Kobe University Repository : Kernel
Title
The Second Great Exchange : The 'Globalization' of
Disease in the Long Nineteenth Century(第二のグレ
ート・エクスチェンジ : 長い19世紀における疾病の「
グローバル化」)
Author(s)
Harrison, Mark
Citation
海港都市研究,7:3-10
Issue date
2012-03
Resource Type
Departmental Bulletin Paper / 紀要論文
Resource Version
publisher
DOI
URL
http://www.lib.kobe-u.ac.jp/handle_kernel/81003835
Create Date: 2017-06-19
The Second Great Exchange
The ‘Globalization’ of Disease in the Long Nineteenth Century
Mark HARRISON
Following the pioneering works of Alfred Crosby and W.H. McNeill in the 1970s, the notion
of the ‘Columbian Exchange’ – the movement of pathogens and other materials between the Old
World and the New – entered the lexicon of history. It was by no means the first occasion on which
continents had been united by disease, for plague had spread across much of Eurasia and some parts
of Africa during the sixth and seventh centuries, and later from the fourteenth to the seventeenth
centuries. But the trans-Atlantic crossing of a variety of ‘Old World’ diseases had a truly devastating
effect on the native population of the Americas. We now know a good deal about the demographic,
social and political consequences of this exchange and the factors which mediated it. But we know
comparatively little about later periods in which there was a significant redistribution of disease.
The most obvious of these is the nineteenth century, which witnessed perhaps the largest and most
varied movement of diseases of any period in history. A host of human, animal and plant diseases
moved out of their endemic areas to affect many parts of the globe and became established in some
of them due to poorly planned urban development and the reorientation of production for global
markets. While numerous studies have analyzed the social and political consequences of these
outbreaks, the epidemiological history of the nineteenth century has yet to be considered as a whole.
Any attempt to understand this second great exchange needs to look simultaneously at disease
transmission and at how it was mediated by social, political, economic and cultural factors. We
therefore need to depart from the framework employed by Crosby, McNeill and others when
considering the ‘Columbian Exchange’ of the 15/16th centuries, for it was conceived largely in
terms of the movement of disease. Likewise, Immanuel Le Roy Ladurie’s famous concept of a
world ‘unified’ by disease takes us only so far. While diseases came for a time to be more widely
distributed than before, the end of the nineteenth century brought a sharp divergence in the mortality
and morbidity rates between poor and industrially developed countries. It is therefore vital to look
at how political and economic factors affected the establishment of pathogens and what happened
to these disease environments subsequently.
海港都市研究
The key to understanding the epidemiological upheavals of the nineteenth century is to examine
the economic and political contexts in which they took place. The waves of disease which swept the
nineteenth century were predominantly the consequence of unprecedented economic integration.
Whereas earlier periods of integration had been trans-regional in nature, the mid nineteenth century
saw the emergence of the first truly global economy and concomitant changes to agricultural
and industrial production. But only a few studies – mostly of specific diseases such as cholera
and plague – have attempted to understand the century’s epidemiological history from a global
perspective. For the most part, historians have studied disease outbreaks through the lens of national
historiographies, their main objective being to analyze the social and political crises which resulted
from them. These studies are very important but we have no more than a superficial understanding
of how these outbreaks may have been linked. Unless we take a more integrated approach, which
lays bare the mechanisms and structural changes which increased the burden of disease, our
understanding of even local crises will be limited.
There are many ways in which these essentially global processes might be understood but one
way of exploring them is to examine different forms of economic activity. Through these links we
can not only trace the movement of pathogens but examine the particular circumstances in which
they became established. A good example is plantation agriculture. The mid nineteenth century
saw a fundamental restructuring of agriculture away from local production and towards large
scale production for regional and world markets. Furthermore, established systems of commercial
agriculture were forced to undergo radical changes. Within the European empires, there was a move
from a system based on slavery to one based on indentured labour. With the abolition of slavery
from the 1830s, many thousands of Indian and Chinese labourers were contracted to servitude of
long duration in the plantations of the Caribbean and later in new plantations in Africa and South
and South-East Asia. Critics saw the system as little more than a form of legalized slavery and were
appalled by the high death rate from diseases such as cholera on what were euphemistically termed
‘migrant’ vessels. In ports of arrival, quarantines and medical inspection were imposed in an attempt
to prevent cholera and smallpox entering the colonies. But outbreaks of these and other diseases
among migrants continued and their pathogens became entrenched in some of the plantations due to
the insanitary conditions in which indentured labourers were forced to live. By comparison with the
home nations of the colonial powers, very little attention was paid to sanitation, it being left mostly
to the whims of the owners – a situation which changed only very slowly.
