At a conference at the Université Indochinoise in 1932, Hanoi director of municipal hygiene, Dr. Bernard Joyeux, asserted that the character of the indigenous population was a barrier to combatting the spread of disease. Citing the “legendary indifference of the Annamites,” treatable disease had run unchecked among the populace (1935, 332). He faulted “the carelessness, ignorance, and fear of the Indochinois,” specifically their reluctance to come to French clinics and submit to alien treatments (1935, p. 333). Moreover, he claimed that charlatans promoting backward local treatments and superstitions preyed on the ignorant and enjoyed “extraordinary success among the masses who are ready to believe anything so long as it is presented in a form that appeals to their mentality” (1935, 333). Such chauvinism characterized the vision of 19th- and 20th-century French colons in Indochina and is documented with great care in Laurence Monnais’s excellent exploration of the production, circulation, and consumption of pharmaceutical medicines.
This book covers medicines introduced and distributed by French settler colonials in Indochina, as well as those developed in French Indochina. It addresses the twin problems of the population’s practical access to such drugs, and the competition among the wide range of therapeutic options available during a period when Western biomedicine and its products had yet to consolidate their epistemological or commercial hold. Monnais asserts that seeking and taking pharmaceutical medicines was one way in which Vietnamese people grew familiar with biomedicine specifically and engaged with and experienced a version of modernity the French sought to make hegemonic. Increased desire for pharmaceutical drugs by Vietnamese persons was read by the colonial medical practitioner as acceptance of their superiority vis-à-vis local therapies, without contemplating the meaning or rationale behind such selection and self-medication. This work draws on a wide range of sources to complicate the colonial medical practitioner’s notion of the Vietnamese as ignorant, resistant, and backwards-looking, as well as to reconstruct the socioeconomic and political milieu in which seeking and taking Western pharmaceutical medicines was a means of experiencing colonialism, nascent Western technoscientific ideologies, and the globalization of industrial and market systems.
Monnais joins a long list of eminent scholars of medical anthropology, science, technology and society studies, and the history of medicine, who have identified the role of science generally, and medicine specifically, as a tool of empire, and who have rightly figured empire as an incomplete and contestable process rather than a fixed and overdetermined product. Colonial medical practitioners sought to reduce morbidity and mortality, but also to convert indigenous populations to the ways of seeing, knowing about, and intervening on bodies and biologies that are acceptable in the Western biomedical tradition. The work moves seamlessly from conceptual considerations of what constitutes “colonial” or “modern” pharmaceutical therapy, to fine-grained analyses of an apparently quite difficult, uneven, and wide-ranging archive, one that is alternately robust and anemic.
One cannot read the middle chapters of this book without marveling at the sheer effort the reconstitution of this industry, in this era, must have taken. For example, included here are extensive descriptions of the geographic distribution, ownership, pharmaceutical specialties, licensing costs, and publicity materials of the principal pharmacies operating in French Indochina from 1900 to 1945 (Chapter 4). Later, Monnais provides us with the exact prices for a wide range of pharmaceutical medicines offered by the French on the eve of World War II and how these compared with what practitioners of what she calls Vietnamese and Chinese medicine charged for their services (Chapter 8). These central chapters, though somewhat more oriented toward the specialist than the conceptual work done in the earlier chapters, will definitely be appreciated by contemporary and future researchers working in this area, and represent a truly virtuoso effort by a first-rate scholar.
My one small quibble with an otherwise consistently excellent work is less a critique than a marking of practical limitations. This has to do with the work’s framing as a “biography” or exposition of the “life” of pharmaceuticals in French Indochina. Monnais explains early on that all medicines “have highly malleable social meanings … a life of their own, a potential for material and therapeutic autonomy” (p. 12), and that this work will delve into these meanings and situate them in the context of the colonial-era consolidation of political and industrial power, the expansion of Western scientific and biomedical norms, and the like. This level of local significance and meaning is, of course, much more difficult to access for a historian working from the uneven archive of century-old colonial-era documents than for a medical anthropologist working with contemporary informants. Monnais astutely admits that she was “particularly challenged by the lack of voice … given to producers, distributors, and especially consumers of medicines” (p. 17).
Monnais admirably and ably addresses this challenge, finding a rich source in the extraordinarily prolific Vietnamese popular press that included advertisements for medicines and content that was allowed to stray from the official line of colonial medical authority. This work may have productively mined examples of literature and art from this period that engages with or lampoons Western medicine(s) or indigenous use of these. I think of the hilarious and truly devastating sections of Vu Trong Phung’s Dumb Luck (which Monnais briefly mentions in Chapter 7), which deploys comic exaggeration and the picaresque to draw attention to the emergence of Western biomedical products, the potential for dubious marketing claims, and which perhaps unfairly frames their consumption by local peoples as an aping of the “civilized” and “modern” French. A more extended analyses of these kinds of works could breathe a little more elusive “life” into this deft exploration of the colonial “life of pharmaceuticals.”
This book is an excellent resource for medical anthropologists, historians, and STS scholars of Southeast Asia. It will no doubt be productively incorporated into graduate seminars on colonial/post-colonial medicine and spawn dozens of dissertations.
Joyeux, B. 1935. Le Peril Venerien en Indochine. In Feuillets d’hygiène Indochinoise, edited by H. Morin, 328–39. Hanoi, Tonkin. Imprimerie d’Extreme Orient.