Postscript - Fritha Langerman

171

Postscript

Image from the exhibition Subtle Thresholds, reproduced with permission of the artist, Fritha Langerman.

The observing gaze refrains from intervening: it is silent and gestureless. Observation leaves

things as they are; there is nothing hidden to it in what is given. The correlative of observation

is never the invisible, but always the immediately visible, once one has removed the obstacles

erected to reason by theories and to the senses by the imagination.

Foucault, The birth of the clinic. (1975: 107)

173

Postscript

Trees, webs and explosions: The analogical imperative in the politics

of knowledge

Fritha Langerman

As A visuAl prActitioner, it is often asked of me how visual art is to be understood

as research. Of course, what underlies such a question is the assertion that all visual

practice is subjective and emotive, and cannot possibly be held to the rigours of

other intellectual endeavours. Yet, as is suggested by the title of this book, Medicine

and the Politics of Knowledge, knowledge is contingent rather than intrinsic. While

method and structure are implicit within any inquiry, visual art has different

methods and is able to appeal to allegory, humour and irony, tools that are not

within the ambit of scientific discourses. It is also able to self-consciously reflect on

its own practice and collapse spatial and temporal linearities by combining vastly

disparate materials, images and references in ways that extend beyond regionalism

and locality. The rejoinder to the probe is most often ‘that which can only be known

through practice’, and while this may be becoming a truism, it suggests that art is

a means of knowing that is deeply invested in active knowledge, in the experiential,

the sensorial and the associative. Visual practice embraces a methodology that is

at variance with typical textual arguments. It is syncretic, it layers, veils, creates

juxtapositions and sets up a multitude of suggestions rather than conclusions. In

accordance with this way of working, the text of this chapter darts and dives, making

and breaking connections, and should be read in parallel with the exhibition images.

Subtle Thresholds, an exhibition of prints, objects and collections, is primarily

concerned with the visual representation of infectious disease, both in popular

imagination and in medical literature, and the language surrounding disease,

which relies on the binary oppositions of clean/unclean, known/alien and sterile/

contaminated. The history of epidemiology reveals the interpretation of infectious

diseases in the West as arising from outside European borders – as immigrant,

foreigner and invader – reinforcing what Sander Gilman (1988) refers to as the

fixity of disease as a constant other. The installation reflects on how constructions

of ‘difference’ have served to mediate the cultural and political understanding

of pathology, and on the ways in which visual analogies of disease inform the

174 Medicine and the politics of knowledge

visualisation of disease as a space of separation through which the patient becomes

identified by illness.

With reference to material drawn from Subtle Thresholds, this chapter

attempts to identify how visual geometries operate as a symbolic rhetoric in

knowledge claims, how they may alter the perception and interpretation of that

information, and how schematic analogies perpetuate ideas about the world. I argue

that visual models intercede with the world and become the seductive keepers of

knowledge. The argument here ought to be read in dialogue with the larger project,

which reflects on the politics of taxonomies and on the ways in which linear modes

of representation and analogy emerged in book form and found their way into

museum exhibits, and which asks whether the recent shift in the visual analogy for

evolution from the tree to the web of life may impact on the presentation of informa-

tion in museums.

Barbara Maria Stafford’s book Visual Analogy makes complex connections

between science and art, proposing that in Western thought there has been no

language to describe resemblance, only ‘an exaggerated sense of difference’. She

writes of analogy:

[By taking us] to the associative origins of human thought, analogy offers

a non-algorithmic technique for binding our perceptual system to our

cognitive systems, expressed in terms of similarities and antithesis.

Learning, in this development scheme, does not spring from a chain of

reasoning, but from a dynamic back-and-forth motion among choices that

embrace the entire universe in their scope.

(Stafford 1999: 176–7)

For Stafford, then, analogical thinking is a means of sense-making that is ultimately

comparative and based in systems of equivalence; however, there can be no sense

of similarity without the corollary of difference. As Stafford indicates, this has

been the dominant means by which Western thought has been ordered. Analogy

is the relationship between word and image – the proportion that exists between

two things – a system of ordered relationships articulated as similarity in differ-

ence. Subtle Thresholds concerns itself with representational taxonomies, in which

taxonomy codifies a system of order based on difference. The word’s etymology,

from the Greek taxis (order or arrangement) and nomos (law or science), suggests

this to be an inflexible system, and one that is ultimately hierarchical. Taxonomic

thought has driven the visual presentation of biological collections and display, both

within the book and museums, and it has developed persuasive visual metaphors to

carry these ideas.

As a printmaker, I have found that my understanding of the world and my

approach to the construction of exhibitions is mediated by and responsive to the

trees, webs and explosions: the analogical iMperative in the politics of knowledge 175

underlying tenets of the discipline of printmaking itself. The print in book form has

been instrumental in the perpetuation of linear models of knowing the world. Not

only were ideas of classification, taxonomy and evolution communicated through

the book, which formed part of the reproduction and replication of those systems,

but underlying linearities were supported by the codex structure, presenting a

constrained and hierarchical ordering of material, not least of all linked to its

origins in the church. The codex book is both binary and sequential in its form.

The symmetry of the open book means that pages are viewed in relation to each

other, while the inclusion of the frontispiece and colophon in more traditional

books ‘sandwich’ the contents between an explanatory narrative and a textual

reflection. The conventions of the structure and divisions imbue it with a tempo-

rality, as, through a slow process of disclosure, its contents are revealed over time.

Enlightenment thinking is inextricably bound to print as both a political innovation

and a creative practice, as it suggests ways of influence and a pattern of thought that

is, again, based on binary referents – of an archive and its text, of object and image,

and of image and text. Print is always bound to an ‘other’, a state outside of itself,

in a discipline of oppositions: matrix and impression, original and reproduction,

negative and positive, oil and water, depth and surface.

Western knowledges have been plagued by a seemingly contradictory desire

to represent encyclopaedic systems within formats that resist fluidity. This is

apparent in the early medieval ordering system, the Imago Mundi, which aimed at

representing a compendium or cosmology of the known world (the creation and the

created) within a geometric order of concentric circles and associated numerical

clusters of symbolic significance. Through brilliant, illuminated images, the

conceptual significance of light as a vehicle of truth and spiritual ‘enlightenment’

was intrinsically married to the ideological position of the knowledge that this

system chose to impart. The schematics of the Imago Mundi provided a reliable, if

reductive, means of knowledge dissemination by which a closed, finite theology was

communicated to those to whom the written word was inaccessible.

The symmetrical geometry of the Imago Mundi is a development of an early

Christian ordering system and world view, the Scala naturae, in which the tree was a

genealogical analogue. Pre-empting the form of Darwin’s tree of life, Scala naturae

presented a divine order of nature, dividing animals and divine beings along ‘evolu-

tionary’ lines of divine ascent. This presented an early system of binary taxonomy

wherein belief was built on the oppositional states of order and chaos; heaven and

hell; human and animal. Early museums were informed both by the legacy of the

Imago Mundi (an encyclopaedic system of human knowledge) and by a pansophic

philosophy, the idea of a comprehensive knowledge, evidenced through collections,

and linking the natural, human and divine worlds.


The popularity of the tree as an analogue spans cultures, religions and

time, yet is traced most obviously to its antecedent as both the biblical ‘tree of life’

and ‘tree of knowledge’. This dual analogy introduces both genealogical kinship

and epistemology. By enjoying the fruit of knowledge, immortality was sacrificed

and through biological propagation the first tree of kinship begun. Genealogy is

encapsulated by the tree schema as it provides a clear system for recording both

succession and relationships over time.

