Epidemic Diseases and their Effects on History

Christian W. McMillen

LAST REVIEWED: 19 MAY 2017LAST MODIFIED: 24 JULY 2013DOI: 10.1093/OBO/9780199743292-0155


There is perhaps no longer-lasting historical relationship than that between humans and disease, especially epidemic disease. The relationship predates agriculture, the formation of cities, and, if current research on the emergence of diseases like tuberculosis is correct, human migration out of Africa. From the earliest times to the present, epidemics have affected human history in myriad ways: demographically, culturally, politically, financially, and biologically. Humans have never known a time in history when epidemics did not loom large. This is as true today as it ever was. This article seeks to introduce readers to this large and varied topic through a selection of key readings from around the globe and across time. The historiography is rich and remarkably comprehensive in scope. Yet there are limitations. The evidence for epidemics in the non-Western world before significant contact with Europeans, and in the New World before contact with Europeans, is scant. This is not to say that epidemic disease did not affect parts of Africa, for instance, before European colonization or that the cholera epidemics that emerged in early-19th-century India were the first instances of epidemic disease there. We just do not know. By contrast, there is a massive amount of evidence on the Black Death and its effects on medieval Europe; likewise, the so-called virgin soil epidemics that devastated native populations all over the world in the wake of European conquest are also well documented, if not always well understood. What follows is a consideration of the topics that have received the most attention from historians: plague, cholera, influenza, smallpox, among others. Likewise, certain topics—the impact of epidemic disease on indigenous peoples and the effects of colonialism, for instance—have a well-developed historiography. The same is not the case for measles; there is no well-developed historiography of this killer disease despite its powerful impact and regular occurrence. Typhus, which does not have its own entry, is nevertheless important, and one can learn about it in the discussion of war and disease in Harrison 2004 (cited under General Overviews). Tuberculosis—another critically important infectious disease—does not have its own entry. One final thing to note: the focus here is on the effects of epidemic diseases and thus this is not a general history of medicine. For that reason, subjects such as infant mortality that would very easily fit into a discussion of medicine and imperialism will not be discussed here.

General Overviews

There are quite a number of excellent introductions to the history of epidemics and their effects on history. General works, covering broad swaths of human history and geographic space, necessarily overlap slightly. However, the following each offer a unique approach. The global history McNeill 1998 is perhaps the most accessible starting point and a touchstone for all future work. Taking a more topical approach, and written after the appearance of HIV/AIDS, Hays 2009 is comprehensive and readable. Ranger and Slack 1995 presents essays on a wide variety of topics concerning the ways in which people have thought about epidemic disease. Writing on different time scales, and considering different places, Crosby 2009Diamond 1997, and Ladurie 1981 all consider epidemics and the transfer of germs across space to be defining elements of human history. Rosenberg 1989 offers a thoughtful discussion of the various features epidemics have in common. Not discussed here are the many works on the history of medicine more generally that consider epidemic disease yet do not make it a focus.

  • Crosby, Alfred. Ecological Imperialism: The Biological Expansion of Europe, 900–1900. Cambridge, UK: Cambridge University Press, 2009.Save Citation »Export Citation »E-mail Citation »Influential book originally published in 1986, but updated. Not solely about epidemic disease, yet disease is a central feature of the story of Europe’s “biological expansion” into and the creation of “neo-Europes” in North America, Australia, and New Zealand.Find this resource:
  • Diamond, Jared. Guns, Germs, and Steel: The Fates of Human Societies. New York: Norton, 1997.Save Citation »Export Citation »E-mail Citation »Considers the peopling of the earth and eventual dominance of Europeans. Argues that geographic advantage led to the development of agriculture and the domestication of animals, which in turn led to settlement and crowd diseases—diseases those in the New World never encountered until confronted by Europeans starting in the 15th century.Find this resource:
  • Harrison, Mark. Disease and the Modern World: 1500 to the Present Day. Cambridge, UK: Polity, 2004.Save Citation »Export Citation »E-mail Citation »Lively, brief, and wide-ranging survey. Excellent on impact of disease on the New World, changing views of disease causation, effects of industrialization, impact of war, and efforts in more recent times to rid the world of disease. Central is Harrison’s contention that efforts to control disease and the rise of the modern state go hand in hand.Find this resource:
  • Hays, J. N. The Burden of Disease: Epidemics and Human Response in Western History. Rev. ed. New Brunswick, NJ: Rutgers University Press, 2009.Save Citation »Export Citation »E-mail Citation »Originally published 1998. From ancient times to the present, the scope of Hays’s survey is impressive. Especially clear is Hays’s sympathy for the view that there is a close connection between poverty, power, and disease and that the disparities in wealth across the globe are often at the root of epidemics. Excellent introduction to a vast array of literature and a superb bibliography. Covers diseases, such as typhus and others, not given their own entries elsewhere.Find this resource:
  • Ladurie, Emmanuel Le Roy. “A Concept: The Unification of the Globe by Disease.” In The Mind and the Method of the Historian. By Emmanuel Le Roy Ladurie, 28–83. Translated by Siân Reynolds and Ben Reynolds. Chicago: University of Chicago Press, 1981.Save Citation »Export Citation »E-mail Citation »During the three centuries from 1300 to 1600, a “‘common market’ of microbes” developed and engulfed the globe like never before (p. 30). The Black Death and the importation of disease to the Americas were particularly devastating.Find this resource:
  • McNeill, William. Plagues and Peoples. New York: Anchor Books, 1998.Save Citation »Export Citation »E-mail Citation »Originally published in 1976. Has had an inestimable influence by arguing, before others and in what became a very popular book, that epidemic disease should be placed at the center of history. “Events but little noticed in traditional histories assume central importance for my account,” McNeill wrote (p. 21).Find this resource:
  • Ranger, Terence, and Paul Slack, eds. Epidemics and Ideas: Essays on the Historical Perception of Pestilence. Cambridge, UK: Cambridge University Press, 1995.Save Citation »Export Citation »E-mail Citation »Essays on the power of epidemics to shape ideas, influence policy, and affect demography as well as a consideration of how ideas about epidemics have changed over time and space. Evans’s well-regarded essay “Epidemics and Revolutions” is included, as are essays on the plague in India, and changing ideas about Christianity in the face of epidemic disease in eastern and southern Africa.Find this resource:
  • Rosenberg, Charles E. “What Is an Epidemic? AIDS in Historical Perspective.” Daedalus 118.2 (1989): 1–17.Save Citation »Export Citation »E-mail Citation »Examines responses to epidemics across time and space. Argues that epidemics have a “dramaturgic form” (p. 2): initial revelation, response, crisis, and closure. Responses can happen on different time scales: the 1918 flu epidemic and the AIDS epidemic might have similar “dramaturgic forms” yet operate on completely different time scales. Most epidemics are united in their ability to raise questions of “volition, responsibility, and susceptibility” (p. 6).Find this resource:

Reference Works

Several comprehensive reference works serve as excellent guides to topics not covered elsewhere in this article. Additionally, they provide excellent bibliographies. (With the exception of Hays 2005, all are edited collections.) The coverage in the two edited volumes Kiple 1993 and Kiple 1997 can be used alongside Hays 2005 and Kohn 2008 as guides to a vast number of epidemics in world history. One feature to recommend all of these is that, because of their comprehensive coverage, they deal with diseases that do not routinely show up in other works on epidemic disease, or that have not yet found their historian, but which nonetheless have reached epidemic proportions, such as measles.

