David Jones is a member of the Department of Psychiatry, McLean Hospital and the Massachusetts General Hospital. This article evolved out of conversations with Allan Brandt, Arthur Kleinman, and John Coatsworth. The author also benefited from advice from Warwick Anderson, David Barnes, Conevery Bolton, Elizabeth Caronna, Joyce Chaplin, Ward Churchill, Alfred Crosby, Ray Fisman, Jeremy Greene, Nick King, Marc Lipsitch, Christopher Sellers, Keith Wailoo, Deborah Weinstein, members of the History of Medicine Working Group at Harvard University, fellows and faculty of the Divisions of Immunology and Infectious Disease at Children's Hospital, Boston, and many insightful anonymous reviewers. The research was supported in part by a grant from the Medical Scientist Training Program, National Institutes of Health.
1 John M. Murrin, "Beneficiaries of Catastrophe: The English Colonies in America," in Eric Foner, ed., The New American History, rev. ed. (Philadelphia, 1997), 4.
Soil Epidemics as a Factor in the Aboriginal Depopulation in America,"
William and Mary Quarterly, 3d Ser., 33 (1976), 289; Diamond,
Guns, Germs, and Steel: The Fates of Human Societies (New
York, 1997), 211–12.
Soil Epidemics," 292.
4 For a challenge of another aspect of virgin soil theory, the assumption that new epidemics caused Indian cultures and religions to wither as quickly as Indian bodies, see Paul Kelton, "Avoiding the Smallpox Spirits: Colonial Epidemics and Southeastern Indian Survival," Ethnohistory, 50 (Fall 2003).
5 William A. Starna, "The Biological Encounter: Disease and the Ideological Domain," American Indian Quarterly, 16 (1992), 513; Arthur E. Spiess and Bruce D. Spiess, "New England Pandemic of 1616–1622: Cause and Archaeological Implication," Man in the Northeast, 34 (1987), 77.
6 David E. Stannard, "Disease and Infertility: A New Look at the Demographic Collapse of Native Populations in the Wake of Western Contact," Journal of American Studies, 24 (1990), 329, 346. Scores of similar accounts exist. Here is a partial listing since 1990: Colin G. Calloway, New Worlds for All: Indians, Europeans, and the Remaking of Early America (Baltimore, 1997), 33; Paul H. Carlson, The Plains Indians (College Station, Tex., 1998), 8; James H. Cassedy, Medicine in America: A Short History (Baltimore, 1991), 5; A. D. Cliff, P. Haggett, and M. R. Smallman-Raynor, "Island Populations: The Virgin Soil Question," in Island Epidemics (Oxford, 2000), 120; Lawrence I. Conrad et al., The Western Medical Tradition: 800 B.C.-A.D. 1800 (Cambridge, 1995), 225–26, 474, 486; Noble David Cook and W. George Lovell, eds., "Secret Judgments of God": Old World Disease in Colonial Spanish America (Norman, Okla., 1991), xv; Francis Jennings, The Founders of America: How Indians Discovered the Land, Pioneered in It, and Created Great Classical Civilizations; How They Were Plunged into a Dark Age by Invasion and Conquest, and How They Are Reviving (New York, 1993), 383; Charles C. Mann, "1491," Atlantic Monthly (Mar. 2002), 43; Adrienne Mayor, "The Nessus Shirt in the New World: Smallpox Blankets in History and Legend," Journal of American Folklore, 108 (Winter 1995), 58; Murrin, "Beneficiaries of Catastrophe," 7; Linda A. Newson, "Old World Epidemics in Early Colonial Ecuador," in Cook and Lovell, eds., "Secret Judgments of God," 88; Gregory H. Nobles, American Frontiers: Cultural Encounters and Continental Conquest (New York, 1997), 41; Mary Beth Norton et al., A People and a Nation: A History of the United States, brief ed., vol. A: To 1877, 4th ed. (Boston, 1996), 18; John Steckley, "Developing a Theory of Smallpox: Huron Perceptions of a New Disease," Arch Notes, 90 (Jan.-Feb. 1990), 17; Ian K. Steele, Warpaths: Invasions of North America (New York, 1994), 22; Rebecca Storey, Life and Death in the Ancient City of Teotihuacan: A Modern Paleodemographic Synthesis (Tuscaloosa, Ala., 1992), 43; Ronald Takaki, "The Tempest in the Wilderness: The Racialization of Savagery," Journal of American History, 79 (1992), 907; Alan Taylor, American Colonies (New York, 2001), 42; Patrick Tierney, Darkness in El Dorado: How Scientists and Journalists Devastated the Amazon (New York, 2000), 56; Daniel H. Usner, Jr., Indians, Settlers, and Slaves in a Frontier Exchange Economy: The Lower Mississippi Valley before 1783 (Chapel Hill, 1992), 16; Richard White, "Western History," in Foner, ed., New American History, 208; Edwin Williamson, The Penguin History of Latin America (New York, 1992), 13, 84–85; and Ronald Wright, Stolen Continents: The Americas Through Indian Eyes Since 1492 (Boston, 1992), 13–14.
7 Murrin, "Beneficiaries of Catastrophe,"7.
Crosby, The Columbian Exchange: Biological and Cultural Consequences
of 1492 (Westport, Conn., 1972), 57. See also William H. McNeill,
Plagues and Peoples (New York, 1977), 184; Neal Salisbury,
Indians' Old World: Native Americans and the Coming of Europeans,"
WMQ, 3d Ser., 53 (1996), 458; and David S. Landes, The
Wealth and Poverty of Nations: Why Some Are So Rich and Some So
Poor (New York, 1998), 169.
9 Jerry H. Bentley, Old World Encounters: Cross-Cultural Contacts and Exchanges in Pre-Modern Times (New York, 1993), 183; Robert Boyd, The Coming of the Spirit of Pestilence: Introduced Infectious Diseases and Population Decline among Northwest Coast Indians, 1774–1874 (Seattle, 1999), 17; White, The Middle Ground: Indians, Empires, and Republics in the Great Lakes Region, 1650–1815 (Cambridge, 1991), 41.