In communicating bodies of knowledge, science has often had to rely on

images to carry complex ideas, and it is these visual analogies that hold persuasive

power, occupying a central role in the formation of public perception. Images are

able to mask points of obscurity within theoretical explanation and provide a unified

gloss – an image of integration and completion, and an imaginary synthesis. The

‘tree of life’ is one of the most pervasive visual analogies and its strong graphic

syntax presents two significant structural problems: its ascendant linearity and its

branching, divisive structure. Both of these have legacies within colonial discourse

and it is the inheritance of these analogies of Linnaean and Darwinian divisions

and classification systems that have allowed for the separation into racial categories

and types. Darwin’s 1859 diagram of a tree to explain natural selection is vertical in

orientation, recent time being represented at the top. It has been suggested that this

orientation is not as much a feature of progress as it is an inheritance of his geological

background, in that the vertical stratigraphy represents near time at the surface of

rock formations. German biologist, Ernst Haeckel’s tree of 1876, on the other hand,

traces a deliberate route from monera at the roots to menschen at the uppermost tips

of the tree. While more contemporary representations of the circular phylogenetic tree

may go some way to overwriting this entrenched visual image, its structure remains

binary, branching and, as such, differential. Stephen Jay Gould has written extensively

on the representation of evolution, and in his Wonderful Life refers to it as an ‘iconog-

raphy of expectation’, arguing that all visualisations of evolution reinforce a ‘march

of progress’ and serve to entrench a ‘comfortable view of inevitability and superiority’

(Gould 1989: 28). He identifies each evolutionary tree as having two distinct morpho-

logical features: monophyly, in that each has a unique basal trunk; and divergence, in

that all branches either die or divide further. He states that the false iconography of

the cone-like tree of increasing diversity conflates placement in time with complexity

and development in a judgment of worth. In echoing Darwin’s description of life in

Origin of Species as an ‘entangled bank’, Gould suggests that the complexity of the tree

is possibly captured better by a ‘complex bush’.

The topological1 design of the tree provides a stability and reassurance, as the

character of organisms (objects) as singular, reliable entities means that they may

be compared and organised with predictable outcomes. However, the oppositional

nature of taxonomy, built on similarities and differences, is currently believed to be


contrary to speciation, which is both relational and contingent on space and time

(Zimmer 2008). Also, recent developments in bio-informatics, and the rate at which

genomes can be decoded, have allowed for complex interspecies comparisons to be

made.2 In the past few years, the results of these comparisons have caused biologists

to question previous evolutionary, phylogenetic models, particularly the iconography

of the Darwinian tree (Dagan & Martin 2006; Doolittle 2000). Lateral or horizontal

gene transfer (LGT/HGT), observed particularly in microbes, suggests that species

transfer genetic material between each other fairly regularly and that this is a

fundamentally non-branching process, thus undermining the vertical descent/

ascent imagined by Darwin. HGT allows organisms to carry simultaneous attribu-

tions (a partial snake genome has been located within the cow genome, presumably

transferred by the action of viruses) (Lawton 2009), and although clearly the

phenotypical expression and cultural understanding of individual species remain

intact, their chimerical genotype undermines the belief that species evolve deter-

minately from a single point. What this does is to dislodge the sanctity of coherent,

independent entities, collapsing hierarchies and tipping humans from their apex. In

addition, this may allow for the possibility of representing other complex behav-

ioural interactions that may influence speciation.

The suggestion that a more appropriate visual model for evolution may be

an interrelated network or web has implications for the interpretation of visual

artefacts and visual knowledge bases, because in arboreal iconography, each node

divides irrevocably into finite objects, whereas in web or net iconography, objects

are fluid, and subject to reattribution and change. The reading of biological and

biomedical visual and material culture may be subjected to the same revisions. In

doing so, chains of reference may be unravelled and objects and images become

ambiguous and multi-referential, this shift in design suggesting a major recalibra-

tion in the construction of knowledge systems. While this may be true, there is

perhaps something more subtle in the oscillation between these systems that can be

evidenced in the history of collections and display.

Since the early modern period, this history reveals the underlying assump-

tion that objects are significant and able to convey meaning, and that their

particular arrangement is able to influence thinking about the world. During the

late Renaissance, objects were organised according to points of similitude; during

the Enlightenment, difference became the primary organising principle. When

examining a potential shift in the iconography of evolution from web to tree, I

translate this as a return to an interest in the connectivity and similarity between

artefacts rather than the divisive structures of Enlightenment order. The web allows

for an openness and generosity of interpretation.

The part museums have played within the colonial project needs no introduc-

tion. The development of museums is often recognised as running parallel to the


rise of national and political consciousness, as museums were seen as a means of

actualising power through object wealth. Similarly, collections were used to reinforce

ideological positions that collapsed science into forms of social control.3 It is also

largely accepted that science museums have a particular link to authoritative clas-

sification and valorised forms of knowledge, as they have promoted an ideology of

progress and mastery over nature as well as appealing to notions surrounding beauty

and discovery (Jordanova 1989). In this way, they intrinsically perpetuate the ascen-

dency theories embedded within evolution and tree iconography. The current ‘crisis of

representations’ within museums has arisen precisely because it is acknowledged that

museums have been complicit in perpetuating certain understandings of taxonomic

knowledge and that the strong metaphors which directed previous curatorial and

display decisions can no longer be used to interpret current theory.

Yet, collecting is not all bad. Collecting as a practice is deeply invested in

ways of knowing and perceiving, and is reliant on a dialogical relationship between

objects. Bruno Latour (1987) stresses that it was precisely the physical proximity

of massed objects within collections that allowed early biologists to reimagine the

formal and conceptual relationships between them. Sixteenth-century cabinets of

curiosities (or Wunderkammers) were based on extreme proximities and adopted

an organising principle based on resemblance, complex linkages and divine logic

(Macdonald 2006). Objects were de-contextualised and ordered according to their

‘intrinsic’ meaning and symbolic value, and the ‘poetic’ rearrangement of objects

was encouraged to provoke conversation and reveal a divine code. The contiguity of

the curiosity cabinet was a consilience – a literal connecting of dislocated objects

and specimens from unrelated disciplines. This may be seen as a precursor of

assemblage, a strategy that will be discussed later.

Ken Arnold (2006), in his overview of early museums in England, points out

that 17th-century education reform, which recognised the ambiguity of language and

called for a pedagogy based on a system of objects, was at the heart of museum philos-

ophy of the time. A language of things rather than words demanded a classificatory

order and grammatology of entities – the emergence of display – and simultaneously

required a new system of naming by which things could be unambiguously under-

stood. The visual, thus, was held above the textual as a means of knowing. Within

‘houses of learning’ objects were arranged so as to make visual arguments, and

meaning was entirely contingent upon the perceived relationships between them.

The shift from cabinet to museum has been seen as a change in represen-

tational spatiality – an epistemic shift as the move towards a system of order based

on observation and physical evidence of objects (comparative binaries of observable

differences and similarities) ran parallel to the development of institutionalised

spaces of collection (MacGregor 2007). Objects were seen to receive meaning from

their relationship to the rest of the collection rather than from their own intrinsic


value and were contextualised in comparison to others. Difference, thus, became the

centre of taxonomy and classification.

This system of ordering again reflects the structure of the book, in this

instance Diderot and d’Alembert’s Encyclopédie (1751–1766), which aimed to classify

and categorise everything about the known world. The structure of the printed publi-

cation had an obvious impact on the manner in which information was understood,

its contents organised according to a tree schema of a ‘system of human knowledge’,

broken into three branches – Memory (history), Reason (philosophy) and Imagination

(poetry). The scope of the project allowed for infinite complexity and philosophical

reasoning, and the structure of the book form introduced the notion of the index and

cross-referencing. For the first time, different sets of ideas could be viewed compara-

tively, and, in doing so, the reader was empowered within the act of knowledge

creation.4 This relative freedom to build associative relationships was not as easily

realised by the restrictions of 18th-century museum display. This was more in keeping

with Linnaeus’s synchronous publication of Systema Naturae (1735–1767), which intro-

duced the notion of a linear classificatory tree stretching from Eden until present time.

In museums, the realisation of this intensive ordering and labelling project took the

form of serialised cases that were able to manifest physically taxonomic knowledge.

Rational, unequivocal labels bound objects to provenance and attribution. Sigrid

Weigel (n.d.) believes that the shift in the 1800s from a classificatory system (listing)

to a genealogical one (tree distribution) presents a tension between systematic and

temporal ordering modes. She argues that while classification relies on the constancy

of species (determined by difference), evolutionary genealogy relies on variation that

allows for change (determined over time), and that these two systems are incompat-

ible. However, Linnaean taxonomy, while not temporal, presents a tree-like schematic

hierarchy of species that is implicitly developmental. Both of these systems rely

explicitly on a structure of difference, and within that structure is a predictable binary

symmetry. I believe that it is the predictability of this structure that has made the tree

such an enduring icon.

