Epidemics and History: Disease, Power, and Imperialism (review)

The focus of Epidemics and History is on six of humankind’s most dreaded and dreadful diseases and on how Western imperialism, Western elites, Western religions, and Western medicine managed to make them even more dreadful. The pathogenic culprits in question are bubonic plague, leprosy, smallpox, syphilis, cholera, and the tropical fevers, malaria and yellow fever. The human villains, by contrast, are far more numerous. They include (but are hardly limited to) Church officials and the wealthy bourgeoisie who blamed plague on the Jews and the poor and stigmatized leprosy victims; the Iberians who initially carried pestilence like smallpox to the New World, and then launched the transatlantic slave trade to replace the native Americans killed by those plagues; men of medicine who first wrote about syphilis for profit and later were part of a general attack on masturbation, thereby helping the disease to flourish; and most especially the British, who in rearranging first India, and then much of Africa, to suit themselves made it possible for cholera to kill millions of Indians and tropical fevers to spread over that continent south of the Sahara.

Such malefactors deserve the vilification that Watts delivers with relish and zeal throughout a work that leaves no doubt about his credentials as an anti-imperialist, anti-racist, and anti-capitalist, as well as an orientation that would seem to be anti-Western medicine, and perhaps even just plain anti-West.

Unfortunately, the author’s passion sometimes comes close to a kind of sneering that makes one wonder if the book should not have been entitled Epidemics and Polemics. Words and phrases, for example, are often intended to offend. Iberians, as well as students of Latin America, may find Watts’ resurrection of the Black Legend of Spanish cruelty and his labelling of the Spanish conquistadors as “guerilla terrorists” responsible for “Spanish genocide” a bit troubling, not to mention naive (94, 235). Similarly, medical historians may be disconcerted with a dismissal of “Ronald Ross [who] took credit for the intuitive insights of his Indian field assistant,” and Walter Reed who, while conversing with Carlos Finlay about the mosquito hypothesis of the latter, was “apparently intending even while Finlay was in the room to claim personal credit” (255).

Chronologically, the book ranges from the middle of the fourteenth century to the first decades of the twentieth century. Although its concern is mostly with the West, comparisons with the Middle East, Africa, India, and China are frequently drawn and the text is liberally sprinkled with useful demographic data.

The endnotes, which indicate that Watts has consulted and incorporated a vast amount of literature in this effort, comprise still another arena in which he chides and chastises. But I was left wondering how well the literature cited was actually read, especially when I found myself and others who have written with me accused of “disease determinism.” The charge apparently stems from our demonstration of a yet to be explained ability of slaves to resist yellow fever in the Americas, which Watts dismissed out of hand with no discussion of the evidence presented (228, 232, 269, 349).

Such high-handedness can also be found in an irritating omniscience, as illustrated by such remarks as “whites felt” (215), or “Gorgas wanted the world to believe” (238). On occasion, Watts’ gross generalizations seem to reveal a shaky grip on epidemiological history.