With the support of Peking University Distinguished Lectureship (北京大学海外名家讲学计划) and Chinese National Social Science Foundation Major Project of the “ Contemporary Historiography and Database Construction of Epidemics ” (PI), Professor Mark Harrison was invited to give a series of three online lectures around themes of great concern on the history of global health in December of 2021. Mark Harrison is the professor of history, co-director of the Wellcome Centre for Ethics and Humanities, University of Oxford, UK.

 

　　 The series of Global Health History Lectures were chaired by Prof Su Jingjing, associate professor of the School of Medical Humanities of Peking University, and organized under the titles of "The Hospital in Colonial History"(December 7，2021), "Understanding Epidemics: a Historical Perspective" (December 14，2021) and "Risk and Security in the Age of Pandemics" (December 21，2021), respectively.

 

 

　　 On December 7, 2021, Professor Mark Harrison delivered the first  online lecture on the history of hospitals within colonial history and global history, chaired by Associate Professor Su Jingjing（苏静静） from Peking University, three experts devoted to this topic were invited for the dialogue session, they are Boya Distinguished Professor Zhang Daqing（张大庆） from Peking University, Dr. Li Naishi（李乃适），endocrinologist from Peking Union Medical College Hospital, and Associate Researcher Yan Yiwei（颜宜葳）from the Institute of the History of Natural Sciences, Chinese Academy of Sciences were invited to talk with him.

 

　　

1.  Introduction

　　 Hospital is viewed as the most visible symbol of modern medicine for at least 100 years. As an institutional form, hospital has spread beyond its origins in Western medicine. It has become truly global colonialism in terms of the history of hospital. It is the primary means through which western medicine spread and the relation between colonialism and medicine could be illuminated. It's a convenient way of exploring some wider issues in medicine.

 

　　 Before the 18^th century , many older hospitals in Europe were run by religious orders, and they mostly aimed at providing welfare assistance to vulnerable groups. There were also counterparts in many non-Western countries and many going back over millennia, for instance in Islamic world and India. 

 

　　 The 18^th century was a period when a large number of modern hospitals appeared in the West. At this time, hospitals took on more treatment work. In the colonial era, hospitals were established by colonists and aboriginal people, focusing on treatment.

　　

2. Hospitals in the colonies, 1500-1800

　　 Iberian Imperial Hospital was an early medical institution that appeared almost at the same time as Spanish colonialism. Initially, it was mainly to meet the needs of the colonists, but with the advancement of the colonial process, it was replaced by a hospital established to care for the indigenous people. For example, in the Portuguese colony, the first hospitals for indigenous peoples opened from 1530s and mainly treated poor and taught western medicine. In addition, colonial hospitals in this period had another task, spreading Christianity. The colonists tried to show the superiority of imperial rule and Christianity while treating the indigenous people, so as to further consolidate the colonial rule.

 

　　 In the late 18^th century, new colonial empires such as the Netherlands, France and Britain rose. With the support of the British East India Company and West India Company, colonial hospitals with the main goal of protecting the lives of European colonists and reducing the mortality of European troops were established. The most representative was Madras Naval hospital. Because the frequent infectious diseases such as malaria and dysentery in the colonies have obvious seasonality, Madras Naval Hospital was designed to be similar to an unfinished building to ensure ventilation. At the same time, in order to safeguard the interests of the army and reduce the loss of European military population, a large number of research and experimental work were also carried out here.

 

　　 Before 1800, the hospitals were established in important colonial cities assembly and played an important role in anatomical and clinical medical research. Professor Mark Harrison believes that colonial hospitals achieved much more results than local hospitals in Europe during this period, and can even be called the predecessor of "Paris medicine". On the other hand, for the colonies, although care provided to indigenous population was minimal, local non-Western medical practitioners undoubtedly participated in the practice and there was considerable interaction between Western and non-Western medical practitioners. The specific performs were: some non-Western practices subjected to trial in colonial hospitals, such as using mercury to treat fever and dysentery; Non-Western practitioners also trained in Western medicine and gained knowledge of Western drugs; Colonial medicine and medical knowledge also flowed in the European market.

 

　　 Therefore, although the early colonial hospital were primarily for the benefit of Europeans, they also provided an important point of contact between different medical traditions. Religious orders ran hospitals for evangelical as well as curative purposes. In terms of development level, some colonial hospitals were in advance of hospitals in Europe when it came to therapeutic trials and morbid anatomy, which has laid a foundation for the development of "Paris medicine".

　　

3. Hospitals in the colonies, after 1800

　　 According to Prof. Harrison, only by investigating different types of hospitals in the colonial context, can we really clarify the different kinds of roles of colonial hospitals and the relationship between colonial hospitals and colonialism.

