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Disease & History: From ancient times to Covid-19

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A newly updated edition of a classic in the history of medicine with information on Covid-19. Arising from collaboration between a doctor and a historian, Disease and History offers the general reader a wide-ranging and accessible account of the ways in which disease has left its dramatic mark on the past. It discusses the impact made by bubonic plague and other infections upon the ancient and medieval worlds; the likely role of syphilis in the careers of Henry VIII and Ivan the Terrible; the significance of smallpox for the conquest of Mexico; and the contribution of typhus to Napoleon’s downfall and of haemophilia to the collapse of Tsarist rule in Russia. Other topics surveyed include the influence of tropical diseases in the history of the colonization of Africa, and the global death-toll taken by the so-called ‘Spanish’ influenza of 1918-9. Michael Biddiss and Frederick F. Cartwright show how successive eras have made progress against pestilence, even while confronting new and often unforeseen threats. The final section of the book highlights many of the current problems now facing a world where disease – especially when combined with war, famine, and ecological recklessness – presents an ongoing challenge to human survival, as is the case currently with the ongoing coronavirus pandemic. Praise for Disease and ‘A study whose outstanding virtues are economy, clarity and readability’ - New Statesman ‘A welcome updating and careful revision of one of the pioneering accounts of the social history of medicine’ - Roy Porter, Professor of the Social History of Medicine, UCL ‘Fascinating and highly recommended’ - Library Journal Frederick Cartwright was the head of the Department of the History of Medicine at King’s College Medical School in London. Michael Biddiss is Emeritus Professor of History and former Dean of Letters and Social Sciences at the University of Reading.

265 pages, Kindle Edition

Published November 11, 2020

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Frederick F. Cartwright

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5 stars
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Displaying 1 - 30 of 41 reviews
Profile Image for Ruby Dixon.
Author 162 books19.9k followers
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February 7, 2022
I mean...it is what it says on the cover. Very readable tho! I will continue my earnest search for more books about Justinian's plague but the stuff about syphilis and how rampant it was in Renaissance Europe is fascinating.
Profile Image for Sherry Sharpnack.
1,026 reviews38 followers
March 7, 2022
First written in 1972, "Disease & History:..." is an interesting look at plagues throughout the ages, beginning in ancient times and hitting all the high spots: disease as a cause of the fall of the Roman empire; bubonic plague; syphilis; smallpox; cholera and typhus; tuberculosis; influenza; and finally, in a new epilogue added in 2020, COVID-19. Empires rose and fell on the basis of not just pestilences' effects upon the general population, but perhaps upon just the ruler of the population, such as Henry VIII's supposed syphilis or Napoleon's gastric disorders.
I really liked the thesis sentence and the Biblical reference to the Four Horsemen of the Apocalypse so will share it here:
"Pestilence, famine, and war {three of the horsemen] interact and produce a sequence. War drives the farmer from his fields and destroys his crops; destruction of the crops spells famine; the starved and weakened people fall easy victims to the onslaught of pestilence. All three are diseases. Pestilence is a disorder of the human. Famine results from disorders of plants and animal food sources...And even war may be regarded, though perhaps more arguably, as a form of mass psychotic disorder." pp 7-8. These three all lead to the Fourth Horseman, Death on his Pale Horse.
I found the earlier chapters more interesting, and felt the later chapters on flu and especially on COVID somewhat detached and harder-to-read. Perhaps that had to do w/ the change in authors for later editions, as Dr. Cartwright died in 2014, per information in the Preface. Professor Biddiss, an historian, had to find a new writing partner for later editions of this book. A reader does not have to have a medical background to be able to read this book, however. I will round up to 4 stars.
21 reviews
March 23, 2022
In my view the book started well, with a sweep through how disease affected history, but then got side tracked into personal views and political hobby horses.

Some of the narrative was a rehash of reasonably commonly known 'epidemics' e.g. the ergot - dancing plague (although I am not sure that was a' disease), the eradication of small pox, the impact of the bubonic plague in England (although there was no discussion of the 'genetic shift' that left in populations nor the impact that had on the later AIDS spread), so I felt I read little new, or changed my context.

Maybe the issue is the book has been updated several times and has gone off track.

So I was disappointed as it is a fascinating subject.

