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Medicine and the Saints

[ Middle Eastern Studies ]

Medicine and the Saints

Science, Islam, and the Colonial Encounter in Morocco, 1877-1956

By Ellen J. Amster

Exploring the colonial encounter between France and Morocco as a process of embodiment, and the Muslim body as the place of resistance to the state, this book provides the first history of medicine, health, disease, and the welfare state in Morocco.

August 2013

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The colonial encounter between France and Morocco in the late nineteenth century took place not only in the political realm but also in the realm of medicine. Because the body politic and the physical body are intimately linked, French efforts to colonize Morocco took place in and through the body. Starting from this original premise, Medicine and the Saints traces a history of colonial embodiment in Morocco through a series of medical encounters between the Islamic sultanate of Morocco and the Republic of France from 1877 to 1956.

Drawing on a wealth of primary sources in both French and Arabic, Ellen Amster investigates the positivist ambitions of French colonial doctors, sociologists, philologists, and historians; the social history of the encounters and transformations occasioned by French medical interventions; and the ways in which Moroccan nationalists ultimately appropriated a French model of modernity to invent the independent nation-state. Each chapter of the book addresses a different problem in the history of medicine: international espionage and a doctor’s murder; disease and revolt in Moroccan cities; a battle for authority between doctors and Muslim midwives; and the search for national identity in the welfare state. This research reveals how Moroccans ingested and digested French science and used it to create a nationalist movement and Islamist politics, and to understand disease and health. In the colonial encounter, the Muslim body became a seat of subjectivity, the place from which individuals contested and redefined the political.

Colonial Embodiments

In 1907, a doctor of the French government was beaten to death by a Muslim mob in the Moroccan city of Marrakesh. After clubbing him to death and crushing his head, the crowd dragged the naked corpse of Dr. Émile Mauchamp by the neck through the city streets on a rope. This gruesome spectacle served as the pretext for the French invasion of Oujda in 1907 and the establishment of a French protectorate in Morocco in 1912. At his funeral, the French minister of Foreign Affairs eulogized Mauchamp as "civilization's martyr" to a fanatical Islamic hatred of science. But just before his death, rumors circulated in Marrakesh that the doctor prepared for an imminent French invasion by secretly poisoning his Muslim patients:

[Mauchamp] belongs to a kind of French Christian freemasonry sworn to destroy the Muslims of Morocco. Savant and capable doctors like Mauchamp are chosen and sent among Moroccan populations. There, the doctors care for Arabs with the appearance of a great benevolence, curing them . . . gaining the confidence of all . . . but they have administered a subtle poison which acts two, three or four years later, and they will surely die.

If we perform a historical autopsy, we find the viscera linking body to body politic. Poison is a way of knowing, a "French, Christian freemasonry" that will enter Muslim bodies to destroy Islam and undermine Moroccan independence, a knowing that annihilates both religion and biological life in Muslim bodies. Conquest appears a political and epistemological invasion, a clash of sovereignties inside a human body that is at once the field of battle and its prize. Colonialism, then, is a story of bodies, how ways of knowing became ways of being in bodies corporeal and political, a story of embodiments.

This book traces a history of colonial embodiment in Morocco through a series of medical encounters between the Islamic sultanate of Morocco and the Republic of France, 1877–1956. On the eve of colonialism, Frenchmen and Moroccans had very different ways of knowing the body. In a precolonial political imaginary derived from Islam, Moroccans invested sovereignty in God's Islamic community (umma) and negotiated authority through a human body known as contiguous with the land, Islamic history in Morocco, and temporal politics. Frenchmen constructed the republican citizen as a bounded, rational, and sovereign individual whose physicality constituted one dimension of his relationship to the state. Medicine reveals the Franco-Moroccan encounter, for it draws upon scientific paradigms (cosmologies), knowledge systems (hygiene and medical theory), and the technologies of physical intervention (therapeutics). As a social vehicle, the body is a mediator upon which to read ways of knowing and doing. A study of healing reveals the body's social logics, for a repair of the body usually entails a repair of society; as Jean Comaroff writes, "The body social and the body personal always exist in a mutually constituitive relationship."

David Arnold has described colonial medicine as the hegemonic inscription of Foucauldian power/knowledge on the colonized body: "Colonialism used . . . the body as a site for the construction of its own authority, legitimacy and control." Histories of colonial medicine illuminate how native bodies were invented as objects of scientific knowledge, racisms were naturalized, and health dictatorships were designed to sanitize, rationalize, and control native bodies. Yet the grand colonial medical schemes collapse in the social histories of colonial Africa and Asia, where unruly bodies eluded colonial control. Native patients often ran away from European hospitals, selectively used European cures while escaping (or ignoring) their ideological designs, or cheerfully extracted biomedical cures for re-integration within indigenous systems of healing. In the colonies, European medicine could not discipline colonized bodies, because it failed to constitute individual subjectivities. As Gyan Prakash notes, colonial biopower failed to create "self-subjecting individuals."

