Re-writing the ‘English Disease’

Migration, ethnicity and ‘tropical rickets’

Authored by: Roberta Bivins

The Routledge History of Disease

Print publication date:  August  2016
Online publication date:  August  2016

Print ISBN: 9780415720014
eBook ISBN: 9781315543420
Adobe ISBN: 9781134857876


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Since the 1980s, historians of medicine have paid increasing attention both to chronic illness and to the reciprocal impacts of medicine and empire. Here, rickets in Britain will serve as a lens through which to examine – and integrate – these analytical strands. I will demonstrate that the geographies of chronicity and empire are far from distinct, despite the historiographical tendency to situate studies of the ‘rise of chronicity’ in the developed world and to locate ‘colonial’ (and increasingly ‘postcolonial’) medicine in developing nations. Thus, if the image of rickets in 1900 was that of a bow-legged London urchin, by the 1960s and 1970s, it was a markedly bowed and unmistakeably dark-skinned infant or a knock-kneed British Asian schoolgirl. In between, Vienna’s starving children and the rickety youth in Abram Games’ famously banned ‘Your Britain: Fight for it now’ World War II propaganda poster served as innocent faces of deprivation. Indeed, it is a matter of some historical irony that in the early 2000s, the public face of rickets became that of sun-screened and socially networked children of affluence; the more vulnerable housebound elderly remained below the threshold of public awareness, just as they had for the entire twentieth century. Shaping and reflecting these changing pictures, the fall and rise of rickets in mid- and late-twentieth-century Britain exposes the interplay between epidemiological, biochemical, molecular and social models of disease in this period. As the tools of the clinician and the public health officer shifted from household surveys, ‘tactus eruditus’, and the clinical gaze to x-ray imaging, biochemical, and then molecular analysis, ‘rickets’ changed from a disease of gross deformity and patent malnutrition to one of subtle signs, asymptomatic deficiency, and ‘risk’. But if the symptoms and meanings of rickets have been fluid since the nineteenth century, the disease itself has consistently retained political significance and emotive power.

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