Returning to the exhibition, Subtle Thresholds, the project rests on the belief that

active curatorship is able to dislodge previous patterns of viewing and understanding,

and that through finely orchestrated relationships objects can sound, if not speak,

independently of any authoritative text. It makes reference to Linnaean taxonomy and

cladistics, yet uses a lattice of conceptual and visual cross-referencing to undermine

this oppositional understanding of species. Cultural and linguistic description and

codification present humans as a discrete species, with defined boundaries. Yet,

infectious disease offers a meeting point, as disease is not something distinct and of

itself, but is dependent on a relationship between a host and an organism in order to

exist, and is evidence of an ongoing inter-speciation. Once a deep connectivity between

humans and other species is acknowledged, all structural hierarchies collapse.5


Images from the exhibition Subtle Thresholds, reproduced with permission of the artist, Fritha Langerman.


In order to disrupt the stigma and fear typically associated with disease, the

exhibition embraces two curatorial strategies: wonder and layering. The light boxes

and complex lattice defer to Stephen Greenblatt’s (1991: 49) well-quoted notion of

wonder or the ‘power of the displayed object to stop the viewer in his or her tracks,

to convey an arresting sense of uniqueness, to evoke an exalted attention’. The

intention is that using this language as the interface between the viewer and the

representation of disease invites a point of contact that promotes further discussion

or investigation.

It co-opts layering and repetition of form through visual ‘hyperlinks’ to

expose the interconnectivity between organisms, worldviews and mythologies.

In acknowledging the history of the relationships between images and text, and

museums and text, this project attempts to disaggregate object and image from text

and label, allowing for a sensorial apprehension of the material alongside a more

traditional reading of details within it.

There are three methods of layering. Firstly, there is a literal layering

of images and objects. The walls contain eight discreet sets of images: shadow

painting, a schematic diagram, chalk texts, Scanning Electron Microscope images

of animal faeces in quatrefoil and trefoil frames, rusted and chromed laser-cut discs

based on bacterial forms, a framed inventory of mythical diseases caught from

animals, a 70-metre timeline and a set of GPS co-ordinates of disease outbreaks

over time.

Secondly, there is a thematic layering that picks up different stories in varied

forms. As an example, Darwin’s diary entry of 1835 describes in chalk the moment

of being bitten by the beetle known to cause Chagas disease. This date is picked up

in a yellow signage plate giving the co-ordinates of Mendoza, Argentina, where the

disease was contracted, and is further sited in the cabinets within a printed board

attesting to Darwin’s diary of health a few years prior to writing Origin of the Species

(1859); in addition, there is a cabinet, sandblasted with a diagrammatic form of his

tree of life, and in another cabinet old chemistry bottles are labelled with the causes

of death of 15 naturalists, Darwin being one.

Thirdly, there is a layering in the means through or by which reading

occurs: the reading of disease through distinct disciplines (for example, diagram-

matical viruses are manifest in pharmacological laboratory plastics); the material

through which reading takes place (for example, chalk texts reflect the personal,

mythical and philosophical reading of the diseased body); the limited access to text

(for example, the scale and height of the framed myths make them unreadable);

the explanatory texts in the cabinets thwart analysis as they lose their numbering

system and direct references; and animal specimens are labelled only by the

diseases they carry.


Images from the exhibition Subtle Thresholds, reproduced with permission of the artist, Fritha Langerman.


In addition to layering, the exhibition co-opts a system of dualisms. The

gallery is simultaneously read as a cathedral and as a laboratory. The angelic wings

are constructed from silhouettes of art historical and popular images of healer’s

hands and, while the shape formally references a schematic tree, it thematically

refers to the religious binaries of damnation and salvation associated with disease

and healing. This work is paired with the ‘ex-voto plague altar’, which uses the

negative form of the hands as a screen, protecting six bandaged, taxidermied

animals (surrogate plague saints) from the viewer. Plague doctor silhouettes run

across the top of the screen, making further connections to the bird as a prevalent

and ambiguous metaphor within the visual iconography of disease. Laser-cut discs

exist in two states: chromed and rusted; a timeline in the form of a printed ruler

circumscribes the entire exhibition area and includes a biblical concordance of

disease, literally running counter to a more conventional microbial history. The

ruler measurements are indicated by a chordate species list, incrementally divided

by microbial species in red; and cabinets ‘contaminated’ by language are tethered to

agents of sterilisation.


The simultaneous co-option and rejection of binary structure is a direct

response to both the tree and web as analogous ordering systems. The iconography of

the tree is a fairly inflexible frame. In an extension of the metaphor, it is essentially a

nurturing image, which provides shade and protection, yet its foliage may disguise its

underlying structure. It is both ascendant and descendent, and its bilateral symmetry

implies an inherent sense of order, whereas, if in a Cartesian framework, order is

taken to be positive, the web has negative connotations. It is complex and disorgan-

ised, simultaneously fragile and furtive and, rather than inviting, is a means to entrap.

I mention this as the multivalent associations embedded within visual analogies have

import for their endurance as cultural metaphors. It is impossible to speak of tree and

web without reference to Gille Deleuze and Felix Guattari’s (1987) writings on arbo-

rescence and rhizomatics. Clearly, the tree corresponds to arborescence, a hierarchical

organisation of thought, demonstrating centres of significance and subjectification.

It is defined and connected, whereas rhizomatic systems take into account that ideas

are dynamic. The web as a schematic of speciation may not correspond entirely to the

rhizome, which is seen as fuzzy, indeterminate and, thus, able to connect to other

systems, yet the sense that there is a wide scattering of knowledge, which slowly

becomes part of a more coherent system, is certainly closer to the visual rationale that

was applied to Subtle Thresholds.

A more useful trope to apply to the construction of the exhibition may be

assemblage, and although this loosely refers to Deleuze and Guattari’s (1987) term

as a non-linear, fluid and adaptable method of knowing, it also has specific art

historical roots. As a modernist device, assemblage is an extension of collage, and its

extreme contiguity brings together a range of seemingly incompatible objects and

images. Assemblage is synchronic and relies on the symbolic reading of relational

material values and forms. Robert Rauschenberg is perhaps one of the most famed

assemblage artists, combining found objects with printed material and paint. He

relied on a vast range of visual resources or what Rosalind Krauss (1999) referred

to as a ‘perpetual inventory’, from which he was able to create complex networks

of associations. What this does emphasise is that visual art provides one of many

ways of knowing. It is this active place of association, this productive space of

emergent ideas that can be useful for the future of museum display. Assemblage is,

of course, also an archaeological term used to describe a range of artefacts found

in the same location or context – in this instance assemblages are seen to represent

singular moments, cultures or industries. In viewing indeterminate objects in close

proximity, assemblage suggests both a dematerialisation and an emergence.

Assemblage is sympathetic in that it sets up objects in relationships that shift

their independent meanings to refer to the language of sympathetic magic, objects

rely on contagion. However, the methodology of this particular exhibition requires

there to be an active fragmentation before elements can be reconciled. Here, I have


chosen to engage a further analogy – that of the exploded book. Unlike Western

science, which is predicated on evidentiary systems, and uses analogy as a form of

persuasion, I am suggesting that art relies on an explosion of established systems.

Through this necessary disordering of accepted structures, it limits the known

values that can be brought to the reading and experience of the work, and this

disorientation generates an active engagement. Powerful mnemonics are activated

when the viewer is confronted with new visual evidence and the default position is

to rely on those established, learned patterns. Accepting this process, particularly

within the museum environment that comes with expectations, Subtle Thresholds

set out to test the ways in which an act of curation is able to simultaneously absorb

and interrupt the patterns of display and reception of information. In doing so, it

creates a system that dislodges those strong visual prescriptors.

The exhibition creates its own index or lexicon, and texts and images within

the cabinets cross reference and provide clues to other elements. It appeals simul-

taneously to the sensory and the intellectual mind, and, in being both immediate

and associative, is both synchronic and diachronic. By actively engaging the viewers,

forcing them to navigate and read the exhibition in a complex way, it is hoped that

the structure of the exhibition undermines linear knowledge systems and, in its

texture and visual richness, presents a seductive and persuasive visuality. It is this

sensorial persuasion that I see as the agency of art in the politics of knowledge.

Endnotes

1 I use this term in relation to ‘network topology’ that shows the layout of computer or biological

networks. The structure of the network demonstrates nodes of convergence and the map

of connections between physical or logical points. Most often, this structure resembles the

branching of a tree.

2 Ian Hacking, amongst others, has drawn attention to the manner in which a bias for

tree-like ordering can obscure alternative understandings of evolution. His lecture ‘The Fatal

Attraction of Trees’, delivered at numerous venues, traces the persistence of the tree over time

from genealogical trees, trees in religion to evolutionary tree diagrams.