10 Cronon, Changes in the Land: Indians, Colonists, and the Ecology of New England (New York, 1983), 85. See also James Axtell, Beyond 1492: Encounters in Colonial North America (New York, 1992), 105; Elizabeth A. Fenn, Pox Americana: The Great Smallpox Epidemic of 1775–82 (New York, 2001), 23, 27; Karen Ordahl Kupperman, Indians and English: Facing Off in Early America (Ithaca, 2000), 34; McNeill, Plagues and Peoples, 3–4, 8, 184–85; and Russell Thornton, American Indian Holocaust and Survival: A Population History Since 1492 (Norman, Okla., 1987), 47.
11 Calloway, New Worlds for All, 37. See also Cook, Born to Die: Disease and New World Conquest, 1492–1650 (Cambridge, 1998), 166–67; Cronon, Changes in the Land, 88; Newson, "Highland-Lowland Contrasts in the Impact of Old World Diseases in Early Colonial Ecuador," Social Science and Medicine, 36 (1993), 1194; Stannard, "Disease and Infertility," 341, 346–47, 349; Taylor, American Colonies, 38–39; Michael K. Trimble, "The 1837–1838 Smallpox Epidemic on the Upper Missouri," in Douglas W. Owsley and Richard L. Jantz, eds., Skeletal Biology in the Great Plains: Migration, Warfare, Health, and Subsistence, (Washington, D. C., 1994), 82–87; and White, Middle Ground, 41.
12 J. S. Cummins, "Pox and Paranoia in Renaissance Europe," History Today, 38 (Aug. 1988), 28; Crosby, Ecological Imperialism: The Biological Expansion of Europe, 900–1900 (Cambridge, 1986), 34; Jennings, The Invasion of America: Indians, Colonialism, and the Cant of Conquest (Chapel Hill, 1975), 22; White, Middle Ground, 41.
13 Axtell, The Invasion Within: The Contest of Cultures in Colonial North America (New York, 1985), 96. See also Mayor, "Nessus Shirt," 74–75n19, and Steele, Warpaths, 84.
14 Murrin, "Beneficiaries of Catastrophe,"5.
15 In both Calloway, New Worlds for All, 33, and White, Middle Ground, 41.
16 Diamond, Guns, Germs, and Steel, 9.
17 Ibid., 16, 92, 191, 212. See also Taylor, American Colonies, 30–31, 41–42.
18 Diamond, Guns, Germs, and Steel, 25.
19 Ibid., back cover of 1997 edition (Ehrlich), leading page of 1999 edition (Crosby). Of more than 40 reviews of Guns, Germs, and Steel examined, nearly all praised Diamond for providing an alternative to racist theories of world history. For representative examples, see Sharon Begley, "Location, Location ... A Real-Estate View of History's Winners and Losers," Newsweek, 129 (June 16, 1997), 47; Thomas M. Disch, "A Crescendo of Inductive Logic," New Leader, 80 (Mar. 10, 1997), 19–20; "Geographical Determinism," The Economist, 344 (July 19, 1997), R4-R5; review of Guns, Germs, and Steel, in New Yorker, 73 (Mar. 31, 1997), 101; and Colin Renfrew, "Human Destinies and Ultimate Causes," Nature, 386 (Mar. 27, 1997), 339–40.
Other critical reviews have not addressed this point. For examples,
see James M. Blaut, "Environmentalism and Eurocentrism," Geographical
Review, 89 (July 1999), 391–408 (focused on geographic
determinism); Brian Ferguson, review of Guns, Germs, and Steel,
American Anthropologist, 101 (Dec. 1999), 900–01 (Diamond
ignores culture, society, politics); and McNeill, "History Upside
Down," New York Review of Books, 44 (May 15, 1997), 48–50.
Three reviewers actually criticize Diamond for downplaying the
importance of racial differences: Laurence Hurst, "Sex, War and
the Pox," New Scientist, 155 (Aug. 30, 1997), 40–41;
Mark Ridley, "The Uselessness of Zebras," TLS: The Times Literary
Supplement, Nov. 14, 1997, 6; and J. Philippe Rushton, review
of Guns, Germs and Steel in Population and Environment,
21 (Sept. 1999), 99–107. Only two reviews comment on Diamond's
implicitly racial arguments, and neither recognizes their pervasive
presence: Bruce Mazlish, "Big Questions? Big History?" History
and Theory, 38 (May 1999), 232–48, and Steve Sailer,
"Why Nations Conquer," National Review, 49 (May 19, 1997),
21 Jennings made a similar argument in Invasion of America, 22.
22 The term "race" requires clarification. Careful writers, including McNeill, Diamond, and (but not always) Crosby, avoid the politically charged term by discussing specific historically and geographically defined populations. American Indians at the time of contact, for instance, were a distinct group compared to Europeans and Africans. It is possible to discuss virgin soil epidemics without ever mentioning race. However, many authors (especially in popular forums) discuss race and racial difference as though they were real and self-evident categories. This position has gained support from genetic analyses of human populations that show a "general agreement" between popularly and genetically defined human subpopulations: Noah A. Rosenberg et al., "Genetic Structure of Human Populations," Science, 298 (Dec. 20, 2002), 2381–85. Such work has re-energized controversies about the relevance of race as a salient category in medical science: Richard S. Cooper, Jay S. Kaufman, and Ryk Ward, "Race and Genomics," New England Journal of Medicine, 348 (Mar. 20, 2003), 1166–70; Esteban Gonzàlez Burchard et al., "The Importance of Race and Ethnic Background in Biomedical Research and Clinical Practice," ibid., 1170–75. Casual use of race, however, introduces unneeded political baggage into debates about human health and disease, confusing an already complicated picture. I avoid race, racial, or racist as much as possible except where those terms are introduced by my sources.
