In February 1890, the British Medical Journal called the attention of its readers to some disconcerting news it had received about recent events in Banaras. During Prince Albert Victorâs visit to that city in January, the municipality had festively inaugurated its new water supply and sewerage projects, with the Prince laying the foundation stone for the waterworks. While appreciating the positive impact both projects were to have on the immediate cleanliness of Banaras and the health of its inhabitants, the article took strong exception to the proposed sewerage scheme:
How are the mighty fallen! [âŚ]. [T]he municipality intend[s] to discharge the sewage of the city into the Ganges a few miles below the town. As India has no enactment similar to the English Rivers Pollution Act there is no power to prevent their doing so, nor to prevent other cities in the Gangetic valley following their example, and thus converting the river by the time it reaches Calcutta into a gigantic cesspool [âŚ]. [I]t is to be hoped that the Legislature will interfere before what is now only a possible danger of the distant future becomes a serious menace to all towns on the lower Ganges [âŚ].1
The Banaras sewerage project, which in the eyes of the Journal and its Calcutta informant threatened to convert âthe noble riverâ into a âsewerâ, and to reduce it âto the condition of Father Thamesâ,2 was just one among several sewerage projects the North-Western Provinces were planning in the early 1890s. As part of his ambitious agenda on urban sanitary reform, Lieutenant-Governor Sir Auckland Colvin (1887â92) declared the introduction of water supplies and sewerage systems in his major cities a priority. Thus, projects similar to that in Banaras were envisaged for other riparian cities, namely Kanpur, Allahabad, Lucknow and Agra. Before we turn to some of these projects and the controversies they ignited, it is important to sketch the wider contemporary context of colonial policies on public health and urban sanitation in which they were situated.
Starting with the early 1860s, the Government of India developed a serious interest in sanitation, which was directly linked to the experience of the Great Rebellion of 1857/58. The large number of fatalities among British soldiers due not to combat, but disease, had distinctly brought to light the sanitary deficits within the military and their potential to jeopardise the stability of the Empire. A similar situation had occurred during the Crimean War a few years earlier, and both gave rise to a vigorous lobby in Britain demanding better health and sanitation within the British army. On these grounds, a Royal Commission on the Health of the Army in India was appointed in 1859. The commissionâs first report of 1863 dealt not only with directly military matters, such as the soldiersâ diet and the living conditions in military barracks, but also with the sanitary state of Indian towns and populations in general. As the commission saw it, the health of the troops was inextricably connected with the health of the Indian people, especially when it came to the spread of epidemic diseases like cholera. As main sanitary defects it identified polluted water supplies, the absence of proper drainage and the general uncleanliness of the urban surroundings, which it blamed on the allegedly insanitary habits of the ânativesâ.3 In direct response to the report, the Government of India expanded its public health administration by establishing a sanitary branch within its home department and by appointing a sanitary commissioner. Additionally, sanitary branches were created in each province and provincial sanitary commissioners appointed. The newly created service complemented the Indian Medical Service (IMS), the existing medical establishment concerned with military and civilian health. As advisors to their governments without executive powers, the sanitary commissionersâ duty was to inspect and report on the sanitary conditions in their provinces and to suggest measures for betterment. For this, they were to take regular tours and to collect vital and meteorological statistics. From the 1870s, they were moreover responsible for the spread of vaccination.4
As in Europe until the late nineteenth century, the miasmatic disease theory provided the intellectual backdrop to official public health policy in India, and of all diseases, it was cholera around which the greatest administrative concern revolved.5 Fundamental in defining medical theory in India during the 1860s and 1870s was James L. Bryden, statistical officer to the newly formed sanitary branch and Indiaâs premier epidemiologist. According to Bryden, epidemic cholera was generated through the interaction of two processes: the reproduction and decay of pathogenic cholera âseedsâ, which was accelerated or retarded by certain environmental conditions, and the epidemic spread of these âseedsâ beyond endemic areas. The latter, Bryden believed, was caused by monsoonal air currents, which accordingly determined the course and geographical reach of cholera epidemics. Combining this belief in the agency of specific meteorological conditions in determining epidemic zones, and the fact that India was the only country in which cholera was endemic, Bryden concluded that India was epidemiologically unique. While the spread of cholera in India followed a specific pattern defined by meteorological conditions, it might as well be spread by contagion or otherwise in Europe. The main object of sanitary policy according to Bryden was the removal of filth, the medium in which the cholera seed thrived, and the improvement of barracks and buildings, in order to prevent aerial incursions of the disease.6
