Plagues and Peoples

by William H. McNeill

  3. On the special conditions of early Chinese agriculture see Ping-ti Ho, “The Loess and the Origins of Chinese Agriculture,” American Historical Review, 75 (1969), 1–36. For Amerindian cultivation see R. S. MacNeish, “The Origins of American Agriculture,” Antiquity, 39 (1965), 87–93.

  4. For instructive remarks on hyperinfestation and its relation to human activities, see N. A. Cr oil, Ecology of Parasites, pp. 115ff.

  5. Ivan V. Polunin, “Health and Disease in Contemporary Societies,” in Don Brothwell and A. T. Sandison, Disease in Antiquity, pp. 74, 84.

  6. Estimates of ancient populations are entirely speculative, based on assumptions about density per square mile. For two such global estimates see Kent V. Flannery, “Origins and Ecological Effects of Early Domestication in Iran and the Near East,” in Peter Ucko and G. W. Dimbleby, The Domestication and Exploitation of Plants and Animals, p. 93; D. R. Brothwell, “Dietary Variation and the Biology of Earlier Human Populations,” ibid., pp. 539–40.

  7. For details see C. A. Wright, “The Schistosome Life Cycle,” in F. K. Mostofi, ed., Bilharziasis (New York, 1967), pp. 3–7.

  8. Today Egypt is the best-known home of schistosomiasis; but much of eastern and western Africa, together with western Asia, the rice paddies of eastern Asia, and offshore areas like the Philippines and parts of Brazil are also infected. Three different varieties of blood flukes are involved; and local strains are often specific to local mollusks, making a very complex and still imperfectly understood series of local variations in the character and, for humans, the severity of the disease. Cf. Louis Olivier and Nasser Ansari, “The Epidemiology of Bilharziasis,” in F. K. Mostofi, ed., Bilharziasis, pp. 8–14.

  9. Marc Armand Ruffer, Studies in Paleopathology of Egypt (Chicago, 1921), p. 18, reports the discovery of schistosome eggs in the kidneys of two mummies from the XXth dynasty. He found such eggs in two out of six kidneys examined; and since the kidneys are not the organ blood flukes are most likely to infect (their usual home being the bladder and soft viscera that were discarded by ancient embalmers) it seems likely that schistosomiasis was as common in ancient as it is in modern Egypt.

  10. J. V. Kinnier Wilson, “Organic Diseases of Ancient Mesopotamia,” in Brothwell and Sandison, Diseases in Antiquity, pp. 191–208, tries to fit cuneiform terminology into modern medical classifications of disease. This is a hopeless enterprise and nothing he reports sounds in the least like schistosomiasis. Cf. also Georges Contenau, La Médicine en Assyrie et la Babylonie (Paris, 1938), and Robert Biggs,”Medicine in Ancient Mesopotamia,” History of Science, 8 (1969), 94–105. On early contacts between Mesopotamia and Egypt, cf. Helene J. Kantor,”Early Relations of Egypt with Asia,” Journal of Near Eastern Studies, 1 (1942), 174–213.

  11. “A Lady from China’s Past,” The National Geographic, 145 (May 1974), 663. The corpse, which was of high social rank, also carried tuberculosis scars in the lungs.

  12. Cf. J. N. Lanoix, “Relations Between Irrigation Engineering and Bilharziasis,” World Health Organization, Bulletin, 18 (1958), 1011–5.

  13. In modern Egypt, hookworm was and remains almost or quite as important as schistosomiasis in debilitating the population. Globally, hookworm is more widespread than schistosomiasis, since it only requires moist soils and a barefoot population to spread from host to host.

  14. Karl A. Wittfogel, Oriental Despotism: A Comparative Study of Total Power (New Haven, Connecticut, 1957) is the principal modern scholar to develop the notion that there was a peculiar type of totalitarianism associated with what he calls hydraulic civilizations.

  15. What modern diseases correspond to biblical leprosy is a much disputed and quite insoluble question. Cf. Vilhelm Møller-Christensen, “Evidences of Leprosy in Earlier Peoples,” in Brothwell and Sandison, Diseases in Antiquity, pp. 295–306; Olaf K. Skinsnes, “Notes from the History of Leprosy,” International Journal of Leprosy, 41 (1973), 220–7.

  16. Olivier and Ansari, op. cit., p. 9.

  17. See below, p. 232.

  18. René Dubos, Man Adapting, p. 237; George Macdonald, The Epidemiology and Control of Malaria (London, 1957), p. 33 an à passim.

  19. Frank B. Livingstone, “Anthropological Implications of Sickle Cell Gene Distribution in West Africa,” American Anthropologist, 60 (1958), 533–62.