23 For a similar argument, see Francis J. Brooks, "Revising the Conquest of Mexico: Smallpox, Sources, and Populations," Journal of Interdisciplinary History, 24 (Summer 1993), 9–10.
24 McNeill, Plagues and Peoples, 196. For epidemics as an alternative to Euroamerican agency, see Terence Ranger, "To Fiji with Measles," London Review of Books, 21 (Feb. 4, 1999), 30. For similar arguments by environmental historians, see Donald Worster, "Transformations of the Earth: Toward an Agroecological Perspective in History,"JAH, 76 (1990), 1088, 1090. For political debates within environmental history, see the discussions by Worster, Crosby, White, Carolyn Merchant, Cronon, and Stephen J. Pyne in JAH, 76 (1990), 1087–1147.
25 Packard, White Plague, Black Labor: Tuberculosis and the Political Economy of Health and Disease in South Africa (Berkeley, 1989), 32.
26 Rozanne Dunbar Ortiz, "Aboriginal People and Imperialism in the Western Hemisphere," Monthly Review, 44 (Sept. 1992), 1–2.
27 Sowell, Conquest and Cultures: An International History (New York, 1998), 327; Stannard, American Holocaust: Columbus and the Conquest of the New World (New York, 1992), xii. However, Stannard himself cited Hawaiians' nonimmunity as a contributing factor to their decline in the 19th century. Stannard, "Disease and Infertility,"325–50.
Soil Epidemics," 296–99; Kupperman, Settling With
the Indians: The Meeting of English and Indian Cultures in America,
1580–1640 (Totowa, N. J., 1980), 5. See also Crosby,
Columbian Exchange, 48–53, and Diamond, Guns,
Germs, and Steel, 210–11.
29 For an example, see Taylor, American Colonies, 41–42.
30 For a discussion of how African Americans in the 1960s and 1970s reformulated sickle cell anemia as proof of their fitness to their ancestral environment, see Keith Wailoo, Dying in the City of the Blues: Sickle Cell Anemia and the Politics of Race and Health (Chapel Hill, 2001), 106, 114–18, 144–47, 182–89. For hypertension and the slave trade, see Thomas W. Wilson and Clarence E. Grim, "Biohistory of Slavery and Blood Pressure Differences in Blacks Today: A Hypothesis," Hypertension, 17 (Jan. 1991, supplement), 1–122. For a refutation, see Philip D. Curtin, "The Slavery Hypothesis for Hypertension among African Americans: The Historical Evidence," American Journal of Public Health, 82 (1992), 1681–86.
31 Jennings, Invasion of America, 15. For changing European attitudes toward Indians, see Joyce E. Chaplin, Subject Matter: Technology, the Body, and Science on the Anglo- American Frontier, 1500–1676 (Cambridge, Mass., 2001). For the fertile reception of European plants and animals, see Crosby, Ecological Imperialism, and Elinor G. K. Melville, A Plague of Sheep: Environmental Consequences of the Conquest of Mexico (Cambridge, 1994).
32 Smith, Advertisements for the Unexperienced Planters of New England, or Any Where (1631), in Philip L. Barbour, ed., The Complete Works of Captain John Smith (1580–1631), 3 vols. (Chapel Hill, 1986), 3:275; Mather, Magnalia Christi Americana; or, The Ecclesiastical History of New-England (1732), 2 vols. (Hartford, 1853), 1:51. For historians' fetish for Puritans' providential responses, see Calloway, ed., Dawnland Encounters: Indians and Europeans in Northern New England (Hanover, N. H., 1991), 12; Cronon, Changes in the Land, 126; Kupperman, Settling with the Indians, 6; and Alden T. Vaughan, New England Frontier: Puritans and Indians, 1620–1675 (Norman, Okla., 1995; orig. pub. 1965), 104. I discuss the role of such providential explanations in Puritan society in Rationalizing Epidemics: Meanings and Uses of American Indian Mortality since 1600 (Cambridge, Mass., forthcoming).
33 This is true for all cases in which social factors generate disparities in health status, as well as the specific case of the few remaining "virgin soil" populations. As late as 1998, experts estimated that 55 groups of isolated South American Indians had yet to encounter Europeans, Africans, and their pathogens; Magdalena Hurtado et al., "The Epidemiology of Infectious Diseases among South American Indians: A Call for Guidelines for Ethical Research," Current Anthropology, 42 (2001), 425–32.
34 Las Casas, The Devastation of the Indies: A Brief Account (1552), trans. Herma Briffault (Baltimore, 1992), 29.
35 Morton, New English Canaan (1632), in Peter Force, ed., Tracts and Other Papers, Relating Principally to the Origin, Settlement, and Progress of the Colonies of North America ... (1836–1847), 4 vols. (New York, 1947), 2:18–19; Lalemant, "Relation of What Occurred in the Mission of the Hurons" (1640), in Reuben Gold Thwaites, ed., The Jesuit Relations and Allied Documents: Travels and Explorations of the Jesuit Missionaries in New France, 1610–1791, 73 vols. (Cleveland, 1896–1901), 19:93. Both Lalement and Pedro de Liévano (c. 1577), dean of the Cathedral of Guatemala, used the phrase "secret, but ever adorable, judgements of God." De Liévano, quoted in Lovell, "Disease and Depopulation in Early Colonial Guatemala," in Cook and Lovell, eds., "Secret Judgments of God," 77.
36 Winslow, Good Newes from New England (1624), in Alexander Young, ed., Chronicles of the Pilgrim Fathers of the Colony of Plymouth, from 1602 to 1625, 2d ed. (Boston, 1844), 346.
37 Heckewelder, History, Manners, and Customs of the Indian Nations Who Once Inhabited Pennsylvania and the Neighbouring States (1819), (Philadelphia, 1876), 221.
