In the Kingdom of Kongo, the bark of the enkasa tree was a powerful antidote for spells and poisons, often used to detect witches in judicial trials. Frequently referred to as the ‘tree of life’, enkasa became the subject of a manuscript written by the Portuguese Sergeant-Major Francisco de Buitrago, who had used the bark as a remedy while stationed in Angola. Enkasa retained popularity among Central and West Africans and visiting Europeans, some of whom lauded the tree as the ‘sister tree from which the cross of the crucified Christ has been made’ (62, quoting Buitrago). Use of enkasa bark spoke simultaneously to the proliferation of Christianity in Kongo and to the blending of healing and harming across early modern African medicine. Returning to Lisbon, Buitrago used enkasa to exorcise bewitched patients, with further uses of the tree's bark recorded across eighteenth-century Portugal. Not only was it administered to evacuate poisons and the devil, it was also employed to treat common bodily ailments like the flux, colic, and fevers. Kalle Kananoja's Healing Knowledge in Atlantic Africa focuses on practices like those associated with the enkasa tree to weave a rich and engaging account of the continuous exchange between European and African medicine across three centuries.

Against much scholarship on the history of global health and medicine, Kananoja argues forcefully that Europeans borrowed more from indigenous Africans than they gave in return. Faced with a new climate and landscape, with accompanying high death rates, European colonists found limitations to their own classical medical models and had no alternative but to draw on the expertise of native medical practitioners, who knew both the land and its resources. After all, natural medicine in Africa was not significantly different from the botanical and mineral-based medicines dispensed in Europe from the sixteenth to the eighteenth century. Medical knowledge was embedded in local experience and in Kananoja's words ‘Europeans depended on other people's eyes and brains in Atlantic Africa’ (3). Enkasa was just one of the many botanical products that Europeans incorporated into their medical practice across both Western Europe and Central and West Africa.

The book is organised thematically; first, it explores the plurality and materiality of medicine in West Central Africa (Chapters One and Two) and moves to a consideration of African botanical expertise on the Gold Coast and science and agricultural development in Sierra Leone (Chapters Three and Four). Kananoja ends with three chapters on the European medical practice in Angola, the limits of (European) humoural medicine, and medical geography in the southern Atlantic (Chapters Five, Six, and Seven). In the penultimate chapter, Kananoja details how new disease categories evolved from the traumatic experiences of enslavement and the Middle Passage, including banza, a mental affliction linked to melancholia, which could be defined literally as a longing for home.

Healing Knowledge in Atlantic Africa adds richness to the historiography of health and healing in Central Africa, engaging with John Janzen's seminal work on the Lemba cult of healing. The bibliography too reflects his incorporation of perspectives from the history of medicine, Atlantic history, and African history. However, as with most histories of this type, it is difficult to escape the reliance on European sources. Portuguese encounters with Central and West African medicine are the chief focus of his research, though he also draws on Danish, Dutch, and English experiences with African medicine as well. Many of the sources that remain, and on which Kananoja relies, were created as part of colonial administration, such as inquisition records (in the case of the Portuguese) or medical texts penned by travelling European collectors and physicians. The analysis is therefore mostly focused on the nature of interactions between Europeans and Africans, rather than on the specific character of African medicine itself.

Nonetheless, Kananoja succeeds at making African healers central to the discussion whenever possible. Through the Inquisicao de Lisboa records at the Arquivo Nacional da Torre do Tombo, for example, he recovers the story of a Mbundu healer in Luvo, who he identified as Domingos Ambundo. Three witnesses, including a Kongolese man named Joa Alvares Vieira, testified against Ambundo, leading to the formal denunciation of his healing practices, which combined herbal remedies with non-Christian symbols. By focusing on exchange, Kananoja uncovers a picture of sustained interaction between European merchants, religious authorities, military officials, and medical practitioners and a wide variety of African experts, from herbalists to ritual specialists. The pluralism of the medical marketplace resulted in the experimental blending of medical techniques and medicines; for instance, medical practitioners mixed the native plant engariaria with brandy and gunpowder to make a remedy to cure dysentery and diarrhoea.

One of the key innovations of Healing Knowledge in Atlantic Africa is how Kananoja brings the west coast of Africa to the forefront of the Atlantic medical complex.Footnote ¹ Much of the existing scholarship on premodern Atlantic African medicine has focused on African healers who were forcibly transported to the Americas, along with their botanical knowledge and healing practices.Footnote ² Although this work has brought out the fruitful medical exchange between enslaved Africans and Indigenous Americans, Kananoja's significant intervention is to analyse African medicine in situ. He demonstrates that in seventeenth and eighteenth century Central and West Africa, there was a multitude of places one could go for medical advice. Against the traditional narrative of the diffusion of European practices to colonial settlements, Kananoja shows how Portuguese and Dutch practitioners competed with African healers in the medical marketplace. Africans also absorbed European practices too, seeking surgical knowledge from the Portuguese and absorbing the use of imported plants, such as chinchona from South America. The importance of this, as Kananoja outlines, is that treating African medicine as ‘traditional’ or ‘prehistoric’ is problematic, for this denies the possibility for African medicine to change and evolve. He shows that both European and African practitioners and markets were receptive to experimenting with new materials and techniques.

In Healing Knowledge in Atlantic Africa, Kananoja has produced a global history of medicine, providing a well-documented account of the high degree of exchange between European and African systems of healing.