  • Hays, J. N. Epidemics and Pandemics: Their Impacts on Human History. Santa Barbara, CA: ABC-CLIO, 2005.Save Citation »Export Citation »E-mail Citation »Fifty short entries on various epidemics in human history from the epidemic in Athens in 430–427 BCE to the contemporary tuberculosis epidemic.Find this resource:
  • Kiple, Kenneth, ed. The Cambridge World History of Human Disease. Cambridge, UK: Cambridge University Press, 1993.DOI: 10.1017/CHOL9780521332866Save Citation »Export Citation »E-mail Citation »Indispensable guide to the place of disease in human history. Concerned with much more than epidemic disease, should be an essential part of any reference collection. Slightly dated.Find this resource:
  • Kiple, Kenneth, ed. Plague, Pox, and Pestilence: Disease in History. London: Weidenfeld & Nicolson, 1997.Save Citation »Export Citation »E-mail Citation »Collection of short essays by leading historians set apart by its superb use of illustrations.Find this resource:
  • Kohn, George C., ed. Encyclopedia of Plague and Pestilence: From Ancient Times to the Present. New York: Facts on File, 2008.Save Citation »Export Citation »E-mail Citation »Details hundreds of epidemics across a vast reach of time and space.Find this resource:


The history of epidemics appeals to both specialists and generalists and is thus not confined to any one journal or type of journal. That said, there are a good number of journals devoted to the history of science and medicine; they regularly cover epidemics. The leading journals are the Bulletin of the History of MedicineSocial History of MedicineMedical HistorySocial Science and Medicine, and History of Philosophy of the Life Sciences. Other journals regularly cover epidemic history.


The term “plague” is one of the most potent in the English language and has been used to refer to a variety of maladies. This section refers to the three major plague pandemics recognized by most historians and running from the 6th to the middle of the 20th century—the Justinianic of 541–542 through 750; the Black Death of 1348 through the Marseilles epidemic of 1720 until plague vanished from Europe in the 1770s; and the epidemic that originated in China in 1894 and spread across the globe only to peter out finally in the 1950s. Because it has been around for so long, in some places is so well documented, and has had an important effect on demography, among other things, plague has generated the largest single body of literature on epidemic disease. The titles in this section are chosen to give readers a way into this large literature. While there are many excellent books that cover major (and minor) aspects of plague, there is no single, comprehensive volume on plague in all its complexity and geographic scope. Such a book would have to run from ancient to modern times, encompass most of the globe, and be, in the age of genetics and molecular biology, at least conversant in these disciplines. Slack 2012 is a superb guide, however, to the subject. Biraben 1975–1976, still available only in French, covers Europe from the 6th to the 19th century and is a major work. Two essays—Cunningham 1992, considering the effect of the identification of Yersinia pestis in the late 19th century on historians’ ability to identify previous epidemics as plague before a proper, lab-based definition was available; and Theilmann and Cate 2007, describing the challenges of diagnosis and what that means for the plague studies—offer shorter entry points into this very large field.

  • Biraben, Jean-Nöel. Les hommes et la peste en France et dans le pays européens et méditerranéens. 2 vols. Paris: Mouton, 1975–1976.Save Citation »Export Citation »E-mail Citation »Classic examination of the cyclic nature of plague and its effects on European demography. Ends before third pandemic begins at the end of the 19th century.Find this resource:
  • Cunningham, Andrew. “Transforming Plague: The Laboratory and the Identity of Infectious Disease.” In The Laboratory Revolution in Medicine. Edited by Andrew Cunningham and Perry Williams, 209–244. New York: Cambridge University Press, 1992.Save Citation »Export Citation »E-mail Citation »Stresses that our modern understanding of plague, only possible with the modern laboratory, is different from that of those living through the Black Death, for example. A caution against anachronism—what he calls “bacteriologic understanding” (p. 238)—and against accusing past actors of “unscientific” thinking. Thoughtful, if not entirely without controversy.Find this resource:
  • Slack, Paul. Plague: A Very Short Introduction. New York: Oxford University Press, 2012.Save Citation »Export Citation »E-mail Citation »Impressive feat of concision. Manages to discuss, however briefly, all major aspects of plague history across all three pandemics. Admirably balanced concerning various controversies in plague historiography. Very useful bibliography.Find this resource:
  • Theilmann, John, and Frances Cate. “A Plague of Plagues: The Problem of Plague Diagnosis in Medieval England.” Journal of Interdisciplinary History 37.3 (2007): 371–393.DOI: 10.1162/jinh.2007.37.3.371Save Citation »Export Citation »E-mail Citation »While focused on England and the Black Death, the authors consider plague in history across time and space, comparing earlier knowledge with what we have learned about plague since 1894 and the identification of the bacillus, thus making the article an excellent introduction to plague studies. Argues that the Black Death was caused by Yersinia pestis, yet gives fair treatment to arguments that the Black Death was not plague but something else. Available online for purchase or by subscription.Find this resource:

First Pandemic

The first wave of plague washed over the world from 541 to 750. From its origin in the Egyptian port city Pelusium, it spread across the entire Mediterranean and eventually reached Persia and the British Isles. By 750, after a last outbreak in Naples, the first pandemic was over. For an overview, the edited collection Little 2007 considers the plague from many scholarly angles. Sarris 2002 and Stathakopoulos 2000 hone in on the Plague of Justinian (541–542) and are good places to start; both touch on the major sources of controversy in the literature regarding from where the plague came and its effects. Conrad 1994 and Conrad 1996 focus on the pre-Islamic Middle East.

  • Conrad, Lawrence I. “Epidemic Disease in Central Syria in the Late Sixth Century: Some New Insights from the Verse of Ḥassān ibn Thābit.” Byzantine and Modern Greek Studies 18.1 (1994): 12–59.Save Citation »Export Citation »E-mail Citation »Follow-up of sorts to the author’s previous work, further detailing, with new sources, the widespread distribution of plague. Insights into plague in remote, rural areas. Available online for purchase or by subscription.Find this resource:
  • Conrad, Lawrence I. “The Plague of Bilal al-Sham in Pre-Islamic Times.” In Proceedings of the Symposium on Bilal as-Sham during the Byzantine Period. Edited by Muhammad Adnan Bakhit, 143–163. Amman: University of Jordan, 1996.Save Citation »Export Citation »E-mail Citation »Conrad works in a class by himself. Demonstrates, using Syriac and Arabic sources, that pre-Islamic Syria was well known for its plague epidemics.Find this resource:
  • Little, Lester K., ed. Plague and the End of Antiquity: The Pandemic of 541750. Cambridge, UK: Cambridge University Press, 2007.Save Citation »Export Citation »E-mail Citation »Essential reading. Wide-ranging collection on archeology, nonliterary sources, epidemiology, and history.Find this resource:
  • Sarris, Peter. “The Justinianic Plague: Origins and Effects.” Continuity and Change 17.2 (2002): 169–182.Save Citation »Export Citation »E-mail Citation »Overview of major issues in the historiography of this particular epidemic. Looks at numismatic and legal evidence. Available online for purchase or by subscription.Find this resource:
  • Stathakopoulos, Dionysios. “The Justinianic Plague Revisited.” Byzantine and Modern Greek Studies 24 (2000): 256–276.Save Citation »Export Citation »E-mail Citation »Historiographical essay showing waxing and waning of interest in the plague. Discusses gaps in research, but also shows how the field has matured. Available online for purchase or by subscription.Find this resource:

Second Pandemic

More has been written about the Black Death than perhaps any other topic in the history of epidemics. It’s easy to see why: it was devastating, there are ample records for some places, and the host of questions concerning demographic and economic effects, among other things, has obvious appeal to historians. The second pandemic, including the Black Death, affected almost all of Europe, the Ottoman Empire, and much of the Middle East. The historiography is vast. The works noted in General Overviews on plague, as well as those on epidemics more generally, all have much to say about the Black Death and the second pandemic more generally. Start with them and their bibliographies. What follows is a mere sample. The dense volume Benedictow 2004 systematically tracks the Black Death as it made its way across Europe, North Africa, Asia Minor, and elsewhere. By contrast, Cantor 2001, a general overview of the Black Death, is easily digested by any interested reader. Slack 1985 is limited to England, but considers the entire second pandemic. Cohn 2010 shows that medical thinking in 16th-century Italy could dynamically respond to plague. Alexander 2002, a singular book on the last gasp of the second pandemic in late-18th-century Russia, rounds out coverage of Europe. Europe has been very well covered by historians; the Middle East and the Ottoman Empire less so. Yet, important work, such as Borsch 2005Dols 1977, and Panzac 1985, has remedied this to an extent. Controversies abound in the study of the plague, such as the question of whether or not the Black Death was or was not modern Yersinia pestis; questions like this are nicely reviewed in Nutton 2008.

