*i.e. Pandemics in perspective—par excellence!
As quoted by the Lancet behind the front cover of this book,
Professor McNeill is an American historian with a sound grasp of epidemiological principles.
As McNeill points out himself in this book (which can be seen immediately in the notes to follow), historians systematically gloss-over the significance of epidemic disease.
In choosing to read Plagues and Peoples third in my sequence of pandemic-themed books, I identified it as the one most complimentary to Daniel Defoe’s A Journal of the Plague Year: for while the latter is “the prototype of all accounts of great cities in times of epidemic”, the former has to be one of, if not the most substantial attempts at a historical interpretation of epidemics (—which is quite distinct from an epidemiological interpretation of history, I would add).
What follows are the complete notes I wrote during my reading of this book (being the somewhat paraphrasing of the original text), presented almost entirely in their original order (except for a few notes that were not directly related to their surrounding ones, which I therefore moved to an Addendum).
The notes are divided into nine Headings (six of which being generalized versions of the book’s Chapter titles); and I have distinguished them from each other by creating summarizing sub-headings in a hierarchical structure (also listed in a table of Contents—which can itself serve as a summary of the key points and concepts I have identified in this book).
Contents
1.1 Historians (and scholars of other fields) systematically mis-contextualize the significance of epidemic disease
1.2 The Parasitic Paradigm pervasive in human life: composed of organism parasites (the microparasitism of diseases) and human parasites (the macroparasitism of human predator groups)
1.2.1 The principle of Equilibrium Patterns in biological and societal organization, producing Systemic Alteration and/or Mutual Adaptation
1.3 The destructiveness of Civilized Diseases in being transmitted to Virgin Populations (i.e. primitive communities)
1.4 The recent rise in importance of Chronic and Debilitating Disease (as opposed to epidemiological disease)
2.1 (i) Parasites thrive in hot climate (ii) Humanity became more liable to disease due to cultural factors (i.e. the transformation of nature)
2.1.1 The inherent instability of Mankind’s relationships due to its proclivity for Virulent Forms of Behaviour [i.e. the ‘Humans-are-a-Virus’ metaphor]
2.2 The customary implementation of essential Population Control Measures
2.3 Increased Population Density as creating the condition for Hyperinfection (i.e. an epidemic)
2.4 (i) Cultural Innovation as being fundamentally disruptive to natural ecology (ii) Ancient hunters were disease-free—unless contacted by civilizing peoples
3.1 Agriculture created the necessity for Political Organization (i.e. protection); and created hyperinfestation by weeds and pests
3.2 The principle of microparasitism (i.e. an epidemic) inviting macroparasitism (i.e. War and Exploitation)
3.3 Infectious Bacteria and Viruses are exclusively Diseases of Civilization
3.4 The parallel between microparasitism and macroparasitism—in Civilized Military Operations and Government
3.5 The Breakdown of Public Order causing Depopulation as a leitmotif of periods of peace and prosperity (i.e. population growth in excess of macroparasitical needs)
3.6 Civilized Disease as a Biological Weapon against Isolated Communities
3.6.1 The Epidemical Decimation of Young Adults as causing the Collapse of Communities
3.6.2 Historians’ overlooking of the bioweapon which civilized peoples have used in War and Raiding
3.7 The Process of Subjugation as analogous to animal digestion (i.e. the assimilation of weaker animals)
4 The Confluence of Civilized Disease
4.1 INDIA: Tropical diseases and parasitic infections of the Indian landscape precluded cultural uniformity and sociological cohesion in India’s civilization
4.1.1 The climatic and consequent microparasitical disparity of China as a formidable problem for Northerners
4.1.2 The microparasitical factor in India’s relative physical, political, and military weakness
4.1.2.1 The transcendental character of Indian religion as having been determined by India’s physical weakness and political passivity (and therefore, by microparasitism)
4.2 MEDITERRANEAN: the Corporate Macroparasitism of the ancient Greeks (as determined by eco-socio-political factors) allowed for relatively disease-free Mediterranean coastlands
4.3 EAST-WEST CONTACT: the opening-up of Movement and Trade (between civilizations) as creating vulnerability to the spread of New Infectious Diseases
4.3.1 The degree of Civilized Development as the determinant of microparasitical (and thus macroparasitical) potency or vulnerability
4.4 The Role of Epidemic Disease in the Fall of Empires
4.4.1 The Historians’ Tradition of emphasizing societal (i.e. macroparasitic) factors to the minimization of epidemiological (i.e. microparasitic) factors in the Fall of the Roman Empire
4.4.2 The disintegration of Roman civilization causing the Inauguration the Dark Ages
4.4.3 The rise of Christianity in the midst of disastrous epidemic—i.e. the Rise of a New Civilization off the back of a disintegrating civilization [Phoenix Society]
4.5 Persistent Plague as a factor in the Shifting of the Balances of Power between civilizations
5 The Shifting of the Balances of Disease
5.1 The Conceit of Modern Medicine (i.e. 20th century) in feigning Scientific Innovation and overstating Medical Effectivity
5.2 The Convergence of Circumstances (i.e. non-epidemic factors) in Major Plagues
5.2.1 The Recurrence and Varying Patterns of Incidence in Major Plagues
5.2.1.1 The effects of the recurrence and irregularity of major plagues
5.3 The Cultural Process of Minimizing Infection
5.3.1 The Lack of Well-Defined Regulations and Administration as the cause of Social Destabilization
5.4 The Psychological and Cultural Consequences of Plague
5.4.1 Fear of Imminent Death; Breakdown of Routines and Restraints
5.4.2 Panic-Based Bizarre Behaviour; Episodic Violence; Anxiety-Discharging Rituals
5.4.3 Anti-Serene Zeitgeist; Macabre Art
5.5 The Economic Impact of Plague
5.5.1 Hedonism, Fatalism, and Mysticism as Plague-Induced Reactions against Rationality
5.5.2 The Transformation of National Sensibility and Cultural Values by New Regulations for Public and Private Behaviour
5.6 Plague Distribution as a factor in causing the redundancy of a trade-route-based society
6.1 Changed Communications Patterns (between communities) as creating Epidemics, attended by Military and Political Upheavals—all together resulting in Depopulation
6.1.1 The Transference of a Foreign Culture and Religion as being facilitated by the (preceding) Total Disruption of a Native Society by Transferred Disease
6.1.1.1 Wholesale Demoralization, Military Actions, and Apparent Superiority (i.e. immunity) as combined Methods for Destroying Native Social Structures
6.1.1.2 Trifling Afflictions utilized as Death-Dealing Epidemics (i.e. in transference from civilized peoples to primitive communities)
6.1.2 The Transplantation of Labourers to Exploit Epidemically Depopulated Land
6.2 Widespread International Immunity by New Era of Regular Travel Patterns as the catalyst for pervasive population growth
6.2.1 The diminution of vulnerability to epidemics by the tight binding of an international communications net
6.2.2 The New Problems brought on by Systematic Population Growth
6.2.3 The Domestication of Epidemic Disease as resulting from Revolutions in Transportation
