Published by EH.Net (May 2012)

Robert A. McGuire and Philip R. P. Coelho, Parasites, Pathogens, and Progress: Diseases and Economic Development.? Cambridge, MA: MIT Press, 2011. viii + 343 pp. $30 (hardcover), ISBN: 978-0-262-01566-0.

Reviewed for EH.Net by John E. Murray, Department of Economics, Rhodes College.

An old saw proposes that holding a hammer makes everything look like a nail.? When Robert McGuire and Philip Coelho suggest (p. 5) that Jared Diamond?s bestseller (1997) should have been titled Germs, Germs, and Germs, the reader may think that the authors carry not a hammer but a microscope.? Everywhere in this history, germs appear as the critical and virtually only influence on economic development.? By the end the reader better understands microbes in American history, but may still wonder if natural resource endowments, property rights and contract law, accumulating human capital, and flexible markets played a role as well.

Parasites, Pathogens, and Progress synthesizes a considerable literature on infectious disease and U.S. economic history, particularly before 1900.? On the purely economic side, a set of verbal and flowchart models of economic growth stress connections between ever greater population density and increasing infectious disease rates.? These connections, they argue, counterbalance better known Smithian growth models in which increasing density leads to the division of labor and Malthusian anti-growth models in which increasing density leads to food shortages.? Traditionally in neither of these stories do infectious diseases play much of a role.? This book aims to fix that omission.? The authors write (p. 6), ?We do not claim that we are the first to bring parasites and pathogens into the history of humanity and the economy, but we do so with emphasis and conviction that are missing in other histories.?? Here is truth in advertising.? Readers familiar with the work of world historians such as William McNeill, Philip Curtin, or Alfred Crosby, or historians of medicine such as Kenneth Kiple, Todd Savitt, or Margaret Humphreys will find little new here.? The same disease agents, transmission processes, and racial differentials appear in this book as in the works of those historians.? To these factors the authors attribute monocausal explanatory power with iron single-mindedness.

Disease in economic development (or stagnation) is fascinating, and this book brings out much of that inherent interest, but with little subtlety.? Much of the authors? case moves forward without reference to work of previous historians.? Concerning European contact with the New World, they write (p. 33), ?The assumptions that the biological environment is unchanging and that the ecology is exogenous to human actions are spectacularly incorrect.?? But after McNeill?s Plagues and Peoples (1976) and Crosby?s Ecological Imperialism (1986), very few scholars believe in a static global disease environment.? The idea that disease might explain some of a historical episode rather than all of it generally is absent.? Two pages concern the irresistible Antebellum Paradox of declining adult heights and life expectancies in an era of increasing per capita incomes.? Expanding transportation networks integrated local, and then regional, and then national disease pools.? The authors conclude, ?The deteriorating disease environment affected the biological standard of living and, as a result, average heights fell? (p. 53).? Full stop.? But no scholar doubts that disease mattered, and most try to account for its influences.? Despite the strongly worded conclusion, no evidence supports their absolute attribution, nor can the authors rule out the explanatory power of trends in pork production, income distribution, infant mortality, and urbanization.? The publication with the best evidence for the transport-disease connection (Haines, Craig, and Weiss 2003) is not cited in this book.

The bulk of the book is given over to the importance of infectious disease, primarily malaria, in determining that the labor force in the South would be drawn from African slaves rather than bound Europeans or Indians.? The authors cast their story of racial differentials in malaria susceptibility against Kenneth Stampp?s claim in The Peculiar Institution (1956) that Africans, Europeans, and their descendants were equally vulnerable to Plasmodium.? In contrast, write McGuire and Coelho, a sound scientific literature has arisen that attributes differential mortality rates by race to physiological differences such as the presence or absence of sickle cells or the Duffy antigen.? This discussion, in Chapter 6, is clearly presented, even in its technical parts, as well as engaging and informative.? But it is a bit beside the point because the hypothesis of differential malaria susceptibility and its consequences for our history is widely accepted by historians.? As a typical example, Humphreys concluded ten years ago in her Malaria (2001, p. 28; not cited in this book), ?While no simple cause and effect can be directly established, and other diseases such as yellow fever certainly played their part, it can at least be concluded that malaria had a substantial impact on labor and settlement patterns in the American colonies, patterns that would ultimately lead to the Civil War.?

The authors occasionally succumb to the temptation to let inferences from their model replace historical evidence.? Here are two examples.? First, on the transition from temporarily-bound Europeans to permanently-bound Africans:? The authors describe a process of natural selection in favor of relative resistance of white people to cold weather diseases and of black people to hot weather diseases, which more or less accords with the scientific literature.? ?As a result,? they write (p. 100), ?there is (sic) an increase in the migration of European indentured servants? to the northern colonies.? To explain the absence of evidence for this claim, they note (p. 100) that ?reliable data for indentured servants bound for New England are not available.?? They seem unaware that the lack of such data, reliable or otherwise, was due to the tendency of indentured servants to avoid New England in the first place, contrary to the conclusions of the authors? model.? A second example concerns antebellum medical practice.? With no reference to its price, they assert (p. 161) that planters could afford quinine for their slaves, that a sufficient quantity of quinine to stem a malarial episode was cheaper than replacing a slave (almost certainly true), and there they stop.? Did planters actually provide quinine to their slaves?? We know from a standard work, Savitt?s Medicine and Slavery (1981, p. 155; not cited in this book), that in fact quinine was widely used on plantations.? A simple citation to Savitt?s findings would have completed their argument.

Disease has played an important role in American history, and the number of historians who think so are greater than this book seems to assume.? If infectious disease might have been overlooked at some point in the historiography, this book will help gain greater attention for its multifaceted influences.? Still, it would have helped the authors? case if they had contented themselves with nominating parasites and pathogens to join the ranks of relevant subjects for historical study, rather than asserting their near-exclusive primacy.


Crosby, Alfred. Ecological Imperialism: The Biological Expansion of Europe, 900-1900. New York: Cambridge University Press, 1986.

Diamond, Jared. Guns, Germs, and Steel: The Fates of Human Societies. New York: W.W. Norton, 1997.

Haines, Michael, Lee Craig, and Thomas Weiss.? ?The Short and the Dead: Nutrition, Mortality, and the ?Antebellum Puzzle? in the United States,? Journal of Economic History 63 (2003): 382-413.

Humphreys, Margaret. Malaria: Poverty, Race, and Public Health in the United States.? Baltimore: Johns Hopkins University Press, 2001.

McNeill, William. Plagues and Peoples. New York: Anchor Press, 1976.

Savitt, Todd L. Medicine and Slavery: The Diseases and Health Care of Blacks in Antebellum Virginia.? Urbana: University of Illinois Press, 1978.

Stampp, Kenneth. The Peculiar Institution: Slavery in the Ante-Bellum South. New York: Vintage Books, 1956.

John E. Murray is Joseph R. Hyde III Professor of Political Economy at Rhodes College in Memphis, Tennessee.? His next book, The Charleston Orphan House: Children?s Lives in the First Public Orphanage in America, will be published by the University of Chicago in early 2013.

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