a map of the moon, drawn by van Langren in 1644, harmoniously combined its scientific contents with the panegyric form. Dedicated to the king of Spain, the map features a conspicuous terra dignitatis, with lunar craters named after the kings, the queens and nobles of European states. A conspicuous crater named in honour of Wladyslaw (Ladislaus) IV Vasa, king of Poland, grand duke of Lithuania, was surrounded by smaller ones, bearing names of higher dignitaries of Poland and Lithuania, the ‘Commonwealth of Two Nations’. The topography of these objects, if somewhat peripheral, nevertheless signified a powerful state influencing the course of events on a vast political subcontinent of north-eastern and eastern Europe.

The Commonwealth was involved in struggle with the budding violent expansion of Sweden (striving for supremacy over the Baltic region), directly in conflict with Muscovy over the territorial claims to vast spaces of the eastern lands of the Grand Duchy of Lithuania; in the south/south-east confronting the Ottoman empire. Political and military conflicts had of course the double-sided effect of inducing some amount of cultural exchange, including in matters scientific. It seems that none of the directions of active political interest enriched, and none could enrich, the scientific milieu of Poland in the early part of the Scientific Revolution. The extensive development of the economy could not enhance the scope of cultural communications; this factor was limited largely to the seaport towns, especially Gdańsk (Danzig).

england has always figured prominently in efforts to explain the Scientific Revolution. An intellectual backwater in the sixteenth century, it more than made up for this in the seventeenth century, so that by 1660 it became, arguably, ‘the major centre for organized scientific activity in Europe’. Accordingly, it has continually drawn the attention of, and provided fertile ground for, historians seeking to explain the changing approach to the natural world and the burgeoning of natural philosophy which constitute the Scientific Revolution. Indeed, the two earliest attempts to reveal the driving forces behind the new science – Boris Hessen's Marxist account of ‘The Social and Economic Roots of Newton's “Principia”’, and Robert Merton's Weberian thesis, ‘Science, Technology and Society in Seventeenth-Century England’ – both focused on the English scene.

In Hessen's case, however, concentration upon England was merely a matter of historiographical expediency. Although the problems of mechanics and hydrostatics which Newton dealt with in his Principia mathematica could be made to support Hessen's claims, and although ‘the English revolution gave a mighty stimulus to the development of productive forces’, Hessen's thesis was by no means confined to late seventeenth-century England. ‘The brilliant successes of natural science during the sixteenth and seventeenth centuries’, Hessen wrote, ‘were conditioned by the disintegration of the feudal economy, the development of merchant capital, of international maritime relationships and of heavy (mining) industry.’

from Gemma Frisius and Simon Stevin to Christiaan Huygens, from Clusius to Hermannus, from Paludanus to Ruysch, from Paauw to De Graaf, from Van Helmont to Sylvius, from Beeckman to Swammerdam and Van Leeuwenhoek, and from Vesalius to Boerhaave, Dutch and Flemish scholars combined excellent educations with investigative enterprise, technical competence, and moral commitment. These and other people of the region achieved wide notice and enduring fame. In the low countries, the intellectual and cultural changes of the late middle ages and Renaissance had not just a broad influence, but a deep one as well. It was a place where local traditions and a patchwork of competing jurisdictions allowed both Humanism and the Enlightenment to prosper in difficult times. It was also a region in which the new science flourished.

Yet when we begin to examine the work of the many scholars of the region who helped to create fundamental changes in the European knowledge of nature, we will be forced to note an important fact: the new science grew mainly by the efforts of people engaged in working out the details of natural history, medicine, chemistry and mathematics. Perhaps the focus of attention people have given to ‘philosophers’ the likes of Galileo, Descartes, Newton and Leibniz has warped our expectations. To be sure, the Dutch Republic can claim Christiaan Huygens, and perhaps even Descartes, since the latter wrote his most important works in the United Provinces.

