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Contagion and the State in Europe, 1830-1930
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 (ISBN-13: 9780511036590 | ISBN-10: 0511036590)

This book is a groundbreaking study of the historical reasons for the divergence in public health policies adopted in Britain, France, Germany and Sweden, and the spectrum of responses to the threat of contagious diseases such as cholera, smallpox and syphilis. In particular the book examines the link between politics and prevention. Did the varying political regimes influence the styles of precaution adopted? Or was it, as Peter Baldwin argues, a matter of more basic differences between nations, above all their geographic placement in the epidemiological trajectory of contagion, that helped shape their responses and their basic assumptions about the respective claims of the sick and of society, and fundamental political decisions for and against different styles of statutory intervention? Thus the book seeks to use medical history to illuminate broader questions of the development of statutory intervention and the comparative and divergent evolution of the modern state in Europe.

• A broad, panoramic view of major health policies in contrasting European countries and regimes, 1830–1930 • Integrates the medical and political history of cholera, smallpox and syphilis • Essential reading for all historians of public health


1. Preventive variations; 2. Enter cholera; 3. Cholera comes of age; 4. Smallpox faces the lancet; 5. Syphilis between prostitution and promiscuity; 6. The politics of prevention; Bibliography.


'… a quite dazzling work, imaginative in conception, broad in vision, amazingly erudite in execution, and perceptive in its judgments. There is simply no work like it - a Europe-wide juxtaposition of medicine and politics. Readers will surely relish the astonishing 'War and Peace' panorama of disease and the destiny of Europe which Baldwin paints, and the consummate mastery with which he handles his materials.' Roy Porter, late of Wellcome Institute for the History of Medicine

'It is the most important recent book in a field that is undergoing a significant renewal. It is also a masterwork of comparative history. Quite simply, it is essential reading for all historians of modern public health.' Bulletin of the History of Medicine

'This is one of those rare works of history, wholly satisfying in its own terms, which also sets a broad agenda for future investigation.' International History Review

'This dazzling book demonstrates how contagious diseases affected politics and public policy in Europe … Baldwin's comprehensive account … contributes to both the history of medicine and the history of political ideology and cultural values … A fascinating tour de force of scholarship.' Foreign Affairs

'… Baldwin is a stylist as well as a deeply curious researcher. Some passages are beautifully written, terms have been artfully chosen, there is humour, amusing and effective anecdotes abound.' The Times Literary Supplement

'This is a path-breaking study that not only integrates a wealth of material, but also furnishes a role model for historians undertaking comparative analysis and a thesis that provides a major source of inspiration for future historians of contagion.' Economic History Review

'The boldness of the undertaking is more than matched here by the astonishing depth and breadth of the research … This encyclopedic bibliographic range makes the book a real treasure for researchers, and even if for no other reason than this, historians of public health will be in Baldwin's debt for many years to come.' Journal of the American Medical Association

'The book is based on a remarkably broad range of sources…. Baldwin's work makes a unique and important contribution to the discussion on the inter-related questions of medical history and politics. Scandinavian Economic History Review

'… this book is well worth the effort it takes to read. Though not abandoning the notion that prevention policies are partially shaped by political and economic interests, it gives a far more nuanced picture of the complex relationships between policies and interests than we have had before, and on a scale unmatched by previous work. It is an important and valuable contribution.' Journal of Interdisciplinary History

'Overall, Baldwin seems to favour the technological, commercial, and geographical explanations for national differences in public policy although at the conclusion he returns to the original Ackernechtian thesis with a certain amount of sympathy … [the book] is an elegantly written work, and constitutes essential reading for anyone interested in the history of public health.' Metascience

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