Epidemics: Hate and Compassion from the Plague of Athens to AIDS by Samuel K. Cohn, Jr. (review)

Samuel K. Cohn, Jr.’s latest book, Epidemics: Hate and Compassion from the Plague of Athens to AIDS, is a masterful discussion of a topic that has come into renewed focus in the wake of the coronavirus, namely the link between disease and xenophobic behavior. Overall, Cohn’s approach to the topic is overwhelmingly empirical rather than theoretical. True, Cohn presents several theories about the relationship between disease and violence, most notably the generally held-belief that disease outbreaks invariably provoke violence against the outsider “other,” and Margaret Humphrey’s more specific and nuanced thesis linking violence to previously unknown, highly deadly, and untreatable infections. However, Cohn smothers such theories under the accumulated weight of over 500 pages of dense evidence. Indeed, the sheer volume of data that Cohn presents is stunning. So is its temporal scope: Cohn’s survey of disease takes us from the plagues and scapegoats of the ancient world to the Jewish massacres of the Middle Ages to the syphilitic prostitutes and untori plague spreaders of the early modern period. In the process, Cohn notes that the prevailing theory that medieval plague provoked anti-outsider violence is only partially true. While the first wave of the Black Death provoked considerable social violence, later outbreaks were conspicuously violence-free.

The largest part of the book, however, is directed towards the epidemics of the early modern and modern world, in particular smallpox, yellow fever, cholera, and the Great Influenza pandemic of 1918. Cohn studies reactions to these diseases by drawing upon the techniques of the digital humanities, conducting OCR searches of a sizable archive of eighteenth and nineteenth century newspapers. The story that emerges varies by disease, by time period, and by geographic region. Cholera, Cohn argues, best fits theories that disease can trigger social violence, though he notes that the violence was only infrequently directed against outsiders. Rather, cholera riots were usually directed against social elites and the medical profession (in Europe) or against agents of colonialism (in China and India). Smallpox also triggered considerable social violence, at least in the United States. However, unlike cholera, smallpox social violence was typically perpetrated by elites against the poor, marginal, and unvaccinated, including the Chinese, Mexicans, French-Canadians, and “negro tramps.”

While smallpox and cholera do seem to have provoked social violence, Cohn argues that yellow fever and the Great Influenza pandemic had the opposite effect, uniting fractured societies and provoking unprecedented outpourings of volunteerism and self-abnegating behavior. In America, yellow fever struck during periods of high racial and anti-immigrant tension, yet its impact was to ease those tensions and facilitate cross-regional humanitarianism between the previously warring north and south. The story for the Great Influenza was much the same, but on a global scale. Despite the influenza’s sudden onset and high mortality it inspired compassion rather than fear amongst its victims, though Cohn does note that the influenza epidemic provoked an unprecedented and highly intrusive level of state surveillance over civil society. In his postscript, Cohn argues against the grain and contends that that the story of AIDS is actually more similar to that of yellow fever and the Great Influenza than to cholera and smallpox. While AIDS did initially provoke fear and social violence, such violence rose to nowhere near the level of the anti-Jewish massacres of the medieval era, and in the long run AIDS served as a unifying force that “mobilized more gay men into political and community organizations . . . than any other event in the short history of the gay movement” (p. 555).

Cohn’s conclusions at the end of this long study are modest and nuanced. While acknowledging that disease does sometimes trigger social violence, he argues that such violence is actually more characteristic of the modern world than the ancient era and that it often took the form...