6.2.3.1 Stabilized Pattern of Parasitism as creating a New Ecological Era
6.3 The macroparasitic exploitation of New Crops as raising the ceilings of population growth
6.4 The diminishment in scope of War and Plunder due to the Global Diffusion of a New Weapon
6.5 The (Varying) Effects of Changes in Macroparasitic Patterns
7 The Impact of Medical Science
7.1 The Religious rejection of precautions (against epidemics) in war or Pilgrimage
7.2 The Parallel between the Role of Doctors and Priesthoods
7.2.1 Doctor’s Establishment of Public Health Measures Justified by Theories of Contagion
7.3 The increasing frequency and (correlated) reduced potency of epidemics as inviting the ‘vital’ revolution—which created ‘Snowballing’ Population Growth
7.4 Damaging or destructive macroparasitism remained rare in China during the Industrial Revolution
7.4.1 The Precocity of China (in greatly anticipating the rest of the world) based on its Cultural Traditions
7.5 Increased protein diets widely creating higher resistance levels (to infectious disease)
7.6 The social acceptance of Inoculation (i.e. the overcoming of public opposition and resistance) being due to the smallpox-death of royalty and the systematic immunization of armies
7.6.1 The fact that inoculation is a very old and widespread folk-practice
7.7 The decreasing significance of epidemic disease facilitated newfangled Mechanistic Worldviews—which made the Medical Profession increasingly Systematic
7.8 Sanitary Reforming Regulations’ infringement on Individuals’ Rights
7.8.1 A lively Fear of Disease – following long-term Reform-Group Propaganda – used to provoke the overcoming of opposition to the Establishment of New and Far-Reaching Public Programs (i.e. ‘Acting Under Fear of Death’)
7.8.1.1 The Ritualization of New Regulations in the Army—as a precursor to the Wholesale, Compulsory Adoption by Civilians
8.1 Science’s profound alteration of the ancient microparasitic and macroparasitic balance
8.1.1 The mechanized and bureaucratic age has put humanity on course for unprecedented Ecological Upheaval
9 Addendum
9.1 Infectious disease is universally associated with foreigners
9.2 The suddenness with which infections occupy a New Ecological Niche
9.3 Syphilis as an accelerator of social mobility
9.4 The overshadowing of bacteriology by technology as a factor in history
9.5 The semi-ritualization of responses to plague and the fear of plague as being manifested (i.e. revived) in future non-disease-related public patterns of expression
9.6 The official validation of Contagionism due to the microscopic discovery of ‘germs’
1 Introduction
1.1 Historians (and scholars of other fields) systematically mis-contextualize the significance of epidemic disease
Whenever epidemic disease has been decisive in peace or war, historians have downplayed its role by giving it only casual mention; whilst outsider scholars – e.g. bacteriologists – who have recognized its decisive role, do so only without historical explanation for disastrous outbreaks—as if epidemics are a sudden and unpredictable phenomenon.
Hence, Plagues and Peoples aims for a historical explanation of infectious disease by showing how varying patterns of disease circulation have affected human affairs.
1.2 The Parasitic Paradigm pervasive in human life: composed of organism parasites (the microparasitism of diseases) and human parasites (the macroparasitism of human predator groups)
Disease and parasitism play a pervasive role in life: it is proper to think of most human lives as caught in a precarious equilibrium between the microparasitism of disease organisms and the macroparasitism of large-bodied predator groups, chief among which have been other human beings.
The development of food-producing communities (from hunter-gatherers) created the possibility of a modulated macroparasitism; which in especially fertile landscapes, allowed a comparatively stable pattern to be established: In the early stages, the macroparasitic basis of civilization was harsh and clear;—later, by slow degrees, the reciprocity of services between parasites and peasantry developed enough importance to diminish the one-sidedness of the relationship.
1.2.1 The principle of Equilibrium Patterns in biological and societal organization, producing Systemic Alteration and/or Mutual Adaptation
Equilibrium patterns (‘equilibria’) are at every level of organization: molecular, cellular, organismic, and social: The alteration from outside tends to provoke compensatory changes throughout the system in order to minimize overall upheaval—but critical limits transgressed result in a breakdown of the previous system.
Thus a catastrophic event may involve a dissolution into simpler, smaller parts (with distinct equilibria); or, the incorporation of smaller parts into a larger or more complex whole.
The prolonged interaction between human hosts and an infectious organism (i.e. throughout many generations and numerous populations) creates a pattern of mutual adaptation that allows both to survive.
1.3 The destructiveness of Civilized Diseases in being transmitted to Virgin Populations (i.e. primitive communities)
There is a roster of diseases that remains thoroughly familiar to all civilized peoples—these being diseases that pass from host to host without an intermediary carrier and with minimal delay: When such a disease invades a human population that does not have previous exposure to it, a high mortality rate is likely for the symptomatic; and young adults who are in their prime characteristically die more frequently than other age groups.
Thus when invading virgin populations, a civilized disease is capable of destroying or crippling entire human communities (e.g. when smallpox and succession of other diseases was transmitted to the Aztec and Inca civilizations.
1.4 The recent rise in importance of Chronic and Debilitating Disease (as opposed to epidemiological disease)
Other diseases – such as chronic slow infections, mental disorders, and ageing debilities – account for a greater sum of human suffering than epidemical ones: they constitute a background noise against which humans have always lived—and such afflictions have increased in importance in recent times.
2 The Hunting Age
2.1 (i) Parasites thrive in hot climate (ii) Humanity became more liable to disease due to cultural factors (i.e. the transformation of nature)
Many tiny organisms that cannot endure freezing temperatures or low humidity thrive in tropical rainforests: the warmth and moisture of that environment allows single-celled parasites to often survive for long periods outside the body of a host. However, tropical rainforests support a highly evolved natural balance at every level; therefore, our ancestors were not perpetually sick: they shared a variety of foods with a variety of parasites—yet without necessarily producing symptoms we would recognize as illness.
Cultural evolution put unprecedented strains on biological evolution: humanity became increasingly capable of transforming the balance of Nature in unforeseen and far-reaching ways—hence the disease liability of humankind began to change dramatically.
2.1.1 The inherent instability of Mankind’s relationships due to its proclivity for Virulent Forms of Behaviour [i.e. the ‘Humans-are-a-Virus’ metaphor]
As an organism, humankind resembles an acute epidemic disease whose occasional lapses into less virulent forms of behaviour never sufficed to permit really stable relationships to be established.
2.2 The customary implementation of essential Population Control Measures
Hunter-gatherers always have customs to keep their population within the limits of their food supply.
