Epidemics and History: Disease, Power and Imperialism

by Sheldon Watts

Overview

"One of the best portrayals of life in Europe and the Islamic world during the medieval Great Plague. . . . Watts offers solid, stunning examples of Western idiocy that created superhighways for once-obscure microbes, leading to horrendous epidemics. . . . A perspective that Western, particularly Caucasian, policy-makers would do well to comprehend."—Laurie Garrett, Foreign Affairs

"Fascinating . . . [Watts] exposes to daylight the dire effect of the elites' often misinformed conception of these diseases, and how they, the elites, manipulated epidemiological crises to their advantage."—Alfred Crosby, Washington Post

This book is a major and wide-ranging study of the great epidemic scourges of humanity—plague, leprosy, smallpox, syphilis, cholera, and yellow fever/malaria—over the last six centuries. It is also much more. Sheldon Watts applies a wholly original perspective to the study of global disease, exploring the connections between the movement of epidemics and the manifestations of imperial power in the Americas, Asia, Africa, and in European homelands. He argues that not only did Western medicine fail to cure the diseases that its own expansion engendered, but that imperial medicine was in fact an agent and tool of empire.

Watts examines the relationship between the pre-modern and modern medical profession and such epidemic disasters as the plague in western Europe and the Middle East; leprosy in the medieval West and in the nineteenth-century tropical world; the spread of smallpox to the New World in the age of exploration; syphilis and nonsexual diseases in Europe’s connection with Asia; cholera in India during British rule; and malaria in the Atlantic Basin during the eras of slavery and Social Darwinism. This book will become the standard account of the way diseases—arising through chance, through reckless environmental change engineered by man, or through a combination of each—were interpreted in Western Europe and in the colonized world, and offers an interesting historical perspective for a world dealing with the spread of COVID-19.

Product Details

ISBN-13:	9780300080872
Publisher:	Yale University Press
Publication date:	11/10/1999
Edition description:	New Edition
Pages:	416
Product dimensions:	6.12(w) x 9.25(h) x (d)

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Introduction

In the summer of 1347 rats and fleas infected with bubonic plague boarded Genoese merchant ships at Caffa on the Black Sea. Later that year some of these ships passed through the Dardanelles, touched down at Messina (Sicily) and then sailed to Pisa, Genoa and Marseilles: other Genoese ships sailed directly from Caffa to the mouths of the Nile in Egypt. Within a few months pestilence of a form unknown to contemporaries began killing men, women and children on both sides of the Mediterranean. As 1348 wore on, the plague began striking populations along the Atlantic and Baltic coasts. Then, traveling up rivers, along paths and across fields, it reached Europeans living deep in the interior.

Though reliable information is scarce, it would seem that during the five years (1347-51) the Black Death was darting about, mortality varied form an eighth to two-thirds of a region's population. Overall it may have killed three Europeans out of every ten, leaving some 24 million dead. This remains the worst epidemic disease disaster in Europe since the collapse of the Roman Empire.

Also appallingly high was the casualty rate in the Muslim Middle East: between a quarter and a third of the population died. Writing in 1349, Ibn Khatimah, a medical writer from Andalusia (Muslim southern Spain), testified that:

"This is an example of the wonderful deeds and power of God, because never before has a catastrophe of such extent and duration occurred. No satisfactory reports have been given about it, because the disease is new....God only knows when it will leave the Earth."

In the years after 1351, bubonic plague continued to make sporadic appearances, sparing neither lands to the north nor to the south of the Mediterranean. Though no category of person was immune, it seems that on every second or third visitation the plagues targeted a region's pregnant women and young children. The net effect was to prune back the sprouts of population growth by killing young people before they were old enough to have children of their own. In the case of ill-favored Florence, generally taken to be the birthplace of the Renaissance, after being hit by plague eight times between 1348 and 1427 the city was left with little more than a third of its pre-plague population of 100,000.

Then for reasons that remain unclear, after around 1450 mortality rates in Christendom began to diverge from those found in the Muslim Middle East; in the latter region pestilence continued to be a frequent population-slashing visitor until the 1840s. By way of contrast, in a Europe that was still overwhelmingly rural, except for localized outbreaks such as those which hit north Italian urban centers in 1575-76, 1630-31 and 1656, the ability of plague to significantly reduce the numbers of humans of reproductive age ended in the mid-fifteenth century. Thereafter, outbreaks of plague became increasingly random, missing whole regions for decades. This pattern allowed the population gradually to recover and then to forge beyond its 1347 proportions.