Yet anthropologies of healing reveal strange reintegrations. Colonial terror is reborn as a healing dynamic between white and Indian residents of the Putamayo region in South America. British biomedical technologies are renamed and circulate in an African semiotic field. Colonial officers long absent from Sudan now reincarnate as possessing spirits in a women's Sudanese zar Islamic healing cult. A South African "madman" wears precolonial cosmologies and global capitalism on his body as colorful bricolage. Colonialism circulates in the viscera of postcolonial bodies, hidden in symbolic languages of corporeality and woven into traditional healing practice. Transformation comes not of inscribing knowledge but ingesting it, how people swallow new ways of knowing and use it to inhabit their bodies and the world.

Theories of embodiment allow us to move beyond the state to deconstruct the human as a meeting-place of social order and interior life. Pierre Bourdieu describes the human as a meeting of external space (home, town, polity) and internal space (emotion, thought, soul), a relationship mediated by the biological human body. But Bourdieu assumes the body as a "pre-social base," a wet clay tablet onto which cultural modalities are inscribed as invisible habits (habitus), "[Where they] cannot be touched by voluntary, deliberate transformation, cannot even be made explicit." Jean Comaroff attempts to restore individuals to agency with a more dynamic model of meaning creation; for example, the Tshidi create their biological/social bodies through healing practice in a "subject-object" encounter with the world. Yet the actual biological body remains a clay tablet. It is the writing surface for the inscription of a socially produced knowledge.

The religious studies scholar Scott Kugle empowers the body through Sufism, the mystical approach in Islam. He adapts the phenomenology of Maurice Merleau-Ponty: "The concept of embodiment asserts that the body is not something residual, like a vehicle upon which the soul rides . . . [Plato] or something subsidiary to the mind . . . [Descartes]. Rather, the body is both the foundation for and product of the coming into being of a meaningful world, which is human being." Islam articulates a human body radiant of meaning; God breathed of His spirit into clay to create Adam, a body that glows with reason, inspiration, and intuitive knowledge (macrifa), where breath (nafas) and soul (nafs) unite. For Sufis, the human body speaks God's signs; it is the "locus of the manifestation of God's names and attributes—a theophany of the highest order." The skin, hearing, and vision testify to God against their human owners in the Qur'an: "They address their skins, 'How can you bear witness against us?' They answer, 'God has caused us to speak, as God causes all things to speak, for God created you in the first instance and you return inevitably to God!'". Kugle shows us the Islamic body as a signifier, a wellspring of meaning and the foundation of human subjectivity.

This book approaches embodiment as a historical and social process, a method aided by Foucault's biopolitics. Foucault outlines the modern relationship of body to body politic, a modern art of governmentality called "liberalism." Liberalism claims to be natural, according to Foucault: "Nature is something that runs under, through [it] . . . It is, if you like, its indispensable hypodermis." Thus, "Nature" ensures good laws, good government, and true political rights. Biopolitics are the "truth regime" that liberalism uses to extract Nature's truth from bodies, making the body a site of veridiction, of distinguishing the true from the false. Extended to empire, biopolitics are the effort to make colonized bodies speak, the mechanisms used to constitute the native body as a truth-teller whose "truth" defines the colonized as a political subject, determines his laws, and structures his governance. The biopolitical will to hegemony produced various historical examples in Africa and Asia of colonial health campaigns to destroy non-Western healing. The colonizer demands, "Believe only our science, accept only our truth of your body, so that we may protect you, our state may expand, and our truth enter your very subjectivity." Biopolitics are also the state schemes created for subject populations as biological species, "It was the taking charge of life, more than the threat of death, that gave power its access even to the body."

Yet postcolonial bodies escape; they are what Bruno Latour calls hybrids, the intermediate realities that defy a modern scientific understanding. Therapy for postcolonial bodies demands a rethinking of modernity's categories, for the Moroccan body is f-l-baynat, "in the betweens," at the interstice between tradition and modernity, Occident and Orient, nature and culture. Stefania Pandolfo describes modern Moroccan subjectivity as a cut, a fragmented narrative body caught between incommensurable worlds: "The epistemological 'cut'—the severing that defines a modernist position—is at the origin of a double exclusion . . . from 'culture' and the sense of community associated with it," and a 'present' of "discrepant temporality." The patient presents the doctor with a symptom of many dimensions, "discrepant and juxtaposed experiential registers . . . a bridge between worlds." "Everything happens in the middle," writes Latour, but the reality of postcolonial bodies is inconceivable to a modern scientific mind, "It is the unthinkable, the unconscious of the moderns."

