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Plague Legends

Plague Legends is a fascinating contribution to the history of medicine. Its novelty lies in a delicate interweaving of concepts of disease derived from theological beliefs and those based on what would be regarded – even in contemporary terms – as scientific evidence. Particularly fascinating is the discussion of ideas of contagion formulated by the Italian physician Girolamo Fracastoro in the 1500s and largely dismissed out of hand by his contemporaries and much of the medical community of the following century. This reception occurred despite the fact that much of what Fracastoro proposed is now part of the accepted canon of knowledge about the nature and transmission of infectious diseases. This work stood in stark contrast to the influential views of Thomas Sydenham in England more than a century later. Sydenham put forth the erroneous notions of epidemic constitution of the atmosphere, a set of ideas that held up epidemiological progress for 150 years.

Litsios’ profiles and interpretations of the 18th and 19th century outbreaks of bubonic plague, smallpox, tuberculosis, yellow fever, cholera, and malaria are masterful. Indeed, anyone who wants to understand the complex evolution of ideas pertaining to the major diseases of past centuries and their relationship to evolving levels of evidence, linked to measurement techniques, would be well-advised to read this book and independently track down original sources. Although measurement with complex instrumentation is taken for granted in modern times, it was a novelty in need of careful defense when introduced by William Harvey in the 1600s.

The treatment of the emergence of Public Health in the 18th and 19th centuries in response to the evidence that poverty and disease went hand-in-hand is succinct and to the point. This history seems to be almost invisible in the modern literature focused on inverse associations between social class and health. Plague Legends provides a much needed institutional perspective on this topic. The entire book would be a very useful required volume in courses on the history of medicine. Perhaps more importantly, it should be read and discussed by students in schools of public health, where a deeper understanding of the origins of Public Health as a profession and as a broad set of academic topics would be highly desirable.

The author, Socrates Litsios, while claiming to be an amateur historian displays all the characteristics of a practiced professional. His previous book, The Tomorrow of Malaria, clearly displays the author’s depth of thought, thoroughness of investigation, and engaging writing style. Plague Legends continues this tradition. It is indeed a very useful and insightful introduction to the complex history of ideas surrounding notions of contagion, the transmission of infectious diseases, and Public Health in both historical and modern settings.

Burton Singer
Charles and Marie Robertson Professor of Public and International Affairs
Princeton University

Old beliefs die hard. This history of society’s war against infectious disease charts the long struggle against plagues of many kinds, and presents a fascinating view of how human beliefs both shaped and distorted responses. Dr. Litsios succeeds in capturing the excitement of each new discovery, uncovering link after link in the chain of causation. Yet he can also rouse our sympathy for the fears which attended every fresh outbreak of unmanageable disease, through the skilful use of contemporary witness documents. This historic view is rounded out by an epilogue in which Dr Litsios examines our current thinking on epidemic disease, and our mechanisms for handling it. The book is clearly the fruit of long reflection and personal experience in public health care. It also sounds a timely warning on the intimate linkages between environmental matters and the spread of disease, bringing us full circle to appreciate the complexities of the issues concerned.

At a time when disease is feared once more as an agent of warfare and destruction, this book sets our fears in context and offers valid models for discussion and understanding in a highly emotive field.

Valery Rees, MA (Cantab)
School of Economic Science, London