the subject of this essay is an historiographical minefield. The very concept of the Scientific Revolution has been challenged on a number of fronts in recent years, and there is now little agreement as to who made the revolution, what the exact nature of the revolution was, and when precisely this protracted event occurred. One might also question the validity of focusing on ‘national’ contexts, for as the distinguished historian J. H. Elliott has warned, the ‘besetting sin of the national historian is exceptionalism’, that is, the inability or unwillingness to see the wood for the trees. Arguably, the need for a less particularistic historical vision is especially urgent when dealing with the early modern period. Despite the growing use of the vernacular, Latin served as the lingua franca in Europe well into the eighteenth century, and this fostered the existence of a cosmopolitan Republic of Letters in which national identities were to a large extent submerged in the broader European realm of learning. Furthermore, during the early modern era regional loyalties were often more powerful than national ones even in a country like France, which boasted a highly developed and increasingly centralized state apparatus. Hence the notion of a French or an English ‘national’ context is an extremely problematic one, in so far as it may not in fact address the contextual specificities it was initially intended to capture.

From the fall of the Roman Empire to the late eighteenth century, two kinds of public health measures dominated: emergency measures to deal with epidemic disease and specific measures relating to municipal nuisances such as offensive trades and waste disposal. The principal goal of public health was the prevention and management of epidemics, whose methods varied, but typically included emergency measures such as quarantines, sequestration, cordons sanitaires, and temporary institutions such as boards of health and sanitary intendancies. These measures were predicated upon two theories of disease causation: an environmentalist and climatic theory – the predominant theory – and a contagionist theory. Plague had traditionally been considered a contagious disease, and epidemic prevention and control were based upon that experience. Epidemics posed severe problems for authorities and created a crisis mentality, demanding immediate attention. Once the crisis was over, however, the institutions established to manage the emergency were disbanded, and business as usual resumed. Endemic diseases received little attention from authorities, since they were a way of life and death known to all. There was little concern for permanent public health regulations and institutions in the rural areas and small towns where most people lived. In larger towns and cities, however, local authorities regulated “nuisances,” such as refuse disposal and offensive trades. Enforcement varied widely from place to place, with many regulations not being enforced at all. If a particular situation became too troublesome, ad hoc action was taken.

Before 1850, most French workers were employed in traditional artisanal industries located in small workshops and workers' cottages, but some areas of northern France, namely, the Nord, Loire, Seine-Inférieure, Alsace, and greater Paris industrialized rapidly. Both handcraft and domestic industries and new mechanized, factory-based industries attracted the attention of sociomedical investigators. Industrialization generated a new interest among public hygienists and social reformers in the health of the working classes, because it seemed to threaten the health of factory workers. Statistics gathered in England and France showed that mortality was much higher in industrial than agricultural areas and that army rejections were greater among the working classes than among the comfortable classes. Hygienists and reformers investigated the condition of the working class to determine how industry and industrialization affected workers' health. At stake, hygienists believed, was the military and productive strength of the nation.

Hygienists identified two principal ways in which industry could affect workers' health: Industrial and occupational processes and working conditions in factories and workshops could cause health problems; and workers' living conditions could affect their health directly or indirectly. Although the hygienists' role was primarily investigative, they advocated socioeconomic reform and legislative measures to improve workers' health. Underlying their recommendations was the strong need for moral reform, or the moralization of workers. This was especially true in the case of Villermé. Sociomedical investigations led to increased awareness of industrial health problems, but they did not lead to effective national legislation.

The germ of this book was a doctoral dissertation entitled “Public Health in France and the French Public Health Movement, 1815–1848,” written in the 1970s, when few secondary sources on nineteenth-century French public health were available. After reading Erwin Ackerknecht's pioneer article, “Hygiene in France, 1815–1848” (1948), his “Anticontagionism between 1821 and 1867” (1948), and George Rosen's A History of Public Health (1958), as well as some articles by Rosen, I set out to write a survey of public health in early nineteenth-century France. I wanted to write a descriptive account, providing the main outlines of the story by looking at public health theories, problems, institutions, and policies. I hoped to find out if the French hygienists actually accomplished anything, and to see how the French movement compared with the more familiar and already well-documented British movement. The dissertation succeeded, I believe, in providing the basic descriptive account I sought, and was, I am gratified to say, the starting point for a number of scholars who went on to write monographs about various aspects of nineteenth-century French public health.

I was subsequently funded by the National Library of Medicine to do further research and write a book on the French public health movement. The present volume is the result of an additional year of research in France and the incorporation of many works that have appeared in the interim on nineteenth-century French medicine and public health.

