[Marxism] How commerce has spread disease

Louis Proyect lnp3 at panix.com
Tue May 28 12:00:25 MDT 2013


LRB Vol. 35 No. 11 · 6 June 2013

Bedbugs and Broomsticks
Joyce Chaplin

Contagion: How Commerce Has Spread Disease by Mark Harrison
Yale, 376 pp, £25.00, August 2012, ISBN 978 0 300 12357 9

The Eclair was a British steam sloop charged with policing the slave 
trade. In November 1844 she set out hopefully in a naval squadron for 
Sierra Leone, where she spent five months patrolling for slavers. West 
Africa was known to harbour ‘fevers’ to which Europeans had little 
resistance, but the officers and crew remained in good health, and the 
sailors were even granted shore leave, which they were described as 
enjoying immensely. After 13 days, the Eclair proceeded to the Gambia, 
at which point many of the men were seriously ill and bringing up 
blackish vomit. By the time the ship made Boa Vista in the Cape Verde 
Islands, one in six men had died. The survivors were taken ashore: 
healthy men were put up in tents, healthy officers in a house, and the 
sick men kept on a nearby island. And people kept dying. Three different 
naval surgeons advised the captain to flee for Madeira’s cooler and 
healthier climate. But nearly two-thirds of the crew who left Boa Vista 
were dead by the time the Eclair reached Funchal, so they sailed on, 
thanks to volunteers who stood in for the fallen crew, to Portsmouth. 
When the Eclair finally anchored on 28 September 1845, there had been 
ninety more cases of fever and 45 more deaths.

The plague aboard the Eclair was identified as yellow fever. It takes 
its name from the jaundice it causes in its patients as their livers 
fail; the black vomit is the result of internal bleeding. We now know 
that it’s communicated by a mosquito-borne virus – however horrifying, 
it’s at least not contagious. But in the early 19th century it was 
feared that the fever could be transmitted from person to person, and so 
the Eclair was placed under quarantine for 21 days, under the 1825 
Quarantine Act, a measure which prevented the crew from receiving fresh 
medical supplies. After the press reported mounting casualties, the men 
were transferred to better-equipped vessels. Slowly, the mortality rate 
levelled and then dropped; no new cases emerged and the survivors began 
to recover. Quarantine was lifted on 31 October and the men were paid 
off. While mopping up one noxious outcome of European imperialism, the 
men of the Eclair had suffered from another, the globalisation of disease.

Diseases can travel impressive distances, though almost never without 
assistance. It’s not entirely clear where the Black Death originated and 
how it spread, but it’s likely to have begun in China and subsequently 
moved along caravan routes to the Near East, as an unintended tax on the 
silks and spices. Merchant ships then transferred the goods and the 
pestilence to Europe and Africa. Alternative routes and different 
stopping points have been proposed for the Black Death, but traders 
always make an appearance: commerce is a constant.

So too is suspicion of commerce. In 1348, as plague spread through the 
Mediterranean, Europeans stopped buying new spices. These were thought 
to bring health and a long life, but that year’s supply was assumed to 
be tainted. Political authorities went further by banning merchants, not 
just merchandise. The Italian city of Pistoia led the way, with 
ordinances in 1348 that forbade its citizens to have contact with anyone 
who carried wool or linen cloth or who had come from any area known to 
harbour plague. Venice instituted a sanitary council in the same year to 
regulate ships’ traffic and manage lazarettos for the sick or suspected 
sick. The Republic of Ragussa (the Italian name for Dubrovnik) 
stipulated in 1397 that vessels were to be detained for as many as forty 
days, in order to prevent the landing of disease along with the cargo. 
That measure became known as quarantine, after Jesus’ forty days in the 
wilderness.
Felix Dennis Tour 2013

Fear of foreign merchants existed alongside an increasing dependence on 
them. It is by now almost standard for academic historians of medicine 
to argue that things don’t inevitably get better over time, and that 
medical experts (including doctors) aren’t always agents of progress. In 
Contagion: How Commerce Has Spread Disease, Mark Harrison confronts two 
narratives of modern history: the consolidation of professionalised 
medicine, and the spread of Western economic ideas, including commerce 
in its capitalist incarnation. He shows that these developments, both 
moving in the direction some would call progress, quite often collided 
with each other.

Medieval and Renaissance doctors had shown little interest in the way 
disease spread, only in how it operated on the body. There was no need 
to close the ports, they thought. The concept of contagion was only 
gradually assimilated into medical literature, even though it had long 
been accepted by ordinary people and public authorities. Muslims in the 
Near East and North Africa tended not to quarantine. Nor did the Mughals 
or the Chinese. Harrison argues that differing ideas of political rights 
and duties may have mattered more than medical traditions. ‘Put simply, 
more was expected of European rulers,’ who felt obliged to do something 
when epidemics loomed, rather than simply offer charity once one had 
started.