Profile Image for Kathy.
767 reviews
March 9, 2022
Rather unevenly written. Heavy on some historical events, not so much on others. Apparently the authors are fans of the Napoleonic wars and of John Keats, because they got way in-depth treatment. And of course, at the end were the obligatory hand-wringing about global warming, overpopulation, and the ozone hole. Covid was blamed on the wet-market, a currently debunked theory. All that said, there were occasional insights: where the term "alcoholism" came from, a claim that one in four hundred Americans were drug addicts in the early 1920's, the huge death toll taken by the plagues that have from time to time swept the earth, the role of disease in some rulers' decisions that shaped history.
Profile Image for Stewart Cotterill.
286 reviews6 followers
November 13, 2022
Fascinating

This book was an eye opener into how living without epidemics or pandemics has been a late 20th century mindset in the ‘Western’ world.

It also provides interesting evidence as to how certain diseases have literally changed history.
Profile Image for Rob Sedgwick.
478 reviews8 followers
May 10, 2022
A good review of mainly infectious diseases, which killed most people until relatively recently. Although they have returned in recent decades with the likes of AIDS and Covid, which are covered in the final chapters.
Profile Image for Nina.
1,870 reviews10 followers
February 11, 2022
This is an update of a book originally published in 1972. Fifty years ago! And that's when I first read it, before HIV, before SARS, before MERS, before COVID. Human behavior hasn't changed much. Seems like we spent the first part of the 20th century winning the battles with measles, chicken pox, tetanus, diphtheria, tuberculosis, and smallpox, and now, thanks to complacency, new viruses, anti-vaxers, science denial, antibiotic abuse, overcrowding, global travel, and third-world poverty, we're setting off a new wave of epidemics that may yet do us in. Climate change is exacerbating the problem as just a few degrees more in average temperatures will greatly expand the habitat of insects like the tsetse fly.

"The primitive is not buried deeply enough for safety. This may be why humans continue to breed unchecked, to foul their surroundings, to exhaust their resources, and to take inadequate thought for their future. Governments tell us that ‘we must come to terms with our environment’, but this is begging the question. Rather, mankind must first come to terms with itself." We will have to make sacrifices to tackle the problems which we ourselves have largely created.
Profile Image for Rory Fox.
Author 9 books47 followers
March 21, 2023

Diseases influence history and historical events make diseases more or less prevalent. So, it makes sense to link history and disease, as doing so gives a more comprehensive understanding of both. That is the underlying premise of this book ,as it takes us from ancient times right up to the Covid lockdowns of 2020.

Of course we hear about the great diseases of the Middle Ages, like the black death and the enormous social upheaval which they caused. But we also hear about Syphilis, which unlike the coming and going of plagues, it seemed to linger across most of the middle ages. Its changing characteristics and transmission contexts made it particularly difficult to isolate and treat, as its sores could easily be misinterpreted. Its possible impact upon royal families like the English Tudor monarchs makes it a particularly political disease, as it may well have driven the mindsets and policies Henry VIII.

The Chapter on Napoleon gives a good sense of how history and disease weave together. We hear of Napoleon and his campaigns, and the way that Typhus ravaged his armies. With no understanding of what was causing disease, armies could easily lose many times more to disease than to enemy action. At times Napoleon’s armies lost up to 6 times more to disease. The British in Crimea seem to have suffered a similar rate of attrition. But that was not a norm. The American civil war, and the Boer war seem to have ‘only’ lost around twice as many soldiers to disease as to enemy action.

One of the myths that the book rejects, is that Napoleon lost his grand army of half a million soldiers due to his disastrous retreat through a Russian winter. Yes the army did get whittled down by the winter, but it was already a fraction of what it had started out, when it arrived at Moscow. That was largely due to the unsanitary conditions that the large army travelled in, as well as the poverty of the areas it travelled through (like Poland), where peasants lived in dirt and squalor and the army often struggled to forage enough food.

And why did Napoleon himself fight his latter battles in a noticeably more lacklustre way than his earlier ones? Well, he was suffering from gradually more and more health conditions, which undermined his stamina and ability to concentrate. The book suggests that he lost the battle of Waterloo, the night before the battle. Physically exhausted he slept, and his armies halted. Yet if he had been stronger (or perhaps delegating better?) he could have worked into the night deploying troops to secure objectives which might well have changed the course of the actual battle of Waterloo. The older Napoleon fought battles less well than the younger Napoleon, because he was sicker!

As well as the obvious physical diseases, the book also takes us through those which involve elements of addiction. Alcoholism is narrated with a particular poignancy as we hear of infant death rates soring during the worst excesses of the eighteenth century gin ‘epidemic.’ Was that due to parents too drunk to care for their children properly?