The first organized public health movement, composed of physicians, pharmacist-chemists, engineers, veterinarians, and administrators – all calling themselves hygienists – organized in Paris around the journal Annales d'hygiène publique and the Paris health council. Although the hygiene movement had no one leader comparable to Edwin Chadwick, the two most influential hygienists were Louis-René Villermé and Alexandre Parent-Duchâtelet.

The French public health movement was born and developed within the sociopolitical context of the Bourbon Restoration and the July Monarchy, with their national public health policies and programs, some of which were inherited from the Ancien Régime and the Revolutionary and Napoleonic eras. Several national health institutions and programs were already in place by the 1820s, when the movement began to coalesce. The Royal Academy of Medicine, for example, was founded in 1820 to replace the defunct Royal Society of Medicine, but it continued the traditions of its predecessor, whose interests focused on epidemics.

The public health movement also developed within the context of competing ideologies: liberalism, conservatism, socialism, and statism – all of them tracing their roots to the Ancien Régime and the Revolution. For the public health movement the two dominant ideologies were liberalism and statism. Liberalism was the political persuasion of the leaders of the July Monarchy, and many hygienists operated within the liberal framework, believing most reform was best handled at the individual level and that only limited state intervention to preserve the public health was justified.

THE AGE OF THE UNIVERSITY

in the second half of the sixteenth and in the early seventeenth centuries the large majority of the French social and cultural elite showed scant interest in unravelling nature's secrets. The socially dominant noblesse d'épée seldom received a sophisticated education in the classical humanities and philosophy and often could read no other language but French. Their physically exacting existence left little time to contemplate God's creation and the few who did so found a soldier's comfort in the sceptical wisdom of Montaigne. The highly-educated members of the liberal professions, on the other hand, had usually studied natural philosophy as part of their professional training. But they too showed little interest in later life in gaining a fuller acquaintance with the natural world. Although many clerics and lawyers were extraordinarily learned, by and large their erudition was focused on the burning religious and political problems of the day, not on the mysteries of nature. Even medical physicians paid scant attention to the philosophy of nature on which their professional activities were supposedly based. Whatever they might claim, the majority were empirical practitioners.

Apart from the odd figure at court the only Frenchmen who had more than a passing interest in the science of nature in the era of the Wars of Religion were likely to be professors of philosophy and medicine. In their case they had little choice, for physics or natural philosophy was part of their teaching brief.

My focus of attention is the great plague of Athens. However, before analysing the impact of the plague upon contemporary Athenian society, I should like, if I may so describe it, to examine Athenian impact upon the plague. More specifically, I wish to examine Thucydides's treatment of the plague. Thucydides provides our only contemporary account.

The Peloponnesian War broke out in 431 bc. In the early summer of the second year of the war the Peloponnesians again invaded Attica and laid waste to the countryside, whose inhabitants had taken refuge within the Long Walls. The city consequently became seriously overcrowded. Thucydides himself mentions this overcrowding (The Peloponnesian War, Book II, Chapter 52) and Aristophanes, with comic hyperbole, speaks in the Knights (792ff) of the refugees squatting in casks and birds' nests. A few days after the incursion of the Lacedaimonian army into Attica plague broke out in Athens – a pestilence, we are told, of unprecedented mortality. The plague raged ferociously during that year and the next. It subsided and then broke out again in 427 bc, wiping out, it appears, one third of the population of the city (a higher proportion, incidentally, than that of medieval London carried off by the Black Death).

The spread of the plague to Athens and its impact upon that overcrowded city is described by Thucydides in the second book of his History of the Peloponnesian War (Chapters 47–54):

We are at the final frayed finish of the age of Europe's territorial expansion, which stimulates curiosity about its beginnings. The Social Darwinists were sure that white people were genetically superior to the other strains of humanity, and that was why they were such successful imperialists; at the end of the twentieth century that explanation seems as antiquated as a whalebone corset. Technological and managerial superiority are probably adequate to explain the brief subjugation of such lands as Algeria and Burma, but meagre when matched to the Europeans' much more thorough and seemingly permanent takeovers of the temperate regions of the Americas. The new right-off-the-shelf-and-ready-for-instant-use explanation is that the Amerindians, unlike Africans or Asians, died in huge numbers of Old World diseases carried for the first time across the Atlantic by Columbus and his emulators, and therefore were easily displaced and replaced by the invaders.