3 Collections allowed comparative measurements to be made between species. This enabled

false equivalents to be drawn between skull size and development in humans and was used as

supporting evidence for racialist ideologies.

4 Diderot and d’Alembert’s Encyclopédie is the subject of my Knowledge Chambers exhibition

(2007/8). See Langerman (2008).

5 This assertion relies on contemporary literature that draws attention to the relationships that

humans have with animals, for example, Donna Haraway’s Companion Species Manifesto (2003),

Derrida’s discussion of his cat in The Animal That Therefore I Am (2008) and Donna Wendy

Woodward’s The Animal Gaze: Animal Subjectivities in Southern African Narratives (2008).


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contributors 187

Contributors

Christopher J Colvin is a senior research officer in social sciences and HIV, AIDS, TB

and STI S at the University of Cape Town’s (UCT) School of Public Health.

Judith B Farquhar is the Max Palevsky Professor of Anthropology and Social

Sciences and Chair of the Department of Anthropology at the University of Chicago.

Diana Gibson lectures in the Department of Anthropology and Sociology at the

University of the Western Cape.

Donna Goldstein is Associate Professor of Anthropology at the University of

Colorado, Boulder.

Oliver Human is a PhD candidate in the Department of Anthropology and Sociology

at the University of Amsterdam.

Fritha Langerman is an associate professor at the Michaelis School of Fine Art,

University of Cape Town.

Susan Levine is a senior lecturer in the School of Gender and African Studies,

Anthropology and Linguistics at the University of Cape Town.

Helen Macdonald is a social anthropologist and a lecturer at the University of

Cape Town.

Estelle Oosthuysen is a qualified pharmacist and pilot and an independent

researcher.

index 189

Index

Please note: Page numbers in italics refer to Figures and illustrations.

AAA (American Anthropological Association) 142 El Dorado Task Force Report 142ABCC (Atomic Bomb Casualty

Commission) 132–133 genetics data 132–134 studies in Japan 145Academy of Medical Science, Tehran 71Access to Genetic Resources and Associated

Traditional Knowledge Bill, Namibia 88Achmat, Zackie 6, 34–35activists 55, 56, 60, 66acupuncture 155, 161New Age spirituality in US 156 see also under Chinese traditional medicineAEC (Atomic Energy Commission) 130 genetic mutations of Yanomami 134 political pressure on findings 133–134African botanical remedies 7African knowledge 61African potato dietary

recommendation 42, 44, 56, 73AIDS 1, 6, 10, 17, 57denialism 7, 49, 51, 58dissidents 6, 58dissident science 35knowledge claims 51politics on national stage 33–35 status and TB sputum test 5 uncertainty about 101AIDS Law Project 61AIDS science 72claims, truth or falsity 48–49mainstream and dissident 34, 37,

49–50, 57in South Africa 34–35, 48–50allopathic medicine 79, 94, 104, 111alternative knowledge systems 37alternative medicine 4, 44, 153alternative remedies 57!amace, Ju/’hoan-speaking San 79–80, 93–94 search for healing 81–87 son Namsje 84 wife Xa//om 81, 82–84Amathila, Dr Libertina 90Amazon 123, 130–136, 140 measles vacination programming 143oral histories and genealogies 130AMBA Pharmaceuticals (pseudonym), Mexico 137 anti-cancer drugs 137

Area of Compliance 138 drugs for HIV-infection treatment 137American Anthropological Association, see AAAAmerican Philosophical Society 142anaemia 131anaesthetics 155analogical thinking 174analysis, written 71ANC (African National Congress) 46, 51, 56–57deployment of SANCO 52Youth League, see ANCYLancestors 10, 55, 60, 62ancestral knowledge of healing 60, 62–63ANCYL (ANC Youth League) 36, 46–48antenatal clinics 60anthropological scholarship 80anthropology 4, 7–8, 48–50, 65, 66,

153, 155of apology 65bioethical domain 121holistic Boasian ideal 121post-postmodern era 55antibiotics 85, 111, 155, 157 intravenous, Thailand 156antiretrovirals, see ARVsantiretroviral treatment, see ARTanti-tubercular medication 86apartheid 63–64appendicites 160Argentina 11 clinical trials research 122 ethnographic field research project 123 HIV and AIDS treatment 137Aristotle 20Arrowsmith, novel (Lewis) 11, 120, 123, 135, 143 characters 126–130, 140ART (antiretroviral treatment) 3, 6, 11, 41–42, 58 denialist approach to 33, 34 programme in Khayelitsha 58ARVs (antiretrovirals) 21, 26, 55, 69, 74 cost, toxicity, efficacy question 33 defaulting, reasons for 55–56 effective dosing 43 efficacy in children studies 35 legal and political battles 34 limited adherence 56 psychosocial criteria for eligibility 25 side effects 69 struggle for access to treatment 73toxicity for food-poor people 65, 73


ASNS (Andh Sraddhã Nirmulan Samiti, Blind Faith Eradication Committee), NGO 102, 104, 108Atomic Bomb Casualty Commission, see ABCCatomic bomb radiation studies 119, 130 exposed and control population data 133–135genetic effects, Hiroshima, Nagasaki survivors 132victims of radiation, Japan 140Atomic Energy Commission, see AECauditing in medical practice 19Ayurvedic form of medicine, see under Indiaazidothymidine, see AZTAZT (azidothymidine), antiretroviral drug 58 clinical trial ethics, litmus test for 125 logic of trials 124–125 trials in Africa 124 vertical transmission prevention 124 Baba, Sai 109bacteriology 155, 157‘bad science’ 137baobab oil and pulp, cosmetics market 87beetroot and garlic dietary recommendation 44,

73belief(s) 4, 101, 102, 153 Hindi meaning of faith and belief 108 language of 155 question of 107–110 visvãs (Indian) in medical treatment and

science 106Belmont Report 141, 143beneficence 135, 141Beresford, Belinda 56‘Big Pharma’ industry 58, 123, 136biocapitalism notion 121bioethicists 125bioethics 142and biopolitics 120code for research 145dilemmas of scientists in global clinical trials 144interdisciplinary field 122of life and death 4biogenetic resources 88bio-informatics 177bio-material 121biomedical categories, global hegemony of 164biomedical interventions 59biomedical knowledge, opposition to traditional

medicine 6biomedical paradigms 94biomedical pathology 164biomedical practitioners 2, 55, 66biomedical science 7, 62biomedicine 3, 5–6, 79, 121 global 165

and indigenous forms of healing 41and political economy of health 153see also under Indiabiopolitical notion 120, 121bioprospectors 55bioscience labs 153Blake, Rosemary 63Blind Faith Eradication Committee, see ASNSblood samples 130bloodwood (Pterocarpus angolensis or n'hàng) 82, 87Borofsky, R 142botanical substances, scientific method for efficacy

and safety 62brain damage caused by virus 55–56 see also TBCBrazil’s Indians and the Onslaught of Civilization

(Rabben) 142breach birth 160Britain 86bureaucracy 24

calories, lack of 44–45camelthorn (Acacia erioloba or /ànà) 82, 87capitalism 121, 125cartoonists, protests by 60see also under Zapiro (Jonathan Shapiro)categoriesexcess of 22–28, 164 individual patients into groups 22–23, 25 of risk 25–26CBD (Convention on Biological Diversity) 88CD4 count 26, 56cemetry 63Center for Drug Evaluation, United States 125 Chagas disease 181Chagnon, Napoleon 4, 11, 119, 122, 130‘Chagnon Critics Overstepped Bounds, HistorianSays’ (Science journal) 122chemotherapy 3–4Chhattisgarhi, see under Indiachild labour in wine industry 63children, ethical issues of research 141China 5, 9 after the revolution 159–160 classical medicine 157 clinical research trials 161communist theory 156 foreign missionary doctors 157 healing expressions 104 hospital care histories 161 introduction of antibiotics 157 Maoist scientific socialism 157, 160 Maoist social epistemology 167 medical assimilation 62

index 191

phytochemical analysis 161 project of modernising public health 160 public health interventions 157 question of medicine as traditional

culture 160–161scientific socialism 156 ‘scientism’ 156, 157 see also objects, Chinese notions; People’s

