Born to Die: Disease and New World Conquest, 1492–1650

Writing in 1947 about the New World and the coming of Europeans and their diseases in and after 1492, P. M. Ashburn, M.D., claimed that “smallpox was the captain of the men of death...typhus fever the first lieutenant, and measles the second lieutenant....They were the forerunners of civilization, the companions of Christianity, the friends of the invader.” Writing half a century later, Noble David Cook takes account of the huge number of publications appearing since 1947 and attempts to establish a new synthesis.

In assessing Born to Die as a potential contribution to the new field of world history, it is important to pinpoint changes that have recently taken place in medical and disease history. Perhaps the most important is the invasion of these fields by non-medically qualified, professional historians, beginning with William H. McNeill and his Plagues and Peoples, published in 1976 and still in print. Though it has taken time, McNeill-inspired insights have gradually filtered down to the level of school textbooks. Thus, according to the president of the American Historical Association, schoolchildren in California are now taught that the compulsory resettlement of local Amerindians in tightly packed towns (congregations) in the seventeenth century by well-meaning Spanish missionaries immensely facilitated the spread of contagious diseases, among them smallpox and measles, contributing directly to their near extinction.

Euro-Americans and Europeans being what they are—bearers of their own distinctive cultures and prejudices—some of them came to feel personally guilty about the behaviors of their ancestors, fictive and real. This phenomenon reached a crescendo in 1992, during the celebration of the five-hundredth anniversary of the “discovery” of the Americas by Columbus. Among the best books published that year were David Stannard’s American Holocaust: Columbus and the Conquest of the New World (New York: Oxford University Press, 1992) and Ronald Wright’s Stolen Continents: The Americas through Indian Eyes since 1492 (Boston: Houghton Mifflin, 1992). I mention these authors in particular because Cook explicitly claims that they wrote within a “paradigm” other than his own (p. 12).

And again, Euro-Americans begin what they are, some of them created a backlash against the orthodoxy of “guilt.” In an essay entitled “When Did Smallpox Reach the New World (and Why Does It Matter?)?” (in Africans in Bondage: Studies in Slavery and the Slave Trade, ed. Paul E. Lovejoy [Madison, Wisc.: African Studies Program, 1986], pp. 11–26), David Henige chastised a whole series of historians for not having gone back to the original sources to authenticate each fact they used, and for accepting the authority of “secondary sources” when writing their own accounts. In 1993, writing in Australia for publication in the Journal of Interdisciplinary History (vol. 24, no. 1), Francis Brooks asserted that “nothing in this historical record allows us to feel confident that one-third to one-half of the Aztec population died of smallpox in 1520. No such catastrophe actually occurred.” Cook relegates mention of Brooks’s holocaust denial claims to a discreet footnote and then passes on. My feeling is that he is running a bit scared.

Perhaps, however, there is emerging a “new history of medicine” that takes into account the insights of moderate postmodernism and accepts that many aspects of “disease” are social constructs. This mode of historical investigation requires an in-depth examination of the cultural context in which people in times past commented upon the effects of disease upon themselves and others, and of the manner in which they identified what any particular disease or disease syndrome was. Postmodern medical history is very much aware of Edward Said’s pioneering work on orientalism, the dynamics of change over time, and the identification of “the Other.” This leads one to ask whether Cook’s Born to Die is a contribution to the “new history of medicine” or if it is better seen as a standard-issue representative of the old.

It is my feeling that Euro-American readers who want to continue to respect the settler ancestors who superseded the Amerindians and became the dominant human type in the Americas won’t be much troubled by what they find in Born to Die. The “Black Legend” created by Bartolomé de Las Casas (stressing Spanish genocide), Nathaniel Bacon’s Rebellion (settler genocide), and King Philip’s War (settler genocide) are taken to be part of an obsolete “paradigm,” which is replaced by the “paradigm” of disease. According to Cook (p. 206), “More than 90 percent of the Amerindians were killed by foreign infection”—which is to say, by nonhuman forces for which the fictive ancestors need not be held responsible.

I am not entirely confident of Cook’s mastery of disease symptoms and types. His statement (p. 134) that “cholera’s arrival in the New World was inevitable but only when sailing vessels were replaced by rapid steamships in the nineteenth century” ignores the symptomless carrier, the apparently healthy person who excretes cholera-vibrio-infected stools for years on end. He is a bit fuzzy on the date yellow fever first appeared in Brazil. I have yet to be convinced that bubonic plague was present in the Americas before it was brought in the course of the third pandemic at the end of the nineteenth century. In a paragraph on page 57 a complex chain of argument appears to link a slow-moving miasmic river; evidence given by the highly placed Spanish arch-propagator of myth, Fernandez de Oviedo; the water from the hands of black African slaves, which turned into toads or fleas; and bubonic plague. Medically speaking, the “pneumonic plague” that Cook and the secondary sources he quotes list among their disease killers can only be found among a densely packed human population among whom standard bubonic plague is already present. I suggest that it is time that someone combining David Henige’s mind-set and the insights of the new history of medicine return to the original sources and sort out the plague situation in the Americas once and for all.

Yet Cook has done yeoman service in summarizing the findings of the old history. He willingly admits that this has been difficult, because of “the virtual impossibility of accurately identifying sixteenth- and seventeenth-century illnesses” (p. 13). This being the case, it perhaps remains for others to identify the mind-sets of the people who made the disease identifications they did, and to sort out why they did so.