  • Alexander, John T. Bubonic Plague in Early Modern Russia: Public Health and Urban Disaster. New York: Oxford University Press, 2002.Save Citation »Export Citation »E-mail Citation »Originally published in 1980. Bubonic plague of 1770–1772 was likely the last appearance of the disease during the second pandemic. Weaves together climate history—unusually warm weather was at work here; the influence of trade and territorial expansion—the disease traveled from the Ottoman Balkan territories; and social, epidemiological, and economic history—shows who the disease hit and why, focusing on economic disparities.Find this resource:
  • Benedictow, Ole J. The Black Death, 1346–1353: The Complete History. Woodbridge, UK: Boydell, 2004.Save Citation »Export Citation »E-mail Citation »Region-by-region, country-by-country tour of the Black Death. Impressively detailed. Takes for granted that the causative agent of the Black Death was Yersinia pestis, though this is a controversial point.Find this resource:
  • Borsch, Stuart J. The Black Death in Egypt and England: A Comparative Study. Austin: University of Texas Press, 2005.Save Citation »Export Citation »E-mail Citation »Compares the landholding systems and land use practices of each country as a way to explain postplague downturn in Egypt. For example, once the labor supply diminished in Egypt, it became impossible to maintain the elaborate irrigation systems.Find this resource:
  • Cantor, Norman. In the Wake of the Plague: The Black Death and the World It Made. New York: HarperCollins, 2001.Save Citation »Export Citation »E-mail Citation »Overview aimed at a nonacademic audience. Good introduction to major themes.Find this resource:
  • Cohn, Samuel K. Cultures of Plague: Medical Thinking at the End of the Renaissance. Oxford: Oxford University Press, 2010.Save Citation »Export Citation »E-mail Citation »Arguing mostly from Italian evidence that 16th-century medical personnel, when confronted with plague, did not simply act on custom. They innovated. This is demonstrated by a burst of publications on the plague.Find this resource:
  • Dols, Michael. The Black Death in the Middle East. Princeton, NJ: Princeton University Press, 1977.Save Citation »Export Citation »E-mail Citation »Pioneering study, principally looking at Egypt and Syria, that argued that the Black Death had a devastating demographic effect from which the Middle East did not recover.Find this resource:
  • Nutton, Vivian, ed. Pestilential Complexities: Understanding Medieval Plague. London: Wellcome Trust Centre for the History of Medicine at UCL, 2008.Save Citation »Export Citation »E-mail Citation »Six essays covering, for example, the similarities and differences between medieval and modern plague and the epidemiology of the Black Death. Nutton’s introduction is an excellent guide to the literature and to a host of controversial questions.Find this resource:
  • Panzac, Daniel. La peste dans l’Empire Ottoman: 17001850. Louvain, Belgium: Éditions Peeters, 1985.Save Citation »Export Citation »E-mail Citation »Monumental history of plague as it receded in western Europe and emerged in the Ottoman Empire. Attempts to trace economic and demographic impact and looks at the importance of western European methods of quarantine and sanitation.Find this resource:
  • Slack, Paul. The Impact of Plague in Tudor and Stuart England. London: Routledge and Kegan Paul, 1985.Save Citation »Export Citation »E-mail Citation »An effort at combining intellectual, social, political, demographic, and medical history into one volume. Shows the increasing involvement of the state in medical matters and demonstrates the increasing association of plague with filth and thus with the poor.Find this resource:

Third Pandemic

Beginning in 1894, a third wave of bubonic plague began to circle the earth. Originating in China, this pandemic was far less deadly than the previous two and had no impact on Europe whatsoever. That said, India and China were both hard hit. It has only been relatively recently that historians have begun to look carefully at this pandemic. As are the first two pandemics, the third is discussed in the General Overviews of plague and those concerning epidemics more broadly. Benedict 1996 traces the emergence of the pandemic across 19th-century China, from where it eventually boarded a ship. Other historians pick up the story at that point. Arnold 1993 looks at the devastating effect the plague had in colonial India. The author of Echenberg 2002 and Echenberg 2007 considered the pandemic twice: first focusing on colonial Senegal, then on the pandemic’s global urban impact. Bulmuş 2012 expands our view further still by looking at the Ottoman Empire; it also straddles the second and third pandemics. Mohr 2005, in contrast to studies that are global or regional in scope, takes a microhistorical approach by looking at the politics of race and disease in Honolulu.

  • Arnold, David. Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-Century India. Berkeley: University of California Press, 1993.Save Citation »Export Citation »E-mail Citation »Discusses both the terrible scale of the epidemic—approximately twelve million died—and the local response to colonial health measures, including quarantine and sanitation, which were at times met by violent resistance. Many Indians became hostile to Western medicine, furthering the divide between colonizer and colonized.Find this resource:
  • Benedict, Carol. Bubonic Plague in Nineteenth-Century China. Stanford, CA: Stanford University Press, 1996.Save Citation »Export Citation »E-mail Citation »Tracks plague as it emerged in China eventually to become the seed for the third global pandemic. Also shows how China, through efforts to combat plague, developed a more centralized approach to public health during the second half of the 19th and into the 20th century.Find this resource:
  • Bulmuş, Birsen. Plague, Quarantines, and Geopolitics in the Ottoman Empire. Edinburgh: Edinburgh University Press, 2012.Save Citation »Export Citation »E-mail Citation »Takes up where Panzac left off (Panzac 1985, cited under Second Pandemic) and makes extensive use of Ottoman sources. Does not fit strictly into a first-, second-, third-wave paradigm; concerned with Ottoman response to plague from the early 19th century through the end of the empire in the early 20th.Find this resource:
  • Echenberg, Myron. Black Death, White Medicine: Bubonic Plague and the Politics of Public Health in Colonial Senegal, 1914–1945. Portsmouth, NH: Heinemann, 2002.Save Citation »Export Citation »E-mail Citation »Uses outbreaks of plague to illuminate social relations, highlight racial animosities, and reveal political structures. Focuses, too, on African Senegalese response to the disease and not solely colonists’ view of disease.Find this resource:
  • Echenberg, Myron. Plague Ports: The Global Urban Impact of Bubonic Plague, 1894–1901. New York: New York University Press, 2007.Save Citation »Export Citation »E-mail Citation »Examination of plague in ten port cities and how they managed the disease. Compares similarities and differences between each city’s handling of the disease. In places like Cape Town, plague became an excuse to further segregate black South Africans, for instance; in San Francisco, anti-Chinese sentiment was inflamed.Find this resource:
  • Mohr, James C. Plague and Fire: Battling Black Death and the 1900 Burning of Honolulu’s Chinatown. New York: Oxford University Press, 2005.Save Citation »Export Citation »E-mail Citation »Detailed look at the local response to a plague outbreak factoring in social, political, and racial dimensions. The quarantining of Chinese on the assumption they were more racially susceptible to plague and the subsequent burning of their residences as an antiplague measure are examined thoroughly.Find this resource:


Smallpox has killed more people than any other disease, but it has not generated nearly as robust a historiography as plague or cholera, for example. There are a number of overviews and accounts of the smallpox eradication program. In addition to these titles, those in General Overviews and Reference Works also consider smallpox, but there are comparatively fewer specialized works. The survey to start with is Hopkins 2002; it is global and authoritative. Eradication of smallpox is widely considered a triumph, and Fenner, et al. 1988, an astonishingly thorough account of the World Health Organization’s (WHO’s) smallpox eradication campaign, is unsurpassed. Several historians have taken a country or regional approach; read together, these works provide an interesting comparative perspective. Among other things, Fenn 2001, an account of the late-18th-century North American epidemic, compares the epidemic’s effects in Mexico, in Boston, and among American Indians. Bhattacharya, et al. 2005 and Bhattacharya 2006 look at India’s nearly two-century effort to control and then eventually rid itself of the disease, while Jannetta 2007 considers Japan’s importation of and engagement with smallpox vaccination in the 19th century. Baldwin 1999 and Willrich 2011, too, are concerned with vaccination, particularly its deployment by the state and the variety of responses state-sponsored vaccination encountered.