Republicof China, founding ofChinese national medicineclaim to transnational value 164–165global science 157and Mr Democracy 156and Mr Science 156–158 political encounter with Western

medicine 158 superstition (mixin) among the people

(laobaixing) 157 see also Qi, translatedChinese traditional medicine 61acupuncture 155, 161collective activity of knowing 163‘eating of’ 43diagnostic outcome ( jielun, resolution) 162as ‘experiential’ 158gods, ghosts, divination, trance 161government support 154herbal medicine and remedies 155, 161pattern-classification of tuberculosis 163‘pattern of disorder’ (zhenghou) 162, 163‘synthesizing thought’ 162–163traditional culture question 160–161Western medical ‘disease’ ( jibing) 162, 163churchcodex structure 175protests by leaders 60cirrhosis 162citizens, protests by 60civics and street committees 46civil society groups 34clinical research trials 2, 62contemporary ethics 8double-blind trials on human

subjects 4, 11global drug trials 11, 124, 143–144HIV and AIDS treatments, Phase 3 137people living with HIV 136 oversight and regulation 139 protocols 136, 139 see also under Argentina; China; Mexicoclinics 15 and hospitals 94 rural HIV in agricultural region 16

cognitive-scientific enterprise 19cognitivism 20, 21, 22, 30cognitivist approach 19cognitivist discourse 18cognitivist view of medical practice 15commiphora resin (perfume), cosmetic market 87complementary medicine 153complex biopolitical assemblage 101Congress of the People, see COPEconsensus between clinician and patient 101control groups 4, 11, 123–126, 129 bioethical concerns 146 ethics of science 141–142 and experimental 120 human research 120, 123, 126 integrity and solidity 123and populations 119–123, 139 reductionist and potentially

dehumanising 121 see also human experimentationConvention on Biological Diversity, see CBDCOPE (Congress of the People) 51corporate insurance sector 55crafts 80cremation as alternative to burial 63critical thinking 71CT (computed tomography) scan 86cultural anthropologists 121cultural beliefs 102culturally based genetic research (Neel &

Chagnon) 119cultural relativism 65Cumes, David 94

D’ Alembert, Jean le Rond 179damage limitation 112Darkness in El Dorado (Tierney) 11, 119, 120, 130,

135Darwin, Charles Robert 175, 176, 177, 181Das, Veena 65data collection problems 133Daughter of Spirit, Mother of Mine, film

(Frankenfeld) 61deaths 16, 63, 64, 84decision-making 4, 21–22 doctors’ abilities 18, 19, 22 experts’ techniques 20 see also ethico-political decisionDe Kruif, Paul 127, 128Deleuze, Gille 184Democratic Alliance (DA) 56Department of Energy 134Department of Health 34examination for traditional healers 62


Department of Health, Education and Welfare 141depression, social indicators of 56Derrida, Jacques 22devil’s claw 87diagnosis 1, 17, 94 act of 27–28 archaeology of 2 contingent, material factors 15 intuition and ‘methodological’ evidence 26 notion of ‘interpretive community’ 24diarrhoea 17 as symptom of TB 26Diderot, Denis 179dietary disciplines 156directly observed treatment, see DOTdiscipline-specific intellectual guidelines 141disease, see illness and diseasedistribution of medicine, state’s governance 26divining 71Dlamini-Zuma, Nkosazana 60DNA 80doctors 16–17 decision-making 18, 19, 22 diagnosis 28and patient relationship 101, 162 socio-economic conditions of practices 18DOT (directly observed treatment) volunteers 81,

85Dreyfus, Hubert 20drugs 121, 122–123, 137 ‘foreignness’ of companies 38regimes 156side-effects 158testing and ethical dilemmas 124 ‘virgin’ or ‘naïve to treatment’ bodies 125Duke University researchers 143

education 109Efavirenz tablets, vitamin supplements packaged

as 42Encyclopédia (Diderot & d’Alembert) Imagination (poetry) 179 Memory (history) 179 Reason (philosophy) 179 tree schema of system of human

knowledge 179Enlightenment order, divisive structures of 177epistemology 2, 5, 8, 80history of 173and methodological assumptions 141–142 and therapeutic diversities 153ESR (erythrocyte sedimentation rate) 86Ethambutol 81ethical codes 143

ethical gate-keeping 140ethical standards in human

research 121, 122ethico-political decision 22ethics debates 121 medicine for profit 4ethnic identities 48ethnographic project (Petryna) 122 support group for men

with HIV 33, 35ethnographic research 10–11euthanasia 4experimental group 120experimentalité 120, 140–146experimentality, Petryna’s notion of 120

FDA (Food and Drug Administration) 124fever plant medicines for 87 tuberculoma and patient with history of 86filmmakers, protests by 60fixity of disease as constant other 173Food and Drug Administration, see FDAfood insecurity and limited ARV adherence 56food parcels 44–45food security 74Foreign AIDS, show (Uys) 56Forever Living brand, immune boosters 51Foucault, Michel, notion of the

biopolitical 121framing process 24–25 ‘administrative frame’ 25–26Frankenfeld, Henner 61, 67Freedom of Information Act 134From Revolution to Rights in South Africa

(Robins) 58–59funerary services industry 63–64 see also cremation as alternative to burial

garlic as rogue cure 56, 73gastroenteritis 17, 26Geertz, Clifford 119, 145Geffen, Nathan 57–58, 65genetic material lateral or horizontal gene transfer (LGT/

HGT) 177 vertical descent/ascent (Darwin) 177genocide, accusations of 60genocide-by-ARV accusations 38, 56genomes 80, 177geophysics 155Germany 1, 86Gestalt psychology 28

index 193

global clinical research trials 119–121, 139, 143

bioethical issues 144 industry 124–125, 144global ethical guidelines 141global market 87global pharmaceutical company 123global pharmaceutical corporations 138–139glucose tolerance tests 130‘good science’ 138–139, 142Gould, Stephen Jay 176Gous, Dr (pseudonym) case study 16–26government 15, 93, 153 certification for traditional practitioners 159 inept bureaucracies 140Guattari, Felix 184Gupta, Justice 104Gwala, Zeblon 56, 57 Haeckel, Ernst 176Hassan, Fatima 56healers, healing systems, interventionist

strategies 103healing indigenous forms 41local 94search for 110healing dances 80, 81–82, 87 altered states of consciousness 93 children 89, 90–91 ‘drawing out’ sickness 82 elephant and giraffe dances 90–91 feminine power (†aisa, singer with n/

um) 92–93 heat/pain/suffering (khúisi) 89 heat up (//un//un) n/um to heal 89, 90,

91, 94 hot/trancing (khui) 89, 90, 92, 93 !kia and healing 92 songs and rhythms 91, 92, 93, 94 spirits (//gauwasi) 93T!ixo (strong n/um singer) 93trance dancing and states 92, 93 women 93healthcare 2, 7, 55health knowledge 42health-seeking behaviour 102Health Unlimited, Namibian NGO 81 TB outreach and education programme 81,

84Helman, Cecil 2Helsinki Declaration 125, 141herbal medicine and remedies 38, 65–66, 155, 161herbs, tradional

chemical properties 60 clinical trials, packaging, marketing 60–62 national accreditation 60–61 transforming wild herbs into tablets 66Hernandez, Dr Victor 123, 136–141, 146Hill, Kim 144–145history and formation of knowledge 155HIV 3, 5, 10, 21, 56 alternative and traditional treatment 50–52 causal link between infection and AIDS 33 denialist or dissident perspective 33 nutrition in combating 65 politics of 50 poor people living with 10, 72–73 workshops and support groups 33, 45, 48HIV and AIDS 63activists 6clinics 16 course on, Worcester 66, 69, 72 denialist approach to 33 efficacy of micronutrients and

multivitamins 11 medical professionals 139 people living with 55, 136 Phase 3 global clinical trials 137 poverty debate 56 social and economic costs 59HIV-positive patients 26HIV-related disease 55HIV-related pharmaceuticals 137–138hoodia 87hopelessness and depression 56hormones 162horn-pod tree (Diplorhynchus condylocarpum org//àqrà) 82, 87Hsiang-lin Lei 158human experimentation 8, 121, 122, 123, 124, 126,129, 139, 141, 144, 146humanitarian interventions, logic of 113human mind as machine 20human rights 74, 109Human Rights Tribunal 56human subjects research 143 ethical pillars for 141 ethical standards 121hunger 8Hutchisson, James 127