38 Chapman, physician report, in "Report of Agent for Yankton Agency," in Annual Reports of the Department of the Interior for ... 1904. Indian Affairs ... (Washington, D. C., 1905), 342.
39 Allan M. Brandt, "Racism and Research: The Case of the Tuskegee Syphilis Study," Hastings Center Report, 8 (Dec. 1978), 21–29; Alan M. Kraut, Silent Travelers: Germs, Genes, and the "Immigrant Menace" (Baltimore, 1994), 78–96, 136–65; Nancy Krieger, "Shades of Difference: Theoretical Underpinnings of the Medical Controversy on Black/White Differences in the United States, 1830–1870," International Journal of Health Services, 17 (1987), 259–78; Charles E. Rosenberg, "The Bitter Fruit: Heredity, Disease, and Social Thought in Nineteenth-Century America," Perspectives in American History, 8 (1974), 189–235.
40 Holder, "Papers on Diseases among Indians," Medical Record, 42 (Aug. 13, 1892), 178; Jones, "Report of the Commissioner of Indian Affairs," in Annual Reports of the Department of the Interior for ... 1904, 36; Hutchinson, "Varieties of Tuberculosis According to Race and Social Condition," National Association for the Study and Prevention of Tuberculosis: Transactions of the Annual Meeting, 3 (1907), 199.
41 Williams, "The Epidemic of the Indians of New England, 1616–1620, with Remarks on Native American Infections," Johns Hopkins Hospital Bulletin, 20 (1909), 340; Bushnell, A Study in the Epidemiology of Tuberculosis, With Especial Reference to Tuberculosis of the Tropics and of the Negro Race (New York, 1920), 35; Cook, The Extent and Significance of Disease among the Indians of Baja California, 1697–1773 (Berkeley, 1937), 1. At about this time, medical authorities in South Africa were identifying the local Africans as virgin populations; Packard, White Plague, Black Labor, 4, 22–23.
42 Dobyns, "An Outline of Andean Epidemic History to 1720," Bulletin of the History of Medicine, 37 (1963), 494. For similar claims, see C. H. Haring, The Spanish Empire in America (New York, 1947), 43, and John Duffy, "Smallpox and the Indians in the American Colonies," Bulletin of the History of Medicine, 25 (July-Aug. 1951), 327.
43 Cockburn, "The Evolution of Infectious Diseases," in Cockburn, ed., Infectious Diseases: Their Evolution and Eradication (Springfield, Ill., 1967), 90.
44 Ibid., 104. McNeill echoed this: see Plagues and Peoples, 272n3.
45 This connection served many agendas, from the desire of molecular biologists and population geneticists to make contributions to medicine, to the needs of the growing black identity movement; Wailoo, Dying in the City of the Blues, 106, 114–18, 144–47, 182–89.
46 Trigger, "Comments," on Dobyns, "Estimating Aboriginal American Population: An Appraisal of Techniques with a New Hemispheric Estimate," Current Anthropology, 7 (Oct. 1966), 440; Neel et al., "Notes on the Effects of Measles and Measles Vaccine in a Virgin-Soil Population of South American Indians," American Journal of Epidemiology, 91 (1970), 418–29. For debates about Neel's role in these epidemics, see Tierney, Darkness in El Dorado, 53–82, and "Perspectives on Tierney's Darkness in El Dorado," Current Anthropology, 42 (Apr. 2001), 265–76.
Soil Epidemics," 291. In other writings on depopulation, Crosby
emphasized the lack of immunity without discussing contributing
social factors: Columbian Exchange, 39, 52, 57; "'God ...
Would Destroy Them, and Give Their Country to Another People ...,'"
American Heritage, 29 (Oct./Nov. 1978), 39.
Crosby as the authority on immunological determinism: Fenn, Pox
Americana, 25–26; Kupperman, Indians and English,
34; Salisbury, "Indians'
Old World," 458; White, "Western History," 208. Crosby as
the authority on social disruption: Axtell, Beyond 1492,
237; Chaplin, Subject Matter, 158; Calvin Martin, Keepers
of the Game: Indian-Animal Relationships and the Fur Trade
(Berkeley, 1978), 49–50.
49 Cook, Born to Die, 22–23; Newson, "Indian Population Patterns in Colonial Spanish America," Latin American Research Review, 20 (1985), 46. Taylor provides a lower, but still severe, estimate of initial population and subsequent mortality, 300,000; Taylor, American Colonies, 38.
50 Stannard, "Disease and Infertility," 325–50 (Hawaii); McNeill, Plagues and Peoples, 171 (Alaska); Neel et al., "Notes on the Effects of Measles," 418–29 (Amazonia).
51 Gookin, Historical Collections of the Indians in New England; of Their Several Nations, Numbers, Customs, Manners, Religion and Government, before the English Planted There (c. 1680) (Leicester, Mass., 1970; orig. pub. 1792), 9–12; Mather, Magnalia Christi Americana, 1:51.
52 S. N. Clark, "Are the Indians Dying Out? Preliminary Observations Relating to Indian Civilization and Education," in Annual Report of the Commissioner of Indian Affairs to the Secretary of the Interior for the Year 1877 (Washington, D. C., 1877), 487–520.
53 The disparate estimates reflect different assumptions about the nature of American Indian life. Low estimates assume that precontact disease, unsophisticated social arrangements, and limited exploitation of ecological potential kept populations low. High estimates assume little precontact disease, limited warfare, high fertility, and full utilization of the ecological potential of American environments; European epidemics wiped out 95% of these populations before European censuses. See Michael H. Crawford, The Origins of Native Americans: Evidence from Anthropological Genetics (Cambridge, 1998), 33–39; Dobyns, "Estimating Aboriginal American Population," 395–416; Dobyns, Their Number Become Thinned: Native American Population Dynamics in Eastern North America (Knoxville, 1983); David Henige, Numbers from Nowhere: The American Indian Contact Population Debate (Norman, Okla., 1998); Ann F. Ramenofsky, Vectors of Death: The Archaeology of European Contact (Albuquerque, 1987), 1–21; and Douglas H. Ubelaker, "Patterns of Demographic Change in the Americas," Human Biology, 64 (June 1992), 361–79.