If we allow an un-modern view, we find embodiment unfolding. The patient's pain renders visible a Moroccan digestion of modernity, the physical internalization of an epistemological, historical, and colonial war between French positivism and Sufi Islam to define the human being. This fragmenting pain bespeaks embodiment-as-process, a digestion of the experience of French colonialism and its forms of modernity; it is "the work of a subjectivity in the making." This digestion and its historical origins are the subject of our study.

We begin in the nineteenth century with the slow implosion of the precolonial Moroccan state, the makhzan, and the reconstitutions of Morocco as a state and polity under French rule (1912–1956). The third of France's North African possessions after Algeria (1830) and Tunisia (1881), the French protectorate in Morocco (1912) was part of the French Third Republic's new mission to guide peoples of the empire to modernity through "association," a policy implemented by Morocco's first resident-general, Louis-Hubert-Gonzalve Lyautey (ruled 1912–1925). "Republican association" was a contradiction in terms, however, for French science progressed from an effort to contain Moroccan bodies to a refashioning of the Moroccan through his body. We trace the positivist ambitions of French colonial doctors, sociologists, philologists, and historians, a social history of the encounters and transformations occasioned by French medical interventions, and the ways that Moroccan nationalists ultimately appropriated a French model of modernity to invent the independent nation-state. We consider the legacy of colonial medicine in contemporary Moroccan health and healing through interviews with patients, doctors, and midwives in Fez, 1995–2000.

Healing the Body, Healing the Umma: Morocco as a Geopolitical Moral Body

At first a distant African conquest of the Arab caliphates in the seventh century, Morocco developed its own unique history and Islamic spiritual tradition. The first Muslims in Berber Morocco were the invading armies of the Arab Umayyads, but Moroccan popular memory credits a blood descendant of the Prophet Muhammad with bringing Islam to Morocco, Idris b. cAbd Allah (d. AD 793), and his son Idris II (d. 829). A blood descendant of cAli, the fourth caliph, Shi'ite imam, and blood cousin of the Prophet Muhammad, Idris I attempted unsuccessfully to overthrow the Abbasid state. Fleeing the Arabian Peninsula in 789, Idris founded a dynasty and state in North Africa entirely independent of the Abbasid administration. Though Sunni, Moroccans retain a reverence for the Prophet's blood descendants, the shurafa' (singular, sharif), and developed an indigenous Moroccan Sufi tradition uniting spiritual guidance with political leadership. Shi'ite and Sufi ideas unified in the figure of the Moroccan leader, who, like the Shi'ite imam and the Sufi shaykh, led from an intimate knowledge of God and His realities.

It is misleading to read Moroccan history in its kings, for the changing fortunes of North African dynasties inspired Ibn Khaldun's cyclical politics in the Muqaddima, and the limits of the sultan's state led nineteenth-century French observers to describe a balad al-makhzan ("land of the sultan's rule") and a balad al-siba ("land of insurrection"). The historian cAbdallah Laroui describes the Moroccan state (makhzan; literally, "storehouse") as a contingent reality continuously negotiated between sultans, religious scholars (culama'), a commercial bourgeoisie, cities, tribes, and Sufi brotherhoods (turuq). But anthropologists touch what historians cannot, the living of Islam as authority, baraka, "a mode of construing—emotionally, morally, intellectually—human experience, a cultural gloss on life." Islam and the Moroccan polity were lived, imagined, and remembered in the body, a discursive and physical meeting-place of God, the polity, sharica (religious law), and the soul. If Brinkley Messick describes Islamic textual domination of social reality as a "calligraphic state," then Morocco was a "geo-political moral body," a topographical landscape shaped by Islamic ways of knowing and healed and protected by Islamic knowers, the scholars (culama') and the saints (awliya').

In precolonial Morocco, sovereignty arose from a Sufi Islamic conception of social corporeality. Moroccans recounted their local and collective histories through visiting shrines and practicing healing, forms of narrative that constructed Morocco as a great family tree. Branching from the generative body of Sultan Idris II to the tribes and cities of Morocco, God's healing mercies (baraka) flowed in water and human blood. Idris II became a Muslim "saint," or wali, the Friend of God whose knowledge of God restores His law to the Muslims, in their bodies and in the community (umma). As human bodies, the saints rooted God's mercy in the earth, dissolving the physical boundaries that separate individual souls from the Islamic umma. Chapter 1 shows how Sufi saints connected God's law in individual life to His law in social life through the body. The thaumaturgy of Moroccan saintly political leaders has been considered a facet of Weberian charisma and secondary to more "important" markers of social power like tribal affiliation, sharifian genealogy, or economic influence. But saintly healing betrays the essence of precolonial Moroccan political legitimacy. Saintly healing is the historical residue of a Sufi model of popular sovereignty, an idea of popular politics that ultimately disappeared in Morocco between 1900 and 1930.

