Mark Harrison (7) (1964–)

This book looks at the history of pandemics in the modern developed world, starting with the second plague pandemic, known as the Black Death, that began in Asia and spread westward to Europe in the 14th century, and ending with the 21st century Ebola, H1N1 and first SARS pandemics. The Black Death was a result of a relative scarcity of food in overpopulated cities in Europe, which led to increased need for and transport of goods from the East on merchant vessels that also carried rats which harbored fleas infected with the bacterium Yersinia pestis. The second plague pandemic ended in Europe in the 1350s, but the plague bacillus remained, and sporadic outbreaks recurred until the 18th century, with the best known one being the plague epidemic in London in 1665-1666. As a result, European countries and port cities developed departments of health, in order to regulate the flow of goods on ships and keep their populations as safe as possible.

The most widely used technique was quarantine, in which ships, crew and passengers would have to stay on their vessels for 40 days before they were allowed on shore. Quarantining began in antiquity but took hold during the second plague pandemic, and proved to be a very contoversial and much disliked method to prevent the spread of disease: merchants did not wish to have to wait forty days to unload and sell their goods — time is money, after all — and many of them tried to subvert these regulations; buyers likewise did not want to wait; ships with plague infected crew or passengers were unable to receive adequate medical assistance, and because the well were not permitted to leave the ships many of them were subsequently infected and died; and cities whose countries enacted strict quarantines were at a relative disadvantage in comparison to neighboring countries with more lenient regulations. Due to the lack of knowledge about the spread of infectious diseases physicians fell into two camps, one which believed that these maladies were imported on ships and supported quarantining and social isolation of ill residents and visitors, and the other which believed that miasmas (bad air) and meteorologic changes were to blame for the spread of disease.

Subsequent epidemics and pandemics such as yellow fever in the United States and cholera in Europe were also linked to commerce by sea, particularly the transport of goods from Asia, or the transport of slaves from Africa. Mark Harrison, a professor of the History of Medicine at Oxford, provides well researched and detailed accounts of these outbreaks, and how public health officials and the business communities in the affected cities dealt with the crises, some far better than others.

Contagion is a detailed examination of major pandemics throughout modern history in the Western world, and the role that commerce has played in their spread from one country or region to another. I found it to be a dry and very academic read, however, and because I was far more interested in the relation of the current SARS-CoV-2 pandemic to past ones I was disappointed that this book did not provide the analysis through time that I was looking for.… (altro)

The British military experience in the First World War has been the subject of memoirs, histories, and narrow studies almost too numerous to count. Yet most of these works have concentrated on the course of the fighting and the experiences of the men on the front lines. Far less thoroughly examined has been their experiences after combat, when casualties were evacuated for healing and rehabilitation. In this award-winning study of British medical operations in the First World War, Mark Harrison takes a panoramic view of his subject, surveying the processes and care of the wounded to understand how they were cared for and how that care varied over the main fronts of the war.

As Harrison notes at the start of his book, attention to the treatment of wounded soldiers was still a fairly recent development. Starting with the Crimean War, the coverage of medical provisions by the popular press turned a previously neglected issue into one of political concern, forcing the army leadership to make provisions for it. These preliminary arrangements paled in compared to their German and French counterparts, however, and the development of what Harrison terms the “medical machine” really began only with the start of the war in 1914 and the initial discovery of the scope of the problem facing the military.

Harrison’s three chapters on medical operations on the Western Front form the heart of his book. The experience of the Royal Army Medical Corps (RAMC) reflected that of the British Army more generally, as the provisions at the start of the war soon gave way to a wholesale reorganization as the duration and scope of the conflict became evident. Much of Harrison’s focus here is on the process of “clearing the battlefield,” as evacuating casualties was the first and in many ways most important step in treating them. Taken first to casualty clearing stations before transportation to field hospitals, the wounded and dying were processed in an operation that adjusted to both the scale of the problem and the many demands upon finite resources. This was especially true in terms of transportation, as moving men and munitions to the front lines took priority over casualty evacuation. The nature of war on the Western Front also posed challenges, as medical personnel coped with the challenges of gas-gangrene and the use of poison gas as a weapon. While not uncritical, Harrison is generally complimentary of the men involved in running the medical services and describes a system that ran reasonably well from the Somme onward.

Though the Western Front is the main focus of Harrison’s work, he does not neglect the other main theaters in which British troops fought. Here the picture is similar, as transportation quickly emerged as the primary problem at both Gallipoli and early in the Mesopotamian campaign. In some of these campaigns there was less time for adaptation, but when such time did exist reforms followed the models established on the Western Front. Yet soldiers fighting in Africa and the Near East faced the added problem of tropical diseases, which posed additional strains upon medical services that were not always successfully addressed.

Nevertheless, Harrison concludes his book by giving the British medical services and their personnel high marks for the professionalism and efficiency under the circumstances of their time. Similar praise is warranted for his book, which draws upon both organizational records and secondary sources to describe the performance of British military medicine in the First World War. While limited in its study of both medical procedures and the social history of the men and women who worked in the various facilities, it is nonetheless a fine survey of its subject, one that is absolutely indispensable for anyone seeking to understand this very important yet too often neglected aspect of the British military effort during the First World War.… (altro)