Within this framework, beginning with Western Europe, I will explore the reasons why elites did not respond to the plague as a sui generis disease crisis requiring a special response until around 1450; only then did well-born north Italians create plague-specific policies based on what I will call the Ideology of Order. After these policies were introduced in the most politically pliable provinces of Europe (Tuscany, Liguria, Lombardy, Venetia) there was a time lag of 200 years before they were given a general continental application. As used after 1660, quarantine and other standard control techniques probably were the agencies that forced pestilence into retreat, though not all experts agree on this. Be this as it may, it is abundantly clear that the new policies severely strained traditional ideas about the roles appropriate to new rulers and those who were ruled. As will be seen, within Europe the creation of plague controls greatly strengthened both the image and the reality of elite authority.

Turning then to the Cairo-based Mamluk Empire and the Ottoman Turkish regime that succeeded it in 1517, I will investigate why no interventionist policy was developed until Muhammad Ali became Viceroy of Egypt in 1805. By that time Egypt's population stood at a mere 3 million, less than a third of what it had been before the onset of plague in 1347.

In this chapter, I do not intend to enter into the debate about the role which urban and rural depopulation, caused by the Black Death and succeeding pestilences, played in the long-term fortunes of the various regions of West Europe and the Middle East. It should be pointed out however that these debates have led to the unsensational discovery that a sudden decrease in human numbers is only one of the variables that can decisively tilt the balance between an old established, flourishing economic region (such as northern Italy) and regions such as England and the Netherlands from which new-style entrepreneurial opportunists emerged. With regard to Italy, the Cambridge historian S. R. Epstein has recently compared the fortunes of Sicily and Tuscany. He suggests that though initial plague mortalities may have weakened the importance of both regions' long-distance trade in luxury goods (of concern only to elites), of more lasting importance was the impetus sudden population decline gave to the development of regional markets for non-luxury goods, and with it the growth in proportion of local people who depended on market transactions for their livelihoods rather than on subsistence agriculture. Within each region, what counted the most was the institutional framework and mindset of the governing classes. In a loosely articulated setting where competition between rival rule-givers left large areas of ordinary people's lives unpoliced (the situation in Sicily), peasants and artisans who survived the plague had room to work out strategies for long-term family betterment. Able to control their spending patterns and family size, they could produce the specialized goods for sale on regional markets which gave them the disposable income they needed to become market-oriented consumers. In contrast, in Renaissance Florence and its contado (hinterland) where the pre-plague institutional framework was authoritarian and efficient, and remained so after the population hemorrhages of 1348-1450, tax burdens and labor requirements imposed on ordinary people prevented them from rising above the poverty level. Here then in two regions hit by the same mass killer disease, differing patterns of elite behavior resulted in quite different consequences.

(Continues...)

Table of Contents

List of Illustrations
Acknowledgements
Introduction
1 The Human Response to Plague in Western Europe and the Middle East, 1347 to 1844
Introduction
Shifting Attitudes towards Disease
Professional Paradigms: Continuities and Change
The Invention of Controls
Responses to Plague in the Middle East
2 Dark Hidden Meanings: Leprosy and Lepers in the Medieval West and in the Tropical World under the European Imperium
Introduction
Leprosy in the European Middle Ages: Background
The Great Leper Hunt, c	1090 to 1363
Leprosy and Empire
3 Smallpox in the New World and in the Old: From Holocaust to Eradication, 1518 to 1977
Introduction
The Disease and its First Impact on New World Peoples
Mindsets and Practices
The African Connection
Towards Eradication
4 The Secret Plague: Syphilis in West Europe and East Asia, 1492 to 1965
Introduction
Initial Perceptions
The Commercialization of Syphilis
Changes in Sociability, c. 1480 to c	1750
The Competition for Control
TreponemaPallidum and the Rise of Mass Society
Syphilis and "Syphilis" in China, c	1860-1965
5 Cholera and Civilization: Great Britain and India, 1817 to 1920
Introduction
Cholera as Disease
Cholera in India to c	1857
Cholera in Britain
Cholera in India after 1857
6 Yellow Fever, Malaria and Development: Atlantic Africa and the New World, 1647 to 1928
Introduction
The Diseases
Slavery and the Fevers in Atlantic Africa to c	1840
Slavery, Yellow Fever and Malaria in the New World
Barbados - Haiti -The United States - Brazil - Cuba
West Africa and Tropical Medicine, 1895-1928
7 Afterword: To the Epidemiologic Transition?
Notes
Select Bibliography
Index