54 Newson, "Indian Population Patterns," 41–74; Stannard, "Disease and Infertility," 325–26; Dean R. Snow, "Microchronology and Demographic Evidence Relating to the Size of Pre-Columbian North American Indian Populations," Science, 268 (16 June 1995), 1601–04; Taylor, American Colonies, 40.
55 For a population of initial size P0 and a growth rate of r, the population at time t can be calculated simply: P=P0ert To find the rate needed to produce 90% loss over 100 years, rearrange the equation and solve for r to get a rate of 2.3%.
56 Las Casas, Devastation of the Indies, 29–31; Smith, A Description of New England ... (1616), in Barbour, ed., Complete Works of Captain John Smith, 1:330; Dermer to Samuel Purchas, 1619, in Purchas, ed., Hakluytus Posthumus, or Purchas His Pilgrimes (1625), 20 vols. (Glasgow, 1906), 19:129. Empty villages did not necessarily mean dead Indians: they might have withdrawn from the coast as part of their normal seasonal migrations, in response to the epidemics, or in response to the threat posed by Europeans.
57 Quoted in H. Evans Lloyd, preface to Maximilian, Prince of Wied, Travels in the Interior of North America, in Reuben Gold Thwaites, ed., Early Western Travels, 1748–1846, 32 vols. (Cleveland, 1904–1906), 22:33. For Alaska, see McNeill, Plagues and Peoples, 181.
58 For genocide, see Thornton, American Indian Holocaust and Survival; Ortiz, "Aboriginal People and Imperialism,"1–13; Stannard, American Holocaust; and Ward Churchill, Indians Are Us? Culture and Genocide in Native North America (Toronto, 1994), 11–63. For hunting Indians, see Lee Miller, ed., From the Heart: Voices of the American Indian (New York, 1995), 306.
59 Diamond, Guns, Germs, and Steel, 373–74. See also Calloway, New Worlds for All, 33; Dobyns, "Estimating Aboriginal American Population," 413–14; and McNeill, Plagues and Peoples, 180–81.
60 For these debates, see Timothy L. Bratton, "The Identity of the New England Indian Epidemic of 1616–19," Bulletin of the History of Medicine, 62 (Fall 1988), 351–83; Spiess and Spiess, "New England Pandemic," 71–83; and Williams, "Epidemic of the Indians of New England,"340–49.
61 For Mayan claims, see the account of Chilam Balam of Chumayel, quoted in Crosby, Columbian Exchange, 36. For Huron claims, see Paul le Jeune, "Relation of What Occurred in New France in the Year 1637," (1638) in Thwaites, ed., Jesuit Relations, 11:193. For the possibility that the Chinese beat the Europeans to America and brought diseases with them, see Gavin Menzies, 1421: The Year China Discovered America (New York, 2003), 114, 412, and Crawford, Origins of Native Americans, 88.
62 Ortiz, "Aboriginal People and Imperialism," 2. For similar claims, see McNeill, Plagues and Peoples, 176; Martin, Keepers of the Game, 48–49; and Cronon, Changes in the Land, 85.
63 Shreeve, "Dominance and Submission," New York Times Book Review, June 15, 1997, 13. For the Arctic passage, see Cronon, Changes in the Land, 85; Storey, Life and Death in the Ancient City of Teotihuacan, 42–43; and Taylor, American Colonies, 41. For a discussion and critique of the theory, see Crawford, Origins of Native Americans, 51–52. For the role of animals and cities, see Cronon, Changes in the Land, 85; Diamond, Guns, Germs, and Steel, 213; McNeill, Plagues and Peoples, 178; Taylor, American Colonies, 41; and Williams, "Epidemic of the Indians of New England," 241.
64 Howard S. Russell, Indian New England Before the Mayflower (Hanover, N. H., 1980), 35, 104–05; Stannard, American Holocaust, 53; Taylor, American Colonies, 41 ; Ubelaker, "Patterns of Demographic Change," 364.
65 Writers sometimes confuse these groups, for example discussing the "smallpox bacillus." See Stannard, American Holocaust, 77.
66The New England Journal of Medicine published a series of review articles on immunology that are accessible to nonexpert, but motivated, readers: Peter J. Delves and Ivan M. Roitt, "The Immune System: First of Two Parts," N. Eng. J. Medicine, 343 (July 6, 2000), 37–49; Delves and Roitt, "The Immune System: Second of Two Parts," ibid., 343 (July 13, 2000), 108–17; Ruslan Medzhitov and Charles Janeway, Jr., "Innate Immunity," ibid., 343 (Aug. 3, 2000), 338–44; Rolf M. Zinkernagel, "Maternal Antibodies, Childhood Infections, and Autoimmune Diseases," ibid., 345 (Nov. 1, 2001), 1331–35.
67 Although immunologists treat the distinction of self versus non-self as self-evident, this concept has an interesting historical and philosophical development. See Alfred I. Tauber and Scott H. Podolsky, "Frank Macfarlane Burnet and the Immune Self," Journal of the History of Biology, 27 (1994), 531–73. Confusion between self and non-self and an unbalanced immune system contribute to allergies and autoimmune disease. See Stuart E. Turvey, "Atopic Diseases of Childhood," Current Opinion in Pediatrics, 13 (Oct. 2001), 487–95.
68 Medzhitov and Janeway, "Innate Immunity,"338–39.
69 For comparisons of American Indians and Hawaiians to people with AIDS or other immunodeficiencies, see Hurtado et al., "Epidemiology of Infectious Diseases,"429; Stannard, "Disease and Infertility,"339; and Tierney, Darkness in El Dorado, 56.
70 For overviews, see Diamond, Guns, Germs, and Steel, 201, and Adrian V. S. Hill, "The Immunogenetics of Human Infectious Diseases," Annual Review of Immunology, 16 (1998), 593–617.