Overall the book gives a good overview to history, with some thoughtful links between historical events and medical factors. Its very readable, but its not a history of diseases. It’s a narration of history and a narration of disease, so it will be of most interest to readers who enjoy both historical and medical narratives.
Profile Image for Mal Warwick.
Author 30 books490 followers
April 5, 2023
Why was Ivan the Terrible so terrible? Why did Napoleon lose the Battle of Waterloo? What did Queen Victoria have to do with the fall of Russia’s last tsar? These are among the intriguing questions Frederick Cartwright and Michael Biddiss answer in Disease and History. The book, first published in 1972, has undergone three later editions. The most recent, the fourth edition, appeared in 2020 and bears the subtitle From Ancient Times to Covid-19. Coauthor Michael Biddiss updated the text, Frederick Cartwright having died nearly twenty years earlier. The result is a compelling story of the impact that microbes and genetics have exerted on our affairs. In short, how disease changed history.

THE IMPACT OF DISEASE ON CHRISTIANITY AND THE ROMAN EMPIRE
Cartwright and Biddiss set the pattern at the outset with a survey of the known facts about the incidence of contagious disease in ancient times. For example, they write, “the pestilences of the first three centuries AD produced two far-reaching and long-lasting effects which are less widely recognized. First, Christianity would hardly have succeeded in establishing itself as a world force and would certainly not have taken the form that it eventually did if the Roman Empire had not been ravaged by incurable disease during the years which followed the life of Christ.

“Second,” they continue, “the thousand-year development of medicine from the fourth to the fourteenth century would have been very different had its practice not fallen under the domination of the Christian Church.” Domination, they later make clear, that virtually stopped progress in medical science in the West for a millennium.

As you can see, the authors think big. But their broader conclusions are scattered among abundant stories about individual men and women and the pivotal roles they played in changing history as we know it. Three examples follow.

THREE SURPRISING AND COLORFUL EXAMPLES OF HOW DISEASE CHANGED HISTORY
To give you a sense of the flavor of this revealing little book, consider how the authors answered the questions I posed in the lede to this review.

WHY WAS IVAN THE TERRIBLE SO TERRIBLE?
“By our standards,” Cartwright and Biddiss note, “Ivan was no doubt a cruel despot even during [his] early years.” However, “by contemporary Russian and, indeed, European standards he ruled wisely and humanely from 1551 to 1560.” Then he started to change. When a young man, he was a notorious womanizer and contracted syphilis. Soon after the death of his wife, Ivan began showing clear symptoms of what we today call paranoia. His suspicions steadily grew more and more severe over the years, prompting him to turn against even his closest friends and relatives.

“Toward the end of 1564 there occurred the first ludicrous incident which clearly shows that Ivan now suffered from cerebral syphilis.” He loaded up all the gold, silver, and jewels of the treasury and abandoned the capitol, leaving no forwarding address. His nobles later found him in a small village. He acceded to their request that he return but only on the condition that he be “free to execute any ‘traitors’ he so desired.” The remainder of Ivan’s reign is a sickening tale of tortures and floggings, of burnings and boilings, of all manner of hideous deaths.” In other words, terrible, by anyone’s standards.

WHY DID NAPOLEON LOSE THE BATTLE OF WATERLOO?
Napoleon was a sick man at Waterloo, unable to give undivided attention to the battle. . . He was in great pain from an acute attack of cystitis, inflammation of the bladder. He also suffered from a heavy feverish cold.” As a result, the French Emperor uncharacteristically left major tactical decisions to his marshals. And the decisions they made proved disastrous.

However, an even more consequential illustration of how disease changed history came three years earlier in Napoleon’s catastrophic invasion of Russia. “Legend has it that almost the whole of Napoleon’s enormous army was destroyed on the retreat from Moscow. The legend is incorrect. A much larger number of men perished on the outward march through Poland and west Russia than on the retreat. . . Napoleon’s central or task army numbered about 265,000 men. Only 90,000 of these reached Moscow.”

Certainly, the Russian army and cooperating peasants had something to do with this. But a far more important factor was disease. First, “the common campaign diseases of dysentery and enteric fevers.” Then, fatally, typhus, which “held the army in its unrelenting grip.” The Grande Armée that faced the Russians at Borodino was weakened and demoralized, far from ready to face a determined force of men fighting to protect their families and their homes.