  • Baldwin, Peter. Contagion and the State in Europe: 18301930. Cambridge, UK: Cambridge University Press, 1999.DOI: 10.1017/CBO9780511497544Save Citation »Export Citation »E-mail Citation »Compares diverse state responses to epidemic disease. Varying degrees of state-sponsored smallpox vaccination emerged in Europe and changed over time depending on a variety of factors including public response to things such as compulsory vaccination. For example, Britain went from having such laws to abandoning them in the face of widespread protest.Find this resource:
  • Bhattacharya, Sanjoy. Expunging Variola: The Control and Eradication of Smallpox in India, 1947–1977. New Delhi: Orient Longman, 2006.Save Citation »Export Citation »E-mail Citation »Explores not-always-smooth relations among Indian states, national government, and WHO from independence to eradication. WHO could not impose its will on India; at every stage, there was contest over such things as what vaccination methods to use or whether or not to vaccinate the entire population or only contacts. Eradication achieved through a combination of Indian and WHO ingenuity and hard work.Find this resource:
  • Bhattacharya, Sanjoy, Mark Harrison, and Michael Worboys. Fractured States: Smallpox, Public Health and Vaccination Policy in British India, 18001947. New Delhi: Orient Longman, 2005.Save Citation »Export Citation »E-mail Citation »Traces British efforts to control smallpox and the Indian response, which was not simply irrational resistance but well-considered hesitancy to tangle with untested medical technology. Vaccination procedures improved, more people accepted the procedure, and by the end of the colonial era India was poised to join the global fight against smallpox.Find this resource:
  • Fenn, Elizabeth. Pox Americana: The Great Smallpox Epidemic of 1775–82. New York: Hill & Wang, 2001.Save Citation »Export Citation »E-mail Citation »Slaves, Revolutionary War soldiers, Mexicans, Comanches, Hopis, and American Indians in the Pacific Northwest were affected by this widespread epidemic. Inoculation protected Continental soldiers, allowing them to defeat the British in the Revolutionary War’s southern theater, while lack of immunity and inoculation caused the Mandan and Hidatsa to be decimated, and forced the Comanche to sue for peace with the Spanish.Find this resource:
  • Fenner, Frank, Donald A. Henderson, Isao Arita, Zdeněk Ježek, and Ivan Danilovich Ladnyi. Smallpox and Its Eradication. Geneva, Switzerland: World Health Organization, 1988.Save Citation »Export Citation »E-mail Citation »Nearly 1,500-page country-by-country narrative of the campaign, written by those directly involved. Essential for understanding how smallpox was eradicated.Find this resource:
  • Hopkins, Donald. The Greatest Killer: Smallpox in History. Chicago: University of Chicago Press, 2002.Save Citation »Export Citation »E-mail Citation »Originally published as Princes and Peasants: Smallpox in History (Chicago: University of Chicago Press, 1983). Covers the disease from c. 1500 BCE to its eradication. Impressively detailed, worldwide survey. Avoids teleology by not writing as if eradication were inevitable.Find this resource:
  • Jannetta, Ann. The Vaccinators: Smallpox, Medical Knowledge, and the “Opening” of Japan. Stanford, CA: Stanford University Press, 2007.Save Citation »Export Citation »E-mail Citation »Explores Japan’s comparatively slow adoption of vaccination; argues that Japan, unlike England, did not have the medical infrastructure necessary to disseminate vaccination technology. The “vaccinators” of the title were those Japanese medical personnel who tapped into the international medical network forming around vaccination from the 1790s on. Vaccinators were likewise modernizers.Find this resource:
  • Willrich, Michael. Pox: An American History. New York: Penguin, 2011.Save Citation »Export Citation »E-mail Citation »When a smallpox epidemic occurred in 1898, the social and political response was swift, contentious, and transformative. Government advocated compulsory vaccination; many citizens, on their own and in organized groups, resisted. Compulsory vaccination—something the Supreme Court found in 1905 to be constitutional—brought into stark relief citizen discontent with an increasingly activist government during the Progressive Era.Find this resource:

Yellow Fever and Malaria

Malaria and yellow fever share a similar vector (the Aedes aegypti mosquito in the case of yellow fever and several species of Anopheles in the case of malaria: Anopheles gambiae is most prevalent in Africa, and after 1931 in Brazil; Anopheles albimanus claims Central America as home), affect similar areas, and can go hand in hand. Both have been viewed as impediments to development in the tropics and subjected to enormous military-style control campaigns; malaria was the target of a massive, though unsuccessful, World Health Organization (WHO)–led eradication campaign. Yellow fever has thrived in the American tropics from New Orleans to Cuba to the Caribbean and beyond. Malaria has thrived in these places and more, especially sub-Saharan Africa. Historians have used the history of yellow fever and malaria to track changes in medical thinking—initially, yellow fever and malaria were thought to be caused by local environmental conditions; eventually, the germ theory of disease took hold, and it was discovered that the mosquito was the vector. Historians have also examined the effects of urbanization and colonization; race and disease; governmental responses to epidemics; and differing approaches to disease control. Both yellow fever and malaria have rich historiographies that the more recent literature takes into account. McNeill 2010 looks at three centuries of yellow fever and malaria across the “greater Caribbean,” arguing that understanding the region is impossible without taking into account these two diseases, which have been responsible for patterns of development and instrumental in determining various military campaigns. For Espinosa 2009, yellow fever is essential for understanding Caribbean history and diplomatic relations between Cuba and the United States. The regional impact of yellow fever was also evident, Humphreys 1992 demonstrates, in the American South, where epidemics appeared regularly as economic development, commercial connections with the Caribbean, and urbanization grew apace from the late 18th and throughout the 19th century. Delaporte 1991, concerned with nationalism, scientific rivalry, and medical breakthrough, shifts the focus to discovery of the mosquito vector and thus to the cause, rather than the effect, of yellow fever. Packard 2007 is less concerned with how malaria has affected historical events than how people across time and space have attempted to control, and even eradicate, malaria. Snowden 2006 looks at Italy and shows how malaria became a crucible for the modern Italian state; by ridding the country’s poor and underdeveloped south of malaria, Italy could become fully modern. Yellow fever did not solely strike the tropics, as Coleman 1987 makes clear.

