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Bulletin of the History of Medicine 74.3 (2000) 617-618

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Book Review

Infectious Diseases: Colonising the Pacific

John Miles. Infectious Diseases: Colonising the Pacific? Dunedin, N.Z.: University of Otago Press, 1997. 123 pp. Tables, maps. $N.Z. 29.95 (paperbound).

In 1826, almost 2,000 people lived on the Pacific island of Rapa-iti, but forty years later fewer than 120 survived; on Rapanui there were 3,000 people in 1862, yet within ten years only 175 were left. After centuries of relative isolation, these and other island communities had succumbed to diseases introduced by European explorers and traders. But while the principles of what Crosby has called "ecological imperialism" are now well known, our understanding of the changing local disease ecologies of the Pacific has remained incomplete. We have grasped the demographic consequences of contact, even though we may have trouble tracing a multitude of local natural histories. In this useful compendium, John Miles, a New Zealand microbiologist, has sifted through the records of exploration in order to document a variety of specific disease outbreaks that together caused the devastating depopulation of the Pacific.

Miles has written a contribution to the natural history of disease, adding to the legacy of Zinsser, Cumpston, Ashburn, Burnet, and other medical doctors who have turned to biology to find a broader intellectual framework in which to place their technical knowledge. More recently, McNeill and Crosby have revived many of these ideas and made them more useful to social historians; and Curtin, Kunitz, and de Bevoise have helped to fill in the historical outlines with detailed epidemiologic research. Although contemporary evolutionary theories have often underpinned twentieth-century explanations of disease patterning, medical efforts to relate humans and their diseases to the environment and the cosmos have, of course, a much longer history. Few recent efforts can match, for example, the sophistication and prolixity of August Hirsch and the other great nineteenth-century medical geographers, most of whom read Hippocrates for inspiration. Over the past hundred years, in contrast, studies of the natural history of disease have thinned out. The Bulletin of the History of Medicine was founded by physicians who still aspired to document a common geographic and natural-historical context for disease, but its pages soon overflowed first with the history of ideas and then with social history. It is only in recent years, with rising millennial concerns about emergent disease and environmental catastrophe, that we have begun to rediscover ecological narratives. In such circumstances the study of the Pacific disease holocaust is both timely and monitory.

There is not much epidemiology in this book, but one finds instead a careful identification of the diseases present before and after contact with Europeans. The author's conclusions are based on his reading of explorers' journals, as well as linguistic analysis and paleopathology. This is primarily an exercise in rediagnosis, the reformulating of historical etiology in modern microbiologic terms. Miles establishes that while some malaria was present in parts of Melanesia before the Spanish arrived, it became much more widely spread afterward; leprosy came late, except perhaps in Fiji and the Solomons; venereal disease was [End Page 617] left behind whenever a ship landed; and, perhaps most devastating of all, explorers spread tuberculosis throughout the islands. Europeans also brought with them new animal parasites, including fleas, and a great armamentarium of bacterial, fungal, and viral infections, including Shigella, Herpes simplex, and hepatitis A. The gonococcus was still being introduced to some isolated islands in the 1930s. Miles is meticulous in differentiating commonly confused diseases, such as yaws and syphilis, or leprosy and Tinea imbricata, but to follow some of his reasoning it may help to have some previous medical knowledge. Terms like "canidae," "enzootic cycle," "endemicity," and "vector anophelae" are strewn throughout the text without explanation, but there is a useful little appendix that tells the nonmedical reader about the principles of microbiology. The bibliography also provides an extensive coverage of the relevant medical literature.

The social historian will look in vain for an account of the nonbiological mechanisms of...


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