WHAT DID QUEEN VICTORIA HAVE TO DO WITH THE FALL OF RUSSIA’S LAST TSAR?
“Queen Victoria’s most fateful role in history,” the authors write, “was to transmit the rare genetic disorder known as Haemophilia A to a number of her descendants.” (Apparently, she inherited the mutant gene from her mother, the Duchess of Kent.) “One of Victoria’s four sons, Prince Leopold, died from haemophilia. Of her five daughters, two transmitted haemophilia to their sons or grandsons.” And a granddaughter, Alexandra, “married Nicholas II, Autocrat, Tsar and Emperor of All the Russias, thus bringing the haemophiliac gene into the Romanov family.”

That errant gene manifested in the youngest child and only son of Nicholas and Alexandra, the doomed boy Alexis. And the couple’s, especially his mother’s, single-minded obsession with keeping Alexis safe led to the intrusion of a drunken peasant named Grigori Rasputin into the affairs of the realm—and to disastrous decisions by the tsar as the war with the Central Powers raged on. We cannot know whether the boy’s affliction was the principal source of his parents’ disastrous choices—and to the Bolshevik Revolution—but circumstantial evidence strongly suggests it was so.

OVERALL ASSESSMENT OF THE BOOK
Disease and History is the product of two academics, and it shows. The writing style is flat and unexciting, but it’s clear enough. However, it does often stumble on from one topic to the next without transition. Throughout, the book could have done with subtitles to ease the reader’s way forward. However, as a whole, the case Cartwright and Biddiss make about how disease changed history is well worth reading. It puts into historical context the COVID-19 pandemic we’ve just experienced—and whatever emerging global disease we may face in the future.

ABOUT THE AUTHORS
Frederick F. Cartwright (1909-2001) was the Emeritus Senior Lecturer in the History of Medicine at King’s College Hospital of the University of London. He was an English anaesthetist and president of the History of Medicine Society of the Royal Society of Medicine. Cartwright was the author of a biography of Joseph Lister as well as coauthor of an earlier edition of this book.

Michael Biddiss (1942-) is emeritus professor of history at the University of Reading. He specialises in the history of the development of racist ideology, and the history of medicine. He was professor of history from 1979 to 2004, when he became emeritus. Biddis is the author, editor, or co-editor of eight books.
Profile Image for Saige Merrick.
3 reviews
August 5, 2025
Writing non-fiction, especially about a subject as complex as disease is no easy feat. While overall well done, I did feel like the book trailed off at times into what felt like irrelevant tangents. The author did a solid job of explaining the impacts of disease on society through history, but I would have liked to see more of the same emphasis placed on effect as was placed on case.
Profile Image for Rhonda Stroud.
13 reviews1 follower
February 9, 2023
An uneven, but still interesting book

This book is meant to be a general survey on how disease has influenced history on both the personal level and the macro level. I felt it did much better at explaining, for instance, the true costs of a disease like malaria and how long it has stymied human progress.
The author the explains how disease affects history by affecting leaders at crucial times throughout history. This is the weakness of the book, and the part that the editor should have rewritten. It reads as if it were written by a Victorian with a bad case of hero worship for Napoleon. He sounds much more like a detached historian when discussing the effects of hemophilia on the Russian revolution.
The last parts of the book discusses modern medicines one big success, the elimination of smallpox and contrasts with the failures to eliminate malaria, tuberculosis and how climate change will make the West vulnerable to many old enemies.
The last chapter deals solely with Covid and contrasts how the various governments dealt with the challenge. I thought this was the strongest part of the book. It didn't use a lot of stats, nor did it try to explain the difference between flu vaccines and RNA-based vaccines.
286 reviews6 followers
July 17, 2021
A magnificent and timely book

As we all lie about moaning about having to stay away.from others, etc. etc (well, not after Monday when we can infect everyone) we would do well to read this book. It is a comprehensive and balanced view of history allied to the diseases that afflicted the various areas of the world.

I did not realise to what extent disease had affected the outcome of so many successions, wars, social conditions et al. It is all laid out for us and how lucky we are to live now, partly because morbidity is lower but also because nursing, drugs and vaccinations are all so advanced. It does not make it any easier for those who have lost people but they would have died in relative comfort. Descriptions of disease in the past makes one's blood run cold.

My own father nearly died of typhus as one of the last White Army soldiers to leave Yalta in a filthy over-crowded ship for Constantinople.

