Pathogenesis: A History of the World in Eight Plagues

by Jonathan Kennedy

In the five years after the Black Death,

Given our Pandemic - which seemed to have lasted from 2019-2021 - is still so recent (less than 5 years old), perhaps a resurgence in the interest of education and the funding of its institutions will emerge mid 2020's.

Henry VIII of England’s decision to break from the Catholic Church in the 1530s led to a century and a half of struggle that culminated in the Civil War (1642–51) and Glorious Revolution (1688). In German-speaking countries, the conflict between Protestant princes and the Catholic Habsburg Holy Roman emperors was responsible for the Thirty Years’ War (1618–48), in which up to 40 percent of the population died from the combined impact of conflict, famine and disease in some parts of Europe.[67] The Peace of Westphalia, which determined that each prince could choose his state’s religion, not only ended the conflict but also shattered the Catholic Church’s supreme spiritual authority.

In this sense, existential questioning triggered by the Black Death didn’t just lead to the rise of Protestantism but also paved the way for the emergence of secularism.

When COVID-19 became less prevalent and the world moved toward "normalcy", people seemed to question our established "traditions". For example, office workers - who had been asked to work from home - argued that they did not need to work in-person everyday during the week. Some agrued that they were more productive since they did not have to drive an hour to two hours a day (time that could be alloted to being online instead). Another example could be seen in the increased automization of our culture. Automatic tellers are seen in most grocery stores, therebycreating a more streamlined shopping expereine. AI messaging and calling-features are more prevalent, thereby reducing the need to go in-person to pay for things. Even dating, which previously relied on in-person communication, has become more popular. In short, our culture has put a premium on freedom and expediency after the Pandemic. Like our ancestors, we too share a common desire for change.

To understand the key features of the feudal system that dominated western Europe in the Middle Ages, we need look no further than G.R.R. Martin’s Song of Fire and Ice novels—or, if you prefer, HBO’s adaptation, Game of Thrones.

I enjoy the author's attempt to help its readership undertand the context/function of different systems and events within this book.

According to the German sociologist Max Weber, the Reformation was responsible for this change in mindset. He argues that what he calls the Protestant ethic

In eastern Europe, where lords had colonized vast areas of Steppe in the High Middle Ages, peasants were essentially free from feudal levies prior to the Black Death. Landowners were only able to persuade peasants to live on their estates by offering them extremely favorable terms.

I find this dynamic interesting. Serfs are "free" in the sense that they can travel to different parcels of land and offer themselves for work. Once on that land, they are expected to make food for the owner of that land. The food would then be consumed by the owner and any surplus (not eaten by the owner and the serfs themselves [their allotted amount]) would go to market and be sold for profit. This system kept vassals accountable - they had to protect and treat the serfs "well-enough" so that they would be abe to make a profit off their hioldings.

In France, lords responded to the demographic crash by building an absolutist state that provided them with income funded by universal, country-wide taxes on the peasantry rather than decentralized feudal levies. This meant that serfs couldn’t play one lord against another to gain better conditions or win their freedom.

Universal taxation still, in a sense, helps the wealthy generate wealth and keeps them in power. Citizens, burdened by taxes and struggling to secure income, are less likely to organize against a political system.

Norman conquest of 1066, when William and his followers almost completely replaced the previous feudal elite. One manifestation of England’s peculiarly strong state was its national system of common law; all lords and freemen were subject to the jurisdiction of the king’s court.

In the wake of the Black Death, feudal lords tried to use Parliament to maintain their control by limiting the social and geographical mobility of peasants. As early as 1349, the state issued an ordinance that fixed wages and prices at 1347 levels and made it illegal for serfs to live and work anywhere other than the manor they were bound to before the plague. At first, the punishment for breaking the law was a fine, but in the early 1360s penalties were increased—indicating that the previous legislation hadn’t had the desired effect. Peasants who asked for higher wages or moved to another demesne that offered better terms could now be imprisoned and branded on the forehead with the letter “F” for “falsity.”[74] In 1363 Parliament issued a Sumptuary Law that decreed the types of clothes people at different levels of society could wear, and even what they were allowed to eat. These rules were unenforceable—even the majority of pilgrims in The Canterbury Tales wore swankier clothes than were permitted—but the fact that such laws were thought necessary indicates that the lords felt threatened by the conspicuous consumption of the newly affluent commoners.

