Nina Studer is a historian and an expert in drinking studies, North Africa, colonialism, and women’s history. She is the author of the book The Hidden Patients: North African Women in French Colonial Psychiatry (Böhlau Verlag, 2015). Since 2009, she has conducted research and taught at the universities of Zürich, Marburg, Bern, Heidelberg, Hamburg, and Basel. She joined the University of Geneva in 2023 as a Swiss National Science Foundation post-doctoral fellow.

Martin Robert (MR): What led you to research medical or health history?

Nina Studer: I came to medical history during my master’s when I was looking for a way to combine my different interests. I had an interest in colonial history, African history, Arabic history, and women’s history or gender issues. While I was looking for a topic that would combine these issues, I decided to write my master’s thesis on the concept of sleeping pregnancies in the colonial Maghreb. This is a local tradition that is accepted in the Maliki School of Law, which is one of the four Muslim schools of law, that a child could fall asleep in the womb of a pregnant woman, and that such a pregnancy could then last two years, five years, but also even twelve or twenty years. And this was used by women in North Africa, consciously or unconsciously, to hide illegitimate children, sterility, infertility, and also abortions.

When I came to that topic, I had initially looked at ethnological research from the colonial period on these issues, but I very quickly realised that the medical sources were, for me personally, simply richer. So, I switched to the medical colonial sources and looked at this concept of sleeping pregnancies in North Africa. And it was maybe one of my most globalised projects to date because this belief was spread throughout Maliki Islam, that is practically all of Islam in Africa apart from Egypt and a bit of East Africa. The founder of Maliki Islam, Malik ibn Anas, was a sleeping child. So, this phenomenon is very much associated to Maliki Islam. From the beginning, I was looking at sleeping pregnancies in Morocco in particular, but also in Algeria and Tunisia, Mauritania, Nigeria, and other African countries. I was born in Morocco, so that is obviously part of my interest. And I was particularly interested, not so much in the construct of sleeping pregnancies itself, but how it was interpreted by the French doctors who looked at it and misunderstood it. That was my introduction to the topic of medical history.

MR: What are your intellectual and historiographical influences and your preferred sources?

My approach to my topic is very interdisciplinary because I have come from such different fields as Arabic linguistics and Islamic sciences. I bring a lot of Arabic linguistics and African history to my interpretation of medical and psychiatric sources. I am interested in comparative, intersectional analysis of gender issues in colonial contexts through medical and psychiatric source material. I have been influenced by many historians in my approach to these topics, but I have to admit that I have been influenced more by practical historians than theoretical ones. I am not much of a theoretical historian. I have, of course, been influenced by the classics of postcolonial studies and postcolonial feminism. I am particularly influenced by brilliant historians of North Africa but also by historians of colonisation from all over the world including, obviously, French colonialism, because that is my field. I am influenced by gender studies people specifically, as well as by those studying colonial psychiatry and colonial medicine. They are all really important to my research. Finally, it is the drinking studies people who influence me, now that I am working on alcohol. So, it is a very varied field.

When it comes to my preferred sources, I have spent a lot of time in the archives, for example in Nantes working on Syria, and also in Paris, as well as in the colonial archives in the United Kingdom. But in terms of medical and psychiatric history, I am particularly interested in printed sources because I am interested in how medical and psychiatric experts influenced the broader public with their opinions and their theories, their diagnoses, and their vocabulary. For example, there was a French psychiatrist, Jacques-Joseph Moreau de Tours, who went on a tour of what he called the ‘Orient’ and visited psychiatric institutions in Malta, the Ottoman Empire, and Egypt. He then published an article in 1843 called ‘Recherches sur les aliénés en Orient’ [Research on the insane in the Orient] about what he had seen. Although this article was specifically about these countries, colonial psychiatrists working in North Africa subsequently adopted it as the founding text of their field. In certain anecdotes that were incorporated into the theories of colonial psychiatry in France, you can see very well that the geographical context was not really important to the psychiatrists. For example, the author of the article I just mentioned recalls how, in Beirut, he observed what he describes as a woman having sexual intercourse in public with a ‘madman’. He says that the people in the street, in the marketplace where it was happening, were standing around them, shielding them and were not upset or outraged, but that he was outraged. He writes that the reason they were not outraged was because they hoped that a new saint would be born from this event (‘le consolant espoir qu’un nouveau saint venait d’être engendré’). Despite there never being any North Africans actually saying that they had ever witnessed such a scene themselves, it was established as part of the colonial psychiatric tradition in North Africa. This belief was transferred into anthropological, ethnological, and travel literature, and that is how it spread. I am really interested in those transfers of knowledge, from medical and psychiatric reports to other genres, and I think the best way to trace them is through published material.

Shiori Nosaka (SN): Can you tell us the main conclusions of your book The Hidden Patients: North African Women in French Colonial Psychiatry (Böhlau Verlag, 2015)?

It is interesting for me to look back on this project because I interpret many things a bit differently now. But my main conclusions are that North African women were invisible, hidden, neglected in the published sources and the secondary literature while not being absent from the institutions. It was not an absence that I was analysing but invisibility. The second point is that some historians of colonial psychiatry have chosen to depict the colonial Maghreb, especially during the heyday of the École d’Alger, as a place of experimentation and innovation, without mentioning that marginalised North African women regularly bore the brunt of this innovation.