The Second Great Exchange
While the old sugar colonies of the West Indies faced an influx of new germs, the creation of new
plantations in colonies such as Malaya, the Dutch East Indies and India also sowed the seeds of
epidemic disease. These plantations relied heavily on indentured labour brought in from outside as
they were often established in areas which were remote and scarcely populated. As in the case of
the West Indies, the influx of labourers had a profound and enduring effect upon the disease ecology
of these regions. In India, for example, many labourers were recruited in impoverished areas
of Bengal (where local manufacturing industries had been devastated by mass-produced textile
imports from Britain) to Assam. Beginning in 1830s, they made the trip to the north-east initially
by steamer and then by rail. Both the indentured labourers and those engaged to build the railways
brought infections new to the area, including kala-azar (leishmaniasis) and cholera (Bengal was
widely regarded as the origin of cholera), which flourished because of the unsanitary conditions.
Indeed, cholera continues to kill people annually in the north-east of India to this day.
But disease also spread the other way. Some infections which were indigenous to the north-east,
such as falciparum malaria spread with returning labourers and those working on railways. From
there, it became established in many other areas of India, including great ports such as Bombay.
In such places, the mosquitoes which spread the disease found many good breeding places in the
pitted ground surrounding construction sites and the places inhabited by labourers, much as in the
fast-growing cities of today. The realization that labour migration had led to the spread of this, the
most deadly form of malaria, led by the early 1900s to a new emphasis upon what was known as
the ‘human factor’ in malaria, although most of the sanitary problems which permitted the disease
to flourish were tackled only slowly.
My second example through which to explore the ‘second great exchange’ is textile manufacture
and distribution. Here again we see how the dynamic between local developments and global
economic processes led to the movement of disease and its naturalization in certain contexts. The
trade in textiles had been associated with the spread of disease for several centuries, because of
the long-standing relationship between the spread of plague from the Middle East to Europe. It
was often said that plague arrived with shipments of cotton. Within Europe itself, the movement of
plague was also associated with the trade in wool. During the eighteenth century, when plague no
longer affected western and central Europe, there was still some concern that it might again reach
ports in the West, for the disease still occurred frequently in the Middle East and Eastern Europe.
After the end of the Napoleonic wars in 1815, these fears intensified because there were some
海港都市研究
outbreaks in the Mediterranean and because there was a boom in the cotton trade due to demand in
Europe for raw cotton and attempts by the Egyptian ruler Mohammad Ali to build his own industry.
The expansion of the cotton trade posed a dilemma for European powers such as Britain and
France. While they wanted to protect themselves from infection, they did not want their trade
to be interrupted continually by the imposition of quarantine. This had been a common cause of
complaint during the eighteenth century, when commerce was often disrupted because of long and
often unnecessary quarantines and sanitary embargoes on trade. In the 1800s, the situation was
even worse because Mohammad Ali had begun to impose quarantines of his own, partly in order to
protect Egypt from plague but also to disrupt the shipping of rivals and protect domestic industries
from cheaper foreign imports. These quarantines were most unwelcome to manufacturing and
commercial nations such as Britain and France.
It was this dilemma which led to the first international sanitary initiatives. Starting in the 1830s,
the European powers began to prevail on Muhammad Ali and rulers of other Muslim states in
the region to establish boards of health which contained delegates from the European powers.
These bodies would be responsible for regulating quarantine alongside the government of each
state. Their aim was to ensure a reasonable amount of protection against plague while preventing
Muslim polities from using quarantine to harm the interests of European powers. The creation of
these bodies also led to attempts to convene an international sanitary conference to standardize and
liberalize quarantine in the Mediterranean in the interests of commerce. The first of these was held
in Paris in 1851. Although it did not result in a binding international agreement, it marked the first
step on a long path towards the international governance of health. All these developments came
about largely in response to commercial imperatives and the growing desire to remove or lower
impediments to trade.
