Disease at the crossroads: Towards a history of therapeutics in Bulozi since 1876 [1

Abstract

This article advances two different types of argument. The first is general and attaches to the fundamental methodology of African history. It derives from the observation that it is extremely difficult to learn much reliably about intellectual history in tropical Africa and that this is largely because of the pervasiveness of manipulation, both conscious and unconscious, in the sorts of data typically available (for example those relating to formal religious practices) through the sorts of technique typically practised (archival research mingled with a greater or lesser degree of direct observation). The article suggests how and why a study of medical cosmology may be a particularly reliable medium in which to perceive the centrally important principles of a culture. The second type of argument is specific and addresses the nature of therapeutic practice and belief in western Zambia (central Africa) over the last century. Three converging perspectives are offered: one presents an abstracted analysis of theories of disease; the second offers a brief narrative of medical pluralism in Bulozi since 1876: the last gives a tentative sketch of the changing epidemiological history of the country during the same period. Together they argue that the introduction of allopathic therapy has not falsified belief in the pre-existing systems of diagnosis and explanation, but that therapeutic systems of radically differing conceptual origin can and do coexist. However, if the colonial century brought new sorts of therapy, evidence is adduced to suggest that it has also brought new patterns of disease. The first two of these converging perspectives are supported in part by three different types of case history, illustrated in each of the three Appendices. The way in which these data are employed illuminates the methodology which underpins the first, general, argument of the paper: that studies of medical theory and practice, especially in the taxing circumstances of a non-Western society, are reliable guides to the nodes of culture and are therefore to be preferred as first steps when little or nothing is known about intellectual history.