It's "strange", how in the face of popular opposition (especially in the aftermath of a pandemic), the elite attempt to use the law and political system to secure their interests. Here, feudal lords attempted to use the law to prevent people from moving. During our modern pandemic, some states (notably California) attempted to tax citizens for moving to different states. Moreover, some people have spoken of a social-credit system whereby citizens not following the "expected norms of society" would have a more difficult time purchasing housing or attempting to make other financial decisions. This sounds very close to branding people with an "F" - commonfolk were penalized for trying to go against "the norms of society" and improve themselves.

the underlying cause was the state’s concerted efforts to stop peasants from taking advantage of opportunities offered by the post–Black Death demographic collapse.

This is why we study history...

John Ball, who in his sermon at Blackheath in southeast London asked the gathered crowd: “When Adam delved and Eve span, who was then the gentleman?,” before railing against the injustice of the feudal system: “From the beginning all men by nature were created alike, and our bondage or servitude came in by the unjust oppression of naughty men.”

Desperate, the lords eventually stopped cooperating with one another and instead began competing for peasants. Serfs streamed away from the manors they were legally bound to and settled wherever they were offered the best conditions. By the mid-fifteenth century, most English peasants were not just paying much lower feudal dues but had also won their freedom; they were even given a copy of the section of the manorial roll that set out the terms of their tenancy. The enfranchisement of England’s serfs was irreversible because the peasants were now freemen who could go to the king’s court to have their new terms of tenancy enforced.

The lords salvaged the situation by persuading the king’s court that when a peasant died, the tenancy should not pass automatically to their heirs on the same terms. In time this led to a system in which lords rented plots of land to agricultural producers at market-determined rates.

In a modern context, this feels the same to a parent passing away. A parent, recognizing their mortallity, attempts to transfer wealth to their children by means of a will. The document itself isn't entirelly legally binding as the housing market - knowing it cannot make more money off an already paid-in-full proprerty - increases the taxes one would need to pay to retain it. In this way, the children cannot pay the taxes and sell (for a lesser price) the property back to the state.

In 1519, Cortés set sail from the Spanish colony of Cuba on an unauthorized expedition to conquer Mesoamerica with 500 men. Shortly after arriving, he scuttled the ships to prevent anyone who was having second thoughts from leaving.

As a coach, I always tell this story to players. While insane, it was this act that motivated his men to go forward - they did't have an option, they had to conquer or die in. This is an extreme example of "when you're back is agaisnt the wall fight".

Cortés’ gang were up against a huge, wealthy and heavily militarized polity that some historians have compared to ancient Sparta. And yet, in one of the most improbable feats of conquest in history, a little over two years after landing in Central America they managed to kill Montezuma, raze his capital and found the colony of New Spain.

It's amazing how 500 men could conquer an empire. I belive however, Cortes did recieve reinforcements after another party was sent to arrest him. Moreover, he had help from other city states opposed to the Mexica. They bolstered his military force and helped Cortes navigate the political environment in that region.

Almost all of the plunder was melted down, and each foot soldier received 20 kilograms of gold—cavalrymen twice that.

Using ChatPT, I researched average income of a Spanish soldier. Based on research, a soldier could have expected 8 ducats per month or 96 ducats a year which amounts to $18,480 today. Converting 20kg to Spanish ducats, a soldier would have received nearly 5,714 ducats at the end of the conquest. This amounts to $1,100,000 today. A soldier would have recieved nearly 52 times his annual salary - a lifetimes worth of money.

A modern-day equivalent might be a right-wing U.S. militia or band of English football hooligans making their way to Moscow, kidnapping and killing Vladimir Putin, seizing Russia’s oil and gas reserves and then declaring the territory a colony, which their descendants go on to dominate for centuries.

This analogy does not feel similar. A modern example might be like 3,000 Navy Seals (infantrymen only) invading South America and subjagating the entire region and using biological warfare to reduce its population size. Political affiliations (right, left, democratic, authoritarian) do not matter so much in this context. The conquest itself was about men overcoming immense odds out of necessity - they would have died if they did not commit themselves fully.

