"It takes a plague to know a plague" may be said both of the principle of inoculation and of the historiography of epidemics. Certainly this was true of Daniel Defoe's book, The Journal of the Plague Year, which was ostensibly about the Great Plague of London in 1665 but which actually was contribution to the planning of the plague in 1721 when both the bubonic plague and the smallpox re-appeared in Europe and the western Atlantic.
In 1721 the bubonic plague appeared in Marseilles where it was met with religious piety and repressive quarantine. In the Dutch ports cargoes were burnt and sailors forced to swim ashore naked. In London merchants, reeling under the interruptions of their profits by the financial scandals of the South Sea Bubble, were reluctant to agree to similar measures of quarantine. The danger appeared at a conjuncture of
a) rural guerrilla movement in some recently expropriated Royal forests,
b) serious strikes by the industrial weavers of London,
c) an urban crime wave, and
d) mobs rioting against the Royal dynasty.
These instabilities took place amidst a widespread debate about the indiscipline of the working class and the desirability of establishing workhouses. The Government, therefore, called upon the Bishop of London to stress the gravity of the situation, so he hired Daniel Defoe to take up his pen to contribute to the formation of that moral panic characterizing the biomanagement of epidemic.
Meanwhile, across the Atlantic in Marblehead and Boston, the inoculation controversy began in the same year. It provides to the history of immunology a classic instance of class war via disease control. The story begins with the famous blue-stocking, Lady Mary Wortley Montagu, who had recently returned from Constantinople where her husband had been ambassador. She brought with her knowledge obtained from two Greek physicians who had studied in Padua (the most advanced medical school) of the effectiveness that inoculation had in immunization against smallpox. The doctors learned the practise from the Greek peasant women in Thessaly. Thus did "lizard talk," or the botanical folk medicine of the poor, contribute to the advance of "western medicine."
One obtains a meaning of what is meant by "western medicine" in the events of the New England inoculation controversy. The smallpox had been a useful ally to the merchants and puritans in their wars against the Indians. Bacteriological warfare was the precondition of expropriation and genocide. As late as 1763 Lord Jeffery Amherst ordered that blankets infected with smallpox be distributed among enemy tribes. By the 1720s, however, the disease threatened to strike closer to home, as a real danger to the ruling elite.
Indeed, the speed with which inoculation was accepted in England was the direct result of the dynastic crises that the disease caused among aristocrats. Queen Anne's son perished from it, leading to the Hanoverian Succession, and a Habsburg smallpox death led to the War of Spanish Succession. So, when Dr. Zabdiel Boylston introduced inoculation into Boston, Cotton Mather readily took up the idea, for at this time, as we've seen, the ruling class could not afford such "sacrifices for science."
"Sickness is in Fact the Whip of God for the Sins of Man," Mather had once said, playing the time-tested Mosaic game. But when that "whip" threatened his back he too turned to a "Mentu," and he learned of inoculation from an African named Onesimus, unpaid in his employ. Otherwise inoculation was vigorously opposed on two grounds. For one thing it was expensive and thus only the rich had access to it, and for another while inoculation conferred immunity it did not prevent contagion. Consequently, a grenade was thrown through Cotton Mather's window, while in Marblehead "heathenish rioting" took place among the fishermen, the maritime workers, and dissident townspeople who pulled down the houses of those promoting inoculation.
1721, therefore, was a turning-point in the history of capitalist epidemiology: the danger of "accidental" death to the ruling class, the expropriation of working-class knowledge, class specification in the biomanagement of its ravages, and the creation of "moral panics" such that the history of the microparasite joined significantly with the class project of macroparasitism. The ruling class began to develop specialists in the subject, physicians and surgeons with their institutional infrastructres in hospitals and the drug trade.
In The Journal of the Plague Year the method was neither the statesman-like analysis we found in Thuc, nor the magical bogeyman of Moses, nor the insouciant delights of Bo' nor the genocidal fulminations of Puritan commanders: Defoe gives the shopkeepers' form of knowledge with its appeals to "common sense," the empirical combination of instances told in the context of "oral history." There is much wagging of the head, crocodile tears, neighborhood gossip, and sharp words against the idleness of the workers. The mode pretends to non-fiction - credible, plausible, "news fit to print." Why? The entire project was brilliant on its surface and counter-revolutionary to its core. The macroparasite attacks by grinding its hosts into poverty, malnutrition, and destruction of pith and marrow. The immune system is defeated by over-work and extraction of increasing surplus-value. The English marcroparasite was on the one hand traditional in its guises (King-in-Parliament, merchant-and-landlord), and on the other hand, it had done some powerful mutating by the 1660s adding to its customary forms two that were new.
One of these was international and it sought hosts to prey upon in Ireland, in Africa, in Bengal, in the Caribbean, and in America. They were an aristocratic DNA which, as did Newton and Locke, developed specifically patterned aggressions upon a variety of hosts. They may be likened to Pharaoh's magicians. They felt kinship with Thuc of Athens and Bo of Florence. Newton, during the Plague of 1665 developed the calculus which taught the macroparasites about vectors, circulation, and flux.
The other form of English macroparasitism was what Napoleon called the "shopkeeper," what historians call "the middling sort," what Thomas Malthus called the "industrious" or the "worthies," and who were numerous and respectable. They sapped the strength from their hosts, the poor of England. They should be depicted with sticks and money bags, for its activity was counting and coercing. They lived in houses not palaces. Tight-assed and thin-lipped, they had been deeply threatened by the English Revolution of 1640-1660. It was to them that Daniel Defoe wrote.
In the Middle Ages poverty was a blessing and work was a curse. The macroparasites after 1660 tried to make it the reverse. The plague of 1665 was a major step in stigmatizing the poor and in sanctifying work. Defoe transcribes municipal orders forbidding wandering beggars from the streets, forbidding plays, games, and ballad-singing, forbidding assemblies at feastings, and ordinances closing the taverns, ale-houses, and coffee-houses at 9:00 P.M. Living with working, having fun, enjoying food too much, or drinking late thus became part of a pathenogenic syndrome. The "loose and disorderly" person was the vector, they thought, of the disease. A system of police invigilation was set up - parochial examiners, watchmen, and searchers. Funerals were abolished, no assemblies for the dead or even church-time prayers were permitted, and burials were permitted only at night. Defoe believed that the poor brought the Plague upon themselves by their "adventurous conduct," for they lived "as lavish, as extravagant, and as thoughtless for tomorrows as ever." That is, the industrial work habits (punctuality, regularity, thrift, and obedience) conferred immunization. Moreover, their "brutal courage" in tending the sick, carrying infested persons to the pest houses, and burying the dead explained why the poor contracted the disease. Women, especially, were "the most rash, fearless, and desperate creatures ... as there were vast numbers that went about as nurses."
Defoe thus attacks not only those infected, but the communities giving them comfort. Furthermore - this is the scary part - he understands the utility of the plague to the maintenance of class discipline. Listen to this. "As I said before, the good Management of the Lord Mayor and the Justices did much to prevent the Rage and Desperation of the People from breaking out in Rabbles and Tumults, and in short, from the Poor plundering the Rich; I say, tho' they did much, the Death Carts did more." This is the first acknowledgement that epidemic disease was becoming, not only a social event, but a social product.