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This book highlights the role of acute hunger in malaria lethality in colonial South Asia and investigates how this understanding came to be lost in modern medical, epidemic, and historiographic thought. Using the case studies of colonial Punjab, Sri Lanka, and Bengal, it traces the loss of fundamental concepts and language of hunger in the inter-war period with the reductive application of the new specialisms of nutritional science and immunology, and a parallel loss of the distinction between infection (transmission) and morbid disease. The study locates the final demise of the ‘Human Factor’ (hunger) in malaria history within pre- and early post-WW2 international health institutions – the International Health Division of the Rockefeller Foundation and the nascent WHO’s Expert Committee on Malaria. It examines the implications of this epistemic shift for interpreting South Asian health history, and reclaims a broader understanding of common endemic infection (endemiology) as a prime driver, in the context of subsistence precarity, of epidemic mortality history and demographic change. This book will be useful to scholars and researchers of public health, social medicine and social epidemiology, imperial history, epidemic and demographic history, history of medicine, medical sociology, and sociology.

This book documents the primary role of acute hunger (semi- and frank starvation) in the ‘fulminant’ malaria epidemics that repeatedly afflicted the northwest plains of British India through the first half of colonial rule. Using Punjab vital registration data and regression analysis it also tracks the marked decline in annual malaria mortality after 1908 with the control of famine, despite continuing post-monsoonal malaria transmission across the province. The study establishes a time-series of annual malaria mortality estimates for each of the 23 plains districts of colonial Punjab province between 1868 and 1947 and for the early post-Independence years (1948-60) in (East) Punjab State. It goes on to investigate the political imperatives motivating malaria policy shifts on the part of the British Raj. This work reclaims the role of hunger in Punjab malaria mortality history and, in turn, raises larger epistemic questions regarding the adequacy of modern concepts of nutrition and epidemic causation in historical and demographic analysis. Part of The Social History of Health and Medicine in South Asia series, this book will be useful to scholars and researchers of colonial history, modern history, social medicine, social anthropology and public health.

Causes of rural ill-health in India; based on the author's experiences in Tamil Nadu.