But the superiority of the Old World has been overstated. There weren’t big disparities in living standards between late-medieval Spain and the pre-Columbus Americas. In a letter to the king, Charles V, Cortés described with amazement how Tenochtitlan’s buildings, pottery, jewelry, clothes, shoes, food, markets and barber shops were either similar to or of better quality than those in Spain.

Its commonly assumed that conquistadors thought of themselves as racially and rechnologically superior. But there seems to be enough historical texts (journals, letters, etc.) of conquistadors being amazed by South American socieities. I think, being so far from home, these men found themselves deprived of "modern" luxuries and may have seen their own living conditions as sub-standard. Suddenly being confronted by an immense and technological society (in the jungle), their current state-of-affairs may have made them more open to seeing their counterparts as "similar" and perahps "more advanced". These conquistadors seem to have appreciated South American civilaization and awed at its differences. In contrast, later Imperalists (such as those in Africa) retained their "modern" luxuries which may prevented them from fully appreciating the nuances of another culture. For example, the Spanish were appreciative of their native allies, the Tlaxcala, against the Mexica. In its aftermath, the Tlaxcala retained semi-autonomy throughout the following 300 years.

The Taliban, on the other hand, were armed with very basic weapons that dated back to the 1980s and in some cases the Second World War. Still, the Americans found it impossible to achieve their relatively modest political and military objectives. In 2021, after twenty years of occupation, the Western powers withdrew and the Taliban returned to power.

Afghanistan is the 21st centur's Vietnam

why the conquistadors managed to conquer South and Central America so decisively, what does? The answer is simple: germs, germs, germs.

This has been a longwided buildup...

Hispaniola, the mountainous Caribbean island that is now divided into Haiti and the Dominican Republic. The land was incredibly fertile and inhabited by an indigenous population—the Taíno—whom Columbus described as “affectionate and without malice.” As the two surviving ships were too small to carry the crew of the beached vessel, thirty-nine men were left behind to build a fortified settlement, La Navidad.

I imagine that the men left to build the fortified settlement had mixed feelings. On one hand, the men may have felt relief that they didn't have to continue onward into the unknown. The likelihood of dying on the journey was high. There were too many variables to contend with. They were given provisions to sustain themselves and had support from the native inhabitants. They had work to occupy themselves and relative freedom to explore the island. On the other hand, they may have felt anxiety. They were, in effect, being left behind - abandoned on an unknown island. In the event that the remaining party did not come back, they were left stranded with no means of contacting the outside world. And if they developed poor relations with the native inhabitants, then they were open to hostility if reinforcements never materialized.

When Columbus returned to Hispaniola with seventeen ships less than a year later, he found La Navidad burned to the ground and the bodies of the would-be conquistadors decaying in nearby fields. The Taíno had attacked the Spaniards after growing tired of their rapacious appetite for women and gold.

yup...

The Spanish entered Tenochtitlan in November 1519, about half a year after they first set foot on the mainland, not as conquerors but as the guests of Montezuma. Historians are not sure whether Cortés took the Mexica emperor captive or the other way round, but it wasn’t until the Spanish had been in the city for seven months that open conflict broke out between the two sides.

I find it strange that the conquistadors were allowed to remain in the capital city so long. To me, it seems like a breach of security to have strangers (military men) linger in your capital.

This led to a war of succession between two of Huayna Capac’s other sons in which the incumbent, Huáscar, was defeated by his half-brother Atahualpa just before the arrival of the Spanish. Pizarro had made two previous attempts to invade this vast and sophisticated society, but it was only after smallpox had left it enfeebled and divided that he was able to conquer the Inca Empire with 100-odd foot soldiers and a few dozen cavalry.

I read somewhere that Pizarro used the civil unrest to his adavnatage. He pitted the factions against one another by promising alligance and men to ther cause.

How do we explain the almost unilateral flow of pathogens from Europe to the Americas, despite relatively high population densities in Mexico and Peru? The infectious diseases that evolved to infect humans in the wake of the Neolithic Revolution originated in domesticated herd animals. There were many of these animals in Eurasia, including pigs, sheep, cows, goats and horses.[31] Guinea pigs, dogs, turkeys, Muscovy ducks, alpacas and llamas had all been domesticated in different parts of the Americas. But of these, the only herd animals were alpacas and llamas, which were found exclusively in South America. Unlike the ancestors of Eurasian farm animals, alpacas and llamas hadn’t lived in vast herds prior to domestication, limiting the opportunities for diseases to emerge and become endemic.[32] As a result, the Neolithic Revolution in the Americas doesn’t appear to have been accompanied by a devastating epidemiological revolution.