ICH (International Conference on Harmonisation)guidelines 125iconography arboreal, finite objects 177 of expectation 176 web or net iconography, fluid objects 177


identity production 109illness and disease 1, 8, 101aetiologies or causes of 112 and dying, approach to 4 fixity of, as constant other 173 infectious 8, 10, 173, 179 and mortality, coping with 8 patterns 9stigma and fear 181and suffering, holistic approach 112symptoms as evidence of 24see also sexually transmitted illnessImago Mundi 175immune boosters 51 see also Forever Living brand 51immune response 161immune system 17 language of Rath and TAC 41–42 role of nutrition 35immunology 155independence of thought 113 ‘deep-seated public secret’ 113India 5 allopathic medicine 111Ayurvedic form of medicine 159 biomedicine (angrezi davai), English

medicine 111 black magic or witchcraft ( jãdû-t,on) 103,

105–6Chhattisgarhi villagers 7, 10–11, 102, 107Chhattisgarhi visvãs 110 critical politics of identity 108 divination to diagnose illness 104 government approval 111 healing at shrines 104 herbal remedies ( jar++-bkt,+) 104 mantrã and ritual sweeping away of illness

(Jhãr(-phkmk) 104 medical pluralism 159 Nav Bhãrat, newspaper 108 Nepalis biswãs 110 pilgrimage and propitiation 104 priest-exorcist ( jhãr(phkmkvl) 110 religious healing rituals 111Siddha form of medicine 159therapeutic massage 104Unani form of medicine 159 village healers (baigã-guniyã) 103–104,

105–106, 107, 112 witches (t,onh+ and t,onh) 103witch killings 103 see also language, Indianindigenous herbs 7infections, opportunistic 57, 65

infectious illness, diseases 8, 10, 173–174, 179informed consent 122, 135, 143, 144 bioethical concerns 146 economic considerations 143 respect for persons 141inhumane living conditions in Prussia 1institutional review board, see IRBinternational AIDS conferences 44 vegetables in SA exhibition booth 44International Classification of Diseases 161International Conference on Harmonisation, see

ICH guidelines‘interpretive community’ and diagnosis 24interspecies comparisons 177intuition 5, 9, 26, 164iodine metabolism study for AEC (Roche) iodine 131 toxic substance 135 lacking informed consent 134–135 use of radioactive iodine tracers 134IRB (institutional review board) 125, 137–139IRIN (Integrated Regional Information

Networks) 57 HIV/AIDS news service 57Isoniazid 81, 85

Janmasthmi (Lord Krishna’s birthday) celebration 105

Japanese study 119Jonas, Hans 144journalists, protest by 60justice 135, 141and human rights struggles 65 Kaesje, Ju/’hoan-speaking guide 90, 91Kailash, see Sahu, KailashKalahari lemon seed oil, natural product 87kaleidoscopic vision 66Kenya 59Khayelitsha township 34healthworkers 42interview with youth counsellor 46–47and Rath Foundation 37‡khomani San 90knowing 65, 153knowledge 5–7, 9, 16, 80 academic industry 153domains 93, 94 home-grown 57 ideologies 156–157 indigenous forms 38, 61, 153 indigenous system 61–62 and locality 155 nature of production 122 recalibration in construction of systems 177

index 195

scientific concepts and principles 72 systems 36 testing 71 transplantation of 155–156 Western 175Kxao, local San teacher 90–91

Langerman, Fritha 9, 10, 13, 99

language, Indian blinded, shut one’s eyes to (andhã honã) 109 blind man (andh) 108 deceive, blind, trick (andhã karnã) 109 deceit, fraud, trickery (chal) 108, 109 devotee and fanatic (andh-bhakt) 108 meaning of belief 107–110 technology of 55Last Adam, The, essay (Lewis) 123Latin America 4, 5, 120–121, 136–140lemon juice dietary recommendation 44, 56, 73Lekotjolo, Nkosana 60Lesotho 56Levi-Strauss on Brazilian sorcerer 112Lewis, Jack 6, 57, 71Lewis, Sinclair 11, 120, 123, 129–130life and death 2, 4of individual versus life of population 22lime trick 106–107, 113Lindee, M Susan 132–134Linnaeus, Carolus 179local settings, constraints or possibilities 79Loeb, Jacques 127, 128, 135logical reasoning 72Lu Guangxin, Dr 9, 154, 156, 160, 161, 166–168 causes of medical disorder 163 object-on-the-move-in-translation 162–165 synthesis of disease and pattern 165lung cancer 160Lu Xun 157–158Lysenko, T D 50

macronutrients, lack of 44–45Makunzi, Lydia 61–74 children’s home 65 chitibhunga (suffering from evil

spirit) 67–68 food-garden project 61, 65, 74 orphanage 61Twasa (training) 67ukuvamisa (tell people what is happening to

them) 67Mandela, Nelson 56mangetti fruit, oil and pulp as medicine 87manufacturing traditional products 62

Marks, Harry M 124Marshall, John 90marula oil, juice and pulp as medicine 87Maseko, Phephsile 61–62Mayeng, Isaac 66Mazuru, Professor Gundidza 60Mbeki, Thabo 6, 33, 34, 36, 51, 56 African Renaissance programme 34, 38 African solutions to African problems 57 HIV and poverty connection 65 opinion of AZT 58measles 4 development of antibody titres 131–132 Edmonston B vaccine 130, 142, 144, 145 epidemic in Venezuela and Brazil 123, 131 Schwarz vaccine 144 vaccination campaign in Yanomami,

Neel’s 130, 144Médecins Sans Frontières, Doctors Without

Borders, see MSFmedical anthropology 3, 7–8, 102medical care and psycho-social care 61 re-conceptualisation of 18Medical College Hospital, Raipur 111medical evidence, nature of 60medical examination, Baghdad 71medical-humanitarian interventions 101medical pedagogies 55medical pluralism 41, 79medical practices, current conceptions of 30medical professionals, protests by 60medicinal plants, see plants, medicinalmedicineevidence-based 19, 21, 27packaging 62and politics of knowledge 3–6 rules and regulations for distribution 62‘medicine as art’ conceptualisation 18medieval ordering system 175memory of content and recall 72mental illness, undiagnosed 55–56methodological rigour 123, 126, 141Mexico 11 clinical research trials 122 control groups for human

experimentation 141 corruption in government institutions 137 ethnographic field research project 123 HIV/AIDS health community 136 neoliberal deregulation 138 phase-3 clinical trials 136Microbe Hunters (De Kruif) 127microbes 162, 177


micro-biological proof of infection 23micronutrients 11, 44–45mimicry with intent to reveal 113Mira, Dr (pseudonym) case study 16–28misdiagnosing patients 17, 24Mishra, Dr Dinesh 102, 104, 108, 109, 111, 113modernist criticisms 103modernist ideals of classification 16modernity 102, 109, 114Modern Medical Institute (Raipur) 105modern scientific medicine, see MSMMoleleki, Miriam 63monophyly and divergence of evolutionary

tree 176Monwabisi (Monwa), dialogue with 33, 35–36mopane essential oil, cosmetics market 87Moral Economy of AIDS in South Africa, The

(Nattrass) 60mortality and morbidity datasets 155Moss, FA 72Moss Test 71–72 true-false and multiple-choice questions 72mother-to-child transmission of HIV 57mother to child treatment plan (MTCTP) 60mouse-eared combretum (Combretum hereroense

or !kàbè) 82MRI (magnetic resonance images) 86MSF (Médecins Sans Frontières, Doctors Without

Borders)ART programme in Khayelitsha 58and Rath Foundation 50MSM (modern scientific medicine) 62multi-drug resistance 23multivitamins, efficacy of 11mural images of hope 63muscular dystrophe 105museums 177 cabinets of curiosities (Wunderkammers) 178 collecting as practice 178 national and political consciousness 178 philosophy of early museums, England 178

N!ai: The Story of a !Kung Woman, film (Marshall) 90

Namibia study 79–80 foot-and-mouth disease 83 government and protocols 87, 93 indigeneity, debating 89–93 indigenous natural products 87 medical knowledge and

contradictions 85–86 N/ami and Ti!xe, healers 82 Naye Naye conservancy 83 political economy of indigeneity 87

protection of biodiversity 87, 94protection of intellectual property rights 87 protection of traditional knowledge (TK) 94regulation of genetic resources 87 seeking diagnosis and healing 81–84 state health services 93 TK, knowledge economies and

complexities 86–89 tourism 80, 87, 89 see also !amace, Ju/’hoan-speaking San; San

peopleNAPWA (National Association of People Living

with AIDS) 51!nara oil, cosmetics market 87National Association of People Living with AIDS,

see NAPWANational Health Care Act 7National Human Rights Commission, India 104National Science Service camp 113National South African Traditional Healers Bill,