2.3 Increased Population Density as creating the condition for Hyperinfection (i.e. an epidemic)
An increase in human numbers results in an increased rate of infection, in that opportunities for transmission multiply in an increased human density: if the critical threshold is surpassed, an infection can suddenly develop into a hyperinfection; and such epidemic situations seriously interfere with normal activity: chronic symptoms may become nearly universal in the community, which seriously hampers food-getting, child-bearing, or child-rearing; and which can soon reduce the population until the local density sinks below the threshold for hyperinfection;—hence, more people now escape the debilitating effects; and activities return to normal… until the population density again transgresses the threshold for a recurrence of hyperinfection.
2.4 (i) Cultural Innovation as being fundamentally disruptive to natural ecology (ii) Ancient hunters were disease-free—unless contacted by civilizing peoples
Originally (i.e. naturally), the ecological system maintained a loose, fluctuating balance that resisted a radical alteration (and which hunter-gatherers did not disrupt). Eventually, cultural adaptation and invention diminished the need for biological adjustment to diverse environments—which introduced a fundamentally disruptive, persistently changeable factor into ecological balances throughout the land masses of the entire Earth (i.e. when humans learned how to create micro-environments that are suitable to survival under widely varying conditions).
Therefore, ancient hunters in the temperate zone were probably healthy (which is supported by knowledge of contemporary hunters in Australia and Americas): they were free from infectious disease and infestation by multi-celled parasites—except for formidable illness from contact with the outside world.
3 The Dawn of History
3.1 Agriculture created the necessity for Political Organization (i.e. protection); and created hyperinfestation by weeds and pests
Efforts to achieve safety – i.e. the necessity of protecting herds and crops from other men (e.g. marauders) – provided the chief stimulus to political organization (of which the process is by no means complete yet).
The radical remodelling of natural landscapes (i.e. agriculture) increased the food supply many times over; which meant a permanent enslavement to an unending rhythm of work; and which prevents the re-establishment of natural climax ecosystems—thereby leaving the door open for hyperinfestation (i.e. weeds and animal pests).
The ravages of disease among crops, herds, and peoples have played a significant part in human affairs throughout history.
3.2 The principle of microparasitism (i.e. an epidemic) inviting macroparasitism (i.e. War and Exploitation)
Widespread, debilitating disease (infection) handicaps a population for work and resistance against military attack; or for throwing-off alien political domination and economic exploitation: it is thus conducive to successful invasion by people armed and organized for war and conquest;—historians are unaccustomed to thinking of state-building, tax-collecting, and booty raids in such context; but such mutual support between microparasitism and macroparasitism is a normal ecological phenomenon.
3.3 Infectious Bacteria and Viruses are exclusively Diseases of Civilization
Immunity reactions impose drastic alternatives upon the host-parasite relationship, in the form of dominance in the interaction, i.e. either a speedy death; or a full recovery and banishment of the invader from the body tissues (at least for months/years until the immunizing antibodies fade). However, resistance is not a sole matter of antibodies, as infections may linger for years or a lifetime without provoking antibodies: latency allows a virus to disappear for up to 50 years and reappear via the infection of a new generation (i.e. by older carriers).
Disease that lack the ability to survive latently must rely on numbers: only in communities of several thousand people – where encounters-frequency is enough to spread infection unceasingly – can such diseases persist, i.e. in civilized communities: large, complexly organized, densely populated, directed and dominated by cities.
Thus, infectious bacterial and viral diseases which pass directly from human to human (i.e. without an intermediate host) are therefore diseases of civilization par excellence: the peculiar hallmark and epidemiological burden of cities, and countryside in contact with cities.
3.4 The parallel between microparasitism and macroparasitism—in Civilized Military Operations and Government
There is a parallel between microparasitism and infectious disease; and the macroparasitism of military operations: civilized communities’ built-up level of wealth and skill made war and raiding an economically viable enterprise.
However, the seizing of harvest by force led to a speedy death of agricultural workforce (from starvation); and which was therefore an unstable form of macroparasitism. Successful raiders became conquerors by learning how to rob agriculturalists without taking all the harvest; which thus enables the cultivators to survive predation by increasing production—the surpluses of which represent the antibodies of macroparasitism.
Thus, a successful government immunizes its host – i.e. by renting and taxing it – against catastrophic raids and foreign invasion; disease immunity arises by the stimulation of antibody, which raises the physical defences to heightened activity; and governments improve immunity to foreign macroparasitism by stimulating a surplus in production of food and raw materials, to support a specialization in violence in suitably large numbers and with appropriate weaponry.
Both defence reactions thus constitute a burden on the host populations; but it is one less onerous than periodic exposure to sudden and lethal disaster:—Hence, the result of establishing a successful government is to create a vastly more formidable society versus other communities: for specialists in violence cannot fail against people whose lives are concerned mostly with producing or finding food.
The development of a powerful military and political organization has its counterpart in the biological defences that populations create when exposed to microparasitic bacteria and viruses;—thus, a suitably diseased society is vastly more formidable than a healthier society.
A disease often requires a massive, megapolitan concentration of human hosts to survive indefinitely, as this keeps a chain of infection going.
3.5 The Breakdown of Public Order causing Depopulation as a leitmotif of periods of peace and prosperity (i.e. population growth in excess of macroparasitical needs)
All successful civilizations managed to assure a flow of people and goods from the countryside into cities, via combining sanctions, religion, law, and custom. Nevertheless, a genuinely stable macroparasitic pattern has rarely stood for long in any part of the world: as civilized history has characteristically exhibited sharp fluctuations up and down, as periods of peace and prosperity induced population growth in excess of the macroparasitic powers of absorption (i.e. destruction); whereupon an increase in death rates asserted itself through the breakdown of public order: peasant revolt, civil war, foreign raid and rapine; as well as the accompanying intensification of famine and disease.
Such breakdowns of public order could always be counted on to reduce populations drastically whenever less drastic regulators of peasant numbers failed to maintain a satisfactory balance: characteristically, it cuts back the numbers far below the previous levels—before successful political consolidation again allows population growth to reassert itself.
However, outside invasions – i.e. by men or disease – or unusual climatic conditions – i.e. resulting in heavy crop losses – are capable of interrupting these cycles. Mounting attacks on neighbouring regions is another method of consuming a surplus of countryside population, in that it opens the frontier lands for subjects to settle and exploit; whilst increasing the number of deaths by wars of conquest (whether won or not).
Trade is also used to support a surplus population, in the relocation of subjects to nearby the sea or navigable rivers to engage in trade with foreigners; but it is difficult to maintain trade balances in as steady a state as demographic balances;—therefore, sharply alternating expansion and contraction was the rule in trade, politics, and war.
3.6 Civilized Disease as a Biological Weapon against Isolated Communities
Civilized diseases constitute a potent biological weapon: when in that contact with smaller, previously isolated groups, a disease let loose quickly assumes drastic proportions, killing off the old and the young alike; and the disruptive effect of such an epidemic is likely to leave the survivors demoralized and with a loss of faith in their inherited customs and beliefs, which didn’t prepare them for the disaster.