While reading, I had been wondering why diseases common amongst those inhabiting Central & South America hadn't ravaged European conquistadors. The explaination given here, that herd animals in the Americas were isolated geographically and gravitated toward solitarity, meant that dieseases were less likely to develop in its population. The explaination seems sufficient. It's just strange that even lesser diseases within the American communities (akin to influenza) didn't effect conquistadors. It would seem from a European perspective that Europeans were more robust humans, thereby affirming their ensalvement of native inhabitants.

Fernando and Isabel, the Spanish monarchs, decided that it was not right to enslave the Native Americans. Unlike Muslims, they had not chosen to turn away from the one true God and had done the Spanish no harm.

This is “forward” thinking for the time period

In 1805, Mungo Park, the Scottish physician and explorer, led a Colonial Office–sponsored expedition that aimed to chart interior West Africa. It took the party of forty Europeans eleven weeks to complete the first leg of the trip, an overland trek from the Gambia to the Niger in the rainy season. By the time they arrived at Bamako, all but ten of the party were dead and the survivors were weakened by illness. Park and four other survivors traveled by canoe along the Niger, but they drowned in the rapids near Bussa, 1,600 kilometers downstream.[80] In 1827 Mungo Park’s son Thomas set out to discover what had happened to his father, but he died from fever before reaching the interior. The British Navy then sent three iron-hulled steamers up the Niger in 1841–42. These were equipped with state-of-the-art chemical filters designed to protect the sailors from the “miasma” that was assumed to be the source of deadly tropical fevers. Unfortunately, they did not filter out mosquitoes—it was almost another half-century before scientists understood how malaria and yellow fever were transmitted—and the expedition fared only slightly better than Park’s: fifty-five of the 152 Europeans died.

While these men were driven by economic and political ambitions, it has to be said that these men were brave. These men were not naive - they knew the likelyhood of them dying from disease or from some other misfortune was high. Still, each man began the journey thinking he'd somehow come out of it alive. I imagine as disease and the climate began to take its toll, it became clear that they were going to die. The anxiety about how-and-when it'd come must've been terrible...

Innovations in transport and weaponry only abetted the Scramble for Africa in conjunction with improvements in the prevention and treatment of malaria. Quinine was crucial in this respect.

So, unlike in New England, they didn’t bring their families with them, settle down and build institutions in the image of their home country. Rather, the Europeans who colonized Africa in the last decades of the nineteenth century created “extractive institutions” that used violence and the threat of violence to coerce the population into mining natural resources and transporting them to the coast, where they were shipped to Europe. The ultimate aim of this brutal endeavor was not to build a new and better society, but to enrich a small group of Europeans by draining wealth from the region.

It's interesting that disease prevented Europeans from colonizing Africa. The risk of dying was so high that settlement couldn't be achieved. With the realization they'd likely die within a year (or as the author states, 4 months) they needed a quick means of extracting resources. Therefore, they needed to be brutal in their methods and cut as many corners as possible. If the African interior had not been so dangerous, I wonder how different Africa would be today...

it never rid itself of white supremacy and Black subjugation. As a result, statues that literally put Confederate politicians and generals on pedestals in Southern state capitals were rallying points for protesters.

Again, this is an over simplication of events and feels biased/left-leaning.

As West Africa was connected to Europe and Asia by overland and now sea routes, the local population had been exposed to Old World pathogens and fared much better. Between 1550 and 1650, 650,000 Africans were trafficked to Spain and Portugal’s American colonies—more than twice the number of Europeans who crossed the Atlantic in that period.

The explanation provided here seems sound as the indigenous populations, the ideal candidates for forced labor, had been killed off by disease. Given that West Africans had previous contact with Europenas, they were accustomed to the diseases associated with them. Since their immune systems could fight off diseases more readily, they would live longer and thereby offer Europenas a more reliable work foce.

