Medicalizing Differences: War, Disease, and the Miskitu in the 1780 San Juan Expedition

This paper relates how tropical disease ravaged the British army in the late-eighteenth-century Caribbean, using the San Juan expedition of 1780 as a case study. Based on contemporary European understandings of epidemiology, martial and medicinal officials of the San Juan expedition believed that the outbreak of pestilence within the British army reflected a failure in discipline, properly provisioning troops, as well as overall leadership and planning. Thus, despite natural agents playing a significant role in stalling Britain’s advance in Nicaragua, eighteenth-century military and medical authorities dictated that difficulties caused by disease and the environment could be overcome by human might. While the British ultimately could not overcome the devastating effects that tropical diseases had on the army, human agency also led to the expedition’s failure. The British leadership were heavily dependent on their Indigenous allies, the Miskitu, to serve as soldiers, guides, suppliers, and laborers for the campaign. Yet, relations deteriorated after the conquest of the Castillo de la Inmaculada Concepcion. British versus Indigenous uses of medicine became this breaking point. British military and scientific officials interpreted the Miskitu reluctance to adopt Western medicinal practices as proof that British and Indigenous bodies and culture were fundamentally distinct. Enlightenment medical thought was another avenue to assert Western colonial power. As sickness increased in the British army camp, Britons began to see the Miskitu’s presence as exacerbating, rather than preventing the spread of disease. The Miskitu, however, refused to be subjugated and displayed their own autonomy by leaving the campaign after relations soured. Indeed, the British conception of their innate “superiority” to the physical environment and the Miskitu contributed to the San Juan expedition’s defeat.