3.6.1 The Epidemical Decimation of Young Adults as causing the Collapse of Communities
New infections sometimes manifest the greatest virulence among young adults; and the resulting population loss within the 20-40 age range is far more damaging to society at large—because a community losing a substantial percentage of young adults in a single epidemic finds it hard to maintain itself materially and spiritually: when an initial exposure to one civilized infection is swiftly followed by similarly destructive others, the structural cohesion of the community is almost certain to collapse.
3.6.2 Historians’ overlooking of the bioweapon which civilized peoples have used in War and Raiding
Simple folk brought into contact with urban populations always risked demoralizing and destructive disease encounters; and the survivors were often in no position to offer serious resistance to thoroughgoing incorporation into the civilized body politic: Thus, warfare has characteristically mingled with and masked the epidemiological process; and trade has been imperfectly distinct from war-like raiding. However, since war and trade are often in historical records; but epidemics among illiterate and helpless border folk are not—historians failed to take adequate notice of the bioweapon that urban conditions have implanted into the bloodstream of civilized peoples.
3.7 The Process of Subjugation as analogous to animal digestion (i.e. the assimilation of weaker animals)
The process of the subjugation of the borderlands resembles ordinary animal digestion: the structural organism of a community is broken down by a combination of war (mastication) and disease (chemical and physical action of the stomach and intestine); and the total extinction (consumption) of a population is not typical: the shattering initial encounter with a civilization left substantial numbers of culturally disoriented individuals on the land; which thus served as human material that could be incorporated into the tissues of an enlarged civilization—either as individuals, or as small family and village groupings.
After mingling a while with emigrants and refugees of the civilized interior, populations become indistinguishable from other rural and remote elements of the civilized body politic. Thus, the way digestion regularly breaks down larger chemical structures of food for molecules and atoms to enter the body structure is a close parallel to the historical process of subjugation: the initial die-off and disruption of social defences opens the way for an overabundant civilized peasantry to move to new ground and find a fresh place to thrive—a phenomenon that is fundamentally responsible for the historically persistent tendency of civilizations to expand its geographical size.
4 The Confluence of Civilized Disease
4.1 INDIA: Tropical diseases and parasitic infections of the Indian landscape precluded cultural uniformity and sociological cohesion in India’s civilization
The Indus river landscape is similar to the Mesopotamian and Egyptian; therefore the irrigation culture supporting the Indus civilization is very similar to Middle Eastern civilizations—but various tropical diseases and parasitic infections that flourish in moist and warm climates protected the Indian civilization against the temperate zone pattern of civilized encroachment: instead of digesting various primitive communities of southern and eastern India, the civilization expanded by incorporating ex forest folk as castes, fitting them into the Hindu confederation of cultures as semi-autonomous functioning entities.
Hence, local cultural and social traditions were not destroyed, but a vast variety of primitive rites and practices survived for centuries: the homogenizing process – including Aryan intruders – fell short of the drastic digestive pattern characteristic of Old World civilizations. Therefore, cultural uniformity and sociological cohesion remains relatively weak in Indian peoples (compared to the more unitary structures of northerly Eurasian civilizations).
4.1.1 The climatic and consequent microparasitical disparity of China as a formidable problem for Northerners
There is a sharp climatic difference between northern and central China: the warmer, moister conditions in the South allows a greater variety of parasites to flourish than can survive in the North;—thus populations accustomed to the disease conditions of the North faced formidable problems in adjusting to the markedly different patterns of the South.
4.1.2 The microparasitical factor in India’s relative physical, political, and military weakness
A heavy load of infestation and infection reduced individual vigour and capacity for physical labour to a significant degree in India—an important reason why their empires were fragile, evanescent structures: political and military weakness made invasion and conquest relatively easy for a long succession of foreigners from the North-West.
Indian diseases were a more reliable protection against intruders than organized human defences, as troops from beyond the Himalayas were liable to die-off heavily when they first met the microparasites of the Indian plain.
4.1.2.1 The transcendental character of Indian religion as having been determined by India’s physical weakness and political passivity (and therefore, by microparasitism)
The transcendentalism characteristic of Indian religions accorded well with the circumstances of poverty-stricken, disease-ridden peasants: the two great religions of Buddhism and Hinduism are fundamentally apolitical; fragile and evanescent state structures and ascetic otherworldly ideals of life may have been necessary adaptations to a narrower range of material surplus attainable in a society where microparasitism was more pervasive than climates where freezing winter weather inhibited various forms of infection and infestation.
4.2 MEDITERRANEAN: the Corporate Macroparasitism of the ancient Greeks (as determined by eco-socio-political factors) allowed for relatively disease-free Mediterranean coastlands
The Aegean system was more complicated: it required the exchange of products between economically different regions; and the cultivation of wine and oil requires less land than the equivalent cultivation of grain: Therefore, macroparasitism in Mediterranean lands became corporate: most Greeks experienced a world knit together economically and sustained politically by transactions; and the local farming population in urban centres were part and parcel of political communities, participating as equals in commerce, war, and politics.
The role of excluded and oppressed peasantries was therefore consigned to distant barbarians; hence the Mediterranean coastlands were a relatively disease-free environment into which populations could and did expand;—and new patterns of cultivation did not themselves invite new forms of microparasitism.
4.3 EAST-WEST CONTACT: the opening-up of Movement and Trade (between civilizations) as creating vulnerability to the spread of New Infectious Diseases
In the pre-Christian era, regular movement between India, China, and Western Eurasia did not attain any stable organization; therefore, opportunities for spreading infectious disease from one part of the civilized world to another remained exceptional and sporadic.
During the two centuries following the Christian era, trade between the Eastern Mediterranean, India, and China operated on a regular basis; and attained a scale dwarfing all earlier exchanges across such distances: Hence, the changes of an unfamiliar infection spreading among susceptible populations multiplied (and there is reason to believe that epidemic disasters struck severe blows to Mediterranean populations).
4.3.1 The degree of Civilized Development as the determinant of microparasitical (and thus macroparasitical) potency or vulnerability
The opening of the oceans after 1500AD had little effect on Europe; whilst millions of Amerindians and other vulnerable peoples suffered catastrophic die-offs. In the 1st and 2nd centuries, Europe and China were the two least disease-experienced civilizations of the Old World; and were therefore in an epidemiological position analogous to the Amerindians from the 16th century, i.e. vulnerable to socially disruptive attack by new infectious diseases.
4.4 The Role of Epidemic Disease in the Fall of Empires
Similar epidemiological disaster was seen in the Roman world between the 2nd and 6th centuries: the disease which spread through the Roman empire in 165AD inaugurated a process of continuous decay of populations in Mediterranean lands, that lasted – despite some local recoveries – for more than half a millennium—partly because fresh outbreaks of serious pestilence continued to occur. However, disease was not the sole factor attacking Mediterranean populations: civil disorders and barbarian invasions (beginning 253AD) spread destruction far and wide within Roman frontiers;—famine often followed; and agreements allowing barbarian tribesmen to settle in return for military service (which multiplied in later times) prolonged population decay from intensified microparasitism and macroparasitism within the Mediterranean.
