Plagues in World History Read Online Free PDF Page A

historians, I am not talking here merely about efforts to redefine the concept of disease but rather about the very practical effects that cultural attitudes toward disease can have in allowing a society to either succumb to or triumph over disease epidemics. These cultural responses to disease are even more important now that modern society has come to realize its limitations in terms of being able to medically cure or thwart challenging new pandemics, such as AIDS. I also will seek in the following pages to go beyond the more obvious impacts humans can have on disease incidence, such as through medicine, imperialism, or bioterrorism, even though these inevitably will be part of the story.43
    By no means do I claim to be opening up unheard of or unprecedented vistas in the history of disease. After al , it was Thucydides who first noticed how humans themselves could alter the course of a plague, such as by succumbing to despair at the very idea of getting the disease or by neglecting to nurse patients, thus hasten-ing or assuring their demise, even if he did not realize the larger implications of these observations.44 We all know, instinctively, that psychosomatic disorders can happen, willing ourselves into suffering simply by dwelling upon it. (Medieval doctors rather poetically diagnosed psychosomatic disorders as “accidents of the soul.”) But I do claim to be expanding considerably upon this idea of humans’
    impact upon disease and to be addressing it in a more comprehensive way than ever before. Readers may also find that I am rather more hopeful than other recent writers about disease with regard to humankind’s future in fighting epidemics.
    Obviously, then, how a society or civilization perceives disease determines how it will respond to it, whether this be at the popular level or at the level of au-thoritative elites, and in terms of al the manifestations of the various social, economic, political, religious, or artistic aspects of this response. But at the same time, I also believe that what the disease is matters, in terms of establishing a clearly recognizable, biomedical identity.45 Yet, the complexities of the historical evidence are such that some throw up their hands in despair of ever definitively identifying the epidemics of the past. Certain historians of disease now take the position that it is futile or even wrong to attempt to match up a historical epidemic with a modern definition of a particular il ness, on the grounds that the present “laboratory” understanding of disease based on the germ theory is so different from how our distant ancestors approached their own, elusive “plagues.”46
    To my mind, this is nothing less than an intellectual cop-out, or perhaps defeatism, that is hardly justified by any supposed lack of concordance of symptoms. On the contrary, in some cases, particularly as the evidence becomes much

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    fuller beginning with the Black Death of the late Middle Ages, premodern doctors and other authorities writing on the subject are able to give quite convincing diagnoses of a given disease. The Moorish physician Ibn Khātima, who authored a plague treatise in February 1349, gives an impressive symptomology, complete with case studies, of the three forms of bubonic, pneumonic, and septicemic plague, while his predecessor, the ninth-century Persian doctor Muhammad ibn Zakariyā al-Rāzī (known as Rhazes in the West), is able to clearly differentiate between smallpox and measles through a detailed analysis of their respective symptoms. And it was the sixteenth-century Venetian physician, Girolamo Fracastoro, who was the first to name and identify syphilis, as well as typhus. But even when premodern observers describe symptoms that are fantastic or that little accord with the “scientific” diagnoses of nowadays, having an “objective” or “ontological” definition of disease may still be helpful in understanding how our ancestors approached the plagues