My third main conclusion is that colonial psychiatry has shaped postcolonial prejudices against North African women just as it has with men, and that these prejudices are still very much present today in France but also in the United Kingdom or in Germany, for example. Some of the contemporary conceptions about North African women were justified, authorised, and disseminated through the theoretical writings published by these colonial psychiatrists. An example of this is the belief that North African women are meek victims of North African men, hypersexual, somehow primitive—I feel uncomfortable saying this, but that is obviously the conclusion from the sources. These beliefs still exist today. So, just as it has been shown by other historians for North African men, the same can be said for North African women.

And the fourth point is that I think you can write the history of colonial psychiatry in North Africa just by looking at women. I think it is important to do so. The psychiatric sources show a clear progression in how insanity was framed with regards to North African women. French colonial psychiatrists first believed that North African women were too primitive to develop mental disorders. They believed that mental issues were a disease of civilisation, and that these women were below the level required to develop psychiatric problems. But after the establishment of psychiatric institutions in North Africa in the 1930s, these French psychiatrists changed their minds. They now suggested that normal North African women—not patients, nor women who had been diagnosed with psychiatric issues—were so abnormal in their daily lives that mental disorders could simply not be identified among them. This development can be seen in colonial psychiatry in general, but I think it is particularly productive to look at women in this regard.

The last point is that among North African men, the knowledge gained from individual case studies in the institutions by French colonial psychiatrists, either in France before the 1930s or in North Africa afterwards, was applied to the general population. Therefore, the whole population of North African men was pathologised by the application of specific knowledge about men with mental issues in the institutions. But when it came to women, the case studies of individuals were almost irrelevant to the theories formulated by French colonial psychiatrists. The case studies contradicted the general assumptions that these women were meek, oppressed, but deeply crafty and sexualised. Some of the case studies showed that women were violent, loud, and demanding of their rights. But all of this knowledge that could have been gained from the case studies was not reflected in the theory. There was a huge difference in how the case studies were treated when it came to North African men and North African women.

SN: The gender lens has recently become increasingly important in colonial history and in medical history or health studies in colonial contexts. What do you think this approach changes?

I think that when we study medicine in a colonial context, we also study the multiple layers of bias in the medical field. Adding the layer of gender to these biases simply allows for a new perspective on this knowledge produced by other historians of colonial medicine. It is not a completely new approach, but it just allows us to discover different mechanisms. I was initially motivated to do my research by this absence of women both in the secondary literature and in colonial psychiatric sources on North Africa and also by the absence of questions related to gender. The inclusion of gender obviously highlights women’s history but also issues of hegemonic masculinity when looking at the descriptions of North African men. I believe that if we do not look at these issues, these colonial hierarchies that are inherent in colonial medicine will remain. I think using the lens of gender allows us to look at these biases more directly.

SN: How have you linked your research to other recent work on gender issues?

I have been very interested in recent publications on the history of gendered addiction, for example, because I am now working on alcohol and drinks. For example, in the United Kingdom there is a cluster within the Drinking Studies Network called ‘Women and Alcohol’. Historical analyses of gendered addictions among Europeans, especially European women, are extremely useful to me in looking at both racialised and gendered addictions in colonial contexts. The gendered addictions of European women and those in the colonial contexts are obviously not the same—not at all, even. But it is no less interesting to compare the mechanisms. And there have also been publications dealing specifically with aspects of gendered addictions in colonies. Recently, there has been a wave of interest in these topics. More generally, I think the recent publications on women’s involvement in colonial medicine have been fantastic, such as Liat Kozma’s work on the Middle East. At the moment, I am writing a chapter on the first Algerian—I mean French, but born in Algeria—female doctor, Dorothée Chellier. All of this work on the active participation of European women, their agency within colonial medicine, in the colonial encounter with colonised women, which were also gendered and racialised encounters, has been very illuminating. So, I would say that my work connects to recent publications through the themes of gendered addictions and women’s participation in colonial medicine.

Guillaume Linte (GL): Since 2014, you have been working on a new research question about beverages in the Maghreb during colonisation. What motivated you to choose this new topic? How does it relate to your previous research?

When I was doing my research for my PhD, I was struck by what I call the ‘-isms’ described by metropolitan doctors in both the colonised and settler populations. By ‘-isms’ I mean all the particular addictions that were described in the colonial context. You can find alcoholism, absinth-ism, wine-ism, but also coffee-ism, tea-ism, and so on. In fact, it was coffee-ism and tea-ism that first sparked my interest. In an article written in 1948, the French psychiatrist Charles Bardenat wrote about the link between crime and these addictions. He wrote about the case of a North African man who had murdered his wife in a jealous rage. A psychiatrist was asked to determine whether the man was responsible for his crime. The conclusion was that he was not responsible for his crime because he had acted under the influence of coffee and tea. So, this man was officially diagnosed with coffee-ism and tea-ism. I was completely baffled by that, as I had never heard of it before. There was no secondary literature on this, so I started to compile sources on tea-ism. I began to map this belief in publications made by French doctors and psychiatrists, and it turned out that the diagnosis of tea-ism in particular was adopted for Tunisians in 1926-1927 by the first Tunisian medical doctor trained in France, Béchir Dinguizli. When I started working on tea-ism, I realised that you could trace very similar developments in many of these ‘-isms’ when it comes to the colonised populations. Since then, I have tried to work on as many of them as I can, especially those that we would see as very clearly distinguished from each other today, like alcoholism and tea-ism.