71 Sarah A. Tishkoff et al., "Haplotype Diversity and Linkage Disequilibrium at Human G6PD: Recent Origin of Alleles That Confer Malarial Resistance," Science, 293 (July 20, 2001), 455–62;D. M. Rodman and S. Zamudio, "The Cystic Fibrosis Heterozygote—Advantage in Surviving Cholera?" Medical Hypotheses, 36 (Nov. 1991), 253–58; Mary Carrington et al., "HLA and HIV-1: Heterozygote Advantage and B*35–Cw*04 Disadvantage," Science, 283 (Mar. 12, 1999), 1748–52; Hill, "Immunogenetics and Genomics," Lancet, 357 (June 23, 2001), 2037–41; J. Claiborne Stephens et al., "Dating the Origin of the CCR5–Δ32 AIDS-Resistance Allele by the Coalescence of Haplotypes," American Journal of Human Genetics, 62 (June 1998), 1507–15.
72 Diamond, "A Pox upon Our Genes," Natural History, 99 (Feb. 1990), 30.
73 Christian G. Meyer, Jürgen May, and Klaus Stark, "Human Leukocyte Antigens in Tuberculosis and Leprosy," Trends in Microbiology, 6 (Apr. 1998), 153.
74 Rima McLeod et al., "Immunogenetics in the Analysis of Resistance to Intracellular Pathogens," Current Opinion in Immunology, 7 (1995), 544–46.
75 Richard Bellamy et al., "Variations in the NRAMP1 Gene and Susceptibility to Tuberculosis in West Africans," N. Eng. J. Medicine, 338 (Mar. 5, 1998), 640–44.
76 These are reviewed in Marc Lipsitch and Alexandra O. Sousa, "Historical Intensity of Natural Selection for Resistance to Tuberculosis," Genetics, 161 (Aug. 2002), 1599–1607.
77 For one claim of racial difference in tuberculosis susceptibility, see William W. Stead et al., "Racial Differences in Susceptibility to Infection by Mycobacterium tuberculosis," N. Eng. J. Medicine, 322 (Feb. 15, 1990), 422–27.
78 Sousa et al., "An Epidemic of Tuberculosis with a High Rate of Tuberculin Anergy among a Population Previously Unexposed to Tuberculosis, the Yanomami Indians of the Brazilian Amazon," Proceedings of the National Academy of Sciences, 94 (Nov. 25, 1997), 13227 ("high susceptibility"), 13231 ("immunologically naïve"); Kathleen Fackelmann, "Tuberculosis Outbreak: An Ancient Killer Strikes a New Population," Science News, 153 (Jan. 31, 1998), 73 ("first responded"), 75 ("ill-equipped").
79 Celia M. T. Greenwood et al., "Linkage of Tuberculosis to Chromosome 2q35 Loci, Including NRAMP1, in a Large Aboriginal Canadian Family," American Journal of Human Genetics, 67 (Aug. 2000), 405–14.
80 Jennings, Founders of America, 130.
81 No "racial susceptibility": Abram S. Benenson, "Smallpox," in Alfred S. Evans, ed., Viral Infections of Humans: Epidemiology and Control, 3d ed. (New York, 1989), 642; Thomas H. Weller, "Varicella-Herpes Zoster Virus," in Evans, ed., Viral Infections, 669. Social confounding: Francis Black, "Measles," ibid., 459; Masahiro Kushigemachi, Lawrence J. Schneiderman, and Elizabeth Barrett-Connor, "Racial Differences in Susceptibility to Tuberculosis: Risk of Disease after Infection," Journal of Chronic Disease, 37 (1984), 853–60.
82 In the 1970s Francis Black estimated that acute epidemic diseases, which require human populations of certain threshold sizes, had only been present for 200 generations, too short a time for significant natural selection: Black, "Infectious Diseases in Primitive Societies," Science, 187 (Feb. 14, 1975), 515–18. For recent refinements of this estimate, see Lipsitch and Sousa, "Historical Intensity of Natural Selection," 1599–1607; Paul Schliekelman, Chad Garner, and Montgomery Slatkin, "Natural Selection and Resistance to HIV: A Genotype That Lowers Susceptibility to HIV Extends Survival at a Time of Peak Fertility," Nature, 411 (May 31, 2001), 545–46; Stephens et al., "Dating the Origin," 1513; and Tishkoff et al., "Haplotype Diversity,"455–62.
83 Cystic fibrosis heterozygotes may have had protection against non-cholera secretory diarrheas, which likely did exist in Europe. See Sherif E. Gabriel, response to Paul Fontelo, "Protection Against Cholera," Science, 267 (Jan. 27, 1995), 440.
84 Bellamy, "Identifying Genetic Susceptibility Factors for Tuberculosis in Africans: A Combined Approach Using a Candidate Gene Study and a Genome-Wide Screen," Clinical Science, 98 (2000), 245–50; Greenwood et al., "Linkage of Tuberculosis,"406, 414.
85 Timothy J. Aitman et al., "Malaria Susceptibility and CD36 Mutation," Nature, 405 (June 29, 2000), 1015–16.
86 Diamond, "A Pox upon Our Genes,"26–30.
87 Black, Gerald Schiffman, and Janardan P. Pandey, "HLA, Gm, and Km Polymorphisms and Immunity to Infectious Diseases in South Amerinds," Experimental and Clinical Immunogenetics, 12 (1995), 214. See also Black, "An Explanation of High Death Rates among New World Peoples When in Contact with Old World Diseases," Perspectives in Biology and Medicine, 37 (Winter 1994), 294–95.
88 Hurtado et al., "Epidemiology of Infectious Diseases," 426; Sousa et al., "Epidemic of Tuberculosis,"13231.
89 John B. Robbins and Rachel Schneerson, "Evaluating the Haemophilus Influenzae Type b Conjugate Vaccine PRP-D," N. Eng. J. Medicine, 323 (Nov. 15, 1990), 1415–16.