  • Coleman, William. Yellow Fever in the North: The Methods of Early Epidemiology. Madison: University of Wisconsin Press, 1987.Save Citation »Export Citation »E-mail Citation »By contrasting the explanation of two outbreaks in the 1860s—one in France, the other in Wales—with an epidemic in Gibraltar in the 1820s, Coleman illustrates the emergence of new ways of seeing and understanding the disease. Especially important was tracing the path yellow fever had traveled in order to demonstrate its exotic and not local origins.Find this resource:
  • Delaporte, François. The History of Yellow Fever: An Essay on the Birth of Tropical Medicine. Translated by Arthur Goldhammer. Cambridge, MA: MIT Press, 1991.Save Citation »Export Citation »E-mail Citation »Short, thoughtful book on the ways in which medical and scientific breakthroughs are made. Argues that Carlos Finlay, the Cuban, and Walter Reed, the American, deserve less credit than they have been accorded by historians interested in lauding one country or another’s contribution; the cast responsible for tackling yellow fever was far larger.Find this resource:
  • Espinosa, Mariola. Epidemic Invasions: Yellow Fever and the Limits of Cuban Independence, 1878–1930. Chicago: University of Chicago Press, 2009.DOI: 10.7208/chicago/9780226218137.001.0001Save Citation »Export Citation »E-mail Citation »Controlling yellow fever’s travels from Cuba to the US mainland was a priority. Once controlled, Cuba needed to keep it at bay or risk losing independence as the Americans would not risk the return of yellow fever. Diplomacy and disease in equal measure.Find this resource:
  • Humphreys, Margaret. Yellow Fever and the South. New Brunswick, NJ: Rutgers University Press, 1992.Save Citation »Export Citation »E-mail Citation »Traces evolving ideas regarding transmission of the disease, its effects on commerce, and its role in pushing the federal government into the business of public health.Find this resource:
  • McNeill, J. R. Mosquito Empires: Ecology and War in the Greater Caribbean, 1620–1914. Cambridge, UK: Cambridge University Press, 2010.DOI: 10.1017/CBO9780511811623Save Citation »Export Citation »E-mail Citation »Mosquitoes, yellow fever, and malaria were responsible for much of Caribbean history, from the partial immunity of African slaves, making it possible for them to survive, to the building of the Panama Canal. They stymied plans time and again, as when Creole revolutionaries with partial immunity were able to defeat European forces with almost none in places such as Haiti.Find this resource:
  • Packard, Randall M. The Making of a Tropical Disease: A Short History of Malaria. Baltimore: Johns Hopkins University Press, 2007.Save Citation »Export Citation »E-mail Citation »Global history of malaria control focused on how the disease has become a disease of poverty and the tropics. Contrasts two methods of control: technologically based vector control, always in search of a magic bullet, and socially based control, rooted in poverty reduction. Essential reading for the history of malaria.Find this resource:
  • Snowden, Frank M. The Conquest of Malaria: Italy, 19001962. New Haven, CT: Yale University Press, 2006.Save Citation »Export Citation »E-mail Citation »Country once plagued by malaria knows it no longer. Through a series of well-organized, sustained efforts—a combination of marsh draining, quinine in the early 20th century, and DDT spraying in 1940s and 1950s—Italy rid itself of malaria. WHO used Italy’s success with malaria control as inspiration to try the same on a global scale.Find this resource:


Cholera is a disease that has been well studied by historians and, like the plague before it, an archetypal example of an epidemic disease. Cholera was pandemic in the 19th century; six separate epidemics, of varying severity and scope, insured that the entire century was plagued by cholera. By the end of the 19th century, cholera was no longer a problem in North America; Europe saw its last serious epidemic in Naples, Italy in 1911. Cholera, however, has not disappeared. We are now in the midst of the seventh global pandemic. Historians have looked at cholera to help explain the rise of the state, examine social and class relations, investigate theories regarding disease susceptibility, explore the rise of public health, track the emergence of the germ theory of disease, and unearth changing ideas on disease prevention, among other things. Cholera was epidemic at a time of great change and upheaval in global history. Transportation and trade networks were becoming ever more complex, for example, and disease could spread far and wide quickly. Because of its global reach, efforts to control cholera spawned an era, in which we still inhabit, of “medical internationalism.” The literature on cholera dates back some decades, and while older work has not necessarily been superseded by subsequent work, the rich historiography is readily acknowledged and discussed in the books below. Hamlin 2009 is an overview that manages to be historical, historiographical, and biological and should be read as a companion to all other work on the disease. Many historians have written about cholera in 19th- and early-20th-century Europe. Snowden 1995 looks at Naples as it confronted two major epidemics, revealing much about Italian society and politics. Baldwin 1999, a comparative look at several epidemic diseases across western Europe, and Evans 2005, an examination of Hamburg, both detail state and popular responses to cholera—from doing virtually nothing to becoming quite active—while charting changing ideas concerning contagion. Rosenberg 1987 looks at three American epidemics and is similar in focus. Echenberg 2011 shifts the focus to Africa and looks at all seven cholera epidemics as they wreaked havoc in different parts of Africa. Bynum 1993 looks at the emergence of “medical internationalism” as cholera drifted around the world during the 19th century; coordinated efforts at control, as well as diplomatic maneuvering, became necessary.

  • Baldwin, Peter. Contagion and the State in Europe: 1830–1930. Cambridge, UK: Cambridge University Press, 1999.DOI: 10.1017/CBO9780511497544Save Citation »Export Citation »E-mail Citation »Baldwin examines varying degrees of state intervention: quarantine to cordons sanitaires to sanitation reforms. Responses to cholera varied and changed over time. Introduces “geoepidemiology”; a given city or country’s place in space will determine the course of disease. Not to be confused with geographic determinism, a much more rigid concept.Find this resource:
  • Bynum, William. “Policing Hearts of Darkness: Aspects of the International Sanitary Conferences.” History and Philosophy of the Life Sciences 15.3 (1993): 421–434.Save Citation »Export Citation »E-mail Citation »Traces the origins of internationalization of medicine through the series of conferences convened around the globe to deal principally with cholera. Delegates worried about the pilgrimage to Mecca, the effects of quarantine on commerce, and from where cholera came; of great import, contentiously debated, was the method by which cholera was transmitted.Find this resource:
  • Echenberg, Myron. Africa in the Time of Cholera: A History of Pandemics from 1817 to the Present. Cambridge, UK: Cambridge University Press, 2011.DOI: 10.1017/CBO9780511976599Save Citation »Export Citation »E-mail Citation »Examines all seven pandemics; principally concerned with the seventh, beginning in 1961. Despite being less virulent, the seventh epidemic has had a devastating effect in Mozambique and Congo due to destabilization and collapse of medical systems. Highlights the importance and success of oral rehydration therapy, also the failure to provide ready access to clean water.Find this resource:
  • Evans, Richard J. Death in Hamburg: Society and Politics in the Cholera Years. New York: Penguin, 2005.Save Citation »Export Citation »E-mail Citation »Originally published by Oxford University Press, 1987. Detailed look at 1892 cholera epidemic; much background from earlier decades and previous epidemics. Throws into relief debates over the method by which cholera is spread, the proper response to the disease, the power of ignorance over action, free-market ideology versus state action, the disproportionate effect on the poor, and class politics.Find this resource:
  • Hamlin, Christopher. Cholera: The Biography. Oxford: Oxford University Press, 2009.Save Citation »Export Citation »E-mail Citation »Meanings of cholera are given nuanced treatment. Cholera “has been an axis of difference, a means for distinguishing places and races as clean or dirty, and a vehicle for despising others” (p. 56). For decades after Koch’s discovery of Vibrio cholera in the late 19th century, the disease’s identity was assumed solid; it is now clear that its identity is more complex. Benefits from scientific work done on cholera unavailable to previous authors.Find this resource:
  • Rosenberg, Charles E. The Cholera Years: The United States in 1832, 1849, and 1866. Chicago: University of Chicago Press, 1987.DOI: 10.7208/chicago/9780226726762.001.0001Save Citation »Export Citation »E-mail Citation »Originally published 1962. Focused largely on New York City. Three different epidemics and three different ways of seeing cholera. In 1832, for example, catching cholera was seen as a consequence of sinful action; by 1866, poor sanitation was at fault.Find this resource:
  • Snowden, Frank M. Naples in the Time of Cholera, 1884–1911. Cambridge, UK: Cambridge University Press, 1995.DOI: 10.1017/CBO9780511582233Save Citation »Export Citation »E-mail Citation »Naples reacted differently to cholera in two epidemics. In 1884, authorities quarantined people, and the public revolted; in 1911, when cholera returned to ostensibly modern Naples, authorities, including the Italian prime minister, and the public made every effort to keep cholera a secret, preferring not to upset commerce or embarrass Italy’s reputation as a modern state.Find this resource:


