Book Review

The Cambridge World History of Human Disease

N Engl J Med 1993; 329:1512November 11, 1993

Article

The Cambridge World History of Human Disease
Edited by Kenneth F. Kiple. 1176 pp., illustrated. New York, Cambridge University Press, 1993. $150. ISBN: 0-521-33286-9

This massive book is the product of the Cambridge History and Geography of Human Disease Project, begun in 1985 under the direction of Kenneth F. Kiple. It is intended to replace August Hirsch's monumental but long-outdated Handbook of Geographical and Historical Pathology (London: New Sydenham Society, 1883-1886), published more than a century ago. Kiple has undertaken the herculean task of assembling the contributions of some 160 anthropologists, historians, demographers, and medical researchers to produce a comprehensive and authoritative encyclopedia of the history of disease.

The work is divided into eight parts. Part I consists of broad overviews of medicine and disease in the West, China, and the Islamic and Indian worlds. These introductory pieces orient the reader to the more specialized essays that follow. Part II chronicles changing concepts of health and disease (e.g., mental illness, sexual deviance, heart disease, and cancer) throughout history. Part III deals with the history of medical specialties and disease prevention, including childhood disease, addiction, occupational medicine, and public health.

The essays in Part IV, largely methodologic in their orientation, treat the measurement of morbidity and mortality. Parts V and VI comprise 25 regional overviews of the history of human disease, each focusing on a particular period. They are followed in Part VII by comprehensive surveys (some of the best in the book) of the ecology of disease in the major regions of the world. The remainder of the book (Part VIII), constituting slightly more than half the entire work, is devoted to 158 of the most notable human diseases, past and present. Each disease is the subject of a separate essay tracing its distribution and incidence, cause and epidemiologic features, clinical manifestations and pathologic aspects, and history and geography. The subjects of the entries range from traditional diseases that are no longer recognized by medical authorities (e.g., catarrh, chlorosis, and typhomalarial fever) to such recent clinical entities as the acquired immunodeficiency syndrome, legionnaires' disease, and Alzheimer's disease. Two detailed indexes of names and subjects add immensely to the usefulness of the book as a work of reference.

Given the vast chronologic scope of the book (from prehistory to the present) and its extensive geographic range (including virtually all regions of the globe), it is not surprising that the coverage is sometimes uneven and marked by omissions. Some essays deal only with the modern period, with hardly a glance at earlier history, whereas several of the survey articles are limited to the Western world. An entire chapter is devoted to the history of chiropractic, but there is no individual treatment of other alternative forms of medicine. A serious omission is the lack of treatment of paleopathology, which has contributed so much in the past generation to our understanding of the history of disease.

In general, the quality of the individual contributions is high. Many of the essays are well written by experts in the field. A few surveys are merely derivative and exceed the competence of their assigned authors. The bibliographies that follow each essay range from short lists of standard works to detailed and comprehensive surveys of the literature. A certain amount of overlap is inevitable. A few well-known pandemics (notably the Black Death) and some familiar problems in the history of medicine (e.g., the origin of syphilis) are treated in several articles. Since the essays are self-contained, however, the duplication does not detract appreciably from the balance of the book, and it offers the reader alternative interpretations.

A review of this scope cannot do justice to the rich and comprehensive nature of this work. More than merely a work of reference, this is a fascinating collection of interdisciplinary essays that constitutes a universal history of human disease. The editor has succeeded in imposing a remarkable degree of thematic and stylistic uniformity on a disparate mass of historical and statistical data., and the lucidity of the essays makes them accessible to nonspecialists and medical specialists alike. The publication of this epoch-making book testifies to the range and the maturity of contemporary scholarship in the history of medicine. It will quickly become indispensable to students of epidemiology and related fields.

Gary B. Ferngren, Ph.D.
Oregon State University, Corvallis, OR 97331