Yellow Fever, Black Goddess: The Coevolution of People and Plagues (review)

The title under which this book was first published in Britain, Plagues: Their Origins, History, and Future, is a fair representation of its content. But the title given here—surely an embarrassment to the author, an English-born geneticist now at the University of California, San Diego—affirms the adage that you can’t judge a book by its cover. The words YELLOW FEVER in inch-and-a-quarter saffron letters stand out boldly against a black stripe at the top of the jacket, and they also adorn the black binding. A mosquito appears on both. In fact, however, yellow fever receives only the barest passing mention on three pages (pp. 33, 161, 163) tangential to a discussion of malaria.

Although cholera, on the other hand, is actually considered, the use of BLACK GODDESS (black letters against a saffron stripe) in the title is also tenuous. While observing worship of the Hindu deity Kali, the Black One, the goddess of disease and death, at the temple of Kalighat in Calcutta, Wills was led to wonder whether the very-dark-to-black appearance of some cholera victims could mean that Kali was the ancient goddess of cholera. If so, he reasons, perhaps the disease has ravaged India for much longer than historians have thought. Be that as it may, Wills is an engaging storyteller, using as he does an abundance of anecdotal material, much of it drawn from family lore and his own extensive travels, in presenting a lively, well-written narrative.

The story that Wills tells follows the by-now-familiar theme, found in both popular and academic literature, of humanity as an inveterate, if not incorrigible, disturber of the natural order of stable ecosystems. “In this book,” he writes, “I would like to explore with you a biologist’s view of just how and why such disturbances of the ecological balance can give rise to plagues” (p. 8). While focusing on the great epidemic and pandemic occurrences, remote and recent, of bubonic plague, cholera, typhoid, malaria, syphilis, and, of course, AIDS, Wills also notes the far greater impact of endemic diseases and their effect in promoting biological diversity. In his view, the evolution of living organisms, to a significant degree, is a disease-driven process in which both host species and pathogens modify toward genetic diversity in order to survive. Wills is keen on diversity: the word is used so often, sometimes with obvious political and social rather than scientific implications, that its importance to him is unmistakably evident. “In the genetic herd-immunity model,” he contends, “there is safety in diversity” (p. 267).

As might be expected, the familiar stories of Dr. Snow and the Broad Street pump-handle, of Yersin, Manson, Ross, Ehrlich, and others, are also recounted here. But since there are no reference notes as such, only suggestions for further reading, serious students of the history of disease should be directed to more authoritative, recognized scholarship. Very possibly, however, the book might well provide an extremely interesting exercise for a graduate seminar in the history of science.

Unfortunately, as mentioned above, the book’s title contains a flat-out misrepresentation. How it could have passed even the most tolerant editorial scrutiny is anyone’s guess. On perhaps a more serious note, the marketing of prescription drugs directly to the general public nowadays by the large pharmaceutical houses is just the latest phase of a cultural trend that includes the marketing of ideologies. It is but fair to say, as a statement on the jacket indicates, that Professor Wills’s work is addressed primarily to a general audience. Nevertheless, whatever the composition of his readership may be, popular or professional, the fact that he is an unusually talented popularizer of science makes even a whiff of genetics as politics, or social science, bad business.