The global influenza pandemic of 1918–1920, washing over the world in three waves, was likely the single most devastating disease outbreak in human history: a recent estimate in Johnson and Mueller 2002 puts the death toll at fifty million. The historiography has become quite rich, with historians looking at its effects in, for example, India, America, Great Britain, Africa generally, and Iran. Barry 2004 comprehensively covers the epidemic but also uses the occasion to discuss the modernization of American medicine and biomedical research. Crosby 2003 pioneered the field more than a generation ago and remains influential and important. Heaton and Falola 2006, in its examination of the historiography on Africa, argues that work on the pandemic is either too global and thus flattens the experience of flu or too local and thereby has no basis for comparison or synthesis; the work urges historians to synthesize. The sixteen diverse essays in Phillips and Killingray 2003 are an excellent introduction to the local and global impacts of the disease in Europe, North America, Asia, and Africa as well as a guide to its epidemiology, genetics, and virology. While there was suffering and death everywhere the flu visited, some places were harder hit than others; Afkhami 2003 and Mills 1986 detail the massive population loss and demographic effects in Iran and India, respectively. On the western Pacific island of Samoa, the devastation was even worse, Tomkins 1992 argues.

  • Afkhami, Amir. “Compromised Constitutions: The Iranian Experience with the 1918 Influenza Pandemic.” Bulletin of the History of Medicine 77.2 (2003): 367–392.DOI: 10.1353/bhm.2003.0049Save Citation »Export Citation »E-mail Citation »Shows that the pandemic arrived in Iran at a time when the country was already experiencing war, famine, and other diseases such as malaria. These conditions compounded influenza. Available online by subscription.Find this resource:
  • Barry, John M. The Great Influenza: The Epic Story of the Deadliest Plague in History. New York: Penguin, 2004.Save Citation »Export Citation »E-mail Citation »Comprehensive narrative history. Concerned with the pandemic as well as the professionalization of American medicine. Looks at medical research before and after the pandemic; argues that the pandemic gave biomedical research a boost.Find this resource:
  • Crosby, Alfred W. America’s Forgotten Pandemic: The Influenza of 1918. Cambridge, UK: Cambridge University Press, 2003.DOI: 10.1017/CBO9780511586576Save Citation »Export Citation »E-mail Citation »Originally published as Epidemic and Peace, 1918 by Cambridge University Press in 1976. First scholarly effort looking at America’s experience. Influential. Considers mortality and diplomacy.Find this resource:
  • Heaton, Matthew, and Toyin Falola. “Global Explanations versus Local Interpretations: The Historiography of the Influenza Pandemic of 1918–19 in Africa.” History in Africa 33 (2006): 205–230.DOI: 10.1353/hia.2006.0014Save Citation »Export Citation »E-mail Citation »Looks at a variety of themes in studies of the pandemic such as demographic effects, the response of governments, and cultural impacts. Calls for more research on the longer-term impacts of the pandemic rather than just the experience of it or its immediate impact. Available online for purchase or by subscription.Find this resource:
  • Johnson, Niall P. A. S., and Juergen Mueller. “Updating the Accounts: Global Mortality of the 1918–1920 ‘Spanish’ Influenza Pandemic.” Bulletin of the History of Medicine 76 (2002): 105–120.DOI: 10.1353/bhm.2002.0022Save Citation »Export Citation »E-mail Citation »Estimates that fifty million died worldwide; suggests that even this number might be too low—perhaps by half. Discusses problems with research such as underreporting, missing data, and others. Useful charts to see differential mortality. For example, the recalculated death rate for Sri Lanka was 17.9 per one thousand, while it was 1.7 per one thousand for the Philippines. Available online for purchase or by subscription.Find this resource:
  • Mills, Ian D. “The 1918–1919 Influenza Pandemic: The Indian Experience.” Indian Economic and Social History Review 23.1 (1986): 1–40.DOI: 10.1177/001946468602300102Save Citation »Export Citation »E-mail Citation »Demonstrates, among other things, that the flu had a particularly profound effect on people, especially women, in the twenty-to-forty age range; this was a departure from other epidemics and had, coupled with concomitant malnutrition and famine, an effect on birthrates. Available online for purchase or by subscription.Find this resource:
  • Phillips, Howard, and David Killingray. The Spanish Influenza of 191819: New Perspectives. London: Routledge, 2003.Save Citation »Export Citation »E-mail Citation »Wide array of essays on the pandemic in places such as Australia, China, Spain, and Tanzania, among others. Concerned with demographic impact, official responses, long-term consequences, virology, genetics, and epidemiology. Of special note is the comprehensive, country-by-country bibliography.Find this resource:
  • Tomkins, Sandra M. “The Influenza Epidemic of 1918–19 in Western Samoa.” Journal of Pacific History 27.2 (1992): 181–197.DOI: 10.1080/00223349208572706Save Citation »Export Citation »E-mail Citation »Up to one-third of the population perished, altering family and social structures. Medical expertise proved central to maintaining European authority. Quarantine was not attempted; thus, the epidemic was much worse than it could have been. Protests of Western Samoans led to a better postepidemic system of communication for notification of diseases—something lacking entirely as flu made its way to the island. Available online for purchase or by subscription.Find this resource:

Colonialism and Epidemics

Epidemic disease in the colonial worlds of Africa and South Asia is a rich field of inquiry. Historians have, in broad terms, followed several paths, at times distinct, at times overlapping: the role of colonialism in creating the conditions for epidemic disease, the colonial powers’ responses to epidemics, the effects of epidemic disease on colonized peoples, the rise of tropical medicine as a specialty, and the clash between local systems of medical knowledge and those of outsiders. Two overviews are good places to start: Arnold 1988, a pioneering edited volume, and Watts 1997, a survey of Western and non-Western responses to epidemics. Some historians have explored specific diseases, while others have looked at particular places. Packard 2007, on malaria, takes the former approach. Arnold 1993, through an exploration of state responses to cholera, plague, and smallpox in colonial India, and De Bevoise 1995, on the colonial Philippines, take the latter approach. Similarly, Gallagher 1984 and Gallagher 1990 have carefully examined the responses to cholera and plague in examinations of 19th-century Tunisia and 20th-century Egypt, respectively. (Other entries cover topics, such as plague, HIV, influenza, and cholera, that had a powerful effect in the colonial world. They are not covered here.)

