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The Burdens of Disease

Epidemics and Human Response in Western History, Revised Edition

J.N. Hays

Publication Year: 2009

In this updated edition of The Burdens of Disease, with revisions and additions to the original content, including the evolution of drug-resistant diseases and expanded coverage of HIV/AIDS, along with recent data on mortality figures and other relevant statistics, J. N. Hays chronicles perceptions and responses to plague and pestilence over two thousand years of western history. Disease is framed as a multidimensional construct, situated at the intersection of history, politics, culture, and medicine, and rooted in mentalities and social relations as much as in biological conditions of pathology.

Published by: Rutgers University Press


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pp. vii


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pp. ix

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pp. xi-xii

In this revised edition of The Burdens of Disease I remain deeply indebted to those historians and other scholars whose works continue to inform my ideas about the history of epidemic disease. Since the first edition was published in 1998 that scholarship has grown steadily richer, deeper, and more enlightening. The updated “Suggestions for Further Reading” reflect some of that wealth, and...

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pp. 1-8

Disease and illness have obvious importance to human life. In recent years, popular awareness of them has sharpened with concerns about a new worldwide pandemic, perhaps of some form of Asian bird flu spreading to humans. More than ever some understanding of the workings of disease within Western (and world) history should inform our responses to present and future...

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One: The Western Inheritance: Greek and Roman Ideas about Disease

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pp. 9-18

The ancient Greek and Roman civilizations, and the Jews, early Christians, and pagans who formed part of their populations, suffered from disease, saw their societies diverted by its effects, and developed a variety of ideas and beliefs to deal with it. Ancient Greek civilization was a predecessor of the West rather than an early stage of it, but extremely close intellectual and cultural links tie the two together; in those respects the Western tradition began in...

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Two: Medieval Diseases and Responses

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pp. 19-36

Most historians now accept the idea that “Western” civilization emerged sometime between 300 and 800 C.E., a fusion of elements of Greco-Roman civilization (including the Christian religion or at least its Latin branch) and the Germanic, Slavic, and Celtic peoples of northern and eastern Europe. The “Middle Ages” conventionally begin in that period and extend down to some time between about 1350...

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Three: The Great Plague Pandemic

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pp. 37-61

The most serious epidemic outbreak in Western history began in Sicily in October 1347. Between that date and the end of 1353 most of Europe was affected. The disease most likely responsible was the plague, apparently in both its bubonic and its pneumonic forms. In the course of this massive epidemic between 30 and 60 percent of Europe’s population died, a nearly inconceivable...

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Four: New Diseases and Transatlantic Exchanges

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pp. 62-76

In its long history the human species has been both extremely mobile and extremely isolated. This paradox has had several different consequences for humanity’s relations with disease. Prehistoric humans fanned out widely from their original central African homeland, across Europe and Asia; they apparently reached the Americas and Australia over land bridges (or at least narrow, shallow...

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Five: Continuity and Change: Magic, Religion, Medicine, and Science, 500–1700

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pp. 77-104

As we have seen, the Western world experienced new diseases in the late medieval and early modern ages. Although in some respects those periods of Western history present remarkable continuities in human responses to disease, some important new thinking about nature and disease also developed. This chapter will first discuss widely shared social and individual responses, and...

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Six: Disease and the Enlightenment

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pp. 105-134

The scientific revolution of the seventeenth century broadened in the eighteenth into the European-wide current of thought and opinion called the Enlightenment. The ideas, assumptions, and methods of the new science spread to other realms of thought and culture. In the course of the Enlightenment, healers adopted a few new approaches to specific diseases and...

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Seven: Cholera and Sanitation

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pp. 135-154

Cholera occupies a somewhat anomalous position in the history of diseases that have affected Western civilization. It shares many of the characteristics of plague: its suddenness of onset, its horrible symptoms, its high rate of mortality, and its apparent inexorability. For many nineteenth-century people cholera seemed as much a visitation from a vengeful God as plague had seemed...

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Eight: Tuberculosis and Poverty

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pp. 155-178

In the nineteenth century more people in the Western world died of tuberculosis than of any other epidemic disease. The “White Plague” generated enormous fears, for good reason. Yet for all its importance, and all the attention lavished on it, tuberculosis presented a tangled picture to nineteenth-century thinkers, who could not agree on its causes. Of great antiquity, tuberculosis...

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Nine: Disease, Medicine, and Western Imperialism

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pp. 179-213

By the end of the nineteenth century Europeans had achieved an unprecedented mastery of the rest of the globe. This mastery included a remarkable expansion of the area settled by Europeans, the extension of European trade and transportation routes to all corners of the earth, and the imposition of European control (of different sorts) on almost all land areas not actually settled...

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Ten: The Scientific View of Disease and the Triumph of Professional Medicine

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pp. 214-242

At the beginning of the nineteenth century physicians occupied an uneasy position in the world of Western healing. Although they still possessed many privileges, in practice the distinctions between them and other healers remained unclear. Thus while physicians belonged to corporate bodies that enjoyed privileges recognized in law, surgeons and apothecaries had begun establishing similar claims; for the most part...

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Eleven: The Apparent End of Epidemics

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pp. 243-282

By the middle of the twentieth century some social and medical observers (including historians) believed that the end of epidemic diseases was in sight. The American magazine U.S. News and World Report, reflecting in 1955 on the development of a poliomyelitis vaccine, maintained, “There are diseases that offer threats, but, over all, in the field of infectious ones, most of the killing ones are under control.” The same magazine confidently predicted that “[m]an...

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Twelve: Disease and Power

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pp. 283-313

In two important ways the twenty-first-century West confronts disease more vigorously than did past societies. The biomedical model has conferred on its practitioners exceptional power, and the modern Western state has used a combination of ideology and technology to exert a new level of control over its populations, their behaviors, and the ailments that beset them. Yet these apparent...


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pp. 315-340

Suggestions for Further Reading

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pp. 341-356


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pp. 357-374

E-ISBN-13: 9780813548173
E-ISBN-10: 0813548179
Print-ISBN-13: 9780813546124
Print-ISBN-10: 0813546125

Page Count: 390
Illustrations: 10 tables
Publication Year: 2009