The majority of medical officials in British India shared Brydenâs views. Instrumental in translating his theoretical framework into practical measures was James McNabb Cuningham, the first sanitary commissioner to the Government of India from 1866 to 1884. His policy is aptly summed up in one of his last writings in office:
Sanitary improvements, and sanitary improvements alone, embrace the whole action which a Government can take in order to prevent cholera. [âŚ] Pure air, pure water, pure soil, good and sufficient food, proper clothing, and suitable healthy employment for both mind and body, these are the great requisites for resisting the cause or combination of causes which produces cholera.7
These official directives and their underlying concepts were challenged by a number of medical men who supported John Snowâs contagionist, waterborne theory. The sanitary commissioner of the Punjab A.C.C. DeRenzy, for instance, repeatedly attacked government for its inactivity to prevent the spread of the disease and pressed for more specific measures to secure the quality of water supplies. Government answered mounting criticisms by resorting to Max von Pettenkofer, whose âsub-soil waterâ theory included a hypothetical, communicable cholera germ, but stressed the primary importance of local environmental factors in its propagation. Where dissent became too strong, government was ready to take more rigorous action, as DeRenzyâs case shows. Owing to his persistent criticisms of Bryden, he was ultimately transferred to military duties in a remote station in Assam.8
British Indian health policies also faced severe pressures from without. Between 1851 and 1894, eight international sanitary conferences were convened to address the threat of recurring cholera epidemics in Europe. There existed a wide consensus that cholera was somehow contagious, transmitted either directly from person to person or, indirectly, through contaminated food or water. Thus, delegates to the sanitary conferences demanded not only the imposition of quarantine regulations against ships coming from India, but also stricter measures to control the disease within the country itself.9 The Government of India however remained adamant in its adherence to localist explanations of cholera. The reasons for this were economic as well as political. In the aftermath of the Great Rebellion, the colonial regime was wary of interfering with Indian religious practices by enforcing wider regulative measures, such as cordons sanitaires and quarantines during pilgrimages and religious fairs, apprehending that these would incite civil unrest.10 Moreover, British trade by 1880 accounted for almost 80 per cent of the total tonnage passing through the Suez Canal. To accept that cholera was contagious and likely to be transmitted by polluted water, irrespective of geographic locality, would have forced government to accept quarantine regulations for ships coming from India as demanded by the international sanitary conferences. This would have considerably disturbed the flow of British trade and was therefore strongly resisted, not only in India but also in Britain itself.11 Another reason for resistance was the institutional and intellectual rigidity that prevailed within the ranks of the IMS. As Mark Harrison has put it, the âslowness of promotion [âŚ], the pervasive anti-intellectualism, and bitter internal conflicts, fostered a climate in which innovation in theory and practice was positively discouragedâ. Trends in medical theory and policy emanating from the metropole were therefore slowly responded to, or actively resisted.12
In the wake of Robert Kochâs discovery of the comma bacillus in Calcutta in 1884, the Indian government geared up its defence. In the same year, it established the first medical laboratory in the capital and appointed the Scottish doctor David Douglas Cunningham as its director. While the laboratory marked the first step towards bacteriological research in India, Cunninghamâs agenda remained deeply entrenched in the political context. Over the next almost 30 years, he extensively researched and published on different aspects of cholera, producing the largest contribution from British India to the field. But rather than conducting original research, Cunninghamâs laboratory functioned as a tool with which the Indian government sought to disprove Kochâs germ theory and legitimate its own sanitary policies. Closely aligned to Max von Pettenkoferâs theories, Cunningham during the 1880s and 1890s acknowledged the existence of a cholera germ, but downplayed its role in causing the disease, insisting on the primacy of local conditions.13
It was only from the early 1890s that colonial medical theory and public health policies started to catch up with the mainstream of contemporary science. At the time, repeated wav...