  • Arnold, David. Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-Century India. Berkeley: University of California Press, 1993.Save Citation »Export Citation »E-mail Citation »An essential book discussing the relationship between the evolution of the colonial system in India and the “accumulation of medical knowledge about the body” (p. 8). Deals with coercion and resistance to state-imposed medical practices such as vaccination and quarantine.Find this resource:
  • Arnold, David, ed. Imperial Medicine and Indigenous Societies. Manchester, UK: Manchester University Press, 1988.Save Citation »Export Citation »E-mail Citation »A uniformly readable and influential collection of essays ranging from influenza in Rhodesia to smallpox in India.Find this resource:
  • De Bevoise, Ken. Agents of the Apocalypse: Epidemic Disease in the Colonial Philippines. Princeton, NJ: Princeton University Press, 1995.Save Citation »Export Citation »E-mail Citation »The disruptions of colonialism—new land use patterns, famine—and then the Philippine–American War were directly responsible for an increase in epidemic diseases such as smallpox, cholera, beriberi, and malaria.Find this resource:
  • Gallagher, Nancy. Medicine and Power in Tunisia: 1780–1900. Cambridge, UK: Cambridge University Press, 1984.Save Citation »Export Citation »E-mail Citation »Study of the clash between Islamic medicine and Western medicine vis-à-vis French colonialism, cholera, and plague in Tunisia. By late in the 19th century, Western medicine had eclipsed Islamic.Find this resource:
  • Gallagher, Nancy. Egypt’s Other Wars: Epidemics and the Politics of Public Health. Syracuse, NY: Syracuse University Press, 1990.Save Citation »Export Citation »E-mail Citation »To become modern, Egypt needed to develop its own public health infrastructure in the face of epidemics of malaria, cholera, and relapsing fever. This happened during the height of nationalism and anticolonialism.Find this resource:
  • Packard, Randall M. The Making of a Tropical Disease: A Short History of Malaria. Baltimore: Johns Hopkins University Press, 2007.Save Citation »Export Citation »E-mail Citation »Mostly, but not entirely, focused on the colonial and postcolonial world, Packard demonstrates that malaria was and is both epidemic and endemic in places such as southern Africa, parts of India, and Brazil under colonial conditions of production and land use. Living and labor conditions in such places prevented many from “growing out of malaria” as had happened in the American South and Italy.Find this resource:
  • Watts, Sheldon. Epidemics and History: Disease, Power, and Imperialism. New Haven, CT: Yale University Press, 1997.Save Citation »Export Citation »E-mail Citation »Shows how epidemic disease highlighted and exacerbated the power differential between imperial powers and their subjects. Discussion covers a range of pandemics, including the plague in the West and the Middle East from the 14th-century Black Death to the 19th century, along with yellow fever and malaria in the 20th century. Development (with a capital “D”) is responsible for the unequal distribution of epidemics and poor health in general. Useful for its scope and its references.Find this resource:

Sleeping Sickness

Sleeping sickness, or trypanosomiasis, is a parasitic disease caused by the bite of the tsetse fly. It is endemic, and at times epidemic, in much of sub-Saharan Africa. It was the focus of both significant scientific research and control efforts by the colonial powers. Because epidemic sleeping sickness coincided with and was arguably caused by the effects of colonialism in parts of Africa, the disease has generated a body of significant historical work. Investigating sleeping sickness has been a means for historians to look at the ways in which different colonial powers attempted to control the disease and the people it affected; the rise of tropical medicine as a field; and the impact of colonial policy on land use, ecology, and human settlement. The magnum opus Ford 1971 surveyed the continent for a comprehensive look at the disease; it is both historical and ecological. Hoppe 2003 focuses on East Africa and the British, while Worboys 1994 compares the policies of Britain, Germany, and, following Lyons 1992, Belgium. Tilley 2004 focuses on scientific research on sleeping sickness between the World Wars.

  • Ford, John. The Role of the Trypanosomiases in African Ecology: A Study of the Tsetse Fly Problem. Oxford: Clarendon, 1971.Save Citation »Export Citation »E-mail Citation »Massive and influential, argues that colonialism was directly responsible for the spread of sleeping sickness in the late 19th and early 20th century. Controversially argues that Africans had achieved equilibrium between animals, humans, and the natural environment in precolonial times.Find this resource:
  • Hoppe, Kirk. Lords of the Fly: Sleeping Sickness Control in British East Africa, 1900–1960. Westport, CT: Praeger, 2003.Save Citation »Export Citation »E-mail Citation »Details the policy and practice of environmental manipulation as the British attempted to separate, through large-scale resettlement, people and their domestic livestock from wild animals. The British tried to control people and the environment as opposed to attempting vector, or tsetse fly, control.Find this resource:
  • Lyons, Maryinez. The Colonial Disease: A Social History of Sleeping Sickness in Northern Zaire, 1900–1940. Cambridge, UK: Cambridge University Press, 1992.DOI: 10.1017/CBO9780511583704Save Citation »Export Citation »E-mail Citation »Focuses on Belgian Congo, where colonial officials attempted to control sleeping sickness through rigid forms of social control, especially cordons sanitaires. Lazarets in which Belgians kept Congolese to restrict movement into potential sleeping sickness zones came to be seen as extreme forms of repression akin to forced labor.Find this resource:
  • Tilley, Helen. “Ecologies of Complexity: Tropical Environments, African Trypanosomiasis, and the Science of Disease Control in British Colonial Africa, 1900–1940.” Osiris 19 (2004): 21–38.DOI: 10.1086/649392Save Citation »Export Citation »E-mail Citation »Explores internationalization of medical research, along with emerging ideas about the ecology of disease suggesting that the control of epidemic disease would never depend on one element alone but on a multiplicity of factors. For a fuller treatment of medical research in Africa, see Helen Tilley’s Africa as a Living Laboratory: Empire, Development, and the Problem of Scientific Knowledge, 18701950 (Chicago: University of Chicago Press, 2011). Available online for purchase or by subscription.Find this resource:
  • Worboys, Michael. “The Comparative History of Sleeping Sickness in East and Central Africa.” History of Science: An Annual Review of Literature, Research, and Teaching 32 (1994): 89–102.Save Citation »Export Citation »E-mail Citation »Concise, expert introduction to the varying ways in which colonial powers approached the disease, from vector control to large-scale social engineering to environmental manipulation, all in an effort to eradicate the tsetse fly. None worked.Find this resource:

American Indians and Epidemics

Historical work on American Indians and epidemic disease is a distinguished body of literature. The subject has not only attracted specialists; it has also been of great interest to historians of epidemics and disease generally. It has been a subject of inquiry for many decades; much of the classic work is cited in the works discussed. All of the books in General Overviews discuss American Indians and epidemics and place them into a larger, global narrative. The work on American Indians highlighted here is largely on the contact-era epidemics and the resulting demographic collapse and subsequent smallpox epidemics—particularly several that ravaged the American West between the late 18th century and the middle of the 19th century. Jones 2004 covers the colonial period through the 1950s using a series of case studies; its time depth, and thus its comparative aspect, makes it unique. Indians’ unique susceptibility to disease has made them, according to Crosby 1976, “virgin soil” for epidemic disease. But Jones 2003, by both an medical doctor and a historian, makes clear that innate immunity is a complex subject outside the expertise of many historians. Following Jones, Kelton 2007 argues that the effect of the early Indian slave trade and the associated social disruption of colonialism, and not innate susceptibility to disease, were the cause of massive southeastern Indian population collapse in the face of epidemic disease. Equally sophisticated in its use of primary sources and in its ethnohistorical methodology is Boyd 1999, a treatment of the effects of epidemics in the Pacific Northwest from the 1770s to the 1870s. Smallpox also had an enormous impact on the Great Plains, nearly wiping out the Mandan and Hidatsa in two epidemics in the 1780s, reconfiguring Comanche–Spanish relations from the 1780s on; numerous groups in the Pacific Northwest were also devastated. Fenn 2001 details these events. Epidemics ravaged populations across the Americas. Cook and Lovell 1991, a wide-ranging collection, surveys Central and South America during the colonial period and offers historical as well as methodological insights. Debate over the size of the precontact population of the Americas and subsequent effects of epidemics on population decline has been going on for generations. Mann 2005 offers a neutral assessment of the arguments accessible to a lay audience as well as discussing the history and importance of the debate.