The resulting eroded wealth of the heartlands led to a rapid die-off of large proportions of urban populations at the most active centres of Mediterranean commerce, which diminished the flow of cash to the imperial fisc—hence the pay for soldiers could no longer be at the accustomed rates; and mutinous troops turned upon civil society to extract it by force from the undefended landscapes which Roman peace had created:—further economic decay, depopulation, and human disaster resulted.
4.4.1 The Historians’ Tradition of emphasizing societal (i.e. macroparasitic) factors to the minimization of epidemiological (i.e. microparasitic) factors in the Fall of the Roman Empire
Historians traditionally emphasize the macroparasitic side of the balance as the cause of the fall of the Roman Empire; but the ravages of armies and ruthlessness of tax collectors (both of which were immense) probably didn’t damage Mediterranean populations as much as recurrent outbreaks of disease, which (as usual) found fresh scope in the wake of marching armies and fleeing populations:
The tolerable macroparasitic system became unbearably top-heavy after the first ravages of epidemic disease in the 2nd and 3rd centuries; and the macroparasitic elements in Roman society became agents of further destruction to population and production: disorders, famines, migrations, and concentrations and dispersals of flotsam and jetsam created fresh opportunities for epidemic diseases to diminish the population still more: Thus, a vicious cycle arose that lasted for several centuries despite some periods of partial stabilization and local population recovery—but historians systematically underestimated the significance of the two initial epidemics in triggering the entire devolution.
4.4.2 The disintegration of Roman civilization causing the Inauguration the Dark Ages
The political and cultural consequences were repeated waves of barbarian invasion; accompanied by the decay of cities, the migration of artisans to the countryside, the loss of skills (including literacy), and the breaking-up of the imperial administration—thus inaugurating the Dark Ages of the West.
4.4.3 The rise of Christianity in the midst of disastrous epidemic—i.e. the Rise of a New Civilization off the back of a disintegrating civilization [Phoenix Society]
Simultaneously, the rise and consolidation of Christianity altered Older World views fundamentally: care of the sick was a religious duty; and elementary nursing gave a feeling of gratefulness and a sense of solidarity to those whose lives were saved—which gave Christians an advantage over pagans: Therefore, the effect of the disastrous epidemic was to strengthen Christian churches at the time that most other institutions were being discredited (Christian writers often boasted of the way Christians offered each other mutual help in time of pestilence; whereas pagans fled from the sick and heartlessly abandoned them); which also had the advantage that faith made life meaningful, even amid sudden and surprising death.
Thus did untoward and unexpected disaster shatter pagan pride and undermine secular institutions; and made God’s hand more evident than it was in quiet times: Christianity was a system of thought and feeling thoroughly adapted to the time of troubles in which hardship, disease, and violent death commonly prevailed; while stoic and other systems of pagan philosophy emphasized the impersonal process and natural law—and was therefore ineffectual at explaining the apparent randomness with which death descended suddenly on young and old, rich and poor, good and bad alike.
4.5 Persistent Plague as a factor in the Shifting of the Balances of Power between civilizations
The demographic disasters that repeatedly visited Mediterranean coastlands from 542AD onwards accompanied Moslems in their first critical stages of imperial expansion; and therefore limited Roman and Persian armies to token resistance: this created a perceptible shift in from the Mediterranean as the preeminent centre of European civilization; and the increase in importance of the northerly lands was powerfully assisted by a long series of plagues, which confined the ravages almost entirely to territories within easy reach of Mediterranean ports.
5 The Shifting of the Balances of Disease
5.1 The Conceit of Modern Medicine (i.e. 20th century) in feigning Scientific Innovation and overstating Medical Effectivity
Long standing customs among natives of Yunnan and Manchuria inhibited the transfer of bubonic infection to humans quite effectively, despite the presence of carrier-rodent burrows in those regions;—only when newcomers failed to observe local superstitions did plague become a human problem; and in both regions, the plague was associated with military-political upheavals of the sort that often provoked disease disasters in the past.
Therefore, the medical prophylaxis developed between 1894 and 1924 is a quite normal response to epidemic emergency: myth and custom are replaced by scientific medicine; new rules of conduct are employed at a worldwide political frame (e.g. international quarantine regulations) to compel a general acquiescence in newly prescribed behaviours. Therefore, the brilliant triumphs in 20th century medicine are not quite so novel.
5.2 The Convergence of Circumstances (i.e. non-epidemic factors) in Major Plagues
There were additional – i.e. non-epidemic – factors in Europe concerning the Black Death: (1) The network of shipping connecting the Mediterranean with Northern Europe: improvements in ship design made year-round sailing normal for the first time. (2) Many parts of Northern Europe achieved human saturation: the frontier boom led to replication of manors and fields across the land; which involved deforestation that caused a shortage in building materials, which led to severe problems for occupancy—thus forming a collision between the expanding peasant population and agricultural resources. (3) The climate worsened: crop-failures and partial failures became more common.
5.2.1 The Recurrence and Varying Patterns of Incidence in Major Plagues
At the middle of the 14th century, circumstances thus converged to lay the basis for a shattering experience of Black Death: the initial shock was severe; and die-offs varied wildly (some small communities suffered total extinction, while others escaped entirely)—the shock to accustomed ways and expectations was severe; and the plague did not disappear from Europe after the first massive attack, but recurrent plagues followed at irregular intervals with varying degrees of patterns of incidence (sometimes rising to a new severity, then receding again).
5.2.1.1 The effects of the recurrence and irregularity of major plagues
The places that escaped the first onset commonly experienced severe die-off in later epidemics; and when the disease returned to places it had raged in before, the recovered were immune—therefore death tolls were concentrated among those born since the previous plague.
In most parts of Europe, the loss of up to one quarter of the population did not at first make a very lasting difference, as a pre-existing heavy population pressure on available resources meant eager candidates were at hand for most of the vacated places (only positions requiring very high skills became in short supply). However, the recurrences of the plague altered the situation: manpower shortages fell in agriculture and humble occupations—hence the socio-economic pyramid was altered in different ways and in different parts of Europe; and darker climates of opinion and feeling became as chronic and inescapable as the plague itself.
Europe entered upon a new era of its history embracing as much diversity as ever, as reactions and readjustments followed different paths in different regions of the continent—but everywhere different from the patterns before the plague.
5.3 The Cultural Process of Minimizing Infection
There is a cultural process of learning how to minimize infection: the idea of quarantine stemmed from the Bible in the proscription of the ostracism of lepers, in that the plagued are treated as lepers (with 40 days of quarantine becoming the standard); while those remaining in good health found public and approved ways to express fear and loathing of the diseased.