This interpretation is at odds with an existing literature on the Moroccan sultanate. For Elaine Combs-Schilling, the reigning cAlawi dynasty (1660–present) embodies the Prophet himself; the sultan is "the popular representation of the collective [Moroccan] self," inscribed on living bodies in public Islamic rituals, sexual relations, birth, and death. Other scholars recognize the Moroccan monarch as a product of history who emerged from colonial rule endowed with a new, absolutist power, the "commander of the faithful, supreme representative of the nation" of the 1972 Moroccan Constitution, a sovereign who somehow transcends politics. Abdellah Hammoudi attributes Moroccan authoritarianism to a co-optation of the Sufi paradigm; the king absolutely dominates the Muslim citizen as the Sufi master (carif) dominates the Sufi adept, eroding the citizen's control over his own body (corps-propre) through a superior spiritual knowing.

In contrast, this book contends that the king as "Moroccan sovereignty embodied" is the invention of Sultan cAbd al-Hafiz (ruled 1907–1912), a construct made into administrative and legal reality by the 1912 Treaty of Fez. Just as the Moroccan sultans adopted European sciences (engineering, medicine, architecture, water management) to enhance their state power from 1660 to 1907, so cAbd al-Hafiz strategically used French positivism to fight Muslim Sufi pretenders to his throne. Islamic saints historically challenged the sultans' authority, sometimes founding dynasties (Almoravids, Almohads), leading jihad against invading foreign armies, or ruling semiautonomous cities and regions (the Wazzaniyya). Using Islamic modernist thought (salafiyya) from the Muslim Orient, Sultan cAbd al-Hafiz and a circle of legal scholars discredited his Sufi rivals and their forms of power by "redefining the real." Like French thinkers, Islamic modernists defined truth as the "positive"—the empirical, the rational, the verifiable, the true, and the visible. A new episteme changed political power, for "questions of epistemology are also questions of social order." Sufi knowledge was suddenly recast as false and Sufi leaders became the scapegoats of Morocco's nationalist historical narrative—the enemies of science, self-seeking charlatans, and the great collaborators with the French occupier.

The historical alliance of sultan-science-nationalism-salafiyya accounts for Morocco's emergence from colonialism in 1956 as an Islamic monarchy rather than a secular Arab-socialist state like neighboring Algeria, Tunisia, or Egypt. The 1912 Treaty of Fez decapitated the Muslim body politic and replaced its makhzan state with a French technocracy, a regime of science imposed over and against the Muslim body politic. In the king, Morocco retains an Islamic sovereignty re-embodied. In the Moroccan postcolonial state, a positive technocracy nationalized and Islamicized.

It is now a commonplace that the Islamic world adopted France as its model for scientific modernity. From Napoleon's invasion of Egypt in 1798, Muslim elites in the Ottoman Empire, Iran, North Africa, and Central Asia looked to France for massive modernization efforts (tanzimat), new militaries, medical schools, modern universities, and modern state bureaucracies. Muslim intellectuals Rifaca al-Tahtawi, Taha Husayn, cAli Sharicati, Ahmad Riza, Jamal al-Din al-Afghani, Muhammad cAbduh and others studied or lived in France and defined a self-conscious search for modernity through dialogues with French positivists. The Moroccan salafis Abu Shucayb al-Dukkali, cAllal al-Fasi, and Hasan al-Wazzani studied the rational social order of French and Islamic Comteans and envisioned its implementation for a modern Morocco. But in embracing French science as an unquestioned good, Islamic modernists have absorbed the French epistemological repugnance for Sufism and the Sufi path to knowledge. "Salafi anti-Sufism" derives not from Islam but from French positive science, an imperial episteme defined 1860–1900 against an Islamic and Sufi Other.

An Empire of Positivism: Medicine and the French Imperial Nation-State

In his [posthumous] work La Sorcellerie au Maroc, physician, secret agent, murder victim, and amateur ethnographer Émile Mauchamp cautions his reader, "If the documentary exposition of this work lacks poetry and grace . . . if it passes like a nausea of garbage, like an unchaste fetidity, it is because it is difficult to idealize garbage . . . As soon as one enters into the conceptions of Moroccan physiology and psychology . . . one must reconcile oneself to manipulating the naturalism of rubbish and latrines." Like many of his Third-Republican contemporaries, Dr. Émile Mauchamp judged Islamic civilization by its sciences, particularly the medical sciences—physiology, anatomy, pathology, public health, pharmacy, and surgery. Medicine was the French yardstick of civilization in Muslim North Africa during the Third Republic (1871–1940) and reveals Greater France as an empire of positivism. France claimed not only to bring the benefits of science to empire but also its forms of knowledge, how to know oneself and the world. British imperialists defined essential difference in biological human races, but the French located civilization in the mind, in a rational ability to know.