  20. Detailed accounts of events in five different regions of Africa may be found in John Ford, The Role of the Trypanosomiases in African Ecology: A Study of the Tsetse Fly Problem (Oxford, 1971). Cf. also Charles N. Good, “Salt, Trade and Disease: Aspects of Development in Africa’s Northern Great Lakes Region,” International Journal of African Historical Studies, 5 (1972), 43–86; H. W. Mulligan, ed., The African Trypanosomiases (London, 1970), pp. 632ff. According to Mulligan, the outbreaks of sleeping sickness in the twentieth century are by-products of a sharp initial disturbance of ecological relationships in Africa arising from the catastrophic spread of rinderpest among African game animals in the 1890s. Die-off of herds was so extensive as to compel a shrinkage of tsetse range, together with a simultaneous reduction in domesticated herds and their ranges. As wild and domesticated herds recovered and began to expand their territories, interpenetration began to occur, allowing transfer of the trypanosome to human populations at many points along the expanding frontier of herding and agriculture. Such a view puts less blame on colonial administration, more weight on ecological processes, than Ford’s book does, though the two authorities agree as to fundamental data.

  21. Cf. R. Edgar Hope-Simpson, “Studies on Shingles: Is the Virus Ordinary Chicken Pox?” Lancet, 2 (1954), 1299–1302; R. Edgar Hope-Simpson, “The Nature of Herpes Zoster: A Long-Term Study and a New Hypothesis,” Proceedings of the Royal Society of Medicine, 48 (1865), 8–20.

  22. Francis L. Black, “Infectious Diseases in Primitive Societies,” Science, 187 (1975), 515–18. T. Aidan Cockburn, The Evolution and Eradication of Infectious Diseases (Baltimore and London, 1963), pp. 84ff; Macfarlane Burnet and David O. White, Natural History of Infectious Disease, 4th edition (Cambridge, 1972), pp. 147–48; T. W. M. Cameron, Parasites and Parasitism (London, 1956), pp. 284ff.

  23. Francis L. Black, “Measles Endemicity,” Journal of Theoretical Biology, 11 (1966), 207–11; T. Aidan Cockburn, “Infectious Diseases in Ancient Populations,” Current Anthropology, 12 (1971), 51–56. Smallpox has a particularly complex and well-known set of relatives that affect cattle, sheep, pigs, horses, mice, birds, mollusks, and rabbits. In addition there are two forms prevalent among humans and in recent years man-made attenuated strains constitute yet another variety of the variola virus. Cf. Jacques M. May, ed., Studies in Disease Ecology (New York, 1961), p. 1.

  24. Thomas G. Hull, Diseases Transmitted from Animals to Man, 5th ed. (Springfield, Illinois, 1963), pp. 879–906.

  25. Extensive work has been done in the USSR to detect natural disease pools capable of affecting human populations. Cf. Evgeny N. Pavlovsky, Natural Nidality of Transmissible Diseases (Urbana and London, 1966). According to Pavlovsky, some infections are shared by as many as a dozen animal species, wild and domesticated alike. Hull, op. cit., pp. 907–9, tabulates 110 diseases shared by humans and wild animals or birds. The total we share with domesticated animals as listed in the same book is 296.

  26. T. W. M. Cameron, Parasites and Parasitism, p. 241.

  27. Richard Fiennes, Zoonoses of Primates: The Epidemiology and Ecology of Simian Diseases in Relation to Man (Ithaca, New York, 1967), p. 126.

  28. John G. Fuller, Fever! The Hunt for a New Killer Virus (New York, 1974); John D. Frame et al., “Lassa Fever, a New Virus Disease of Man from West Africa,” American Journal of Tropical Hygiene, 19 (1970), 670–96.

  29. Cf. Kent V. Flannery, “The Origins of the Village as a Settlement Type in Mesoamerica and the Near East: A Comparative Study,” in Peter J. Ucko, et al., Man, Settlement and Urbanism (London, 1972), pp. 23–53; and Kent V. Flannery, “The Cultural Evolution of Civilizations,” Annual Review of Ecology and Systematics, 3 (197
2), 399–426, for interesting discussion of the genesis of village social structures and of civilized governments or, as he calls them, states.

  30. Alteration of virulence, that is, alteration of the type and severity of symptoms that a disease organism provokes, is a normal result of any transfer of parasitism to a new host species. Cf. Burnet and White, Natural History of Infectious Disease, pp. 150–51. On disease and gregarious-ness, cf. T. W. M. Cameron, Parasites and Parasitism, p. 237.

  31. Frank Fenner and F. N. Ratcliffe, Myxomatosis (Cambridge, 1965), pp. 251, 286, and passim. Myxomatosis was also introduced into France and England in the 1950s with drastic and somewhat different results, owing largely to differences in the insect vectors that spread the infection.

  32. Even here there are analogies. Careful observers reported that English rabbits reacted to the outbreak of myxomatosis by living more above ground, and spending less time in burrows. Fenner and Ratcliffe, op. cit., p. 346.

