Plagues and Peoples (51 page)

61.
On sanitation in European armies in the eighteenth century, see Paul Delaunay,
La Vie Medicale aux XVI
^e
, XVII
^e
et XVIII
^e
Siècles
(Paris, 1935), pp. 84ff, 275–80 and
passim;
Charles Singer and A. E. Underwood,
A Short History of Medicine
(New York, 1928), pp. 169–71; George Rosen,
From Medical Police to Social Medicine: Essays on the History of Health Care
(New York, 1974), pp. 120–58, 201–45; David M. Vess,
Medical Revolution in France, 1789–1796
(Gainesville, Florida, 1975). On Frank, see Henry E. Sigerist,
Grosse Arzte
, 4th ed. (Munich, 1959), pp. 217–29.

62.
Cf. R A. Lewis,
Edwin Chadwick and the Public Health Movement, 1832–1854
, (London, 1952, pp. 52–55 and
passim
. Chadwick’s proposal for using urban sewage for fertilizer was not a new idea. It had, in fact, been projected as early as 1594. Allen G. Debus, “Palissy, Plat and English Agricultural Chemistry in the 16th and 17th centuries,”
Archives int. hist, sci., 21
(1968), 67–88.

63.
Cf. C. Fraser Brockington,
A Short History of Public Health
(London, 1966), pp. 34–43.

64.
Cf. Charles E. Rosenberg, The Cholera Years: The United States in 1832, 1849 and 1866 (Chicago, 1962), pp. 175–212; John Duffy, A History of Public Health in New York City, 1625–1866 (New York, 1968).

65.
Cf. Longmate,
King Cholera
, pp. 228–29.

66.
In Cairo, Egypt, for example, the birth rate was 44.1 per thousand, the death rate only 36.9 per thousand in 1913, the year
before
a modern sewage system was inaugurated in part of the city. Cf. Robert Tignor,
Public Health Administration in Egypt under British Rule, 1882–1914
(Unpublished Ph.D. thesis, Yale University, 1960), pp. 115–1.

67.
C. Fraser Brockington,
World Health
, 2nd ed. (Boston, 1968), p. 99.

68.
For an incisive account of one of the most extreme examples of how dowry rules may postpone marriage and regulate population growth to economic circumstances, see Conrad Arensberg and Solon T. Kimball,
Family and Community in Ireland
, 2nd ed. (Cambridge, Massachusetts, 1968).

69.
A couple of examples may be in order: Egypt’s population, about 5.3 million in 1846, grew to 26 million in 1950; Java’s population of 12.4 in 1860 grew to 40 million in 1940; world population is estimated to have grown:

Cf. Gabriel Baer, Population and Society in the Arab East (London, 1964), p. 3; Reinhard and Armengaud, Histoire Générale de la Population Mondiale, p. 379; United Nations Demographic Yearbook, 1972, p. 119; Ronald Freedman, ed., Population, the Vital Revolution (New York, 1964), pp. 18–19.

70.
Laverne Kuhnke, op. cit., p. 70.

71.
Cf. Robert Tignor, op. cit., pp. 91, 102.

72.
Cf. Harry Wain,
A History of Preventive Medicine
, pp. 284–87, 353–58, 250–63.

73.
Oliver Cromwell suffered from malaria for much of his life and malarial sweats played a part in his final illness. He is said to have refused the “Jesuit bark” as nothing but a popish plot to get rid of him. Antonia Fraser,
Cromwell, the Lord Protector
(New York, 1973), pp. 770ff; A. W. Haggis, “Fundamental Errors in the Early History of Cinchona,”
Bulletin of the History of Medicine
, 10 (1941), 417–59, 568–92; Paul F. Russell,
Man’s Mastery of Malaria
(London, 1955), pp. 93–102.

74.
Russell, op. cit., pp. 96, 105–16. For illustrative details of the consequence of trying to penetrate Africa without malarial suppressant drugs, see Frederick F. Cartwright,
Disease and History
(London, 1972), pp. 137–39; Philip Curtin,
The Image of Africa: British Ideas and Action 1780–1850
(Madison, Wisconsin, 1964), pp. 483–87.

75.
Cf. William Crawford Gorgas,
Sanitation in Panama
(New York, 1915); John M. Gibson,
Physician to the World: The Life of General William C. Gorgas
(Durham, North Carolina, 1950).

76.
George K. Strohde, ed.,
Yellow Fever
(New York, 1951), pp. 5–37.

77.
Cf. W. A. Karunaratne, “The Influence of Malaria Control on Vital Statistics in Ceylon,”
Journal of Tropical Medicine and Hygiene
, 62 (1959), 79–82.

78.
Cf. the interesting discussion in R. Manseil Prodiero,
Migration and Malaria
(London, 1965) of how migration patterns have helped to upset WHO plans for eliminating malaria from parts of Africa.