Imperial positivism illuminates the historical trajectory of the French civilizing mission in North Africa between 1830 and 1912. Alice Conklin locates the French "mission to civilize" in the republic of France and its boundless confidence in French superiority, mastery of nature, and a "perfectibility of humankind." Yet historians have criticized the French Third Republic as racist, expansionist, and less benevolent than the military government in Algeria (1830–1871) or the monarchic "Royaume Arabe" of Napoleon III. Gérard Noiriel wonders that scientific racism should be elaborated after 1871, at the very moment when the Rights of Man were finally applied in France. Gary Wilder finds no paradox in a racist republic, for Republican France was "never not an imperial nation-state." Created around a constitutive antinomy between universality and particularity, Republican France generated paradoxical outcomes for its colonized peoples, "social development without civil society, citizenship without culture, nationality without citizenship." By 1902, France had abandoned direct rule and the assimilation of native peoples in favor of indirect rule and "association" with the colonized. Wilder attributes this policy shift to a rationalization of the French empire into a single juridico-political body, the interwar welfare state of Greater France. Yet as Osama W. Abi-Mershed notes, assimilation and association shared the same underlying goal: to civilize, enlighten, unify, improve, and liberate the native through rational knowing. The only true difference lay in method—how exactly to replace the native's irrational thought with a superior (French) rationality.

For a humane, rational, and modern imperialism, French colonial elites appropriated the ideas of Auguste Comte and sociologie, a "science of society." Émile Durkheim's sociologie offered colonial administrators an applied science through which to identify a society's evolution along a trajectory from the primitive to the civilized, a social laboratory for the classification of ethnographic "social facts." France thus became an "empire of facts," as policymakers used ethnography to design native education, medicine, cities, and laws uniquely tailored to the "Negro mind," the "Muslim mind," and the "Annamite mind." Alfred Le Chatelier, chair of "Muslim sociology and sociography" at the Collège de France, launched a Mission du Maroc to render Moroccan society as text, "ethno-graphy," thus constituting the archive from which to govern Morocco. The École Coloniale trained colonial administrators in sociologie to enable them to govern each society according to its culture and capacities, yet help peoples to evolve toward scientific method with hygiene, roads, and public works; a persuasion through science to the liberation of true thinking itself.

This book examines French empire through medicine, the French revolutionary science that became a "civilizing science" during the Third Republic. The revolutionary idéologue physicians of 1794 defined the human being as a "finite, biologically-contrived entity" knowable and cultivable through the scientific method, the Paris École de Médecine naturalized the French rational self in observable anatomical phenomena, and hygienists such as Louis-René Villermé rendered human life in statistical tables. Physicians designed state hygiene schemas to improve the citizen and strengthen the national body, programs which doctor-legislators implemented as social-welfare legislation in the Third Republic. Colonial medicine had been a practicality for soldiers but became a pedagogy for natives—hygiene to illustrate the public good, hospitals to demonstrate the benevolent paternalism of French rule, and the laboratory to prove the mechanical, biological, and universal truth of humanity. Pasteurian biomedicine was an empire-wide network in which local knowledge and metropolitan theory intertwined, where doctor-administrators circulated between colonial fields, metropolitan medical schools, and laboratory evidence. The imperial, transnational nature of the Pasteurian scientific community produced Charles Nicolle's typhus discoveries in French Tunisia, Alphonse Laveran's isolation of the malaria parasite in French Algeria, and Alexandre Yersin's identification of a plague bacillus in French Indochina.

But French colonial medicine was also torn by the internal contradictions of the French imperial nation-state itself. Pasteurian medicine was the universal republic made flesh, an empirical science predicated upon the universality of biological function in all human beings, a literal improvement of life by applying science to humanity. Pasteurian medicine was also racial and particularizing, as colonial doctors elaborated exotic pathologies from the ethnographically observed habits, morals, behavior, and intellect of colonized peoples. The French compendia of "North African Pathology" were not merely topologies of disease organisms particular to the geographic region of Algeria-Tunisia-Morocco, they were also articulations of Islam-as-pathology, corporeal manifestations of a "Muslim mentalité" on the biological body.

Chapter 2 traces the twining of French hygiene with sociologie in North Africa from 1830 to 1900. In 1830, French doctors accepted Algerian native physicians as fellow practitioners; by 1900, the same native healers were considered magicians and sorcerers. This rationalist critique was invented by French social scientists, sociologues, who used healing as a method of veridiction, "Tell me how you cure yourself, and I will tell you who you are." Magic betrayed the primitive mind trapped in the literal, visual, and sensory body, a Muslim mentalité incapable of abstract or conceptual thought. This colonially constructed Muslim mind became both the mentalité indigène prémorbide of the Algiers School of Psychiatry (1918) and a deformed "Muslim physiognomy" in the work of Algerian-French physician-legist Émile-Louis Bertherand. In Morocco, doctors interrogated the Muslim body to reveal Islam's "truths" and to civilize the Muslim mind. Mauchamp claimed that French medicine would transform the Muslim through his body: "[Hygiene] will finish by impressing [the Moroccan], penetrating him, and fashioning him."

