From Rajayak s(h)ma (‘Disease of kings’) to ‘Blackman's Plague’

This article attempts to conceptualise tuberculosis from a socio-historical perspective by looking into its prevalence and aetiology in the Madras Presidency. Since the last decade of the nineteenth century, the indifference of the British contributed to the tardy identification of the disease, leading to its widespread prevalence and attendant high mortality rate. Various perceptions of the disease evolved in a distinctive ‘formative process’ wherein different medical systems, institutions, political and socio-cultural realities played a vital role. Tuberculosis acquired its real meaning in a process of complex negotiation with various professions, including policymakers and the general population. It was particularly after the advent of the germ theory (discovered by Robert Koch in 1882) that the colonial state negotiated the disease primarily as a social phenomena by locating it in socio-cultural practices like early marriage, childhood, purdah, habits of the people, urban space and overcrowding. On the other hand, the economic aspects of malnutrition, poverty, poor housing conditions, etc., were explained away through an aetiological rationalisation of the disease attached with discursive meanings. This was, however, countered by indigenous medical practitioners who considered tuberculosis as an outcome of modern civilisation.