- Harrison, Globalization, and the History of Health, Medicine, and Disease
When I agreed to comment upon Marc Harrison’s article on globalizing the history of health, disease, and medicine I did not realize what a difficult task that would prove to be. Harrison made it hard for me by recommending to his colleagues in the field just what I would recommend: a more global outlook, one that does justice to both comparison and connections across space and time. While reading his essay, each time I thought I had a solid objection to register, such as his initial statement that globalization “spawned an entirely new field of enquiry” in global history (p. 639), I found within a few sentences that Harrison offered it himself, leaving me bereft. He made it no easier by writing generously of my own work. So I am left with only a few meager criticisms, suggestions, and speculative musings.
Among Harrison’s failings is that he is too generous in his remarks on my book Mosquito Empires. I wish it were true that “[McNeill] shows how pathogens and disease vectors were shipped from Africa” (p. 648) to the Americas. Alas, I could only assert that it must have been so in the cases of yellow fever and malaria and their mosquito vectors, but found no direct evidence. A few others among Harrison’s statements struck me as wide of the mark, but none of them matter for his general argument: “commercial monopoly” (p. 643) is too strong a term for the Ottoman position in the Indian Ocean at any time in history; the rise of the Soviet Union added a novel ideological dimension to international affairs, but did not introduce such dimensions; Asia did not provide “most of the labor to build railways in Africa and North America” (p. 655). Determined readers can find a few other statements with which to quibble.
Harrison’s point of departure is that the history of health, disease, and medicine (HDM hereafter) has been slow to take the global turn. If that is so, it is far from a unique shortcoming, however, as many subsets [End Page 696] of the historical discipline have resolutely resisted the temptation to recognize that the globe is one. HDM historians are hardly laggards compared to historians of law or gender. As Harrison notes, some historians have long noticed that pathogens easily spread across borders—Biraben, Crosby, Curtin among others from a generation ago. If other historians of disease have been slow on the global uptake, there is little to be said in their defense, except that many other historians are slower still. The international and intercontinental mobility of infections is so obvious in both past and present that historians of disease, at least, should be in the forefront of the global turn.
Historians of medicine, on the other hand, have a better excuse for not taking the global turn. It is they, more than historians of disease, who fall short of Harrison’s ambitions for the HDM history field. The resistance of systems of medicine to foreign ideas was and is rather more robust than the resistance of human bodies to alien infections. So while there are important stories within the history of medicine that are transnational and intercontinental—cinchona, variolation, and so on—these are more exceptions than rules. That said, it could well be that the time has come when diminishing returns have set in for the history of medicine pursued within national frameworks, and new insight is likelier to come from larger perspectives. But it is less obviously so for historians of medicine than for historians of disease.
When showing just how global the history of HDM can be, Harrison concentrates on the surge of globalization in the nineteenth century. Surely he is right to stress the rapid expansion of long-distance trade and migration in the nineteenth century as underlying forces accelerating the circulation of pathogens. One needs to consider this trend against the record of changes to nutrition, public health apparatuses, and portfolios of immunity and resistance to various infections. States and empires acquired greater capacity to blunt the ravages of disease, even as they strove...