90 Robert P. Erickson, "Southwestern Athabaskan (Navajo and Apache) Genetic Diseases," Genetics in Medicine, 1 (May-June 1999), 151–57.
91 Crawford, Origins of Native Americans, 88–148. However, he noted that new DNA markers have shown more diversity than previous estimates.
92 Black, "Why Did They Die?" Science, 258 (Dec. 11, 1992), 1739–40; Black, "Explanation of High Death Rates,"301 ("can adapt"); Black et al., "HLA, Gm, and Km Polymorphisms,"215 ("limited genetic diversity"). This theory has been picked up by some historians: Fenn, Pox Americana, 26–27, 141; Robert McCaa, "Spanish and Nahuatl Views on Smallpox and Demographic Catastrophe in Mexico," Journal of Interdisciplinary History, 25 (1995), 419–20.
93 Carrington et al., "HLA and HIV-1," 1748–52; Hill, "Defence by Diversity," Nature, 398 (Apr. 22, 1999), 668–69.
94 Benenson, "Smallpox,"634; Zinkernagel, "Maternal Antibodies," 1331.
"Virgin Soil Epidemics," 293–96.
96 Some historians have argued that influenza and other epidemics single out young adults for the highest mortality, stripping vulnerable societies of their most productive individuals. In fact, most infections have U-shaped mortality curves: high in infants, low in school-aged children and adolescents, then increasing steadily with age: Benenson, "Smallpox," 641; Anne A. Gershon, "Measles Virus (Rubeola)," in Gerald L. Mandell, John E. Bennett, and Raphael Dolin, eds., Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 5th ed. (Philadelphia, 2000), 1801–09; Weller, "Varicella-Herpes Zoster Virus,"668.
97 Many authors list tuberculosis, treponematosis, pneumonia (streptococcus), staphylococcus, typhoid, shigellosis, salmonella, leishmaniasis, Chagas' disease, toxoplasmosis, amebiasis, giardiasis, tinea, blastomycosis, tapeworm, whipworm, pin-worm, roundworm, and hookworm. See Suzanne Austin Alchon, Native Society and Disease in Colonial Ecuador (Cambridge, 1991), 20–24; Boyd, Coming of the Spirit of Pestilence, 15; and Starna, "Biological Encounter,"512. These diseases were found in some places; they were not likely endemic everywhere.
98 Arthur C. Aufderheide, "Summary on Disease before and after Contact," in John W. Verano and Ubelaker, eds., Disease and Demography in the Americas, (Washington, D. C., 1992), 165. For other rebuttals of the disease-free paradise, see Calloway, New Worlds for All, 25; Clark Spencer Larsen, "In the Wake of Columbus: Native Population Biology in the Postcontact Americas," Yearbook of Physical Anthropology, 37 (1994), 109, 114; Ubelaker, "Patterns of Demographic Change,"372; or many of the other essays in Verano and Ubelaker, eds., Disease and Demography.
99 For the impact of common bacterial pathogens on a disease-experienced population, see Walsh McDermott, with David E. Rogers, "Social Ramifications of Control of Microbial Disease," Johns Hopkins Medical Journal, 151 (1982), 305. In 1990, viral pneumonia and diarrhea remained the leading causes of infectious deaths. See Christopher J. L. Murray and Alan D. Lopez, eds., The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020 (Cambridge, Mass., 1996), 176. It is tempting, but impossible, to extrapolate this prevalence back to pre-contact America.
100 Eric T. Sandberg, Mark W. Kline, and William T. Shearer, "The Secondary Immunodeficiencies," in E. Richard Stiehm, ed., Immunologic Disorders in Infants and Children, 4th ed. (Philadelphia, 1996), 553–601; Christopher L. Karp et al., "Mechanism of Suppression of Cell-Mediated Immunity by Measles Virus," Science, 273 (July 12, 1996), 228–31.
101 The phenomena of obesity demonstrate the impact of social factors even on diseases that have strong genetic components. Studies have shown that 50% to 90% of the variance of obesity can be attributed to genetics. But the expression of genetic tendencies depends on social context: famine will prevent the expression of obesity, regardless of genetic predilection. Similarly, the prevalence of obesity in the United States has increased rapidly over recent decades, in the absence of significant genetic change; Gregory S. Barsh, I. Sadaf Farooqi, and Stephen O'Rahilly, "Genetics of Body-Weight Regulation," Nature, 404 (Apr. 6, 2000), 644–51.
Squire, "Reports of Societies: The Epidemiological Society," Medical
Times and Gazette, 1 (1877), 324; Hrdlika,
Tuberculosis among Certain Indian Tribes of the United States
(Washington, D. C., 1909), 31; Cook, "The Significance of Disease
in the Extinction of the New England Indians," Human Biology,
45 (Sept. 1973), 506. See also August Hirsch, Handbook of Geographical
and Historical Pathology, trans. Charles Creighton (London,
103 Sandberg, Kline, and Shearer, "Secondary Immunodeficiencies,"565. See also Black, "Measles," 451; Gershon, "Measles Virus (Rubeola)," 1805; and Weller, "Varicella-Herpes Zoster Virus," 674.
104 For an overview, see Robert Dirks, "Famine and Disease," in Kenneth F. Kiple, ed., The Cambridge World History of Human Disease (Cambridge, 1993), 157–63. For a specific example (tuberculosis during the siege of Paris), see David S. Barnes, The Making of a Social Disease: Tuberculosis in Nineteenth-Century France (Berkeley, 1995), 6–9. Malnutrition remains the major risk factor for mortality worldwide, accounting for 11.7% of the attributable risk (compared to 6% for tobacco, 5.8% for hypertension, 5.3% for sanitation and hygiene, and 1.5% for alcohol). See Murray and Lopez, Global Burden of Disease, 311.