The sanitary conferences which were convened later in the century also aimed to strike a
balance between sanitary protection and commercial freedom. Those held in the 1860s and ‘70s
concentrated on the problem of cholera, spreading along commercial links and also with the
pilgrimage to Mecca. They produced no binding agreements and were blighted by imperial rivalries,
especially between Britain and France. Nevertheless, they did lay the framework for measures in
the Middle East and resulted in the creation of what was effectively a sanitary buffer zone, allowing
navigation to be conducted between European ports with fewer impediments. After the conference
held in Constantinople in 1866, a system of quarantine was established which regulated the flow
The Second Great Exchange
of traffic into the Red Sea and in the Persian Gulf. Later, attention focused on shipping passing
through the Suez Canal, which opened in 1869. As the world’s pre-eminent maritime power and
commercial nation, these quarantines affected Britain disproportionately. Indeed, four fifths of the
shipping passing through the canal in the 1870s was British.
Britain therefore sought to reduce quarantine and remove items such as cotton goods from lists of
merchandise deemed capable of carrying cholera and plague. It had little success until the 1890s
and 1900s, but then there was growing recognition of the mutual commercial interdependence
of nations and a growing desire to remove what were regarded as unnecessary barriers to trade.
The plague pandemic of the 1890s and 1900s brought tremendous disruption to commerce and
particularly to the trade in so-called ‘susceptible’ articles like cotton. Sanitary conferences in
Paris in 1903 and Washington in 1905 established a ‘light-touch’ system of sanitary regulation,
using better intelligence and sanitary precautions like fumigation in preference to quarantine.
These conferences produced the first binding sanitary regulations but not all countries signed the
conventions. A notable exception was imperial Japan, which regarded the conventions as merely
the latest in a long-line of ‘unequal treaties’ designed by foreign powers to keep it in subjugation.
Indeed, Japan did not become a signatory to any of these treaties until 1926 and then only in a
qualified way. The Japanese feared the spread of disease throughout their new imperial territories,
which included sources of plague such as Manchuria, but they also saw their quarantine stations as
a screen against unwelcome visitors from outside.
The trade in textiles had been the focus of much of the international discussion about disease
and sanitary regulation during the nineteenth century but, locally, the mass-production of textiles
was fostering infections which claimed far more lives than cholera and plague ever did. At the
beginning of the nineteenth century, the industrial production of textiles was concentrated heavily
in the home nations of the European colonial powers. Their main concern until the middle of the
century was to ensure the supply of raw cotton to factories in Europe and to export commodities
made in them as freely as possible. However, during the 1860s one of the principal sources of raw
cotton – the southern USA – was blocked due to the American Civil War, which led to a search
for alternative sources, including cotton grown in India. At the same time, however, the growth of
cotton plantations stimulated local manufacturing on an industrial scale, particularly in western
India. Indigenous entrepreneurs also began to establish their own mills to produce for domestic and
regional markets. This, in turn, transformed the epidemiological situation, much as it had in the
海港都市研究
industrialized cities of Europe. Workers migrated to parts of cities like Bombay and Ahmedabad
in western India, where the new mills were established, often drawn there from the countryside
which was in the grip of a severe and prolonged famine. In the mills and the overcrowded slums
surrounding them, a host of water-borne and respiratory ailments thrived; not least tuberculosis. In
short, the industrial workforce of Asia began to suffer from the same diseases as the working classes
of Europe.
Until the late nineteenth century, tuberculosis scarcely registered as a health problem in India.