GL: What does the relationship to beverage consumption in this broad dimension tell us about medicine and the life of societies during colonisation?

I am interested in how medical and psychiatric theories influenced the general public but also how they were influenced by the local population, both North African and settlers. French settlers believed that North Africans were immoderate in their consumption, and then French psychiatrists turned this into a medical theory and pathologised it. In a recent article, I called this the ‘born addict’ theory, based on the idea that North Africans were born liars, born slackers, born thieves, and so on. I added ‘born addicts’ in reference to the psychiatrist Pierre Maréchal who developed this theory in 1937. He said that Arabs, not just Tunisians, were ‘born addicts’, meaning that they could become addicted to anything. This applied to any substance, literally from spices and tea to heroin. All these substances were considered dangerous in their hands but not for the French. This was supposed to explain the difference in consumption between the French and North Africans. But if you look at addiction in colonial North Africa, it was mainly French men who became addicted to alcohol, which was clearly the main addiction problem. But this is not reflected in the sources. I see drinking habits as a lens through which we can study wider social developments in the colonial context, just like gender. Many of the drinks were socially constructed: they were seen as relatively harmless when consumed by educated French men, but when consumed by women, the working classes, the colonised, and some settlers, it started to become a problem, a medical problem. The other thing that interests me about drinks in colonial contexts is that it always comes back to the question of ‘civilisation’. The French sources attributed a level of civilisation and nationalities to drinks. Alcohol was French, tea was North African, coffee was something of both, but very different when consumed by each group. The question of assimilation comes up again and again in colonial sources when whether or not the colonised could become French at some point is specifically discussed. Doctors and psychiatrists often believed that they could and should measure how civilised the North Africans had become under the influence of France, and they often referred to the drinks that they consumed as a way of measuring assimilation. That is why drinks are so interesting. They ascribe nationalities, civilisations, and identities.

GL: What was the place of Islam in this construction of identities based on alcohol and other beverages before and after decolonisation?

I think that of all the drinks, wine was really the barometer for civilisation for the French in North Africa. I am always amazed at how little my sources know about Islam. They have a very limited understanding of how it works, but they know about polygamy and the prohibition of alcohol. In their understanding, Islam is defined by abstinence from alcohol, whereas Frenchness is defined by the consumption of wine. If the settlers had migrated from France, they were used to drinking alcohol. They continued to drink alcohol to celebrate their particular way of life in the colonies. They saw abstinence as one of the biggest differences between themselves and the colonised populations. The French at that time understood alcohol as an all or nothing approach, as I call it. If you start drinking alcohol, you are no longer a Muslim. For this reason, drinking alcohol was seen as a sign that the North Africans were assimilating and turning away from Islam. At the same time, the French saw it as evolution with negative aspects, that is, as an assimilation that could go wrong because of overconsumption. This also included wine production and colonisation of the territories. Algeria was not a wine-producing region before the French colonisation. With the crisis that destroyed the French vineyards in the 1870s and 1880s, huge vineyards were planted all over Algeria. The vocabulary used to describe these vineyards is fascinating because it really is as if the French civilisation was taking root in colonial soil. During the decolonisation process, some Algerian resistance fighters talked about uprooting this symbol of France from Algerian soil. For the French, but also for some Algerians and Muslims, alcohol was seen as a major symbol of what France brought, as something that created a distinction between the two populations. If Muslims drank it, it was seen as an act linked to colonisation.

MR: To what extent does the idea of a global history of medicine or health make sense to you?

This is a difficult question for me because I am so regional, so to speak, in my research. But I do think these global approaches to the history of medicine are important. For example, when I look specifically at the history of addiction and the history of drugs, it does not make sense to look at them outside of at least the international context, and maybe the global context of regulations, prohibitions, taxes, etc. For instance, what was the influence of United Nations reports on the use of prohibited substances in colonial contexts? At the moment, I am writing a history of absinthe and I am looking at how the prohibition of absinthe spread. Belgium was the first to ban it in 1905, then Switzerland in 1908, and France in 1915, and so on. In fact, these bans began in Algeria in the 1840s. The demonisation of absinthe started in Algeria when the French settlers and soldiers drank too much of it and people believed that the colony was in danger because of the absinthe consumption of the colonisers. They thought they were going to lose the colony because these people drank too much. I argue that this fear came specifically from North Africa, migrated to France, and from France migrated to other countries. Similar developments can be observed in Indochina or in Madagascar and other French colonies. I think it makes sense to look at these developments in as global a way as possible, but, of course, it remains very limited because of the language barriers.