03 May 2022

Dr Livingstone, I presume. New medicine and anti-slavery missionaries (by Dr Joe)

Dr Livingstone, back in the UK, 1864
Scottish National Portrait Gallery
                                                                                 
David Livingstone (1813–73) was born into a relig­ious Glaswegian working class family. From 10, Livingstone worked in a cotton mill on the Clyde banks, followed by some schooling in the room he shared with his par­­ents and siblings. At 21 he planned to become a mission­ary, believing med­ical training and natural his­tory would help his plan.

Science fascinated him. But his devout Christ­ian father rejected a scientific education until pers­uaded that medicine would help Dav­id to do God's work. In 1836 he enrolled at Strathclyde University in Glas­gow to study anat­omy, chemistry, surgery, pharm­acology and practical an­atomy. Then he studied at Char­ing Cross Hosp­ital Medical Sch­ool in 1838–40, completing cl­inical learning in surg­ery, medicine, mid­wif­ery and phar­m­acology. He gained good pract­ical exper­ien­ce with scient­ific instruments and equip­ment, vital in Africa!

Once they graduated, the young doctors worked in schools attach­ed to the great hospitals and dispensaries. But having committed to medicine for religious reasons, Livingstone also did courses in Greek, La­t­in, Hebrew and theology. He attended theology lectures by the anti-slavery campaigner Richard Wardlaw at Congregational Church Col­l­ege and was accepted on prob­ation by London Missionary Society in 1838.

In Jan 1840 he attended more medical classes and learned clin­ic­al skills at the British & Foreign Medical School, Charing Cross Hos­pit­al, Ald­ersgate St Dispensary and Moorfields Ophthalmic Hosp­it­al. In Dec 1840 he graduated Medicine, was licensed by the Fac­ulty of Phys­ic­ians & Surgeons of Glasgow, and ordained as a miss­ion­ary.
                             
Livingstone' medicine chest covered in cow hide
Wellcome Collection

Livingstone set sail for Cape Town in South Af­rica in 1841, to spread Ch­rist­ianity and to end slavery. He would abolish slavery by exploring the continent and exposing the evil to the rest of the world. His great geograph­ical discoveries including Lakes Ngami and Nyasa (Mal­awi) and the Victoria Falls are well known, since Livingstone was the first to expose them to the European public.

In Zambia & Malawi, Livingston was blessed for his geog­r­aphical dis­c­overies and his role in changing British pub­lic opinion about sl­avery. Yet this was only poss­ib­le because his medical training all­owed him to of­fer tr­eatment to the Africans he sought to convert. And since resp­ecting local healers was vital to Living­stone, he never chal­­­l­­­en­ged their practice in front of patients. Mostly he was tol­er­ant of native medical pr­ac­t­ices, seeking to understand their ma­t­erials and methods.

It was quinine, from Peruvian cinchona tree bark, that allowed him to survive in Africa. Quinine mixed with jalap and rhubarb became his remedy of choice to remove malaria-related deposits in blood, later marketed by Burroughs Wellcome.

Livingstone's writings also recorded cases of hookworm, el­ephantiasis, leprosy and yellow fever. He noted that relap­s­ing fever was transmit­ted by the African sand tick. He showed that the presence of mosquito­es correl­at­ed with mal­aria, alth­ough he got their transmission process wrong.

Back in U.K late in 1856, Livingstone received a he­ro’s welcome with the gold medal from the Royal Geographic Society. Living­stone believed the land around the Upper Zambezi was perfect for Euro­p­eans and off­er­ed huge potential for expl­oiting natural res­ources. He set off for a second trip in 1858 to learn more. Alas many other mis­sionary famil­ies whom Livingstone had insp­ired to travel to Af­rica lacked his med­ical know­ledge and arrived in the Zambezi reg­ion woe­fully ill-prep­ar­ed. Malaria killed them, incl­ud­ing David’s wife Mary (1821–62). The fail­ed Zambezi ex­ped­ition shocked everyone.    
 
To restore his reputation, in 1866 Livingstone left for a third trip for Af­rica, to discover the source of the Nile. But the Brit­ish lost him, so in 1871 journalist Henry Morton Stanley (1841-1904) was sent by the New York Herald to find him. This he did, in Nov 1871, greet­ing him with the famous words: Dr Livingstone, I presume? Stan­l­ey failed to persuade him to return home. Ageing, lonely and sick, the explor­er re­­­t­urn­ed to the barren swamp lands which he’d be­lieved to be the Nile's source. By May 1873 he was immobilised, so was car­ried by his African empl­oy­ees to the village to die. The men buried his heart under a tree, embalmed his body, and carried it to a ship going home.   

