Plagues in World History Read Online Free

conceive of it in environmental terms, in which humans through their variegated behaviors alter their disease environment, which in turn adapts to their modifications, and so on in an unending war of mutual attrition; in many respects, this is comparable to how microparasites have adapted to their human and animal hosts, selectively evolving to neither kill them outright nor in turn be eliminated completely. In this way then, human beings can, in effect, create their own sense of just what is a disease. McNeill fully realizes that this can change “the very concept of disease,” making it entirely dependent on social and historical circumstances. As an example, nearsighted-ness and a “dull sense of smell” may be considered perfectly normal in today’s society, but they would have been crippling debilities—indeed a disease—among Paleolithic hunters struggling to survive. However, McNeill rejects a completely relativist approach to disease, preferring to hold onto “a firm and universal nu-cleus to the concept of disease,” one in which “bodily disorder” mainly arises from “parasitic organisms.”30
    Despite McNeill’s reservations, the relativist, or “social constructionist,” approach, which increasingly viewed disease as an endogenous phenomenon arising solely out of factors intrinsic to the society or culture in which it occurs, became more popular among historians, particularly during the 1980s; for it was at that time that the emerging AIDS pandemic seemed to be a perfect illustration of how a disease can be a function of socially risky behaviors.31 Indeed, one historian in this school goes so far as to suggest, perhaps facetiously, that one day harmless skin freckles may be deemed unsightly enough to be classified as a disease, complete with a “National Institute of Freckle Research” devoted to eradicating them.32
    However, if one goes to extremes with such an argument, one wonders what historical statements, if any, can be made about disease, if the very definition of the term is subject to such speculation. It seems that McNeill was right to insist upon a commonsense foundation from which to start a discussion.

Introduction y 11
    McNeill’s other contribution comes at the end of his book, where he speculates about the future of disease history. Despite the fact that Plagues and Peoples came out at the very same time that the World Health Organization was successfully eradicating smallpox, and in stark contrast to traditional views of medical historians that foresaw an “end to epidemics,” McNeill concludes that infectious disease will remain an inseparable part of the history of humanity, indeed, for as long as humanity itself continues to exist. Ironically, he sees the very success of medical treatments of disease as only contributing to its perpetuation. A good example is the rash of polio infections that broke out among even the higher classes of American society in the mid-twentieth century, a circumstance attrib-utable, McNeill insists, to the higher standards of hygiene that wiped out minor infections among children, which earlier had conferred some immunity to more serious, full-blown infections.33 In a new preface written in 1997 to take account of the current AIDS pandemic, McNeill maintained his pessimistic view of humankind’s ability to “conquer” disease, citing the worldwide AIDS crisis as just one more example of how the global transmission of disease was only accelerat-ing the biological evolution and adaptation of microorganisms to their hosts.34
    The efforts of humanity—the “macroparasite”—to wipe out disease were upset-ting the natural balance and, as recent disease history made clear, was only making things worse, not better. This gloomy perspective has been taken up by a host of far less restrained authors who peddle an alarmist, even apocalyptic, scenario where disease in the end conquers humankind, not the other way around.35
    On a very basic level, one