 

　　 Overall, in the late 19^th century, colonial hospitals in Britain, France and the Netherlands mainly received poor people with acute diseases or trauma. These hospitals tended to have mixed sources. Colonial countries and wealthy individuals would provide some financial support for the hospitals at that time. Most of these hospitals were in larger towns with large and ornate decorated. At the same time, dispensaries became more and more popular in the colonies. At the end of the 19^th century, there were traveling dispensers who provided services for epidemic areas such as Malaria. During this period, colonial hospitals still undertook the mission of education, hoping to win the local people to accept colonial rule or maximize the benefit of the colonists with the image of benevolence.

 

　　 Under the guidance of science and technology, modernity showed the potential of reforming colonial society in many aspects, which was easier to understand in various particular types of hospitals. Plantation hospitals were established to retain more labor and carry out economic activities provide more basic medical care and surgical treatment for slaves. For example, a hospital on the Danish Virgin Islands in the Caribbean also carried out a large number of clinical medical research by dissecting the bodies of slaves. 

 

　　 By the late 19^th century, the number of hospitals mainly established for teaching and research began to increase, including the Calcutta Medical College Hospital established in 1852. The main purpose of these hospitals was to impart western medicine knowledge to indigenous practitioners, and launch a variety of medical research subjects represented by infectious diseases.

 

　　 The specialized hospital represented by lying-in hospital had a great impact on the social superstition and cultural tradition in this period. Female doctors entered hospitals and women were expected to teach their children about health knowledge and the benefits of Western medicine, which had an important significance to the colonies. The Fever Hospital was also established in some colonies. 

 

　　 Missionary hospitals remained an important part of providing health care services to remote areas or colonies where state infrastructure was threadbare during this period. For example, the missionary hospital in Baluchistan province (an area within the territory of Pakistan) was characterized by the close combination of medical care and evangelical mission, advocating "faith healing", which was a representative of fused spirituality with science.

 

　　 These types of colonial hospitals did not force people to receive treatment. However, in some areas, there were carceral institutions, such as Lock Hospital, which forcibly treat women to prevent the spread of sexually transmitted infections, and isolation hospital for types of infectious diseases.

 

　　 Isolation had different manifestations in different colonies. In addition to short-term confinement, there were also long-term confinement established for continuous treatment of diseases (such as leprosy, tuberculosis and mental illness), but such confinement was rarely compulsory.

 

　　 Japan and the United States are representatives of new colonial countries. When the colonial hospitals were established in the United States and Japan, the health concept became more modern and the bacteria theory also made great progress. Therefore, these colonial hospitals had a more strict and institutionalized management model and were more modern in nursing patients and family visits.

 

　　 Colonial countries also established their own hospitals. For example, some philanthropists and rich people in India cooperated to establish their own medical institutions with indigenous staff who had received western medicine training. Most of their patients were poor or minority population. Local and western medicine knowledge was also integrated here. 

 

　　 In addition, nationalism began to rise in this period, and the wave of resistance to colonial rule continued. On the one hand, the colonial people began to query the anatomical research carried out by western medicine regardless of the opinions of family members or patients. On the other hand, local medical personnel attempted to preserve national sovereignty and esteem by establishing their own modern hospitals, which made the hospital became the center of conflict in this period.

 

　　 After the Second World War, colonial hospitals still exist, but they have got rid of colonial rule and become important training grounds for local nurses, doctors, and public health workers. Ironically, however, aboriginal people who had received training in colonial hospitals (such as nurses in the West Indies, India or Africa) were employed to continue their medical work in London or other colonial countries.

　　

4. Conclusions

　　 By investigating the development history of colonial hospitals in various periods, Prof. Harrison suggested that colonial hospitals changed considerably over time, reflecting the changing nature of imperialism itself and the imperatives of colonizers. The design and architecture of the colonial hospitals reflect the advantages of the colonists and the adjustment combined with the colonial culture to some extent. The medical function of colonial hospitals was similar to those in imperial centers, but chief purpose was maintaining colonial power. In the colonial context, the racial hierarchies gradually emerged in the colonial hospital, making the hospital became an important site to resist colonialism and express nationalism. Colonial hospitals helped to sustain and destroy colonial rule at the same time.

　　  

　　 During the discussion and Q&A sessions, Prof. Zhang Daqing, Dr. Li Naishi and Prof. Yan Yiwei also generously commented and contributed to the discussion according to their own research fields, prof. Harrison also patiently responded to the questions raised by the students.

 

　　 Professor Mark Harrison’s lecture was highly and widely appreciated. It was live webcast on the platform of BiliBili), attracting thousands of international viewers and very positive feedback from scholars and students.

 

　　

Wang Xinyue, Su Jingjing; School of Health Humanities