Plagues in World History (review)

In this densely informative yet entertaining small volume, John Aberth offers a social interpretation of disease throughout history using a comparative global framework. He has a lively writing style, and each chapter is framed by lucid summary descriptions of disease symptoms, progression, transmission, treatments, and the respective debates. It should be a profitable and successful textbook for undergraduate students and general readers.

Plague receives the initial and longest treatment of the six diseases discussed. The Second Pandemic or Black Death is the primary focus, presented as a comparative study of Christian Europe and the Muslim Middle East in terms of contagion, flight, prevention, and treatment. Aberth claims that for both regions, doctors followed ancient authorities “more intensely and more urgently” (p. 38), a point that needs to be argued with evidence, which readers presumably will receive in his forthcoming book on late medieval doctors. He emphasizes that Muslims did have a conception of contagion, despite the generally acknowledged tenet that plague is only transmitted by God. Europeans, on the other hand, accepted contagion without reservation. Unfortunately, the example Aberth provides here, namely, Gentile da Foligno’s discussion on poisonous vapors in his Long Consilium of 1348 is not a case of a concept “that precludes disagreement or challenge” (p. 41). A contemporary, Giovanni della Penna, challenged Gentile on his argument for poison here, and this debate is well discussed by historians of medicine, especially Jon Arrizabalaga. This may seem a minor point, since it was the details on causality, not the general concept of contagion, that was the matter of debate, but Aberth cites only the primary sources here, making no reference to the extensive and careful scholarship on this subject. A similar approach appears in his discussion of medieval attitudes on flight from plague. While flight was rejected by Muslims, it was accepted by Christians but, according to Aberth, remained a contentious matter until it was settled in the late fifteenth century by an Italian bishop’s treatise stating flight from plague was religiously acceptable, even preferred by the Church. Aberth’s analysis of the text provides little historical context and no reference to secondary scholarship. When scholarship is acknowledged it is often to contradict: Dols, for example, receives a thrashing for his interpretations on Islamic views of plague as punishment and on flagellation. The analysis of the Black Death continues with Aberth’s own arguments that the pogroms and the charges of well poisoning against Jews had less to do with religious intolerance than with medical and scientific theories on disease through poisoning—again one must note the contemporary medical debate on this—and that Christians were better able to face the psychological challenge of mass death than Muslims because the commemorative masses encouraged by the invention of Purgatory reassured dying individuals they would not be forgotten despite the disturbing prospects of a common grave.

This foundational chapter closes with the Third Pandemic, which began after the mid nineteenth century, spreading from China to India and Africa before entering the United States in 1900. The analysis here sets the stage for the subsequent chapters, as Aberth explains how colonial powers were forced to change their policies of implementing modern prevention methods when they met with strong native resistance. There was a strong link between foreign domination and plague control in the minds of natives and British officials alike. He leaves us with the valuable lessons that medicine will always be limited by cultural factors, that epidemic disease is now global and so should be our response.

The second chapter deals with the ancient killer smallpox. Unlike plague, which confers no immunity and kills indiscriminately, the effect of smallpox on a population is varied. The fact that it appears to display disease “favoritism” (p. 76) could work to bolster those immune, while demoralizing the victims. Thus, Aberth argues, the history of smallpox epidemics must take into account sociological, cultural, and psychological factors. He reviews the major epidemics in the ancient and early modern world, emphasizing the devastation...