In This Review

Contagion and the State in Europe, 1830-1930
Contagion and the State in Europe, 1830-1930
By Peter Baldwin
Cambridge University Press, 1999, 581 pp

This dazzling book demonstrates how contagious diseases affected politics and public policy in Europe. Baldwin explains how particular nations chose specific preventive courses while emphasizing the multiplicity of factors behind their decisions. He contrasts the preventive strategy of "quarantinist" approaches, which interrupted the circulation of carriers, with "localist" approaches, which tried to remove the environmental causes of disease. Political traditions did not explain much; the proximity of a country to the sources of infection and cultural factors were more significant, especially the latter. Baldwin's comprehensive account of the politics of cholera, smallpox, and syphilis contributes to both the history of medicine and the history of political ideology and cultural values. For example, vaccination against smallpox raised the issue of "the community's right to trespass on personal autonomy"; prostitution (a source of syphilis) engendered battles between regulators and reformers who wanted to end regulation and prostitution itself; the anticholera quarantines met with firm opposition by Britain out of "commercial" concerns. A fascinating tour de force of scholarship.