Indians did suffer from the disease but it was not common. By 1900, however, cotton manufacturing
cities such as Ahmedabad were notorious for high rates of tuberculosis and, as they relied heavily
on migrant labour, the disease began to spread back to villages throughout India. The same thing
happened as jute manufacture was industrialized in Bengal. Urbanization and mass-production thus
united the disease experiences of labour in both India and industrialized Europe. Some medical
writers acknowledged this, seeing the rise in diseases like tuberculosis as an inevitable consequence
of economic development. Tuberculosis came to be seen as a ‘disease of civilization’ – a rite of
passage for all developing countries. However, there was a marked difference between the attention
given to health conditions in factories in Europe and its colonies. Legislation governing working
conditions evolved far more slowly and fitfully in the colonies, even though legislative precedents
existed in the imperial countries themselves. Indeed, the sharp rise in diseases such as tuberculosis
received very little official attention in the colonies by contrast with diseases which were important
to colonial governments for economic and political reasons – plague and cholera being obvious
examples. Nationalists began to point to these disparities and saw in them evidence of colonial
neglect. However, indigenous capitalists also tended to favour the sanitary projects which aided
their own businesses while caring relatively little for the welfare of the lower classes. This
combination of class interest and imperial neglect meant that sanitary and workplace reform did not
proceed as rapidly or evenly as in the West.
My final example is the international trade in animals. Just as the growth in disposable income
in developing countries today has led to a surge in demand for cheap meat, the same occurred
in Europe and North America in the nineteenth century and this provided a great stimulus to the
commercialization of livestock farming and the movement of animals and meat products over long
distances. To begin with, this could be seen within Europe – with more cattle being brought to the
centre and west of the continent from stock-rearing areas in Russia – but later, with the growth
The Second Great Exchange
of steam-ship navigation, also from the expansive ranches of the New World. This increasingly
globalized market led to a massive surge in livestock diseases. From the 1830s, foot and mouth
disease spread from hot-spots in Eastern Europe to become an almost worldwide disease.
Rinderpest similarly spread from Central Asia to most of the world apart from America, as did other
infections such as lung-sickness.
The movement of animal diseases thus seems to be an excellent example of how the world
came to be ‘unified’ by disease, in the sense made famous by Ladurie. But it also shows just how
quickly it became disunited. When rinderpest, for example, began to spread more widely from the
1860s, it created terrible devastation in all the countries it visited, reducing farmers to penury and
laying waste the pastoral cultures of many parts of Africa, thereby reducing resistance to colonial
intrusion. But after the 1860s, most governments in Europe introduced legislation to control animal
diseases and used robust measures such as quarantine and mass slaughter in an effort to stamp out
the disease. In many cases, these methods – brutal though they were – worked and the disease never
took hold again. But in the European colonies, it took much longer for such legislation to be passed
and in some cases it was not passed at all, for reasons of expense most often, but also in the case of
India because of political considerations – the potential hostility of Hindus to the slaughter of cattle.
The vast distances involved in Africa and India also militated against the success of techniques such
as quarantine and slaughter. The century thus ended with rinderpest banished from most parts of the
industrialized world while it continued to rage throughout Africa and Asia, and indeed to spread to
infect new areas such as South East Asia because of the desire to keep ports in European colonies
open to trade.
To conclude: the ‘second great exchange’ was a global one in the sense of geographical coverage
and the multiple directions in which pathogens travelled. It was also global in the sense that it was
fundamentally linked to the emergence of the first world economy, in the latter half of the century.
It was an exchange of pathogens affecting humans and other animals, and these pathogens need to
be considered together because their (re)distribution was caused by the same factors and was interlinked. However, disease unified the world only in the most superficial of ways – the legacy of the
nineteenth century was largely one of division and a form of ‘sanitary imperialism’ which managed
international health largely in the interests of the great powers.
The primary object of the international sanitary conferences during the nineteenth century was
to control the global economy in ways that rendered it relatively safe to the major powers without
10
海港都市研究
interfering too much with the growth of long-distance trade. By the early twentieth century, this
system had become more sophisticated and was beginning to be more truly international in the sense
that a consensus was beginning to emerge over how to deal with disease in a closely integrated
world economy. Sanitary initiatives were still driven by the major powers – which now included
the United States – but there was recognition on the part of most governments, and certainly on the
part of big business, that a more liberal and standardized system was necessary. It was fortunate
that this move occurred at a time of rising confidence in the power of medical science to understand
and control diseases such as cholera and plague but it was economic imperatives that drove sanitary
reform internationally and domestically and which also account for the wide disparities in health
and mortality which had emerged by the end of the nineteenth century.
(University of Oxford, the Wellcome Unit for the History of Medicine)