Description

A sweeping global history that looks beyond European urban centers to show how slavery, colonialism, and war propelled the development of modern medicine.

Most stories of medical progress come with ready-made heroes. John Snow traced the origins of London’s 1854 cholera outbreak to a water pump, leading to the birth of epidemiology. Florence Nightingale’s contributions to the care of soldiers in the Crimean War revolutionized medical hygiene, transforming hospitals from crucibles of infection to sanctuaries of recuperation. Yet histories of individual innovators ignore many key sources of medical knowledge, especially when it comes to the science of infectious disease.

Reexamining the foundations of modern medicine, Jim Downs shows that the study of infectious disease depended crucially on the unrecognized contributions of nonconsenting subjects-conscripted soldiers, enslaved people, and subjects of empire. Plantations, slave ships, and battlefields were the laboratories in which physicians came to understand the spread of disease. Military doctors learned about the importance of air quality by monitoring Africans confined to the bottom of slave ships. Statisticians charted cholera outbreaks by surveilling Muslims in British-dominated territories returning from their annual pilgrimage. The field hospitals of the Crimean War and the US Civil War were carefully observed experiments in disease transmission.

The scientific knowledge derived from discarding and exploiting human life is now the basis of our ability to protect humanity from epidemics. Boldly argued and eye-opening, Maladies of Empire gives a full account of the true price of medical progress.

Publisher Review

For those of us looking warily toward future epidemics, this book draws our attention to oft-forgotten sources of medical knowledge...Deserves to be read, particularly now. Few will question the salvational power that epidemiology will likely have in the years to come. -- Suman Seth * Science * Maladies of Empire has a captivating writing style, is exhaustively researched, and is persuasive in argumentation. Jim Downs has written a game-changing book. -- Deirdre Cooper Owens, author of Medical Bondage: Race, Gender, and the Origins of American Gynecology Maladies of Empire provides an illuminating, painstaking, yet engaging interrogation of original records and sources, filling critical gaps in the development of epidemiology. Indispensable and compelling. -- Harriet A. Washington, author of the National Book Critics Circle Award-winning Medical Apartheid Exposes how doctors with few clues made concerted efforts to track and understand deadly epidemics at a time when the colonialist enterprise was aggressively remaking the world...[Downs] fleshes out a crucial part of a larger tapestry to help explain the onset of racial segregation in the United States. The people whose experiences he tries to recover 'appear only as fragments' in the historical record but they impart a crucial dimension that remains utterly germane to the present. -- John Galbraith Simmons * Los Angeles Review of Books * Downs has written an eye-popping study of the history of infectious diseases, how they spread, and especially how they have been thwarted by experimentation on the bodies of soldiers, slaves, and colonial subjects. For three centuries medicine transformed science and human longevity by knowledge garnered from battlefields, slave ships, and mass migrations of vulnerable people. This is a timely, brilliant book about some of the brutal ironies in the story of medical progress. Our health today owes so much to the blood and suffering of nameless predecessors. -- David W. Blight, author of the Pulitzer Prize-winning Frederick Douglass: Prophet of Freedom In this brilliant and timely book, Jim Downs uncovers the origins of epidemiology in slavery, colonialism, and war. Controlling large populations through violence and burgeoning state bureaucracies allowed for new insights into the genesis and spread of human disease. A most original global history, this book is required reading for historians, medical researchers, and really anyone interested in the origins of modern medicine. -- Sven Beckert, author of the Bancroft Prize-winning Empire of Cotton: A Global History Maladies of Empire is a major contribution to the ongoing investigation of the impact of slavery and colonialism on the modern world. Jim Downs shows how studies of exploited groups helped scientists understand the spread and treatment of infectious disease. At a time when epidemiologists are rightly lauded for their work in controlling the COVID-19 pandemic, Downs calls on us not to forget the role, without their consent, of the long forgotten enslaved, colonized, and imprisoned in the development and global dissemination of medical knowledge. -- Eric Foner, author of The Second Founding: How the Civil War and Reconstruction Remade the Constitution Maladies of Empire shifts the site of medical knowledge from European cities to the international slave trade, colonial lands and wars, and the resulting movement of populations. This vivid and brilliant analysis of these critical sites fundamentally changes our views of the origins of epidemiology and the transnational flow of medical knowledge about disease transmission. This excellent work will surely become required reading for historians of medicine, disease, and empire. -- Evelynn M. Hammonds, coeditor of The Nature of Difference In this meticulously researched and beautifully written work, Jim Downs transforms our understanding of the relationship between the history of medicine, colonialism, and the institution of slavery. Maladies of Empire illuminates the crucial connections between eighteenth- and nineteenth-century comprehension of disease and the evidence gathered from captive Africans, enslaved plantation workers, and soldiers throughout the Atlantic world. Charting the origins of modern epidemiology in the inequities of forced labor, Downs makes foundational contributions to the histories of medicine, colonialism, and slavery. Everyone interested in the connections between race and disease should read Maladies of Empire. -- Jennifer L. Morgan, author of Reckoning with Slavery A powerful account of the intertwined histories of medicine and empire, within a truly global framework. Simultaneously intimate and sweeping, Maladies of Empire reveals the human side of the development of epidemiology. Inverting the traditional focus on medical men, Downs puts soldiers, prisoners, and enslaved people at the heart of the rise of scientific medicine, providing a compelling account of how our modern-day tools of epidemiology were shaped by war, slavery, and colonialism. -- Erica Charters, author of Disease, War, and the Imperial State