exploring possible intersections between the two camps, his analysis, delivered in 1947 to the American Association of the History of Medicine, remains a powerful statement on social medicine and the relationship between physicians and political agendas. More specifically, while some historians have criticized Ackerknecht for not taking into consideration specific national contexts, others have claimed that his description, aimed to be transnational, follows too closely the German model.⁸ Following the course of German history, anticontagionism is then defined as a set of liberal political and economic values whose decline came about “after the failed revolutions of 1848 and the German unification ‘from above’ in the 1860s.”⁹ However, by pointing out the common goals of anticontagionists, Ackerknecht was able to transcend the national framework and make fruitful connections among different countries, liberal goals, and leading physicians.

      In Germany, one of the main opponents to Henle’s contagionist views was his colleague Rudolf Virchow, who was also a famous liberal activist and pathologist. Virchow disagreed with the germ theory mainly because he believed that the cause of any affliction was not found outside an individual’s body. He ascribed the occurrence of pathologies to local disturbances of the cells. For him, a cell was not only the unit of life; it was also the pathological site.¹⁰ In his view, diseases were to be understood as mere alterations inside the organism of normal bodily processes. He also rejected Henle’s idea that an illness affected the body through the nerves and thought that attention should be directed to other anatomical parts too. Virchow’s major concerns at the time were democratizing the medical profession and making the field more scientific. Henle had similar goals, and throughout his career he advocated for freedom of thought in medicine. He wanted to open a space for theory and observation—which he termed “rational medicine”—in a profession that was becoming increasingly materialist. Despite their differences in approach—contagionist and anticontagionist—both Henle and Virchow were leading representatives of the new experimental turn in science that began to dominate the medical profession at a time when a new generation of German intellectuals was also considering different projects of national unification.

      The rise of the medical profession in the 1830s and 1840s coincided with political and social revolutions that mobilized a young generation of German scholars with the goal of strengthening their voice in the political purviews of the German lands. Given that illnesses and treatments are constructed culturally as well as biologically, one can consider the different theories that connected diseases to the body as another form of continuing discussions about the relationship between an imagined German nation and the outer world. Whereas Henle emphasized connections of the individual body with popular mobility and other organisms in nature, Virchow underlined internal developments, local approaches, and environmental improvements. As Virchow expressed in 1848, “Everything political that we’re now doing, the whole constitution, is only the structure through which social reform will come into being, the means by which the conditions of society will be transformed right down to their foundations.”¹¹ In this context, being anticontagionist was another aspect of being a social reformer and a critic of state authoritarianism. Anticontagionists questioned old draconian state measures, such as quarantine and isolation, that had failed multiple times in containing cholera and plague epidemics. Instead of controlling contagious diseases, these measures had only served to aggravate illness among the general population. Hunger, poverty, and filth were seen as the main causes of disease.

      According to Ackerknecht, during this period anticontagionists throughout Europe were not merely scientists; they were also social and political reformers who fought for individual rights and commercial freedoms.¹² Many of them were liberal physicians concerned with local and environmental improvements that ranged from cleaning the streets and teaching personal hygiene to canalizing rivers and installing new sewer systems. For them, these sanitary measures seemed to have better effects on the health of any given community than submitting individuals to quarantine ordeals. In Europe, anticontagionism seemed to go hand in hand with revolutionary and progressive ideals. However, while in the German and European contexts these medical views were used to safeguard individual rights and advance developmental and hygienic programs, in the colonial realms environmental approaches and miasmatic explanations served to underscore the fundamental sanitary differences between temperate and tropical zones.¹³ In colonial settings, miasmatic theories tended to identify natives with their natural environment in pessimistic and deterministic ways.

      It is within this cultural and political context that one should understand the initial rejection of the germ theory in Germany. Although Virchow’s approaches were useful in the years leading to unification, Henle’s views made a successful comeback in the 1870s and 1880s as physicians began to work closely with the German Empire and demanded an aggressive colonial policy abroad. Without leaving behind the sanitary revolution of anticontagionists in earlier decades, a new generation of physicians went on the offensive against dangerous microbial intruders. As Baldwin observes, “bacteriologists and sanitationists could readily agree that unhygienic conditions promoted the spread of disease, even though the latter saw filth itself as the generator of disease, the former regarding it mediately as a condition favorable to propagating the microorganisms ultimately responsible for illness.”¹⁴ Although debates about disease etiology, which in Germany continued well into the 1890s, tended to separate the two camps, bacteriologists did not break away from the long tradition of sanitary and hygienic measures used to transform the environment. Protecting the “soil” against diseases was a metaphor used both for humans and for localities, usually generating similar disinfection responses.

      In the 1860s, discussions about the microscopic world began to appear in Germany in the works of Ferdinand Julius Cohn, a Jewish botanist from the University of Breslau; Ernst Hallier, a German botanist from the University of Jena; and Karl Wilhelm von Naegeli, a Swiss botanist from the University of Munich. The main debate at the time was over whether or not bacteria could be classified into different groups with their own distinctive physiological and morphological features. Cohn was the main proponent of the taxonomic classification of microbial life. Other scientists believed that fungi, molds, and yeasts were all different stages of a limited number of fungal entities that changed according to environmental conditions.¹⁵ To ensure experimental success