Heather Sauls

Plagues and Poxes: The Impact of Human History on Epidemic Disease

is an entertaining and informative read for both historians interested in medicine and medical professionals with a curiosity of their field’s history. In his book, Alfred Jay Bollet builds a connection between the proliferation of disease and human activity. In some instances, disease is brought to new, susceptible populations through increased travel either unwittingly or deliberately. Other diseases are regarded as having evolved into major public health concerns due to an increase in technologies or a change in social culture. Bollet fully explores the unidirectional effects of human action on the choice diseases addressed. He makes a very convincing argument; however there is a lack of acknowledgment of the reverse association: disease evolution effecting human behavior and culture.

I thoroughly enjoyed reading Plagues and Poxes. It was easy to read technically and maintained accessibility to the person with little to moderate medical experience. The explanations of disease transmission and/or acquisition are detailed and provide a good basis for explaining how human actions affect spread. Bollet also does a good job of compiling both historical statistics and personal anecdotes left for further generations to see. His background in American war history shows through with the strength of his references for the war-related diseases highlighted of malaria, smallpox, and cholera. Bollet amusingly notes that when President Lincoln contracted smallpox he ironically protested quarantine remarking, “I finally have something I can give everybody.” Through descriptions of cultural attitudes, practices and the eventual scientific understandings of epidemic diseases a relationship between human technological, navigational, and societal evolution on disease becomes clear. Especially poignant to Bollet’s position is his description of the effects of the industrial revolution in England. The increased pollution directly caused a lack of access to sunlight for those living in large, industrialized cities. This led to outbreaks of rickets due to Vitamin D deficiency. The ties that Bollet describes between human-disease interactions are direct, well founded, and reasonable, giving the reader a sense of detailed understanding.

Plagues and Poxes is broken down into three sections, each focusing on particular types of disease. The first section addresses infectious diseases; the second, non-infectious diseases; the third, intentionally induced and emerging diseases. Each chapter is dedicated to a specific infectious disease. It would be impossible to cover all the illnesses affecting mankind, therefore particular attention is paid to the most widespread and devastating diseases throughout time. The structure of the chapters flows with relative ease from the earliest historical recordings and treatments through to either present day or eradication. However, at the end of each chapter Bollet presented a section regarding each disease and its potential use as a terrorist weapon. The inclusions did not fit with the texture of the rest of the information and seemed out of place, especially considering the subject matter of the third section. If we take into regard that this book was published in 2004, while the events of September 11, 2001 were still fresh in the public’s mind, the focus on terrorist applications would be relevant to the times. Still, the ending of the chapters feel most like crude, unnecessary additions.

While Bollet describes how populations reacted to disease before and after discovery of true causes, he does little to actively acknowledge the major effects disease has on human history, in lieu of the opposite effect, which is the theme of Plagues and Poxes. There are several instances where the spread of diseases causes humans to institute a new social behavior. The most impressive of these is the use of quarantine to isolate contaminated parties and avoid the further spread of illness. The use of quarantine is indicated countless times throughout the book. To the commendation of the author, he does detail the origins of quarantine. Similarly to this incidence, Bollet several instances where epidemic disease directly affected human history. The victories in the American Civil War, the Battle of Trafalgar, the Peloponnesian War among others are attributed to the prevalence of yellow fever, scurvy, and the bubonic plague, respectively. These are not the only examples that presented within book, yet both quarantine and military history both represent obvious examples of the reverse of Bollet’s assertion that human advances play the more important role in the history of epidemic disease.

Within Plagues and Poxes: The Impact of Human History on Epidemic Disease, Alfred Bollet effectively displays the extent to which human actions have increased the spread of disease throughout the world. Yet his attempt to singularly establish human epidemic disease breaks down in the process of detailing history. Trying to identify one as the cause of the other is difficult, as both are wound up so entirely in each other. The major shortcoming of this text is the inability of the author to appreciate that the relationship between human activity and the spread of disease is not one of cause-and-effect, but of interaction. The appearance of disease affects human behavior just as much as human behavior affects the appearance of disease. It is especially important to remember that agents of infectious disease, such as those addressed in the majority of this text, are not inert; they are living creatures always finding new ways to survive. Human actions will shape what ways they use, while their mode of survival shapes how we, in turn, react.