5.3.1 The Lack of Well-Defined Regulations and Administration as the cause of Social Destabilization
Quarantine regulations became institutionalized in Medicine—yet the plague continued and constituted a significant demographic factor in late-Medieval and early-Modern Europe: 17th century outbreaks in Spain were a significant factor in its decline as an economic and political power; the absence of well-defined public quarantine regulations and administration routines (both religious and medical) in Northern Europe to deal with plague and rumour of plague gave scope for violent expression of popular hates and fears provoked by the disaster: in particular, long-standing grievances of the poor against the rich often boiled to the surface—manifested in local riots and the plundering of private houses, which put the social fabric to a severe test.
5.4 The Psychological and Cultural Consequences of Plague
5.4.1 Fear of Imminent Death; Breakdown of Routines and Restraints
Of the psychological, economic, and cultural consequences of Europe’s encounter with plague in the 14th and succeeding centuries, the psychological and cultural reactions were most obvious and varied: in the face of an intense and immediate crisis – which implanted the fear of imminent death in the centre of the entire community – ordinary routines and customary restraints regularly broke-down.
5.4.2 Panic-Based Bizarre Behaviour; Episodic Violence; Anxiety-Discharging Rituals
In time, rituals arose to discharge anxiety in socially acceptable ways;—but in the 14th century, panic provoked bizarre behaviour: the first efforts at ritualizing responses took extreme and ugly forms (involving episodic violence). In time, fear and horror of the first onset relaxed: diverse writers treated plague as a routine crisis of human life (an act of God, like the weather)—which gave rise to the vernacular tongue as a medium for serious writing.
5.4.3 Anti-Serene Zeitgeist; Macabre Art
The plague-darkened vision of the human condition – i.e. provoked by repeated exposure to sudden, inexplicable death – was responded to by the painting world in a reaction against serenity and a preference for sterner portrayals of religious scenes and figures; as well as by the entrance of several macabre themes into their repertory.
5.5 The Economic Impact of Plague
Thus, the buoyancy and self-confidence of the cathedral-building previous century gave way to a more troubled age: social tensions between economic classes and intimate acquaintance with sudden death assumed far greater importance for almost all than before.
The economic impact was enormous: in the highly-developed regions, harsh collisions between the social classes manifested, as the boom times of the 13th century faded into the past; and the plague’s disruption of wage and price patterns exacerbated these conflicts.
5.5.1 Hedonism, Fatalism, and Mysticism as Plague-Induced Reactions against Rationality
When the plague was raging, a person in full health may die miserably within 24 hours; and this fact utterly discredited human efforts to explain the mysteries of the world—hence rational theology could not survive such experiences: only a worldview allowing scope to arbitrary, inexplicable catastrophe was compatible with the grim reality of the plague. Hedonism and the revival of fatalistic philosophy were confined to a few: far more popular and respectable was an upsurge in mysticism; which aimed at encountering God in inexplicable, unpredictable, and purely personal ways;—and, as the recurrence of the plague refreshed its need, all branches of organized Christianity made more room for personal mysticism and other forms of communication with God.
5.5.2 The Transformation of National Sensibility and Cultural Values by New Regulations for Public and Private Behaviour
In contrast the Church, governments responded quickly to the challenges presented by devastating disease: magistrates learned how to cope at a practical level and established regulations for public and private behaviour in time of plague—which contributed to the general transformation of European sensibility (i.e. the shift from Medieval to Renaissance cultural values).
5.6 Plague Distribution as a factor in causing the redundancy of a trade-route-based society
The changed distribution of bubonic infection in Eurasia was (supposedly) to the disembowelment of steppe society: the systematic opening-up of the sea route between Europe and other major centres of civilized population; along with the development of effective handguns (which made the archery of the steppe ineffective) meant that the steppelands were no longer the cheapest route to carry trade.
6 The Transoceanic Era
6.1 Changed Communications Patterns (between communities) as creating Epidemics, attended by Military and Political Upheavals—all together resulting in Depopulation
The changed communications patterns created by the Mongols in the 13th century were a recapitulation of the first Christian centuries: massive epidemics and attendant military and political upheavals leading to a sharp diminution of population.
Less than 50 years from the time of Cortez’ inauguration, epidemiological and other exchanges between Amerindians and European populations, the population of Mexico shrunk to one tenth of its original size; and the decay continued, halving the population again over the next 50 years;—similar drastic destruction of pre-existing Amerindians also occurred in other parts of the Americas; and continued into the 20th century.
6.1.1 The Transference of a Foreign Culture and Religion as being facilitated by the (preceding) Total Disruption of a Native Society by Transferred Disease
Such total disruptions carry drastic psychological and cultural consequences: faith in established institutions and beliefs cannot easily withstand such disasters—hence skills and knowledge disappear: This allowed the Spaniards to transfer their culture and religion to the New World, making it normative even in regions where millions of Indians had previously lived according to standards and customs of their own.
Labour shortage and economic retrogression is another obvious concomitant: the development of forms of compulsory labour and the dispersal from cities to rural estates are necessary responses for social hierarchies to survive at all.
6.1.1.1 Wholesale Demoralization, Military Actions, and Apparent Superiority (i.e. immunity) as combined Methods for Destroying Native Social Structures
Wholesale demoralization and simple surrender of will live played a large part in the destruction of Amerindian communities: the failure to attend to newborn babies, as well as suicide, represented bewilderment and despair. Military action and the harsh treatment of labourers (gathered forcibly for large-scale undertakings) also had a role in uprooting and destroying social structures.
Both the Spaniards and Amerindians readily agreed that the epidemic was a particularly dreadful and unambiguous form of divine punishment (i.e. from God’s displeasure); and the near-immunity of the Spaniards stunned the Amerindians into acquiescence of Spanish superiority, which was their only possible response—hence the native authority structures crumbled (as the old Gods has seemed to have abdicated); and therefore, the situation was ripe for mass conversion: docility to commands of priests, viceroys, landowners, mining entrepreneurs, tax collectors, and anyone white who spoke with a loud voice—thus were there no grounds for resistance.
6.1.1.2 Trifling Afflictions utilized as Death-Dealing Epidemics (i.e. in transference from civilized peoples to primitive communities)
Relatively trifling afflictions of the Old World regularly became death-dealing epidemics among New World populations, appearing at intervals throughout the 16th and 17th centuries: wherever a new region or isolated population came into contact with the outside world, a cycle of repeated infections picked up renewed force, mowing down helpless inhabitants;—German missionaries reported that ‘Indians die so easily that the bare look and smell of a Spaniard causes them to give up the ghost.’
6.1.2 The Transplantation of Labourers to Exploit Epidemically Depopulated Land
African slaves took the place of the vanished Amerindians along the Caribbean coast, and most islands where plantation enterprises called for a heavy input of human labour. Thus, the scale of disaster to Amerindian populations was unimaginable: enormous and repeated human anguish as whole societies fell apart, values crumbled, and the old way of life lost all meaning.