  33. See below, p. 185.

  34. Fenner and Ratcliffe, op. cit., p. 42.

  35. Andre Siegfried, Routes of Contagion (New York, 1960), p. 18.

  36. M. S. Bartlett, “Deterministic and Stochastic Models for Recurrent Epidemics,” Proceedings of the Third Berkeley Symposium in Mathematical Statistics and Probability, 4 (Berkeley and Los Angeles, 1956), 81–109; M. S. Bartlett, “Epidemics,” in Janet Tanur et al., Statistics: A Guide to the Unknown (San Francisco, 1972), pp. 66–76; M. S. Bartlett, “Measles Periodicity and Community Size,” Journal of the Royal Statistical Society, 120 (1957), 48–70; Francis L. Black, “Measles Endemicity in Insular Populations: Critical Community Size and Its Evolutionary Implications,” Journal of Theoretical Biology, 11 (1966), 207–11.

  37. Cf. René Dubos, Man Adapting, p. 134.

  38. Robert J. Braidwood and Charles A. Reed, “The Achievement and Early Consequences of Food Production: A Consideration of the Archaeological and Natural-Historical Evidence,” Cold Spring Harbor Symposium on Quantitative Biology, 22 (1957), 28–29.

  39. On this linguistic shift and the absence of any signs of military conflict in connection with it, cf. Thorkild Jacobsen, “The Assumed Conflict between Sumerians and Semites in Early Mesopotamian History,” Journal of the American Oriental Society, 59 (1939), 485–95.

  40. Emil Schultweiss and Louis Tardy, “Short History of Epidemics in Hungary until the Great Cholera Epidemic of 1831,” Centaurus, 11 (1966), 279–301, estimate 1831 cholera deaths in Hungary at 250,000. Not all of these were urban; but a majority were. Such a sudden die-off obviously opened places in town for scores of thousands of peasants, who brought their languages with them.

  41. For modern examples of devastating disease encounters of this kind and an easily comprehensible outline of factors affecting immunity to infectious disease, see René Dubos, Man Adapting (New Haven and London, 1965), pp. 171–85.

  42. Burnet and White, Natural History of Infectious Disease, pp. 79- 81, 97–100. The influenza epidemic of 1918–19 was the most recent disease to manifest this surprising preference for killing off young adults.

  43. Cf. William H. McNeill, The Rise of the West (Chicago, 1963), Chs. 4, 5.

  Chapter III

  1. Epic of Gilgamesh, Tablet 11, line 184; “Story of Sinuhe,” J. B. Pritchard, ed., Ancient Near Eastern Texts Relating to the Old Testament (Princeton, New Jersey, 1950), p. 19.

  2. Translated by Joseph Cha.

  3. Exodus 9:9, J. M. P. Smith translation.

  4. Exodus 12:30.

  5. I Samuel 5:6–6:18.

  6. II Samuel 24.

  7. Isaiah 37:36.

  8. Georg Sticker, Abhandlungen aus der Seuchengeschichte und Seuchenlehre (Glessen, 1908), 1, 17, falls into this trap in listing antecedents to the plagues he chronicles.

  9. Marc Armand Ruffer and A. R. Ferguson, “Note on an Eruption Resembling That of Variola in the Skin of an Egyptian Mummy of the Twentieth Dynasty (1200–1100 B.C.),” Journal of Pathology and Bacteriology 15 (1911), 1–3, tentatively diagnose smallpox on the basis of microscopic examination of a small section of skin. Their techniques were clumsy compared to methods of microscopic and chemical analysis available today and results are not always dependable. Modern techniques have been used only sporadically and without notable results as yet. Cf. T. Aidan Cockburn, “Death and Disease in Ancient Egypt,” Science, 181 (1973), 470–71.

  10. As sidelight and confirmation: medical specialists were of ancient standing in Egypt and Mesopotamia; and Babylonian medical texts accepted the notion that some diseases were contagious as early as the seventeenth century B.C. One letter, indeed, says that since a lady is suffering from a contagious disease, no one should drink from her cup, sit on her bed, or visit her quarters. The concept of contagion may have been magical, but magic sometimes had a solid empirical base. Cf. Robert Biggs, “Medicine in Ancient Mesopotamia,” History of Science, 8 (1969), 96.

  11. Cf. William H. McNeill, The Rise of the West, Ch. 5, for remarks on the definition of the Greek, Indian, and Chinese civilizations.

  12. The river made this sort of drastic change of course as long ago as A.D. 11 and as recently as 1937. For the disaster of A.D. 11 and its population consequences cf. Hans Bielenstein, “The Census of China During the Period 2–742 A.D.,” Museum of Far Eastern Antiquities, Bulletin, 19 (1947), 140.