  • Boyd, Robert T. The Coming of the Spirit of Pestilence: Introduced Infectious Diseases and Population Decline among Northwest Coast Indians, 1774–1874. Vancouver, BC: University of Vancouver Press, 1999.Save Citation »Export Citation »E-mail Citation »Estimates that up to 90 percent of the precontact population was struck down by epidemic disease. Considers the effects of population loss on religious ritual, subsistence practices such as whaling, and the emergence of new power structures.Find this resource:
  • Cook, Noble David, and W. George Lovell. “Secret Judgments of God”: Old World Disease in Colonial Spanish America. Norman: University of Oklahoma Press, 1991.Save Citation »Export Citation »E-mail Citation »Eight essays ranging from Mexico to southern Chile from contact through the 18th century. Woodrow Borah’s introduction is an excellent guide to the field; discusses methodological problems and poses questions for future research.Find this resource:
  • Crosby, Alfred. “Virgin Soil Epidemics as a Factor in the Aboriginal Depopulation of America.” William and Mary Quarterly 33.2 (1976): 289–299.DOI: 10.2307/1922166Save Citation »Export Citation »E-mail Citation »Influential article arguing that Indians’ unique susceptibility to Old World diseases explains, in part, population decline. Not as determinist as subsequent historians have portrayed it; the “genetic weakness hypothesis” is unsustainable. Urged that factors like malnutrition be considered in assessments of susceptibility. Available online for purchase or by subscription.Find this resource:
  • Fenn, Elizabeth. Pox Americana: The Great Smallpox Epidemic of 1775–82. New York: Hill & Wang, 2001.Save Citation »Export Citation »E-mail Citation »Places the smallpox epidemic in a continental context and demonstrates its effects on American Indian demography and diplomacy.Find this resource:
  • Jones, David S. “Virgin Soils Revisited.” William and Mary Quarterly 60.4 (2003): 703–742.DOI: 10.2307/3491697Save Citation »Export Citation »E-mail Citation »Takes historians to task for too easily accepting the idea of innate susceptibility to disease, resulting in the notion that Indian population loss was inevitable and natural and not the result of historical processes. Does not suggest that epidemics were purposeful events; wants historians to look at the totality of reasons for susceptibility to disease. Available online for purchase or by subscription.Find this resource:
  • Jones, David S. Rationalizing Epidemics: Meanings and Uses of American Indian Mortality since 1600. Cambridge, MA: Harvard University Press, 2004.Save Citation »Export Citation »E-mail Citation »From contact-era epidemics to smallpox on the Great Plains to the Navajo experience with tuberculosis in the 20th century, a sophisticated look at disease in different places and times. Intellectual and medical history.Find this resource:
  • Kelton, Paul. Epidemics and Enslavement: Biological Catastrophe in the Native Southeast, 1492–1715. Lincoln: University of Nebraska Press, 2007.Save Citation »Export Citation »E-mail Citation »Detailed study of ways in which colonial slave trade in Virginia and South Carolina disrupted subsistence patterns, created crowded living conditions, wreaked havoc on sanitation, increased warfare, and generally produced all the ingredients necessary for epidemic disease, especially the so-called Great Southeastern Smallpox epidemic of 1696–1700, to flourish.Find this resource:
  • Mann, Charles C. 1491: New Revelations of the Americas before Columbus. New York: Knopf, 2005.Save Citation »Export Citation »E-mail Citation »Offers a wide-ranging, highly readable account of the Americas on the eve of discovery and shortly thereafter. Guides readers through difficult scientific data on population, disease, and other matters. Sensitive to scholarly debates; the most comprehensive synthesis available.Find this resource:


While still a young disease, HIV/AIDS has been with us long enough to have developed a small but robust historiography. There is a massive and ever-growing social science and scientific literature on HIV/AIDS. The work on the history of AIDS is, by contrast, much easier to manage. Despite the disease having only emerged onto the world stage since the 1980s, its history dates back to the turn of the 20th century, and several works account for this. Much historical work on the disease is general in scope and based not on archival sources but on published medical research, newspapers and other kinds of journalism, and interviews. We do not yet have fine-grained social histories, for example, of HIV/AIDS; nor are there works that examine policy machinations at places like the World Health Organization, for instance. This will change as time moves on and archives begin to open. The overview Engel 2006 is a good place to start for a general history of AIDS, though its primary focus is the United States. Hooper 1999, a controversial book on the origin of AIDS, is still unsurpassed in detail but must be read in conjunction with more recent work such as Pepin 2011Baldwin 2005 and Berridge 1996 examine European state responses to the epidemic, while Behrman 2004 offers a detailed examination of the slow US response to the global pandemic. Africa’s encounter with HIV/AIDS is covered in Iliffe 2006Oppenheimer and Bayer 2007, an oral history, hones in on South Africa. None of these titles adequately address the extraordinary rise in tuberculosis as a result of HIV.

  • Baldwin, Peter. Disease and Democracy: The Industrialized World Faces AIDS. Berkeley: University of California Press, 2005.Save Citation »Export Citation »E-mail Citation »The author uses his considerable knowledge of state responses to diseases such as cholera and smallpox, as noted in Baldwin 1999 (cited under Cholera), to examine historical antecedents to various state responses to AIDS. He shows that different countries reacted differently, employing more or less restrictive policies, and argues that this has much to do with their past practices.Find this resource:
  • Behrman, Greg. Invisible People: How the U.S. Has Slept through the Global AIDS Pandemic, the Greatest Humanitarian Catastrophe of Our Time. New York: Free Press, 2004.Save Citation »Export Citation »E-mail Citation »Written before George Bush introduced PEPFAR (President’s Emergency Plan for AIDS Relief); a scathing look at US policy toward AIDS outside the country during the 1980s and 1990s. Depressing account of missed opportunities and bureaucracies moving slowly.Find this resource:
  • Berridge, Virginia. AIDS in the UK: The Making of a Policy, 1981–1994. New York: Oxford University Press, 1996.Save Citation »Export Citation »E-mail Citation »Chronicles four phases of British reaction to AIDS and argues that throughout, Britain favored protecting individual rights. Looks exclusively at policymaking and policymakers and the political, not social or cultural, response to AIDS.Find this resource:
  • Engel, Jonathan. The Epidemic: A Global History of AIDS. New York: Smithsonian-HarperCollins, 2006.Save Citation »Export Citation »E-mail Citation »Looks at early reactions to the disease; activism; pharmaceutical research; cultural politics. Mostly about the United States with discrete chapters on Africa and Asia.Find this resource:
  • Hooper, Edward. The River: A Journey to the Source of HIV and AIDS. Boston: Little, Brown, 1999.Save Citation »Export Citation »E-mail Citation »At more than one thousand pages, a thorough, and controversial, examination of just where AIDS came from. Despite one of its central claims—that AIDS spread through needles infected by polio researchers in the 1950s—having been debunked, this is a valuable book on medical research.Find this resource:
  • Iliffe, John. The African AIDS Epidemic: A History. Athens, OH: Ohio University Press, 2006.Save Citation »Export Citation »E-mail Citation »Densely packed, though very readable, history of AIDS as it marched across Africa. Examines its geographical spread, the responses of politicians and the public, and its impact on communities. A model of concision; essential reading.Find this resource:
  • Oppenheimer, Gerald M., and Ronald Bayer. Shattered Dreams? An Oral History of the South African AIDS Epidemic. New York: Oxford University Press, 2007.Save Citation »Export Citation »E-mail Citation »Accounts from doctors and nurses involved from the beginning. Invaluable for learning about the experience of AIDS, missing from most of the other books in this section. The migrant labor system, apartheid, and other forms of social inequality help explain AIDS in South Africa. Covers rollout of life-saving antiretroviral therapy as well as Thabo Mbeki’s controversial views on AIDS.Find this resource:
  • Pepin, Jacques. The Origins of AIDS. Cambridge, UK: Cambridge University Press, 2011.DOI: 10.1017/CBO9781139005234Save Citation »Export Citation »E-mail Citation »Best read in conjunction with Iliffe 2006. Benefits from recent findings in genetics and argues that AIDS emerged out of central Africa early in the 20th century when it made the leap from chimpanzees to humans. HIV remained at a low level for many years. Mass vaccine campaigns in the 1930s in central Africa turned up the heat, as did increasing urbanization and ease of transportation.




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