Zwelethemba 72Nattrass, Nicoli 60natural health remedies 34natural medicine market 87Nazi medical experimenters, Rath’s

comparisons 50Ndaki, Kanya 57, 73Neel, James V 4, 11, 119, 120, 121, 140, 141–144 anthropological subjects 122 career choices 135 doctor and geneticist 130–136 excursion to Amazon 130, 134 Japanese skeletal data 141 measles epidemic, Venezuela and Brazil 123 research agenda and behaviour in the

field 142 separation of science and politics 134neoliberal global economy 8neoliberal globalisation 143–144neoliberalism 121neurologist, expertise of 86neuropsychiatrists 55New Age seekers 153spirituality and treatment of pain 156New England Journal of Medicine 143Ngcwe, Nothemba 63, 74NGOs (non-governmental organisations) 80, 85, 89promotion of San knowledge and rights 94Nishad, Kulwantin Bai (alleged witch) 104non-compliance 7, 101, 102non-governmental organisations, see NGOsnon-Western healing knowledges 153normative framework 19North America 5, 18

index 197

N/um Tchai: The Ceremonial Dance of the !KungBushmen, film (Marshall) 90Nuremburg Code 141nutrition and ARV treatment argument 74Nywagi, Phuzmile 50–51, 52

Obadare, Ebenezer 59Ober, Dr William B 129–130, 143objectivity and scientific protocols 2–3objects, Chinese notions 165–168 image we face, translation of duixiang 166 learning from objects 166–167 object (duixiang) 165–167occult economies 102Okeke, Iruka 59olive oil dietary recommendation 44, 56ontological issues/questions 80, 162–165ontological multiplicity 86opportunistic infections, TB in HIV-positive

patients 16Origin of Species (Darwin) 176

pansophic philosophy 175paracetamol 87‘Paradise of Wisdom, The’ (Ali Ibn Rabban) 71parasite burden 130pathology 9patients 66 adherence 102 traditional modes of protection 144Pauling, Linus 34People’s Republic of China, founding of legalisation of traditional medicine

practice 159 national public health policy 159 paramedicalised practitioners 160 socialism as ‘scientistic’ 160 state control 160 training of medical practitioners 159 translations 159 see also Chinaperformances 80Petryna, Adriana 120–123, 124–125, 143–144pharmaceutical activism, grassroots 33–34pharmaceutical capital and power 120pharmaceutical colonialism 49pharmaceutical companies 55, 58 ghostwriting of studies 125 profit-seeking interests 125 products generating profits 137 protocols in Mexico 137pharmaceutical corporations and protocols 136pharmaceutical industry 123pharmaceutical politics 120–121, 146

pharmaceutical production and distribution Latin-America 120–121, 136–140 Mexico and Argentina 11pharmaceutical science 120pharmaceutical technology 42photographers, protests by 60phronesis 20–22Physician to the Gene Pool, memoir (Neel) 131physics, modern 167phytochemical analyses, see under Chinapills‘naturalness’ residing in 42 power of 37, 42 size and similarity to food 43 symbolic referents 43placebo, use of 124control studies 126effect 112placebo-controlled trials 124 among impoverished populations 139 global clinical trials 125–126placere (to please) 124plants, medicinal 82, 87, 93, 94ancestral knowledge 62–63local community knowledge 88, 94in the wild and value of 66wild foods and fungi 87playwrights, protests by 60pluralistic medical development 154, 158pneumonia 162political economic analysis 56politics 3–7of competing AIDS knowledge claims 51of knowledge 56populations 4, 5, 17, 122–125post-apartheid era African renaissance 66of ‘reconciliation’ 63 traditional medicine 73–74poverty 8, 10, 16, 56, 74power 8 and corruption 47practical reasoning 20see also phronesispregnant women 60printmaking 174–175problem solving 71, 72prognostic dimension 112Progress of Experiment, The: Science and

TherapeuticReform in the United States (Marks) 124protocols, medical 15–17, 20, 21–2, 28–30, 60 critique of 18 and logic of the machine 17–22


responsibility or ethics and politics 22 universal 27Pruitt, Liese 50–51pseudo-scientific pariahs 50pseudo-scientists 58, 74psychiatric diagnosis 23public health 48–50, 101 interventions in China 157 policy-makers 153 protests by practitioners 60 sectors 66, 146 studies 155public hospitals, resource-poor 140Pyrazinamide 81

Qi, translated Chinese word and quantum physics 161 configurative force 161energy, matter-energy 161 heteropathic class (xie qi) 163, 164 and immune system 163 illness patterns (zhenghou) 163 orthopathic class (zheng qi) 163, 164 pattern of disorder and disease 164–165 wholesome and pathogenic qi struggle 164 yin-yang harmonies 163Quackdown, website 57–58, 61quackery 102, 113

Rabban, Ali Ibn, Persian physician 71Rabben, Linda 142radiation 160randomised, controlled trial, see RCTRath, Dr Matthias 11, 33, 50, 51, 57, 74alternative treatment programme 35‘clinical trials’ 37–38enactment of treatment in practice 42–44entry points and legitimisation 46on ‘foreignness’ of drug companies 38‘junk science’ or ‘pseudo-science’ 37 local and national network of supporters 35 message of corruption and need for

scepticism 47 modernity and indigeneity 38, 42 structural poverty and social exclusion 52 true believers and modern believers 41, 52 truth or falsity of claims 48–50Rath Foundation 34, 49, 52 at community level 35–37 conflicts, TAC and Rath volunteers 36 engagement with SANCO and

ANCYL 46–48, 52 struggle against, in research and

practice 49

vitamin and micronutrient supplements 33, 42

see also food parcelsRauschenberg, Robert 184RCT (randomised, controlled trial), double-

blind 124, 126‘real worlds’, plurality of 155Reason. Diderot, etching (Langerman) 13, 99researchers, protests by 60resources, equitable allocation of 15‘Retreat from Clinical Medicine’, memoir

(Neel) 135Reynolds, Pamela 63Rifampicin 81risk 25–26, 126Robins, Steven 58Roche, Marcel 134–135Rockefeller Institute, New York 127rogue cures 56, 59, 102, 112, 113Rosenberg, Charles 128Ross, Fiona 63

Sahu, Kailash 102–106, 109, 111Pott’s spine (tuberculosis spondylitis) 104Saidi, Dr Farrokh 71Salk Institute, neuroendocrinology laboratory 121SANCO (South African National Civics

Organisation) 36, 46–48 political and social exclusion of

members 47–48sangomas degree programme, Wits 60–61 divining, diagnosis and treatment 62–63 hiding and finding test 68 Nandi’s dreams about snakes 68–69 patient to pay (inicoma) 67 photograph, Sangoma with trainee 70 professionalisation 66 Twasa (training) 67 see also under tests, nature ofSan people ‘brand’, copyright, intellectual

property 80, 89 ‘brand’ of healing knowledge globalised 94 children and village school 81 claim on land and resources 87–88 ethnicity and authenticity debates 80 Ju/’hoan healing dance 90 Ju/’hoan knowledge 10, 90–91, 94 Ju/’hoan-speakers 81, 87–88 Kxao Moses, councillor 83 ‘trance’ techniques 94satirists, protests by 60Scala naturae

index 199

divine order of nature 175early Christian ordering system 175tree as genealogical analogue 175 see also Imago Mundi; treescepticism 4, 7, 40, 102–102, 110, 113–114 causal link between HIV infection and

AIDS 33 about human experimentation 144 hybrid or eclectic 103 and notions of belief 101 pragmatic and disenchanted 10–11 trickery 106–107schizophrenia 21science 109, 155 and art connections 174 capitalist perversion 139 corporate control over 124 global 167–168 mainstream and dissident 41 methodology 26 pre-capitalist 146 ‘pure’ and ‘commercialised’ 126 and TK 94 used for profit 137science laboratory findings 128scientific definitions 72scientific design and method 120scientific medical practice 19scientific process 121scientific secular rationalism 102scientists 55Scholastic Aptitude Test for Medical Students 72Scripps Research Institute 94sexually transmitted illness 59Shapiro, Jonathan, see ZapiroShikongo, Sem 88sickness, construction of 80social and political networks 46social sciences 1, 5, 101socio-economic constraints 18Socrates 20sorcery (gawau xai) 82sourplum (Ximenia caffra or g//oeh) 82South Africa 6–7, 15, 56, 86 conditions of life in townships 47 economists and sociologists 59 Global Fund 29 HIV-positive people 23 national medical exams 72South African AIDS conference, International