Given that people working on plantations would have been more exposed to mosquitoes than soldiers stationed in ports and towns (and that for every death two more people got seriously ill), it’s clear that agricultural laborers imported from Britain would have fared very badly in the Caribbean.

Still, it's strange that European sugarcane owners did not see this connection. If they had brought European workers (indentured servants even) the spread of disease would have been less or even nonexistant. While trasnporting European workers to the New World would haven been expensive, the survial rate would've been higher and likely producation of surgarcane would have been nearly as profitable.

The Scottish Darien Company’s expedition was funded by public subscription and thousands of people had invested their life savings in the enterprise. In total, this amounted to between a quarter and half of Scotland’s wealth.[28] In 1698, 1,200 people set sail to “New Edinburgh” with a year’s food supply and the “the nation’s finest woollen hose, tartan blankets, ornamental wigs, and leather shoes—25,000 pairs” to trade with the natives.[29] Within eight months of arriving, over three-quarters of them were dead and the survivors returned to Scotland. Tragically, just before this party arrived back in Scotland to tell their compatriots about the disaster, the Darien Company sent another group of 1,300 people to New Edinburgh. Within nine months, all but 100 of the second group were dead. Infectious diseases weren’t the only problem encountered by the Scottish colonialists—as you can imagine, there wasn’t much demand for itchy socks or warm blankets—but they were the most significant cause of failure.

The execution was poor and the products to be traded were not ideal. Additonally, if the settlers aimed to be self-suffcient (not relying on trade with indingenous communities) they may have avoided diseases.

included not just American forces but also newly arrived French soldiers who had come to help their fellow revolutionaries.

France had not experienced the French Revolution yet, therefore they were not assisting the colonists out of "revolutuionary" sympathy. The French Revolutuon did not occur until 1789; the Continental Congress was reorganizng itself at this time and did not intervene on behalf of the French.

The fragile alliance between North and South was thrown into crisis in 1860 with the election of Abraham Lincoln, the standard-bearer of a newly formed Republican Party that strongly opposed the westward expansion of slavery. He became president without receiving a single Southern Electoral College vote.

From a Southern perspective, one could argue that Lincoln's election was not representative of half the nation. Southern States could argue that they were widely ignored during the election. Additionally, the Republican party was relatively new and therefore could be seen as novice and unreliable. Given these reasons, Southern anxiety about the president and his cabinet could be seen as warranted.

The murder of George Floyd and the massive Black Lives Matter protests that broke out across the country in the summer of 2020 indicate that, more than a century and a half after the abolition of slavery, there remains a long way to go until African Americans have the same rights to life, liberty and the pursuit of happiness as their white compatriots.

I am displeased with this statement as it does not take into account the great strides made by the Civil Rights movement in the 1960s. Since then, all Americans have been subject to the same laws and have had the ability to exercise their rights. The racism that some people experience is not sanctioned by the state, rather it comes from individuals who hold prejudices against them. While the state is responsible for curbing individuals from acting upon their prejudices, it is the ultimately the individual himself that must change. Often, these individuals who harbor resentment toward other ehtnicites have experienced their own traumas in life (i.e. parental abuse, poverty, etc) and exercise their discontent upon others.

According to the Old Poor Law, anyone in need was entitled to receive relief from the parish where they were born—of which there were about 10,000 in England and Wales. It usually took the form of food or money handouts and was paid for by a progressive tax on the value of landholdings known as the “poor rate.” This system had been formalized at the start of the seventeenth century and was a response to the breakdown in the feudal system and dissolution of the monasteries, which provided a safety net in the Middle Ages. It was not only popular among the recipients, who believed it was their birthright to receive help from more fortunate members of the community when times were hard. It was also supported by the landowning elite, who bore most of the cost and who saw it as a way of conserving the status quo amid growing calls for equality and the revolutionary chaos then engulfing France.[36]

At the end of the eighteenth century, the physician Edward Jenner noticed that milkmaids seldom caught smallpox. He deduced that their work brought them into contact with cowpox, which had much milder symptoms but conferred crossover immunity against smallpox. Jenner used this insight to develop a “vaccine”—vacca being the Latin for cow.

John Maynard Keynes is supposed to have said that such an idea assumes that “the nastiest of men for the nastiest of motives will somehow work for the benefit of all.”