Henry Morton Stanley met David Livingstone,
Nov 1871, Wiki

Dr Livingstone was the missionary who was able to change the medical world, so the Victorian estab­lishment made him the patron saint of the British Emp­ire. It was not until the post-colonial 1970s that hist­or­ians re­visited his story. Tim Jeal’s biog­raphy Livingstone (1973) used available notebooks and journals, corr­ecting 100 years of pro-Living­stone propaganda. The book concentrated on Livingstone's concern for Empire rather than local African issues, his rel­ation­sh­ips with slave-owners,  and neglect of his wife and 6 child­ren.

 Livingstone memorial at Victoria Falls, Zimbabwe

But Dr Livingstone’s contributions to medicine were vital. Read Central African Journal of Medicine, July 1965. In 1856 he was asked to report on the caus­es of illness on the Lower Zambezi. He attributed it to the low-lying nature of the land, poll­ut­ed expanses of water and de­c­omposing vegetable matter. He re­ported on a disease character­ised by a spread­ing gangrene of the rec­tum; he described the earth-eating habits of Northern Rhodesian nat­ives; he wrote a vivid account of slaves’ tropical ulcers; and he noted that Africans living on a high carbohydrate diet suffered from disturbed vision. Living­st­one recorded that the tick was the vector for relapsing fever; and he concl­ud­ed that quinine was effective again­st malaria, IF given early enough.

The next gener­at­ion of Scott­ish phys­ic­ian scien­t­ists went on to further ident­ify the caus­es and transmission of tropical dis­eases, based on Dr Living­st­one's records. 

Dr Livingstone's 3 trips across Africa
Britannica

By Dr Joe

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10 comments:

Train Man said...

The Christian missions pioneered European medicine and public health in Africa, long before the colonial governments provided those services. But only a few missionaries were trained doctors, so what did the other missionaries do when faced with sick Africans in their missions?

Deb said...

Who really discovered malaria? I have seen 3 different names so far.

Luiz Gomes said...

Boa tarde. Obrigado pela excelente matéria. Uma excelente missionário e um verdadeiro herói da fé. Sou apaixonado pela história dele.

Joe said...

Train Man

In their attempt to educate the Africans about the benefits of Western civilisation, missionaries were well trained in Scotland before they travelled south. Not many were doctors, but science was as important as Christianity for all missionaries. Medicine, good nutrition, clean water, proper child care and body cleanliness were important parts of Western science and Christianity.

Joe said...

Deb

At least three, yes. Dr Livingstone was regularly struck with malaria, recording his first bout in May 1853. He explicitly correlated the presence of swamp mosquitoes with the disease.
Dr Alphonse Laveran was a French military doctor in Algeria where he identified the malaria parasites in infected blood in 1880.
Sir Robert Ross believed that malaria parasites were in the blood stream when this was demonstrated to him by Sir Patrick Manson in 1894. Ross investigated and devised anti-malaria schemes in West Africa.

Joe said...

Luiz

He was truly a committed missionary over a very long time and a true hero of the faith. But he paid a great personal price with his young wife dying of malaria in Zambesi at 40.

Student of History said...

Did Stanley really meet only one European in Africa and say "Dr Livingstone, I presume"?

Hels said...

Student

Noone will ever know. But Clare Pettitt suggested Stanley, working for a newspaper, represented the beginnings of a mass media culture; the meeting became so famous because it was spread throughout the world quickly through the Herald's use of the telegraph. Even the meaning of this meeting changed in popular culture eg copious amounts of American triumphalism was tied to the easing of tensions between Britain and America. So the handshake between the 2 men was a fitting symbol of a thaw in Anglo-American relations, and thus very significant.

Robert Clemm
https://origins.osu.edu/review/dr-livingstone-i-presume-missionaries-journalists-explorers-and-empire?language_content_entity=en

mem said...

It interesting to look at how Livingston has been portrayed as a hero with little or no mention of his wife Mary who really made a lot of what he achieved possible with her language skills ,understanding of African culture and general support for this driven man who it has to be acknowledged adored her in return but not at the expense of his exploration of Africa .He neglected his children and made life for his wife unimaginably difficult for her because she adored him and insisted on not being parted from him .

Hels said...

mem

Mary Livingstone was presumably as committed to the missionary mission as her husband, and her own parents. And she was well prepared, having already travelled a lot, learned African languages and so on. But while David pushed on in difficult times in Africa, Mary was pregnant 6 times and given full responsibility for all the child care of her children that survived.

If I was Mary, I would have supported David as much as possible, but lived in Scotland to give her precious babies as the safest and and most healthy 19th century life available.