There is a large body of documentary evidence in support of this theory, but much of the evidence was collected in the pre-scientific and pre-statistical centuries and almost always by soldiers, missionaries, trappers and traders, rather than by physicians and demographers: i.e. it is no better than impressionistic. Furthermore, the enormous extent of the Americas, the number and variety of their aboriginal peoples and the length of time since the first contacts between the Old World invaders and the New World aborigines bring into question even the most obvious interpretations of what accounts we do have of the impact of exotic diseases on Amerindians.

Dragons exist. Let us begin with the effort of imagination necessary to make that assertion plausible. Let us entertain the idea that never having seen a dragon may reflect only narrowness of experience. Others have, if not encountered the beast, at least come close to doing so. Here is the opening of a paper by the anthropologist Dan Sperber, appropriately entitled ‘Apparently Irrational Beliefs’. It takes the form of a quotation from his field diary:

[Dorze, Southern Ethiopia]

Sunday 24 viii 69

Filate did not return – to the anthropologist's embarrassed relief.

THE FIRST DEFINITIONS OF THE EPIDEMIC

In 1908 a debate unfolded on the pages of The Lancet and of the British Medical Journal over the causes of an apparently alarming ‘epidemic’ of syphilis which had broken out in the Uganda Protectorate. In both journals the debate began with an account of a paper recently presented by an officer of the Royal Army Medical Corps, Colonel Lambkin, entitled ‘An Outbreak of Syphilis on Virgin Soil’. Lambkin, known for his work on sleeping sickness in Uganda, had described to his medical audience a situation in which syphilis was so widely spread that an estimated 80 per cent of the population of Buganda was infected, and in which a resulting infant mortality rate of 50 to 60 per cent threatened the very survival of what he referred to as the ‘race’. The causes of this outbreak, according to Lambkin, were three: the introduction of Christianity, the abolition of previously severe punishments for sexual offences and the opening up of the country to traders from the East. In his analysis, Lambkin laid great stress on the notion of Uganda as a ‘virgin soil’ in which an innocent and unsuspecting population had been exposed to a new and devastating disease. But the very vulnerability of the Bagandan people had, according to Lambkin, been created by the disintegration of their traditional social and political system brought about primarily by the introduction of Christianity.

The chapters in this volume are, with one exception, revised versions of papers delivered to the Past and Present conference on ‘Epidemics and Ideas’ held in Exeter College, Oxford, on 21 and 22 September 1989. The exception, chapter 7 by Richard Evans, was originally published in Past and Present, no. 120 (August 1988). The Past and Present Society is grateful to the Wellcome Trust for a grant towards the expenses of the conference. The Editors also wish to thank those who gave papers on that occasion, and especially Virginia Berridge, Lawrence Conrad and Peregrine Horden who stepped in to fill gaps in the programme at a late stage. We owe a considerable debt finally to all those who commented and contributed to discussion at the various sessions, and who have generously allowed us to draw on their remarks in our own contributions to this volume.

INTRODUCTION

In his chapter in this book and in his splendid monographs Alfred Crosby describes how epidemic and endemic diseases, introduced by Europeans, wiped out whole aboriginal populations and decimated and demoralised others. The victims lost confidence in their own culture and in their capacity to respond. This chapter also describes a crisis of human and animal epidemic, this time in eastern and southern Africa during the late nineteenth and early twentieth centuries when diseases from Europe and from imperial India ravaged Africa. One African people – the so-called ‘Hottentots’ of Cape Colony – were destroyed as a culture by disease, expropriation and settler violence. But in general my story is different from Crosby's. It deals with societies which biologically were not undermined and which in the end survived the crisis of disease to commence vigorous population growth. Above all, it deals with societies which had not lost cultural self-confidence and which retained the capacity to respond intellectually. It is with these intellectual – and particularly religious – responses to epidemic that this chapter is concerned.

The chapter deals with two human diseases – smallpox and influenza; and two cattle diseases – lungsickness and rinderpest. Its argument is that study of response to these diseases allows us to understand something of the dynamics of all three of the major ideological systems of eastern and southern Africa. In the period under study such ideological systems were inevitably religious.