In 1817, the first cholera pandemic emerged from the brackish waters of the Bangladeshi coast.1 The bureaucracy of British India tasked regional Sanitary Commissioners with eliminating cholera, beginning a country-wide movement in public health, but both social pressures and imperial concerns impacted medical progress. Compared to the local officers, the national division of the Sanitary Department and the Indian Medical Service (IMS) crafted and employed a narrow scientific perspective, distinct from popular research and Western measures to counteract the disease. In the West, medical practice and study resulted in the successful implementation of public sanitation and new standards for clean water, unlike in India where effective prevention and treatment remained elusive until the end of the 19th century. During this time, the work of local Sanitary Commissioners offered a first-hand approach to the treatment and study of the disease, but if the broader implications of their research threatened the social, economic, and political outlook of the British Empire, their analysis was disavowed by the Raj. Between 1866 and 1884, the Indian government dominated and controlled medical discourse on cholera, which delayed the implementation of effective sanitary measures addressing the disease and localized the efforts of regional Sanitary Commissioners.



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