Hygeia, Apollo’s granddaughter, and the goddess of good health and cleanliness, stands imperious in the foreground, staring over the heads of any mortals that might deign to look at her. She is either oblivious or indifferent to the suffering going on in the background, where a tangle of naked bodies—some of them emaciated, others grimacing with pain—represents the river of life. In the center of this mass of humans is a skeleton. Klimt’s message is clear: life is painful, death is certain, and modern medicine hasn’t altered this fundamental reality.

In Nigeria, Chad, Sierra Leone, Central African Republic and Lesotho, the average person can expect to live a full three decades less than in the healthiest countries.

As of time of writing, the entire Sahel-region has undergone political upheaval with several civil wars currently brewing. While not yet finished reading this section, I imagine that the author will speak about how poverty (in the wake of post-colonial governance) has been the major force behind the recent violence througout Nigeria, Chad, etc. This poverty is only worsened by the lack of medicine due to the medical system itself crashing.

Haiti was hit by an earthquake in 2010

Over a decade later, Haiti itself has fallen into chaos partly due to these reasons. The government has completely dissolved and has been replaced by gang authority; the gangs themselves fight for political dominance. This only worsens the situation as citizens no longer have access to food thereby becoming malnurished and easier to be infected.

middle-income countries.

Middle-income countries (MICs) are those whose incomes per capita lie between the levels used to define low- and high- income countries, with thresholds established by the World Bank. As of 1 July 2023, the group comprises 108 countries with a gross national income per capita of between $1,136 and $13,845.

First Opium War (1839–42) and the foundation of the People’s Republic in 1949 as the “Century of Humiliation.”

In the mid-1960s, the Chinese state introduced a bottom-up approach to public health led by “barefoot doctors” (so called because in the southern provinces they balanced their medical duties with work in the waterlogged rice paddies). These were local people who looked after the health care needs of their community.

Within a communist structure, this role fulfills the lack of physicans. Given that intellectuals were targeted during the Great Leap Forward, a vaccum was left within healthcare. However, training common-folk to oversee the ill, prescribe generic medicines, and educate younger generations is not a bad idea. Within a society like the US, this practice could be implemented in a lesser way. For example, parents who are expecting could be automatically enrolled by the state into an adolescent nutrition course. This would provide parents with a general understanding on nutrition and how it could be applied to their child. Within an education setting, children could be taught basic hygiene (washing body/food handling) along with basic wound care (wrapping/tapping injures). In combination, society would have a better grasp on general healthcare.

deindustrial revolution

The system is so inefficient that if the U.S. had a national health service like the UK’s, its health outcomes would improve and it would save almost 2.5 trillion dollars every year. Deaton and Case point out that the dysfunction in the U.S. health care system is, in monetary terms, more of a handicap than the reparations that Germany had to pay following the First World War.

This comparison seems spotty - not fully fleshed out.

Less than a year later, multiple groups of scientists had successfully developed vaccines that provided a great deal of protection against Covid-19. That medical science can reduce the virus from an existential threat to a vaccine-preventable disease in a matter of months is a remarkable—even miraculous—achievement. Governments in high-income countries cut deals with pharmaceutical companies to buy vaccines and began jabbing their populations as soon as possible.

Even so, testing is said to have been rushed and the possible side-effects had not been fully understood or disclosed to the general public, thereby causign further damange and strain on the health system. Moreover, the government rush to get a vaccine also caused red-tape to be lifted; WHO, CDC, FDA suddenly approved drugs and said they were "miracle drugs" or "completely safe to use" and "100 percent" protected against COVID-19. In a way, the govenrment and healthcare system gave its citizens only a "half-truth".

At one extreme is the laissez-faire approach taken by the U.S. government. Citing concerns about the economic impact and curtailing individual freedom, President Trump let the virus rip through the country. As a result, over a million people in the U.S. died—0.31 percent of the total population.[73]

Given the structure of the US political system, the federal government was mostly handicapped - they could give out mandates, but the mandates were given to states and local municipalities to enforce. Quarantine was largely regulated by local municipalities and the states themselves. The deaths experienced during the Pandemic, while sad, were not that devasating - only 0.31 (less than 1 percent) or people died. Compared to the deaths seen during the Spanish Influenza and the Black Death, COVID-19 was a blip.