The soldier, administrator, and colonial theorist Louis-Hubert-Gonzalve Lyautey invented the indirect-rule strategies codified in the interwar period by Minister of Colonies Albert Sarraut and the École Coloniale as "colonial humanism." Lyautey advocated a peaceful conquest through science, a method he named pénétration pacifique, deploying four principles of action: savoir, savoir-faire, savoir comment faire, and faire savoir, ("knowing, knowing-how, knowing how to do, and making known"). Lyautey is often portrayed as a Catholic, royalist, antirepublican anti-intellectual, yet Lyautey theorized a Le Playist regeneration of France through a technocractic military-imperial French state in two articles published in the Revue des Deux Mondes. Lyautey's field technique of collaborating with native elites attracted Minister of Foreign Affairs Théophile Delcassé, who wanted a makhzan strategy for the proposed Moroccan venture, and the scientifically minded Algerian député and leader of the École d'Alger, Eugène Étienne. Lyautey became the hero of the associationist colonial lobby of administrators from the AOF (Afrique Occidentale Française; French West Africa), the Union Coloniale Française, the Comité de l'Afrique Française, and their parliamentary group, the Parti Colonial. Lyautey implemented his vision as the founding resident-general of Morocco (1912–1925) and in France as director of the 1931 Paris Colonial Exhibition.

The treaty establishing the French protectorate in Morocco concretized Lyautey's vision and its internal contradictions. France was to modernize yet conserve, to incorporate Morocco to French empire yet preserve her sovereignty, to protect Islam with a positive science inherently hostile to it. Lyautey relied upon the physician to bridge these contradictions and to create Franco-Islamic social harmony, a colonial version of Third Republican solidarisme. Instead, the French colonial welfare state broke apart at its seams of contradiction. The disjuncture between an ideal Moroccan-French social solidarity and a racially differentiating protectorate state came to crisis in the 1930s, as Moroccan nationalists reproached France for her failures and began to formulate an independent Moroccan modernity.

Colonial Science Re-embodied, or Becoming Islamic Modern

One of the suspects to Mauchamp's murder was the Saharan jihadist, Islamic reformer, and leader of the Fadiliyya Sufi brotherhood Muhammad Mustapha Ma' al-cAynayn Qaldami (1831–1910), the head of armed resistance against the French military in Mauritania. When his "blue men of the desert" aimed their rifles at Mauchamp some months before the murder, the doctor complained afterwards, "[The governor] would do nothing and besides between a great saint like Ma el Ainin and myself there was no choice!" But Ma' al-cAynayn was already the last of a vanishing political idiom by 1907, a saintly, miracle-working Sufi Islamic leader like the Mahdi of Sudan or cAbd al-Qadir in Algeria. Fighting saints disappeared in the twentieth century, to be replaced by self-styled modern and nationalist bourgeoisies who embraced Western political philosophy, industrialization, and the nation-state. Embodied modernity did not make Moroccans into Frenchmen, but it did change Moroccan political authority; it made marabouts into nationalists.

The public spectacle of a French doctor's mutilated corpse in 1907 might suggest that Moroccans held little appreciation for French medical science and less for its practitioners. Yet European physicians, engineers, and army officers served the Moroccan court from the sixteenth century, and rural populations clamored for access to the new European sciences. Chapter 3 examines the complexities of French medicine on the eve of colonial conquest. Because the Moroccan public imagined sovereignty through the body, popular fears of imminent European territorial invasion and the concomitant loss of Moroccan self-determination took shape as medical rumor and collective symbolic violence to the body of a French doctor. After conquest, France used the body to co-opt Islamic authority in Morocco, both by reconstructing the Moroccan sultan as a sovereign ruler and by attempting to bring the wali's saintly mediation to French scientific spaces.

In Moroccan cities, municipal hygiene forced a definition of the public: who is the citizen, what is the social body served by the protectorate state, how is sovereignty to be defined and located? Lyautey expected colonial medicine to generate a Franco-Moroccan civic culture, but colonial medicine produced instead state dysfunction and ultimately popular nationalism. Because a state not a republic provided health care to a patient who was not a citizen, Moroccans fought the imposed French medical state and hygienists treated Moroccans as a disease environment rather than a public to protect. Chapter 4 examines the dis-junctures of state-nation-body in French empire by following the social histories of malaria, plague, typhus and typhoid in Moroccan cities. Through their biological bodies, Moroccans were able to assert themselves as political subjects and to contest the urban polity of which they were a part. Failed colonial urban hygiene politicized traditional Moroccan elites, who seized upon new French-created municipal government to demand promised scientific reforms, exact redress, and, ultimately, to question the legitimacy of French rule itself. Disease, not pamphlets, drove the public to young Moroccan nationalists, who demanded a new polity through the suffering Muslim body itself.