Conference Centre, Durban 57South African Civics Organisation, see SANCOSouth African Healers Association 69

South African Museum of Natural History 9South Americans, native tropical 144Spencer, Warren P 135spiritual forms of healing 40sputum 16–17, 81, 86, 87Stafford, Barbara Maria 174standardisation 15, 17, 21, 22, 24, 27, 28–30 intuition and excess problems 164 of medicine and protocols 28–29state, the 46, 55, 66, 93, 94 administrative orders 18, 25ownership of biogenetic resources 88 and public service development

projects 47 resources and training, access to 66statistico-HIV 23statistico-HIV/tuberculosis XDR 23statistico-tuberculosis concept 23Steinberg, Jonny 65Stern, Curt 135stigma 56 people with TB 84street committees 46sub-Saharan Africa, HIV-positive population 23Subtle Thresholds (Langerman) 9, 179–185images from Iziko Museum exhibitions viii, , 14,

32, 54, 78, 100,118, 152, 172, 180, 182, 183Suburban Shaman: A Journey Through Medicine

(Helman) 2Suffering Made Real: American Science and the

Survivorsat Hiroshima (Lindee) 132–134suicide 4, 24superstition 5, 113belief and scepticism 102–103 andhvisvãs (Indian) 104, 106, 108, 109 surgery 158, 160syphilis disease 161Systema Naturae (Linnaeus) 179systematic and temporal ordering modes 179

TAC (Treatment Action Campaign) 6, 34, 51, 56, 57–58, 61

advocacy for free access to ART 33 ART programme in Khayelitsha 58battle with Rath Foundation 34 campaign and public health advocates 35 comparing Rath to Soviet scientist

Lysenko 50 comparisons between and Nazi

‘Brownshirts’ 38 interview with volunteer 39–41 Rath’s comparison of activists 50


‘The End of the Matthias Rath Affair?’, email 50, 52

treatment literacy approach 38Taking HAART film (Lewis) 6, 57 ‘Traditional Healers for ART’ poster 6Tanzania 56taxonomic thought 174taxonomy, Greek meaning and classification 179 nomos (law or science) 174 oppositional nature of 176–7 order and chaos 175 taxis (order or arrangement) 174TB (tuberculosis) 2, 6, 10, 23 drug-resistant strains of 101 in HIV-positive patients 16 medication 17 NGO’s responsibility 85nutrition, hunger, smoking, labour 84 plant medicines for 86–87 poor people living with 10 prevalence among San children 84 prevalence among San people 81protocol for diagnosis 16resources for testing and curing 24sputum for microbiological test 5, 16–17tibi in San language 85, 86, 87transmission 84 see also tuberculoma infectionTBC, tumour-like growth in brain 82TB Vaccine Initiative 65–66T-cells and immune system 55–56technologies 20, 24, 94, 155Tejram, narrator 102, 105–107, 109–110, 111Temple, Dr Robert 125terminalia root bark 87tests, nature of 71–72fertility, blood, urine, eyes 71hiding and finding 68, 71legitimacy of trials 60, 71manhood, courage, fidelity 71see also Moss TestThakur, Dr 104therapeutic regimens 112Tierney, Patrick 11, 119, 120, 122, 130, 134–135,144–145TK (traditional knowledge) 80, 86–89, 94Tobacco Mosaic Virus 161tourist operations 80tracking abilities 80traditional healers 2–3, 6–7, 66 legal codes of conduct 6–7 natural, tradition, and/or African

solutions 34

need for professional sector 60 role in HIV and AIDS prevention and

treatment 57Zwelethemba township study 55–56Traditional Healers’ Association 61–62, 72Traditional Healers Organisation,

South Africa 37, 74traditional healing 40, 153 professionalisation 60–63Traditional Health Practitioners Act 57, 66traditional knowledge, see TKtraditional medicine, see TRMtraditional plants, Eastern Cape 65–66transcendental meditation 155transformationmultifaceted 29–30, 156risks and promises 162translation 156 circumstances of Euro-American

sciences 157 questions of 8–11, 154 transportation or globalization of

languages 29 twentieth-century era and

biomedicine 159–160treatment adherence and compliance 101 alternatives 41Treatment Action Campaign, see TACtreatment-naïve populations for research 139treearborescence and rhizomatics 184 biblical tree of life 176 Darwin’s tree of life 175, 177 evolution, shift from web to tree 177 geneology and tree schema 176 Gould’s evolutionary tree 176 Haeckel’s tree 176 of kinship 176 of knowledge 176 phylogenetic tree 176 and web as analogous ordering systems 184 see also visual analogies; web or net

iconographytriaging care 160trickery 113 mimicry with intent to reveal 113TRM (traditional medicine) 2–3, 5, 10, 55–57, 60, 62 legal codes of conduct 6–7 modernisation of 66Tshabalala-Msimang, Manto 33, 44, 56, 57, 73–74 nutrition instead of ARV treatment 56tuberculin test 86tuberculoma infection 79–80

index 201

diagnosis 86 TB micro-bacteria in brain 80tuberculosis, see TBtyphus epidemic, Upper Silesia 1

Ubhejane, herbal ‘remedy’ 56, 60, 61, 65, 69university, role of 37, 48–50University of the Western Cape 79University of the Witwatersrand, see WitsUys, Pieter Dirk 56

vaccines, see under measlesVedic astrologers 109Verghese, Abraham 1, 2Vilakazi, Herbert 61violence conceptual and bodily 155–156 in South African history 63 witch-related 109Vioxx case, cherry-picking of data

results 125Virchow, Rudolf 1, 73virus culture 156visual analogiesof disease 173–174 Linnaean and Darwinian divisions 176 racial categories and types 176 see also under treeVisual Analogy (Stafford) 174visual art and research 173visual artefacts and visual knowledge bases 177visual memory 72visual technologies 86vitaminsnew forms of pills 51supplements packaged to look like Efavirenz

tablet 42 treating HIV and AIDS 74vocation and profession distinction 66

Ward, Ryk 144web or net iconography 177 as schematic of speciation 184 web to tree 177 see also treeWeigel, Sigrid 158, 179Western medicine 2, 158Western philosophy 20Western rationalism 26Western science 57West Indies 127WHO (World Health Organisation) 18

psychosocial criteria of ARVs 21wholesale biomedicalisation and political

opposition 158WIMSA (Working Group of Indigenous Minorities

in SouthernAfrica) 89witchcraft 82, 93, 102, 108, 109, 114Wits University 72 degree for sangomas 60–62 diagnosing and treating sickness 61 indigenous knowledge systems

programme 60women’s empowerment 109Wonderful Life (Gould) 176Working Group of Indigenous Minorities in

SouthernAfrica, see WIMSAWorld Health Organisation, see WHOworld medicine, heterogeneous global

networks 162, 167Wreford, Jo 57, 67writing skills 71 XDR (drug-resistant form of TB) 23X-rays 85, 86

Yanomami: The Fierce Controversy and What We Can Learn from It (Borofsky) 142Yanomami tribe, Amazon 4, 121, 122, 123, 145last human virgin soil population 140 measles vaccination campaign 130 radiation-free control group 119 research trip, Neel & Chagnon 130–136seen as link in a Darwinian chain 119

Zambia 56Zapiro (Jonathan Shapiro) 57AIDS Science, Mail & Guardian cartoon 58 Antiretroviral roll out, Mail & Guardian

cartoon 64 condemnation of medical quackery 74 TAC vs Matthias Rath, Mail & Guardian

cartoon 73UN AIDS Conference, Mail & Guardian

cartoon 59Zwelethemba township 55, 67 Alfred, sangoma 72 HIV and AIDS 63–64 Nandi, junior sangoma 68–69, 74 poverty, racial injustice, suffering 63–64 youths killed in apartheid struggle 63–64Zuma, Jacob 51

Documents

Postscript - Fritha Langerman