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This book explains 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, and uses medical history to illuminate broader questions of the development of statutory intervention and the comparative and divergent evolution of the modern state in Europe.
- Sales Rank: #1640108 in Books
- Brand: Brand: Cambridge University Press
- Published on: 2005-11-21
- Released on: 2005-10-06
- Original language: English
- Number of items: 1
- Dimensions: 8.98" h x 1.22" w x 5.98" l, 2.04 pounds
- Binding: Paperback
- 596 pages
- Used Book in Good Condition
Review
"I find this a quite dazzling work, imaginative in conception, broad in vision, amazingly erudite in execution, and perceptive in its judgements. There is simply no work like it--a Europe-wide juxtaposition of medicine and politics. Readers will surely relish the astonishing 'War and Peace'-like panorama of disease which Baldwin paints and the consummate mastery with which he handles his magazine of materials."
Roy Porter, Wellcome Institute for the History of Medicine, University of London
"...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."
Times Literary Supplement
"Peter Baldwin has written an expansive book bridging political history and the history of disease regulation."
American Historical Review, Andrew R. Aisenberg
"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."
JAMA
"...this book is well sorth the effort it takes to read. Though not abandoning the notion that prevention poliicies 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
"Peter Baldwin takes his readers on an unprecedented, century-long grand sanitary tour through Britain, France, Germany, and Sweden. At ease in all four languages, weaving his way skillfully through innumerable sources and the results and remains of many an earlier expedition, never losing his verve and good humor, our navigator demonstrates as has never been done before the sheer mass and complexity of state policy, action, and public deliberation on contagious disease in the nineteenth and early twentieth centuries. This is an achievement in itself."
Journal of Modern History
"The recent publication of this work in paperback form makes it an excellent resource for upper-level and graduate college courses. Scholars and students of medical history, political theory and European history in general all have much to gain from Peter Baldwin's contribution to the field."
H-German, Jason M. Wolfe, Department of History and Humanities, Lee University
About the Author
Peter Baldwin is Professor of History at the University of California, Los Angeles. He is the author of The Politics of Social Solidarity: Class Bases of the European Welfare State (1990) and Disease and Democracy: The Industrialized World Faces AIDS (2005).
Most helpful customer reviews
2 of 2 people found the following review helpful.
Masterful, detailed comparative history
By Nathaniel Lane
"Contagion and the State in Europe, 1830-1930" is a comparative history tour de force, combining political economy and epidemiology for an encyclopedic account of how states mobilized public policy against three devastating diseases (syphilis, small pox, and cholera). As a work of social history, Baldwin's ear is turned towards the social landscapes, as well as constraints, that shaped variation in policy. Behind each encyclopedic chapter, he attempts to locate the central variables driving state policy (geo-epidemiology and economics alike), arguing that public health strategies were not simply a function of political regime. To understand state response through Ackerknechtian logic misses the point. Whether you believe Baldwin's central thesis, this book is worth its weight--over 500 pages of fine print--for anyone interested in the history of social policy. Meanwhile, the skillful, perhaps even beautiful, prose is icing on a cake for a potential classic.
Baldwin first makes his case with the cholera epidemics blitzing Europe in the early 1830s. The first two swaths of the book are dedicated to the initial dramatic encounters with the disease and the evolution of policy as cholera became a persistent feature of public health concerns. From the early historical narrative, Baldwin pokes holes in Ackerknechtian logic: a tight fit between state response and regime type is flawed. It wasn't necessarily true that liberal Western states pursued vast sanitarist policies, while the eastward autocrats pursued heavy handed quarantinism. In fact, all nations in the 1830s faced the mysterious epidemic with equal severity--even liberal England showed little restraint in pulling the sick from their beds. As cholera came of age, and with it, scientific insights from Koch, regimes adjusted policy in distinct ways. While all states converged on a type of surveillance approach to cholera, trade reliance, state capacity, and geoepidemiology truly dictated policy variation. Britain's isolation allowed them to learn from the failures of hardline, Continental quarantine policy, while their reliance on sea-bound trade made strict quarantine of ships undesirable-particularly to capital. Meanwhile, the turn to sanitationist policy reflected a wealthy state's capacity to implement sweeping hygienic reform rather than an appeal to enlightened liberalism.
Baldwin's case of small pox, an equally puzzling illness, further illustrates the complexities of disease and state response beyond Ackerknechtian logic. Unlike other diseases, small pox policy revolved around the effective implementation of vaccination. While the efficacy of the smallpox vaccine was accepted universally, coercive vaccination policy inspired widespread reaction. Policy had to contend with social movements, and, like cholera, was mitigated by the capacity of states to actually implement policy. Unsurprisingly, repeatedly imprisoning the peasantry, or harvesting lymph from orphans inspired resentment in the populace, as well as social movements that bridged the political compass. While the ability of mass anti-vaccination movements to appeal to liberal states has coherence, for Baldwin, variation in policy is more aptly accounted for by the ineptitude of governments to implement good prophylactic policy. In Britain, vaccination was turned over to local Poor Law authorities and, unsurprisingly, was tainted as anti-poor. While vaccination activists were less convincing to Germany, the state readily accepted vaccination deficiencies and tempered fears with technical improvements that made universal vaccination policy feasible--not identified with draconian class warfare. Whatever the variation in politics or prophylactic strategy, Balwdin details a convergence to a mishmash of neoquarantinist policy with both voluntary and compulsory vaccination.
Perhaps the most intriguing chapter, is Baldwin's analysis of state response to venereal disease in the late 19th century. Unlike the anonymous transmission of small pox or cholera, syphilis was the product of discreet encounters, where social welfarist and moralist social movements collided in the form of "regulationism" and "absolutism," respectively. As public health responses evolved, nations converged along a spectrum of voluntary and statist approaches, more the result of social movements and timing than ideology. Scandinavia was an early adopter of universal, free, compulsory medical treatment. At the other end of the public health spectrum was Britain, which instituted voluntary strategies. Far from a product of British liberalism, this approach was rather the culmination of particulars of the isle's feminist movement and Puritanism , which spoke to regulating sexual morality of the demand side (men), rather than intervene directly with female sex workers. Baldwin goes to great lengths to describe the delicate interactions between shifting sexual mores, social movements, and the politics of treatment. Again, the complex social forces that molded state policy bolster Baldwin's thesis.
Each chapter of Baldwin's book could be a study unto itself in their level of breadth and detail. It makes cursory reading troublesome, as the complete picture of each epidemic is quite nuanced, with multiple subplots and themes. To summarize each disease to a paragraph is almost antithetical to the author's thesis. The devil, as a scholar of historical policy, is in the details. As a complete work, Contagion and the State stands as a detailed refutation of how neither political ideology nor scientific progress alone dictated the course of historical public health policy. Beyond being a go-to bibliography for historians of public health, this work is useful to any scholar of public policy, as well as economic historians and comparative history scholars.
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