79.
This is the opinion of René Dubos,
The White Plague: Tuberculosis, Man and Society
(Boston, 1952), pp. 185–207. He bases his estimate on the reported numbers seeking relief from scrofula (a form of tuberculosis) by the “King’s Touch.” But obviously, the number of sufferers who attended levees at which the King of England touched scrofulous persons in hope and expectation of a cure also depended on how vividly the populace believed in such magic. The supposed retreat of tuberculosis in the eighteenth century may therefore be a result of mounting skepticism as to the efficacy of the royal touch. After all, something went out of the mystique of monarchy in England with the Hanoverian succession; and Louis XV and his successor Louis XVI never commanded the charisma Louis XIV had done in France. The spread of American food crops and of the New Husbandry provided better nutrition for some Europeans; and this would tend to check tuberculosis, as the contrary experience of recent upsurges of tuberculosis rates in wartime when food rations run short amply shows. But exact statistics are irrecoverable and Dubos’ opinion remains a possible but by no means a necessary interpretation of what is known.

80.
René Dubos, The White Plague, p. vi and passim; T. Aidan Cockburn, The Evolution and Eradication of Infectious Diseases, pp. 219–30.

81.
H. H. Scott,
A History of Tropical Medicine
, I, 44–54; A. J. P. Taylor,
English History 1914–1945
(New York, 1970), p. 121.

82.
Ralph H. Major,
Fatal Partners: War and Disease
(New York, 1941), p. 240.

83.
R. H. Shryock,
The Development of Modern Medicine
(Philadelphia, 1936), p. 309.

84.
In the Austro-Hungarian army, for instance, despite prolonged exposure to the epidemic of typhus raging in Serbia, disease losses never exceeded 50 per cent of losses from enemy action, according to Clemens Pirquet, ed.,
Volksgesundheit im Krieg
(Vienna and New Haven, 1926), I,70.

85.
Cf. R. S. Morton,
Venereal Disease
(Baltimore, 1966), p. 28.

86.
Cf. Harry Wain, A History of Preventive Medicine, p. 306.

87.
Cf. Thomas McKeown and C. R. Lowe,
An Introduction to Social Medicine
(Oxford and Edinburgh, 1966), p. 126.

88.
For a conveniently brief summary, see Ernest L. Stebbins, “International Health Organization,” in Philip E. Sartwell, ed.,
Maxcy-Rosenau Preventive Medicine and Public Health
, 9th ed. (New York, 1965), pp. 1036–45.

89
Isolation of an islanded population could create similar vulnerability. Thus in Taiwan in the 1960s some 40,000 cases of crippling poliomyelitis came to official medical attention. Presumably what had happened was that the virus broke in upon a previously unexposed population, and attacked vulnerable adults and adolescents not because their sanitary regimens had previously shielded them from infection, but because the infection had been absent from the island entirely.

90.
August Hirsch,
Handbook of Geographical and Historical Pathology
, I, 6–18, lists no fewer than ninety-four epidemics of influenza between 1173, the earliest he thought he could identify, and 1875. Of these he calculated at least fifteen had been pandemic, i.e., affected Asia as well as Europe. Given the imprecision of historical disease descriptions, there is no reason to suppose that influenza was new in 1173, however; and prior to the sixteenth century, when European doctors began to describe symptoms precisely enough to make identification reasonably sure, the history of the disease remains irrecoverable.

91.
F. M. Burnet and E. Clark,
Influenza: A Survey of the Last Fifty Tears in the Light of Modern Work on the Virus of Epidemic Influenza
(Melbourne and London, 1942); Edwin O. Jordan,
Epidemic Influenza
(Chicago, 1927), p. 229.1 was also privileged to read a history of the flu epidemic of 1918–19 by Alfred W. Crosby, Jr., in manuscript.

92.
Joseph A. Bell, “Influenza” in Ernest L. Stebbins, ed.,
Maxcy-Rosenau Preventive Medicine and Public Health
, 9th ed., pp. 90–104.

93.
Cf. the cataclysmic possibilities of up to a 90 per cent
die-off
outlined in Richard Fiennes,
Man, Nature and Disease
(London, 1964), p. 124.

94.
See W. E. Woodward, et al., “The Spectrum of Cholera in Bangladesh,”
American Journal of Epidemiology
, 96 (1972), 342–51.

95.
See above, p. 46.

ABOUT THE AUTHOR

William H. McNeill is one of America’s senior historians. He was professor of history at the University of Chicago for forty years before retiring in 1987. In the course of his career, he has published more than twenty books, including
The Rise of the West: A History of Human Community
, which won the National Book Award in 1964;
Pursuit of Power: Technology, Armed Force and Society Since 1000 A.D.;
and
Plagues and Peoples
. Dr. McNeill was president of the American Historical Association in 1985. In 1996, he was the first non-European recipient of the Erasmus Prize, an annual award given for exceptional contributions to European culture, society, and social science.