By the early 17th century, quarantine was frequent within Europe, along 
with embargoes on suspect goods. It was also a way to exclude social 
undesirables. By the time of the Anglo-Dutch wars of the later 17th 
century, quarantines and sanitary embargoes had begun to serve political 
purposes: measures to prevent the spread of plague constituted war by 
other means. High mortality rates (35,000 in Amsterdam alone in 1664) 
made it clear that the danger wasn’t imaginary, but whether trade 
stoppages were a good idea, given the economic damage the plague had 
already caused, was in doubt. And yet the practice of quarantine spread. 
The first visible cordon sanitaire was created along the border between 
the Austro-Hungarian and Ottoman Empires. In 1710 a thousand-mile 
stretch was lined with watchtowers and patrolled by soldiers who were 
told to shoot on sight anyone who tried to sneak over from Ottoman 
territory without observing quarantine.

But by the late 18th century, ‘anti-contagionists’ and ‘contagionists’ 
were sparring over embargoes and quarantine measures. Anti-contagionists 
tended to be liberals, supporters of the free flow of people and goods, 
while contagionists preferred vigilance. The difference was especially 
apparent in debates over an outbreak of yellow fever that hit 
Philadelphia in 1793: Federalists thought the disease had arrived with 
refugees from the slave revolt on Haiti; Republicans blamed local 
conditions. When cholera struck Europe in the 1830s and 1840s, 
authorities in the port of Hamburg did little to regulate traffic while 
their less trade-oriented counterparts in Prussia were pro-quarantine. 
Quarantine measures could be used to control trading partners or punish 
rivals. Rather than raise tariffs, Egypt’s quarantine measures raised 
the cost of imports, which had much the same effect; Russia used 
quarantine to harass merchants and travellers.

Haphazard local regulations worked against the spirit of the Congress of 
Vienna, which, at the end of the Napoleonic Wars in 1815, had smoothed 
over many of the causes of the conflict. In 1851, delegates from 12 
Mediterranean states, including the Ottoman Empire, met in Paris for the 
first international convention on quarantines. While there was no 
binding agreement, the meeting created a model for gatherings of this 
kind. The next sanitary convention was in Constantinople in 1866; many 
others followed, with a final prewar meeting in Paris in 1938.

Two things have complicated all modern efforts at sanitary regulation. 
The first is the accelerating speed at which disease can be transmitted, 
first on steam-driven vehicles, later on petroleum-fuelled ones, 
particularly aircraft, with shortcuts such as the Suez and Panama Canals 
also speeding things up. (On the plus side, medical warnings also 
circulate very much faster.) The second factor was empire. In the 
British colonies, beginning in the West Indies, quarantine came to be 
seen as a ‘vexatious restriction’ which hampered trade and damaged an 
empire that depended for its efficient working on the free circulation 
of labour. Other imperial powers enforced their own, conflicting 
policies. But it was only just before the Second World War that a shift 
away from quarantine and towards surveillance came to represent a more 
subtle kind of sanitary regulation.

Since 1995, much of the regulation has fallen to the World Trade 
Organisation. But individual nations, trading blocs and business groups 
have been active in protecting their interests against WTO agreements. 
The result has been a continuing atmosphere of suspicion, as seen, for 
example, in bans on US beef in 2003, after a case of BSE was identified 
in the States. The WTO helped to lift the embargoes, but while the 
Korean government insisted that imported beef was safe, diners thought 
otherwise. ‘I could study hard in school,’ one schoolgirl complained, ‘I 
could get a good job and I could eat beef and just die.’ It took ten 
years for the EU ban on exports of British beef to be lifted after BSE 
was first found in UK cattle in 1996, and testing continued to be 
mandatory until last year. Distrust is everywhere: of government 
officials, scientific experts and international organisations.

The transfer of disease from animal to human is a recurring theme: the 
Black Death from rodents to humans in the Middle Ages, the many 
outbreaks of parasitic infection from eating tainted pork, the likely 
contraction of plague from Siberian marmots in 1910, the variant 
Creutzfeldt-Jakob Disease that results from BSE, the occurrence of Sars 
in humans who were in contact with mammals in China, as well as epidemic 
influenza (including H5N1 and H1N1) contracted from poultry and swine. 
The Sars outbreak alone is estimated to have cost $50-100 billion in 
medical care, revenue lost by travel restrictions and capital flight 
from affected areas. The latest bird flu, H7N9, transmitted from animals 
to humans in China, is now said to be under control (cost: $6.5 billion) 
but the same is not yet true of a new coronavirus with origins in the 
Middle East that has already spread, human to human, to the UK, Germany 
and France. Harrison’s book is a reminder that even a rudimentary notion 
of the common medical good has been centuries in the making and is still 
far from universally accepted. Please turn your head when you cough.




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