105 Cronon, Changes in the Land, 88. See also Chaplin, Subject Matter, 158, and White, "Western History," 208.
106 John H. Coatsworth, "Welfare," American Historical Review, 101 (1996), 1–12 (general discussion); Crawford, Origins of Native Americans, 53 (Arikara); Larsen, "In the Wake of Columbus," 109–54 (worsening health); Storey, Life and Death in the Ancient City of Teotihuacan, 253–66 (cities); Ann L. W. Stodder et al., "Cultural Longevity and Biological Stress in the American Southwest," in Richard H. Steckel and Jerome C. Rose, eds., The Backbone of History: Health and Nutrition in the Western Hemisphere (Cambridge, 2002), 481–505 (ill-health).
107 Steckel and Rose, "Patterns of Health in the Western Hemisphere," in Steckel and Rose, eds., Backbone of History, 563–79. While agricultural societies (e.g., Mexico, Andes) experienced poor health, rural areas (e.g., coastal Georgia, Brazil) did better. Societies with a pre-contact life expectancy of 40 years could more easily absorb new pathogens than societies with a life expectancy of 20 years; S. Ryan Johansson and Owsley, "Welfare History on the Great Plains: Mortality and Skeletal Health, 1650 to 1900," in Steckel and Rose, eds., Backbone of History, 556.
108 Newson, "Highland-Lowland Contrasts,"1191–94 (Ecuador); Melville, Plague of Sheep (Mexico); Cronon, Changes in the Land, 107–56 (New England); Alchon, Native Society and Disease in Colonial Ecuador; "Occasional Correspondent" to The Times, Apr. 23, 1875, quoted in Cliff, Haggett, and Smallman-Raynor, "Island Populations,"163 (Fiji).
109 Larsen, "In the Wake of Columbus,"137 (Maya); Steve J. Stern, Peru's Indian Peoples and the Challenge of Spanish Conquest: Huamanga to 1640, 2d ed. (Madison, 1993), 44 (Huamanga); Stodder and Debra L. Martin, "Health and Disease in the Southwest before and after Spanish Contact," in Verano and Ubelaker, eds., Disease and Demography, 63 (Pueblo); Enrique Tandeter, "Crisis in Upper Peru, 1800–1805," Hispanic American Historical Review, 71 (1991), 40–51; Alden and Miller, "Unwanted Cargoes: The Origins and Dissemination of Smallpox via the Slave Trade from Africa to Brazil, c. 1560–1830," in Kiple, ed., The African Exchange: Toward a Biological History of Black People (Durham, N. C., 1987), 35–109;Cliff, Haggett, and Smallman-Raynor, "Island Populations,"148–56 (Fiji).
110 Newson, "Highland-Lowland Contrasts," 1194. See also Newson, "The Demographic Collapse of Native Peoples of the Americas, 1492–1650," Proceedings of the British Academy, 81 (1993), 247–88.
111 Hurtado et al., "Epidemiology of Infectious Diseases,"428. See also Marcos Cueto, The Return of Epidemics: Health and Society in Peru during the Twentieth Century (Burlington, Vt., 2001).
112 Decker, "Depopulation of the Northern Plains Natives," Social Science and Medicine, 33 (1991), 383; Fenn, Pox Americana, 162, 187; Dollar, "The High Plains Smallpox Epidemic of 1837–38,"Western Historical Quarterly, 8 (Jan. 1977), 29; Kelm, Colonizing Bodies: Aboriginal Health and Healing in British Columbia, 1900–50 (Vancouver, 1998), 177. See also Maureen K. Lux, Medicine That Walks: Disease, Medicine, and Canadian Plains Native People, 1880–1940 (Toronto, 2001).
113 Kunitz, Disease and Social Diversity: The European Impact on the Health of Non-Europeans (New York, 1994), 5, 73. See also Crawford, Origins of Native Americans, 41–49.
114 Cook, "Interracial Warfare and Population Decline among the New England Indians," Ethnohistory, 20 (Winter 1973), 1–24; McCaa, "Spanish and Nahuatl Views," 429; Newson, "Indian Population Patterns," 47–65; Snow and Kim M. Lanphear, "European Contact and Indian Depopulation in the Northeast: The Timing of the First Epidemics," Ethnohistory, 35 (Winter 1988), 17; Trimble, "1837–1838 Smallpox Epidemic,"82; Ubelaker, "Patterns of Demographic Change,"364–69.
115 Stannard, "Disease and Infertility," 325–50; Ubelaker, "Patterns of Demographic Change," 364.
116 Larsen et al., "Population Decline and Extinction in La Florida," in Verano and Ubelaker, eds., Disease and Demography, 35. See also Larsen, "In the Wake of Columbus," 124.
Kupperman, "Apathy and Death in Early Jamestown,"JAH,
66 (1979), 24–40; Crosby, "Virgin
Soil Epidemics," 292–93 (smallpox); Squire, "Reports
of Societies,"324 (measles).
118 Ubelaker and Verano, "Conclusion," in Verano and Ubelaker, eds., Disease and Demography, 281.
119 Newson, "Indian Population Patterns,"42–44.
120 Cliff, Haggett, and Smallman-Raynor, "Island Populations," 147.
121 Compare Dobyns, Their Number Become Thinned, 13–16, to a critique, Alden and Miller, "Unwanted Cargoes," 37.
122 Cook, Born to Die, 5.
123 This story of science fiction has been told in Orson Scott Card, Pastwatch: The Redemption of Christopher Columbus (New York, 1996).
124 Jones and Allan M. Brandt, "AIDS, Historical," in Joshua Lederberg, ed., Encyclopedia of Microbiology, 2d ed., vol. 1. (San Diego, 2000), 104–15, esp. 114.
125 My own perspective is shaped by awareness of how social factors determine contemporary patterns of disease, by skepticism of the relevance of increasingly detailed genetic information, and by concern that observers often seek to blame victims to avoid responsibility for disparities in health status.