Plagues in World History (review)

The prospect of a slender volume about plagues in world history would certainly be attractive to all those who teach either disease history or world history. Moreover, although the disease-by-disease organization of this book is not a structure that well accommodates most world-history narratives, it is an approach that most students would embrace. But that market was not Aberth’s intended audience. Instead, he claims to offer “a unique contribution to the study of disease,” as well as an “optimistic” assessment of enduring human ingenuity in solving the challenges in which human existence hangs “in the balance.” He does not see his perspective as traditional or positivist, but it is both. He asserts that his book is governed by a core question—“Why study disease?”—but a different question—“Why does the history of the Black Death still matter?”—could have been useful and more comfortably argued from his area of greatest historical expertise.

Aberth’s immediate dismissal of pre-Neolithic “legacy diseases” betrays his old-style Western European orientation to the topic. He dubs malaria to be one of those Paleolithic infections, but it has long surpassed tuberculosis on the World Health Organization’s (who) list of top-ten causes of death among infectious diseases, particularly the more-recent emergent, falciparum malaria. Another such legacy was yellow fever, which many other historians find to have been a significant and frightening epidemic infection in the early modern era. If the true purpose of the book was to show how humans “have been able to redirect the course and meaning [of massive, lethal epidemics] in history,” neither of these diseases can be easily omitted. Selected for special study instead are bubonic plague (which claims much more than one-third of the text), smallpox, cholera, tuberculosis, influenza, and hiv/aids. The plague chapter tries to establish a set of patterns in religious, cultural, and literary responses to plague that echoes through the “second” and “third” Eurasian plague pandemics, but Aberth is swept away in yet another formulation of Black Death history, fully omitting European (or even governmental and other secular institutional) approaches to plague control.

Instead of comparing social and cultural responses to epidemic “plagues” (used in a generic sense), as the introduction promised, the non-plague chapters more often compare biological and physiological aspects of each pathogen to one other. Why the pathological and microbial features of the killer organisms matter to a cultural history, and why the original geographical origins of each disease reveal something important become unexamined problems for Aberth’s “unique contribution.” By the time he reaches the hiv/aids chapter, pages of semidi-gested science and who websites describing the mechanisms of rna virus replication substitute for a more logical and historically useful survey of modern blood banking and hiv/aids.

The book is thus disappointing. Aberth throughout offers reasons rather than explanations for the issues that he introduces. He alludes to classic epidemic stories that will appeal to specialist readers, whom he seems to consider the right audience for this “study.” Schematic historiographical asides substitute for an analytical approach. Later chapters veer from the subject at hand through such detours as a discussion of tuberculosis in film and a recounting of autobiographical experiences. Aberth also indulges in a few odd formulations—such as the phrase “life-expectant margins of society,” by which he refers to the typical risk groups for influenza. Nowhere does he offer an instance of a society’s failure to meet the crisis of a massive epidemic to balance his unrelenting focus on Western “winners” and non-Western resisters. A few research discoveries and interesting asides appear along the way, but the book does not offer the unique analysis that Aberth promised.