Plagues & Poxes
Alfred Jay Bollet is a distinguished academic rheumatologist who has chaired the department of medicine at two medical schools. The first edition of Plagues and Poxes, published in 1987, focused on the waxing and waning of specific diseases and their impact on world history. Half of that edition was organized around the status of medicine as illustrated by the treatment of U.S. presidents or their family members. This new edition devotes more space to noncontagious diseases and traces the effect of historical events, in particular the use of diseases as terrorist weapons and the modern potential for such uses. Eleven chapters are either major or minor revisions of those in the first edition, and six chapters are entirely new. The writing is for a general readership, with explanations of the rather few anatomical terms and other technical references. The content is presented in an interesting fashion, with numerous bits of obscure information scattered throughout, often with a relevance that is more historical than medical. For example, the chapter on yellow fever relates that during the famous charge up San Juan Hill in the Spanish-American War, Colonel Teddy Roosevelt was the only rider. The price of Scotch whiskey increased during the 1918-1919 influenza pandemic because of a belief that the drink had therapeutic value. Regarding poliomyelitis, we learn that during Franklin Roosevelt's numerous railway journeys, the speed of the train was limited to 35 miles per hour to minimize his discomfort from the vibration of the car. "Spring fever" originated as a term of American colonists for the scurvy-induced lassitude that set in after a winter without fresh fruits and vegetables. Unfortunately, I cannot determine the basis for some dubious statements because specific references are not given. For instance, bubonic plague was not called the Black Death in the 14th century but, rather, "the great mortality." "Black Death" came into use in 16th-century Scandinavia and was used in England in the 17th century. And, the author claims, "venereal urethritis . . . was known at least two millennia before syphilis appeared," even though no ancient description of involuntary urethral discharge mentions pain, making the diagnosis of gonorrhea doubtful before an English description in the 14th century. Also, the book states that "in 1831 . . . John Snow published a report suggesting that cholera was being spread by contaminated water," despite the fact that Snow would have made this report at the age of 18 years; it usually is dated to 1849. "The Ebers papyrus . . . recorded the effectiveness of extracts of the autumn crocus (the source of colchicine) for treating arthritis" is an unlikely statement that might have resulted from confusion between saffron (the dried stigma of Crocus sativus), which is believed to have appeared in the Ebers papyrus (although not in association with arthritis), and the bulb of another crocus, Colchicum autumnale, the source of colchicine. Names sometimes appear inconsistently, such as "Dr. Karl Landsteiner and his assistant, E. Popper" (Erwin), and the virologist Flexner's first name (Simon) should have been given to avoid confusion with his equally famous brother, Abraham. Of the rather few typographic errors, the most serious appears in a reference to Bacterial and Mycotic Infections of Man, supposedly edited by "Dubois, RJ" and published in 1848; Rene Jules Dubos actually published this book in 1948. Eighteen illustrations, all accompanied by descriptive text, are a new feature of this edition. References are given at the end of each chapter, mostly to secondary sources, and the index is adequate. Although not authoritative, Plagues and Poxes is entertaining and concisely offers much information that is not easily available.Thomas G. Benedek, M.D.Copyright © 2005 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.