  13. The population maps appended to Bielenstein’s article, cited above, show how preponderant the Yellow River flood plain remained until after the eighth century A.D.

  14. Shih-chi, Ch. 129, translated by Ping-ti Ho.

  15. For literary records of the unhealthiness of the South, see the collection of references assembled in Edward H. Schäfer, The Vermilion Bird: T’ang Images of the South (Berkeley and Los Angeles, 1967), “Miasmas,” pp. 130–34.

  16. I counted five diseases as plotted in Ernst Rodenwaldt et al., eds., World Atlas of Epidemic Diseases (Hamburg, 1952–56), that were present in southern China and absent in the North. This atlas attempts to describe twentieth-century disease distributions, but data from China were so defective that for many diseases the compilers simply treated the entire country as a single whole. Thus the real differential in disease incidence in modern China is by no means recorded in this Atlas; and the distinctions it does make between north and south are doubtless liable to correction whenever more accurate and abundant data become available. I should also point out that one disease, Kala Azar, caused by a protozoal infection, is recorded only for northern China, so not everything intensifies in softer climes!

  17. Lu Gwei-Djen and Joseph Needham, “Records of Diseases in Ancient China,” in Brothwell and Sandison, eds., Diseases in Antiquity, pp. 222–37, assign modern names to a long list of Chinese terms, but their confidence in an easy convertibility between ancient and modern nosology remains unconvincing.

  18. Mark F. Boyd, ed., Malariology: A Comprehensive Survey of all Aspects of this Group of Diseases from a Global Standpoint (Philadelphia and London, 1949), II, 816.

  19. C. A. Chamfrault, Traité de Medicine Chinoise, 5 vols., 2nd ed. (Angoulême, 1964), I, 697–706.

  20. Cf. C. A. Gordon, An Epitome of the Reports of the Medical Officers of the Chinese Imperial Customs Service from 1871 to 1882 (London, 1884), p. 118.

  21. “A Lady from China’s Past,” The National Geographic, 145 (May, 1974), 663.

  22. Hippocrates, Epidemics I, 1.

  23. Hippocrates, Epidemics I, vi; cf. W. H. S. Jones, Malaria and Greek History (Manchester, 1909), pp. 62–64.

  24. Cf. Angelo Celli, The History of Malaria in the Roman Campagna from Ancient Times (London, 1933), pp. 12–30.

  25. For a non-technical introduction to the complexities of malarial ecology of the Mediterranean, L. W. Hackett, Malaria in Europe: An Ecological Study (London, 1937) can be warmly recommended. More recent, and more difficult, are George Macdonald, The Epidemiology and Control of Malaria (London, 1957), and Marston Bates, “Ecology of Anopheline Mosquitoes,” In Mark F. Boyd, ed., Malariology, I (Philadelphia, 194
9), 302–30.

  26. Airs, Waters, Places, VII.

  27. According to J. Szilagyi, “Beiträge zur Statistik der Sterblichkeit in der Westeuropäischen Provinzen des Romischen Imperium,” Acta Archaeologica Académica Scientiarum Hungaricae, 13 (1961), 126–56, average age of death for a sampling of persons buried in Roman times comes out as follows:

  City of Rome 29.9

  Iberia 31.4

  N. Africa 46.7

  Britain 32.5

  Germany 35.0

  These figures are based on study of statistically inadequate samples, and the medical judgment that assigns an age to imperfectly preserved skeletal remains is liable to error as well. Hence no great store should be placed in such statistics, though the enhanced risk of early death inherent in megapolitan living seems clear enough.

  28. M. L. W. Laistner, Greek History (Boston, 1931), p. 250.

  29. Julius Beloch, Die Bevölkerung der Griechische-Römischen Welt (Leipzig, 1886), remains fundamental, summarizing all that can be deduced from written records in a very sensible way. For more recent and specialized population studies, see A. W. Gomme, The Population of Athens in the Fifth and Fourth Centuries B.C. (Oxford, 1933), and Tenney Frank, An Economic Survey of Ancient Rome, 5 vols. (Baltimore, 1933–40).

  30. On Chinese population cf. Michel Cartier and Pierre-Etienne Will, “Demographie et Institutions en Chine: Contribution à l’Analyse des Recensements de l’Époque Imperiale (2 ap. J.C.-1750),” Annales de Démographie Historique (1971), 161–235, and the review of this work by Hans Bielenstein in T’oung Pao, 61 (1975), 181–85. The divergence between the two quoted figures reflects two different manuscript sources, and there seems no basis to prefer one as against the other. In his earlier work, Hans Bielenstein, “The Census of China During the Period 2–742 A.D.,” Museum of Far Eastern Antiquities, Stockholm, Bulletin, 19 (1947), 125–73, cited only the lesser of the two figures.