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| Plague Legends is a fascinating contribution to the history
of medicine. Its novelty lies in a delicate interweaving of concepts of
disease derived from theological beliefs and those based on what would
be regarded - even in contemporary terms - as scientific evidence. Particularly
fascinating is the discussion of ideas of contagion formulated by the Italian
physician Girolamo Fracastoro in the 1500s and largely dismissed out of
hand by his contemporaries and much of the medical community of the following
century. This reception occurred despite the fact that much of what Fracastoro
proposed is now part of the accepted canon of knowledge about the nature
and transmission of infectious diseases. This work stood in stark contrast
to the influential views of Thomas Sydenham in England more than a century
later. Sydenham put forth the erroneous notions of epidemic constitution
of the atmosphere, a set of ideas that held up epidemiological progress
for 150 years.
Litsios' profiles and interpretations of the 18th and 19th century outbreaks of bubonic plague, smallpox, tuberculosis, yellow fever, cholera, and malaria are masterful. Indeed, anyone who wants to understand the complex evolution of ideas pertaining to the major diseases of past centuries and their relationship to evolving levels of evidence, linked to measurement techniques, would be well-advised to read this book and independently track down original sources. Although measurement with complex instrumentation is taken for granted in modern times, it was a novelty in need of careful defense when introduced by William Harvey in the 1600s. The treatment of the emergence of Public Health in the 18th and 19th centuries in response to the evidence that poverty and disease went hand-in-hand is succinct and to the point. This history seems to be almost invisible in the modern literature focused on inverse associations between social class and health. Plague Legends provides a much needed institutional perspective on this topic. The entire book would be a very useful required volume in courses on the history of medicine. Perhaps more importantly, it should be read and discussed by students in schools of public health, where a deeper understanding of the origins of Public Health as a profession and as a broad set of academic topics would be highly desirable. The author, Socrates Litsios, while claiming to be an amateur historian displays all the characteristics of a practiced professional. His previous book, The Tomorrow of Malaria, clearly displays the author's depth of thought, thoroughness of investigation, and engaging writing style. Plague Legends continues this tradition. It is indeed a very useful and insightful introduction to the complex history of ideas surrounding notions of contagion, the transmission of infectious diseases, and Public Health in both historical and modern settings. Burton Singer
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