In both French Republican and Moroccan Islamic contexts, the law defines the individual's capacities, the signs of his birth, life, and death, and the biological and ontological sources of his political rights. Chapter 5 shows how the male French doctor's quest for medical authority extended colonial technocracy into Muslim law, Muslim family life, and Moroccans' conceptions of their own bodies. Medical authority was also a gender question, for Muslim women made health decisions for the family, delivered babies, and provided expert legal evidence about women's bodies to Islamic courts. Women thus mediated how law and medicine met to constitute the Moroccan as juridical subject. But by offering a urine test for pregnancy, the Institut Pasteur relocated truth-telling from the Muslim soul to the French laboratory, the "essential characteristic of modern power." In the laboratory, the body testified to scientists instead of to God, a new concept of truth that Moroccans themselves introduced to Islamic law courts.

Industrialization and urbanization progressed very rapidly in Morocco between 1915 and 1950, producing a food, disease, and housing crisis for which French authorities were entirely unprepared. To prevent a nationalist revolution and to protect its native industrial workforce, the French protectorate created a self-proclaimed "médico-social" welfare state after World War II, uniting the surveillance of individual bodies with the census, new housing, and maternal and infant health programs for Muslims. Paternalist France posed as patriarch to a modernizing Muslim family, sending Muslim girls to French "mother schools," opening maternity wards for Muslim women, and training native birth attendants to replace traditional midwives. Public health became the battleground between colonial authorities and Moroccan nationalists, who fought back with their own vision of state patriarchy.

Chapter 6 examines the biopolitical struggle between the colonial state and salafi nationalists to define the Moroccan nation and control the Muslim family. Moroccan nationalists framed colonialism as disease, yet even as they indicted the French civilizing mission, nationalists adopted the French language of scientific modernity. Moroccans reimagined the Muslim umma as a nation and targeted women as the polity's biological and cultural foundation. Amid clashing colonial-nationalist biopolitical schemes, the example of colonial obstetrics in Morocco suggests that the body itself remains a seat of individual human agency. In the Moroccan woman's collapsed pelvis and the Moroccan infant's kwashiorkor, the body itself testified, giving direct evidence against a failed state and a divided body politic.

Each chapter of the book addresses a different problem in the history of medicine and thus draws upon a range of sources and methodologies. The colonial is examined not in a linear narrative but as a series of medical encounters: international espionage and a doctor's murder (Chapter 3), disease and revolt in Moroccan cities (Chapter 4), a battle for authority between doctors and Muslim midwives (Chapter 5), and the search for national identity in the welfare state (Chapter 6). The sources are written and oral, French and Arabic: French military archives, municipal records, maps, French diplomatic archives, hospital records, medical photography, colonial ethnography, French medical journals and monographs, Arabic medical manuscripts, Moroccan Sufi hagiography, Moroccan newspapers, and my interviews with Moroccan herbalists, midwives, doctors, and patients in Fez, 1995–2000.

Colonial Embodiment and Questions of Modernity

A considerable theoretical literature asks what colonialism teaches about modernity, if it was invented in the laboratory of the colonies and imported to the metropole, or the modern is a European self-construct defined against an un-modern non-West, or the elements that we call "modernity" are actually a collective invention of the world's peoples, or the European modern is one in a multitude of modernities, or that modernity is a singular, universal project undertaken by various Western and non-Western societies in a self-conscious desire to be modern. But as Bruno Latour insists, We Have Never Been Modern, because modernity's premise—the absolute separation of nature and culture—is impossible. Modernity is not only impossible, it is also blinkered, for a modern way of thinking cannot see the world as it truly is, full of hybrids. Why then would we—would anyone—wish to be modern?

Modernity offers a promise, a guarantee, that man can exact truth from nature and have sovereignty over himself as a citizen-subject. By separating nature and culture, science claims to perfectly translate Nature's truth, "it is not men who make Nature," and society is made by absolutely free beings, "human beings, and only human beings, are the ones who construct society and freely determine their own destiny." To create truth and freedom, "There shall exist a complete separation between the natural world (constructed nevertheless by man) and the social world (sustained nevertheless by things)." Yet man is hybrid, he is the hybrid by virtue of his body, a reality that the liberal political subject continually flees. Modernity is flight from the body, an internal self-mutilating cut to invent a modern citizen free of his body. The non-moderns are those enmeshed in bodies—the colonized, children, deviants, women—those whose unmastered corporeality excludes them from full political rights. These body-subjects are nature-culture contaminations unable to separate "what is knowledge from what is society," "For Them, Nature and Society, signs and things, are virtually coextensive. For Us they never should be." Colonial modernity can only be conceived as the therapeutic rescue of Muslims, a replacement of Islamic epistemology by natural law and the liberating cutting-away of minds from bodies.