As time goes on, and populations increase, Pandemics will come again, even if the current one eventually comes to an end or we regard as just another flu from which sadly, people already die each winter.
12 reviews
July 1, 2024
History of diseases veers into strange territory

I was attracted to this book because although it originally came out in the Early 1970s, it's been updated with a chapter on the Wuhan Virus, er, I mean, Covid. The book starts off and focuses on widespread illnesses, including malaria and diseases bought about by poor sanitation. Much of it focuses on Great Britain. My problem is the inclusion of chapters on witches and Adolf Hitler that have little to nothing to do with epidemics or diseases. Bizarre. Also, the chapter on Covid was written during its more virulent period and therefore it's outdated. For instance, the authors claim that it originated in the infamous wet markets of China while the latest information points to the equally infamous Wuhan laboratories as a likelier source.
Profile Image for Aimee Taylor.
21 reviews3 followers
December 20, 2023
A truly insightful look into history and disease going back to the plague (and referencing even earlier moments in history it may have proliferated) all the way to the Covid-19 pandemic, which modern readers have firsthand experience of. The writing was accessible to those without medical experience, however, I would have appreciated a bit more of the author’s voice throughout as the sections and diseases covered show a nuanced look at the intersection between history and disease. I particularly enjoyed the exploration through historical figures and events, such as the Witch trials.
Profile Image for Nisha Ward.
123 reviews5 followers
September 18, 2023
Very informative but dry

As far as history and virology go hand in hand, there is no doubt that the two share a connection. Smallpox radically changed the new world and many of the incidents mentioned in the book have had great global and historical impact.

That said, as informative as it was, it was also just really hard to get through. I had a rough time reading it despite enjoying what it had to offer.
36 reviews
February 16, 2022
Dry, repetitive

I like history and the lessons it can teach us. As a pharmacist I find interesting the histories of diseases, and the ways that diseases can change societies. So i thought the book would be right up my alley. But the dry writing style me the reading less than enjoyable.
Profile Image for Beth.
149 reviews
December 10, 2022
Really interesting little book, which has been updated several times since original publication. The covid section needs another update as analysis has moved on a fair bit. It also would have been good to cover more about AIDS, Ebola and others, given the extensive research available.
Profile Image for Betsy.
1,129 reviews144 followers
March 30, 2023
Some of the chapters are more interesting than others such as the one on Napoleon and the one about Nicholas and Alexandra. Glad to see that they managed to include information about COVID-19, including some of the lies put out by politicians. Scary world out there, and not likely to get better.
89 reviews1 follower
April 17, 2023
A bit dry for my taste

A United Kingdom oriented work. Well written and researched. Interesting reading. Links widespread diseases to U K history identifies epidemic, & pandemic likely sources and distribution paths.
Profile Image for Crystal Toller.
1,162 reviews10 followers
May 31, 2023
Disease & History

This book discusses the interrelation of different diseases on the course of history and how different diseases in different eras have affected history. Really enjoyed this book and enjoyed learning more about the relationship between disease and history.
Profile Image for Dayla.
1,371 reviews41 followers
January 1, 2025
This book should be required reading for every student before heading out into the world.

And so far, this book has tied four other books I'm currently reading together.
1) "Mrs. Shelley" with her loss of three of her children to diseases untreatable at the time in the early 19th century
2) "A Black Women's History of the United States" discussing diseases brought from the explorers to the indigenous people of South America.
3) "I Contain Multitudes" which explains how food, especially overly processed food is destroying our health.
4) "The Greater Journey" describing how many children and spouses died during a mid 19th century sojourn to Paris.
3 reviews
November 6, 2022
Great book

Apart from the epilogue about covid which falls foul of regurgitating headline stories about covid. The rest is riveting read.
Profile Image for Old Bob.
153 reviews
November 10, 2022
Almost straight away the authors refer to the Bible as a source of factual information.
I was hoping for something more scientific.
100 reviews
January 1, 2023
Interesting book, a bit dry at times but enjoyed it
75 reviews1 follower
April 22, 2023
It was okay it was more speculative than anything.
213 reviews4 followers
May 25, 2023
Interesting read

As much a history lesson as learning about diseases that have afflicted mankind. Well worth your time to read and enjoy.
Profile Image for Andrew Degruccio.
341 reviews
June 15, 2023
A brief review of the impact of disease on history. More in depth coverage can be found in other books. Lumping mass hysteria with multiple other infectious diseases seems a stretch.
Profile Image for Tammi.
49 reviews1 follower
August 3, 2023
Some interesting info, good overview of wide variety of topics... but much of it was a slog.
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