Sheldon Watts took us on a journey of exploration of a gigantic subject, followed his political views and lost his way. This book wants to put such a strong spin on disease as as an element of conquest, that it neglects and distorts too many facts. You can usually find the distortions by noting which paragraphs contain statements that treat some previously unknown fact as common knowledge and then not finding an end note providing some references. I also noted that most of the sources for the book were less than ten years old, and were often teritiary. Sheldon Watts also gets his biological facts wrong on many occasions, usually when trying to underline some action he feels is imperialist. His most unpardonable sin has to be attributing current knowledge to figures who had no such understanding, and then judging their actions using that assumption. For example, he assumes that since people understood that smallpox was communicable, that they had to understand that all diseases were communicable. This was long before Koch or even Snow. And Sheldon Watts does this even though he acknowledges that medical knowledge was effectively non-existant until the mid-1800s. Unless of course it is folk wisdom that he is talking about, which gets a pass, no matter how silly. If you are a Powerful White Man, on the other hand, you are assumed to be omniscient.

If you want a more limited treatment about the subject of diseases and public thought, I suggest that you try "The Cholera Years" by Charles E. Rosenberg. If you want a good treatment of multiple diseases and their biological progression around the world, try "Plagues" by Christopher Wills. Those two books together will cost less than this one, and you'll learn more. And they are far, far more readable.

This work is impressive in its breadth of scholarship, but the author's personal rancor at Europeans' ill treatment of the rest of the world detracts from the narrative. The descriptions of the decimation of the Taino, the Aztecs, Inca and others within a century by the Spanish is truly horrific. Repeatedly referring to the Spanish as "terrorists" weakens, rather than reinforces the point. They were not terrorists: they were behaving as Europeans historically have. The author's succinct explanation of the reasons for the Spanish attitudes toward New World peoples makes his subsequent indignation with their actions curious, to say the least. Similarly, his explanation of malaria and yellow fever is extensive, but his indignation at Europeans in response to the diseases detracts from his scholarship. That Europeans are arrogant, naive, biased, pig-headed, murderous and short-sighted should come as no revelation to anyone reading this book. Other peoples in the world are too, but they didn't all have the opportunity to impose their will on others. To complement this work, Diamond's Guns Germs and Steel,and MacNeill's The Rise of the West, and Plagues and Peoples cover much of the same ground and posit theories how Europeans came to be in a position to impose their will on much of the rest of the world. Overall, a very interesting book, which would be better without these occasional, distracting polemics.

I found this book an excellent companion to earlier books on the subject (McNeill, Crosby), as it puts diseases in human society in a historic social/cultural and political context. I started out sceptical but then got caught by the book and its analyis was for me an eye-opener on how (Western) medicine was a tool often used for ends that had nothing to do with physical well-being, sickness prevention and care. The end conclusions on economics and health economics i do not share at all, i think the author gets carried away a bit and goes way too fast to condemn economists here, (guess what my profession is). Definitely worth while.