Maritime Quarantine: The British Experience, c. 1650–1900 (review)

John Booker’s magisterial history of maritime quarantine fills an enormous gap in the historiography of British public health. Until now, the secondary literature on quarantine has evolved piecemeal and with a strong bias toward the nineteenth century. Even then, it has tended to focus on particular issues such as early-nineteenth- century debates over contagion or the later shift from old-style quarantine to medical inspection. Booker’s history is therefore unique in providing a consistent analytical narrative of the evolution of quarantine and related issues over a period of 250 years. On that account alone it is thoroughly to be welcomed.

Maritime Quarantine is based on extensive and meticulous archival research in Britain, Malta, and Marseilles. Marseilles was a major quarantine station, and what happened there affected British shipping in the Mediterranean and throws light on frequent disputes between France and Britain over the imposition of quarantine. Malta played an increasingly important part in British quarantine policy as a destination at which British ships—sailing from Eastern Mediterranean ports suspected of infection with plague—could perform quarantine before reaching Britain.

The book traces the history of quarantine with due regard to legislation, institutions, and practices, the responses of mercantile interests, and the broader context of international diplomacy, which is vital in understanding the way in which quarantine figured in disputes between nations. These disputes were not only about the risks posed to public health but about suspicions that quarantine was being used as a tool to gain economic and political advantage over rivals. Booker’s unparalleled knowledge of official documents on quarantine enables him to write with great authority about all of these dimensions of quarantine. He does not, however, see his work as a “medical history” of quarantine, meaning that he pays less attention to the medical debates underpinning and surrounding the practice. Although he does not ignore the medical literature altogether, it is certainly true that the book’s greatest strength is its analysis of the mercantile and political aspects of quarantine. The chapter on the “anticontagion” debates, for example, is rather limited in its reading of medical arguments on this topic but sheds far more light than previous literature on how key medical figures such as Charles Maclean interacted with politicians and government select committees.

Booker’s main thesis is that the British found quarantine “impossibly difficult.” By this he means that quarantine was more suited to autocratic states than to a state like Britain, which had strong parliamentary traditions. He provides ample evidence, too, of mercantile opposition to quarantine and of the power of the mercantile lobby, which grew stronger in the late eighteenth century. He shows how mercantile opposition to quarantine arrangements was assisted by criticism from philanthropic reformers such as John Howard, which served to raise public awareness of the issues surrounding quarantine from the 1790s. Howard’s intervention seems to have fused the narrow, commercial concerns of merchants and shipowners with broader concerns about humane treatment and individual liberties. In the years that followed, these came increasingly to the fore, both in Britain and, to some extent, internationally.

It is certainly true that the tensions created by quarantine were probably more apparent in Britain than they were in most other European countries, but Booker may have slightly overstated his case. Although merchants were often able to secure important concessions, the attachment of government to quarantine did not waver until the middle of the nineteenth century. At around the same time at which quarantine became more prominent on the political landscape, the government and many senior medical figures actually became more resolute in its defense. The idea of the defense of Britain from alien forces and revolutionary ideas arguably found a parallel in concerns about the invasion of alien diseases such as yellow fever and plague. More research also needs to be undertaken on popular attitudes to quarantine, especially in ports likely to...