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Author Edna Robertson. Published by Argyll Publishing in 2010. £14.99. ISBN 978 1 906134600. 224 pages paperback.
Review by David Hawgood, BSHM webmaster.
When I received this book for review I dipped into it, found it fascinating although my interest is as a layman, and read it through. I recommend it any general reader as it is an interesting account of Zanzibar around 1870. For the medical historian it gives a clear account of Christie's important work on the spread of cholera, and his later work in public health in Glasgow.
James Christie (1829-1892) studied for a Glasgow University arts degree and at the same time studied to become an ordained non-conformist minister. Then he studied medicine, and was awarded a Glasgow M.D. For three years he was assistant physician at Glasgow Lunatic Asylum. Then in 1865 he went to Zanzibar with the Universities Mission to Central Africa as honorary physician. He set up a medical practice in Zanzibar and became well established with the Sultan. For a time he went into business in a sugar factory, but this did not succeed and he returned to his medical practice.
There had been cholera in Zanzibar in 1836 and in the 1850s. In 1869 there was another epidemic. The book gives a vivid account of it and Christie's attempts at treatment - a forlorn hope, there were 30,000 deaths, 10% of the population of Zanzibar. He looked at the spread of disease and concluded that it was waterborne not airborne. Different ethnic and religious groups had totally different mortalities. Hindus had strict caste rules about sources of drinking water, Europeans boiled and filtered water, and these groups largely escaped from cholera.
The London Epidemiological Society asked Christie for a report on the origins of the epidemic and course of the disease in Zanzibar. Knowing Swahili and having many local contacts he asked many locals, including traders who visited the interior, about the spread of this and previous epidemics. He concluded that the disease travelled at human pace along trade routes. He sent his report to London and it appeared in The Lancet and provided new information on cholera in East Africa.
Christie continued to make enquiries for another three years, learning about the spread from Muscat to Somalia, also from Mecca through Abyssinia. At this period Snow's conclusion that cholera was spread by contagion and contaminated water rather than by airborne miasma was not universally accepted. The Indian Medical Service still believed in the miasma mechanism. Christie's work was a valuable addition to knowledge.
Christie was involved in other matters in Zanzibar. The book gives a vivid description of the slave trade. He campaigned in favour of Britain negotiating with the Sultan of Zanzibar, rather than imposing a naval blockade. He also gave advice to Stanley on his search for Livingstone.
In 1874 Christie returned to live in Scotland. He wrote a substantial book on the spread of cholera in East Africa. He became Medical Officer of Health for Hillhead until it was absorbed into Glasgow, and was influential in i mproving sanitary conditions.
As well as a portait of Christie the book has illustrations of life in Zanzibar, and a map showing the spread of cholera from Aden and Mecca through Africa to Zanzibar and Madagascar.
Copyright 2012 by David Hawgood, review authors and the British Society for the History of Medicine
This page by David Hawgood
was amended 2 Feb 2012