But if we take the body as a unit of analysis, we can both avoid and historicize modernity's epistemological cage. Embodiment offers a not-modern way of seeing, a subjectivity in and of the body. "The body is my point of view on the world," writes Merleau-Ponty, "I am the absolute source, my existence does not stem . . . from my physical and social environment; instead it moves out towards them and sustains them." Healing is a beginning from which to recover being; as Victor Turner argues, the afflicted connect material and spiritual worlds in otherwise impossible combinations, overcoming mental categories to express "the act-of-being itself." In Morocco, Vincent Crapanzano finds the Hamadsha Sufi order simultaneously treating "real" physical ailments and engaging history; the Hamadsha healers and patients "act out, albeit symbolically, the scars of their past." This book offers a history of Moroccan politics and sovereignty through the body, a way to analyze the Islamic social discourses that currently challenge the legitimacy of postcolonial North African states. Bodies are what Timothy Mitchell has called the "unmanageable excess" of the modern, the repositories of nonmodernity that challenge us to rethink modernity itself.

Ellen Amster is Associate Professor of Middle East History at the University of Wisconsin–Milwaukee and a specialist in French and Islamic medicine. Her research includes global health, non-Western health and healing systems, women's studies, the history of North Africa, and French imperialism in the Islamic world. She has been a simultaneous translator for an ORBIS ocular surgery mission and a researcher at the National Institute of Hygiene in Morocco, and she also created a global women's health program in Morocco.

"This first book from an exciting new figure in the field of Islamic medical history offers a fresh look at how the Moroccan ‘body’ became the site for competing influences leading to a political and scientific modernity. The clear prose, creative use of sources, and historical accuracy are exemplary. Nor will the reader be bored; the narrative is full of twists, turns, and unexpected surprises that engage the mind and stimulate the imagination, regardless of one’s disciplinary orientation."
—Susan Gilson Miller, Professor of History, UC Davis, and author of A History of Modern Morocco, 1830–2000

"This book is a significant contribution to the field with much new information and original archival research. It brings together earlier work on colonial medicine in Morocco and gives the reader a new appreciation of the importance of medicine and public health in the colonial encounter and in the nationalist resistance movement, and in the state building that followed. It adds to the study of gender and empire, showing how the colonial authorities manipulated the health and well-being of indigenous women for their political interests. . . . It will be well received by scholars interested in the history of the Maghrib and Middle East, Islamic medicine, Sufism, French Empire, and gender, health, and empire."
—Nancy Gallagher, Professor of History, University of California, Santa Barbara

"This is a dazzlingly good book. Amster takes us on a bewildering tour of medicine and public health in colonial Morocco in a pioneering study. Health was a critical site of contestation in the protectorate. . . . The differences of authority between doctor and patient were dramatically exacerbated by the gulfs of power in the colonial state. Western biomedical and local Islamic epistemologies produced enormous conflict, and yet opened a critical space of resistance to colonial rule. . . . As opposed to those who would find in colonial medicine a demon of oppression, or those who would use it to excuse colonial excesses, Amster has produced a nuanced study that opens an important window on the enormous complexity of medicine and public health as a staging area for the colonial encounter. Among other critical elements of the book, she places the intersection of gender and religion at the forefront, making this a truly notable addition to the literature."
—Richard Keller, Associate Professor, Department of Medical History and Bioethics, University of Wisconsin–Madison

"Medicine and the Saints offers readers a complex analysis and interpretation of French colonialism in Morocco..."
—Sahar Bazzaz, American Historical Review

"Medicine and the Saints challenges the very notion of modernity and provides fresh insight into contemporary questions of post-colonial epistemologies of personal and social health. This book is essential for scholars interested in social life at the interstices of colonial-modern Morocco."
—Adam Guerin, Social History of Medicine

Honorable Mention, Alf Andrew Heggoy Book Prize
French Colonial Historical Society 

 

Amster: Medicine and the Saints

Ellen Amster discusses the first history of medicine, health, disease, and the welfare state in Morocco.
Series: UT Press Audio

Author: | Date: Monday, 17 March 2014 | Duration: 1:17:00

In an interview conducted by Matthew Long for New Books in Islamic Studies, Ellen Amster unpacks her ground-breaking, interdisciplinary work Medicine and the Saints.

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