6.2 Widespread International Immunity by New Era of Regular Travel Patterns as the catalyst for pervasive population growth
By 1700, sailing ships had done what they could to spread new diseases to new lands; and the demographic significance of epidemic outbreaks began to drop off—opening the way for the modern experience of persistent, pervasive growth among disease-exposed and disease-experienced populations of all the Earth.
6.2.1 The diminution of vulnerability to epidemics by the tight binding of an international communications net
The tighter became the communications net binding each part of Europe to the rest of the world, the smaller became the likelihood of a really devastating disease encounter: for only genetic mutation of a disease-causing organism; or a transfer of parasites from some other host to humans—were the possibilities in the development of an epidemic.
6.2.2 The New Problems brought on by Systematic Population Growth
The lightening of the microparasitic drain upon European populations – particularly in North-Western Europe – unleashed the possibility of systematic growth;—but substantial local growth quickly brought new problems – particularly in food and water supply; and in the intensification of other infections in cities that had outgrown older systems of waste disposal – which began to affect European populations significantly after 1600; and for which an effective solution did not arrive until the 18th century or later.
6.2.3 The Domestication of Epidemic Disease as resulting from Revolutions in Transportation
The domestication of epidemic disease that occurred between 1300 and 1700 resulted from two great transportation revolutions—those being the Mongols by land and the Europeans by sea: Civilized forms of person-to-person infection entered the scene with the rise of cities and development of intercommunicating herds of about half a million—which initially, could only occur at selected spots on the globe; but later, played a double role: it cut down isolated peoples in contact with civilized centres, which facilitated the process of the digestion of small primitive groups into the body politic of persistently expanding civilized communities; and the same disease could often invade a particular city or rural community with almost the same lethal force exerted against isolated populations.
6.2.3.1 Stabilized Pattern of Parasitism as creating a New Ecological Era
A new relation between humankind and parasitic microorganisms was thus formed: a more stable pattern of parasitism, in which massive growth of civilized populations and the corresponding accelerated destruction of isolated populations, created a new ecological era representing the shift from epidemic to endemic forms of infection.
6.3 The macroparasitic exploitation of New Crops as raising the ceilings of population growth
Food crops also were diffused more uniformly throughout the civilized world as a result; and also due to transoceanic voyaging—with the most important crops coming from America: many regions of the Old World contained new crops capable of producing far more calories per acre than anything before; and were rich sources of vitamins—hence the older ceilings on population rose correspondingly whenever new crops became cultivated.
6.4 The diminishment in scope of War and Plunder due to the Global Diffusion of a New Weapon
The superior productivity and nutritiousness of American crops was of greatest importance to life in every part of the Old World:—changes in disease patterns and increased productivity from the spread of crops were the two most active factors in triggering population growth in modern times: it operative worldwide in parallel fashion to allow more to survive and grow to maturity than ever before; and governments became fewer and more capable of maintaining domestic peace over broader regions of the Earth because of the global diffusion of a new weapon – the cannon – the effect of which was to concentrate wealth into fewer hands: the consolidation of a relatively small number of ‘gunpowder empires’. Hence, war and plunder diminished in scope accordingly, because more and more people were brought under bureaucratic control; and it was directed towards distant and often thinly populated frontiers.
6.5 The (Varying) Effects of Changes in Macroparasitic Patterns
Such changes in macroparasitic patterns did not occur since the Iron Age, i.e. when weapons and tools became vastly cheaper; which increased the devastation that could be wrought upon one’s fellows. The cannon, however, made weaponry more expensive—and it therefore had the opposite effect: it directed organized violence into narrower channels, which meant that fewer people died in war or from its consequences despite the enhanced killing power of well-equipped armies;—the taxation for the arms were heavy; but it was almost always less destructive than raiding and rapine of armed bands.
The symbiosis of the cannon with a limited number of imperial bureaucracies was thus the third global factor favouring worldwide growth of civilized populations from the late 17th century to the present.
7 The Impact of Medical Science
7.1 The Religious rejection of precautions (against epidemics) in war or Pilgrimage
Religious doctrines rivalled warfare in provoking epidemics: the doctrine that disease came from God is easily interpreted to mean that it is impious to interfere with God’s purpose by precautions in war or pilgrimage; and therefore, the risk of sudden death was at the very core of the enterprise.
7.2 The Parallel between the Role of Doctors and Priesthoods
It is doubtful whether the physiological benefits of even the most expert medical attention outweighed the harm done by common forms of treatment: everyone felt better when self-confident and expensive experts were called in to handle a vital emergency; whereby doctors relieved others of responsibility for deciding what to do; and thus the role of doctors was strictly comparable to that of a priesthood: ministrations to the soul relieved anxieties parallel to those by medical ministrations to the body—however, the difference was that doctors dealt with things of this world; therefore their skills and ideas were more liable to empiric elaboration over time.
7.2.1 Doctor’s Establishment of Public Health Measures Justified by Theories of Contagion
By the end of the 15th century, Italian doctors worked out within the framework of city-state government a series of public health measures designed to quarantine plague and cope with heavy die-offs;—over the 16th century, the measures became more elaborate and better administered; and theories of contagion were used to justify quarantine.
7.3 The increasing frequency and (correlated) reduced potency of epidemics as inviting the ‘vital’ revolution—which created ‘Snowballing’ Population Growth
Increasingly frequent epidemics worked less and less demographic damage: one disaster after another verged towards the relatively harmless status of becoming an endemic childhood affliction; and this opened a wide gate towards all the familiar features of the vital revolution: lessened adult mortality; which allows for the sustaining of more complete families; whereupon a numerically reinforced generation expands the number of its children even more, etc. (i.e. snowballing population growth).
7.4 Damaging or destructive macroparasitism remained rare in China during the Industrial Revolution
European population growth during the Industrial Revolution (18th century) was far less massive than the Chinese expansion of the same period (one fifth as great): The Chinese response to the altered ecological balances of the world was atypical, as parallel potentialities elsewhere were masked by a variety of countervailing circumstances: only in China did public peace prevail unbroken and conventional limitations on taxes and rents remain well defined; so that damaging or destructive macroparasitism remained rare.
7.4.1 The Precocity of China (in greatly anticipating the rest of the world) based on its Cultural Traditions
China’s circumstances gave full scope to the new possibilities inherent in the changed disease regime, crop distribution, and military technology resulting from the opening of the oceans to movement: China anticipated – by more than a century – similar responses among peasant populations in other parts of the world—this precocity largely due to the cultural traditions of the Middle Kingdom: political unity came easier because of accustomation from antiquity to regard imperial centralization as the only rightful form of government; and Confucian principles put a high value on family continuity from father to son: Such attitudes contributed to the early and dramatic expansion of China’s population;—and only in the frontiers of colonization did the same combination of circumstances prevail (i.e. as in most of China), which also unleashed extraordinary population growth in land thinly inhabited previously.
