In this chapter, I will examine public health and medical infrastructure in the tea plantations in the context of their physical location and economic position as enclaves of specialized medical attention. An analysis of disease, medicine and health in a plantation economy can be made from an understanding of public health in a privileged area of colonial economy. Were the public health measures, which were not undertaken in rural India due to lack of financial resources, carried out in the tea plantations? Official discourse and planters' perspectives emphasize the view that the plantations were a privileged, segregated sector so far as the availability of medical care was concerned. This was attributed to the economist logic, articulated in various government reports as well as by planters associations, that planters invested in medical care to ensure high productivity. I intend to argue here that although the tea plantations were often constituted as areas of focus for government policies in public health, as well as sites for the study of diseases prevalent in the plantations, the provisions for health care did not follow the pattern of ‘privilege’ for the purpose of better health care for the labourers. The management of disease in the tea plantations was dictated by a range of imperatives: some economic, others political, and each such contingency was related to the nature of the plantation system as it developed in northern Bengal in the colonial period.