7.5 Increased protein diets widely creating higher resistance levels (to infectious disease)
The spread of a new style of agriculture led to more animals; which produced more meat and milk, and thus protein; which led to an increase in antibody levels (antibodies being proteins): this created a significant rise in general levels of resistance to infectious disease among wide segments of the population.
7.6 The social acceptance of Inoculation (i.e. the overcoming of public opposition and resistance) being due to the smallpox-death of royalty and the systematic immunization of armies
In England, inoculation (against smallpox) became general in rural communities and small towns from the 1770s: the innovation spread first in rural and small-town environments, bypassing large urban centres; and thus adopting it 70-100 years earlier. Public opposition lasted much longer on the continent, where it was criticized as both interference with God’s will; and wanton spreading of infection among healthy people;—and which was countered with statistical studies. In France, not until the death of Louis XV from smallpox did organized resistance crumble; and only when entire armies began to be immunized by command from the top did that practice really penetrate the lower social orders of continental Europe. Ultimately, the effective prophylaxis against smallpox in Europe was a by-product of the Napoleonic Wars.
7.6.1 The fact that inoculation is a very old and widespread folk-practice
The practice of inoculation was found to be very old and widespread at folk level (e.g. it was discovered to have been in much of Asia for centuries): personal and political accidents, scientific and professional organization, and a systematically expanded network of communication among men of learning all came together to equip European doctors with the inoculation method and procedures.
7.7 The decreasing significance of epidemic disease facilitated newfangled Mechanistic Worldviews—which made the Medical Profession increasingly Systematic
The decreasing significance of epidemic disease in the 18th century was due partly to medical advances; but mostly to ecological adjustments which men were unaware of—which was the essential background for the popularization of ‘enlightened’ philosophical and social views: the retreat of plague and malaria and the containment of smallpox were essential preparations for the propagation of the deistic opinions that became fashionable in advanced circles in the 18th century: for there no longer stood so much need for belief in divine providence to explain sudden deaths in the prime of life (i.e. because it now seldom happened): Hence, newfangled mechanistic worldviews made the medical profession increasingly systematic in testing new treatments: for the thought that human intelligence and skill could improve life not only in mechanical matters, but in matters of health too, became increasingly plausible.
7.8 Sanitary Reforming Regulations’ infringement on Individuals’ Rights
Following military achievements in medicine, sanitary reformers (in the 1830s-40s) faced the problem of organization: libertarian prejudice against regulations infringing the individual’s right to do what he chose with his own property was deeply rooted; and theories of disease and its propagation remained under dispute—therefore clear imperatives were hard to agree upon.
7.8.1 A lively Fear of Disease – following long-term Reform-Group Propaganda – used to provoke the overcoming of opposition to the Establishment of New and Far-Reaching Public Programs (i.e. ‘Acting Under Fear of Death’)
The fear of cholera acted as a catalyst to the situation, in that to do nothing was considered no longer sufficient: old debates and stubborn clashes had to be quickly resolved by public bodies acting literally under fear of death;—hence the first outbreak in Britain prompted the establishment of local bodies of health, which instituted far-reaching programs and public sanitation (which had been championed by a noisy group of reformers for a decade or more). The health bodies proceeded to use their extensive legal powers to remove innumerable sources of defilement from towns and cities; and began the installation of water and sewer systems all over the country—this involved the intrusion of private property necessary for water mains and sewer pipes efficiency; as well as substantial capital expenditures.
Ultimately, the lively fear of cholera was necessary to provoke the overcoming of entrenched opposition; and international medical cooperation achieved new efficiency as a result of Europe’s encounter with cholera.
7.8.1.1 The Ritualization of New Regulations in the Army—as a precursor to the Wholesale, Compulsory Adoption by Civilians
The ritualization of passing men through delousing stations (to prevent typhus) was established in European armies during World War 1: new chemicals made formerly formidable diseases easy to prevent and cure; and the military command channels were exceedingly effective in delivering them where most needed: Hence, military medical administration was extended to civilian communities whenever infectious disease threatened trouble for occupation authorities—which resulted in the wholesale, compulsory delousing of civilians, refugee camps, slave labour camps, and other forms of official accommodation for displaced persons—all of which shared the pattern of military medical administration.
Since 1940, the impact of scientific medicine and public health administration on the conditions of human life became literally worldwide: epidemic disease became unimportant in most places; and many common and serious infectious diseases became rare.
8 Conclusion
8.1 Science’s profound alteration of the ancient microparasitic and macroparasitic balance
Skill and knowledge can never extricate humanity from its age-old position, intermediate between microparasites attacking invisibly; and the macroparasitism of some men upon their fellows: the simple polarity of older ages, where societies were neatly divided between food-producers and those that preyed upon them, has been profoundly altered by the development of scientific farming; and the services and supplies food-producers now receive from those not directly involved in food production.
8.1.1 The mechanized and bureaucratic age has put humanity on course for unprecedented Ecological Upheaval
The old problem of adjusting relations between producers and consumers has thus now taken a more complicated form (i.e. in the mechanized and bureaucratic age); and it is obvious that humanity is now in the course of one the most massive and extraordinary ecological upheavals the planet has ever known: a sequence of sharp alterations and abrupt oscillations in existing balances between microparasitism and macroparasitism is expected in the near future—and infectious disease will surely remain one of the fundamental parameters and determinants of history.
9 Addendum
9.1 Infectious disease is universally associated with foreigners
The universal human penchant for attributing the origin of an unfamiliar and nasty disease to foreigners makes it impossible to trace the origins of any particular infection to anywhere with any sort of historically convincing textual evidence.
9.2 The suddenness with which infections occupy a New Ecological Niche
When old barriers to its diffusion are breached, an infection occupies new ground with suddenness: for a new ecological niche, wherever presented, tends to be occupied quickly by an organism – human or non-human – and multiplies in kind.
9.3 Syphilis as an accelerator of social mobility
The demographic impact of Syphilis was not very great: Royal houses often suffered; and the consequent inability of aristocratic families to birth healthy children merely accelerated social mobility, making more room at the top of society.
9.4 The overshadowing of bacteriology by technology as a factor in history
Bacteriology was – at the least – as important a factor as technology in the vast process of European expansion: the decay of native numbers; and the availability of European populations to occupy such vast and varied empty spaces—both derived from the distinctive modern pattern of epidemiology.
9.5 The semi-ritualization of responses to plague and the fear of plague as being manifested (i.e. revived) in future non-disease-related public patterns of expression
During the terror in Paris and France of 1973-4, public manifestations were derived from patterns of expression and popular excitement that became semi-ritualized as responses to plague and the fear of plague in the 17th century.
9.6 The official validation of Contagionism due to the microscopic discovery of ‘germs’
Contagionism was discredited until the microscope abruptly reversed the balance of medical opinion, i.e. with the dramatic discovery of disease-causing ‘germs’.
*Or – in the parlance of contemporary political baffoonism – an “invisible mugger”, assailing people in the streets.
Stepping Stones 
