Samuel Cohn’s Epidemics: Hate and Compassion from the Plague of Athens to AIDS is true door-stop of a book, encyclopedic in ambition, coming in at a full 650 pages of prose and citations. In a new book review over at the Washington Examiner I describe the book’s origins:
In the summer of 2009, Samuel Cohn, historian of plague and malady, was contacted by the New York Times. A new strain of deadly flu was then sweeping the land, and the New York Times was concerned that the popular name for the new disease, “Mexican swine flu,” might lead to hate crimes targeting a vulnerable minority. This is what had happened to the Jews during the Black Death, the editors reminded Cohn, and the world needed a man with Cohn’s expertise to warn that it might happen again. The only problem: Cohn did not think it would happen again. In the historical case studies he was most familiar with, epidemics led not to acts of hate but to acts of compassion. Often that compassion crossed class and racial lines.
The New York Times declined to publish Cohn’s more optimistic op-ed. For that, we should be thankful. As Cohn tells us in the introduction to his 656-page tome, Epidemics: Hate and Compassion from the Plague of Athens to AIDS, the New York Times’s rejection launched a decade long research program to discover who was right. This sort of research would not have been possible in an earlier era: To write his book, Cohn used computer search tools to locate all mentions of plague and sickness in the classical corpus, scan through hundreds of medieval documents, and scour thousands of epidemic reports in databases of newspapers from 19th- and 20th-century Russia, Italy, Germany, England, America, Canada, Australia, and India.
This book review builds on the earlier spate of books I read back in March on epidemics in world history (see the post “Bullet Reviews: A Bunch of Posts on Epidemic and Disaster Response“). I secured a copy of Epidemics: Hate and Compassion for review back in April, but due to its immense size and other writing commitments, only finished it last month. I am glad I read it, however, and wished many more had read it before our current pandemic began.
Cohn’s central finding is that the vast majority of epidemics had a positive, “pro-social” effect on the peoples plagued by them. We do not to appreciate this, for even the historically minded among us tend to be most aware of the outliers. Thucydides’ eloquent description of the disintegration of Athenian society after being ravaged by a still-unidentified disease is well known; the Black Plague, with its mass attacks on Jews, is another common historical touchstone. How Europeans reacted to the hundreds of epidemics between those two dates is not often reported. Nor is the social reaction to the diseases of the next millennium especially well represented in our historical memory. This is partially due to a historiographical quirk. Modern historical study of disease owes much to the social impact of the AIDS epidemic of the 1980s, which prompted historians to search back for past examples of disease related stigma and persecution.
One finds what one looks for. American commentators in the 1980s were quick to connect the American response to AIDS to the Medieval response to the Black Death (a claim Cohn rejects as utterly sophistical). They were also able to find many case studies of hate and discrimination in other epidemics across Western history. Cohn does not reject these comparisons outright (though in some cases, such as his chapter on syphilis in Early Modern Europe, he comes close to doing so), but he does suggest they suffer from a narrow, blinkered view of the human past:
With this picture of disease-fueled hate, little attention was paid to how different social classes might align as the targets or perpetrators of violence. More astoundingly, these views have reflected little, if at all, on the power of past plagues to ignite compassion, bringing volunteers to make sacrifices for complete strangers across class, ethnic, and racial divides. Nor do these accounts recognize epidemics’ political effects that mobilized citizens to combat governmental neglect in medical and social services, dilapidated hygienic infrastructures, and unjust, abusive, and ineffectual controls that stigmatized and persecuted sectors of the population. Yet from the 1990s, writing on AIDS began to shift from a view darkly centered on blame to one forged by compassion and political activism.
As that last sentence hints, even the response to AIDS was not the simple story of discrimination and hate we are familiar with today. More recent historians of the disease describe how in America and Europe AIDS strengthened LGBTQ solidarity and the organizational capacity of LGBTQ organizations, spurred mass voluntarism to aid AIDS patients, led to legislation like the American Disabilities Act, and ultimately improved the relationship between gay patients and citizens with medical and government authorities. In Africa, AIDS was a more general crisis, and did not have any special association with homosexuality, but produced similar waves of voluntarism and association-forming on behalf of AIDS patients and orphans.
If the traditional narrative surrounding AIDS only tells half the story, attempts to ret-con the hateful half of that story onto epidemics past is even worse practice. With a few exceptions (which we will get to a minute), these were isolated incidents out of sync with the general social response to the diseases in question. Most epidemics bring out the best in humanity. Shared suffering creates solidarity, compassion, and an admirable determination to sacrifice for the sake of fellow human beings. If you have read very much in the disaster-management literature this will not surprise you. Resilience and selflessness are hallmarks of human behavior in the face of most terrible disasters.
But not every disaster. Cohn identifies three diseases that reliably brought out the violent side of our natures: plague, cholera, and smallpox. With the exception of the Black Plague, this violence was all a 19th century affair. As I write in my review:
Significant disease-related violence would not return to European shores until the 1800s, when large-scale riots, several with tens of thousands of rioters, accompanied breakouts of cholera, and then, later, a new strain of the bubonic plague. Similar disturbances on a slightly smaller scale would occur when these diseases arrived in North America and the Indian subcontinent. None of this violence was targeted at the sick, nor was any of it directed toward a scapegoated minority. In all of these cases, the main target of popular anger was the state. Again and again, poor communities subjected to quarantine, centralized isolation schemes, or invasive surveillance would rise in revolt against government action they believed was discriminatory or oppressive. Over the last two centuries, Cohn found, the main cause of pandemic-related disorder was not disease but government attempts to control diseased citizens.
The only modern case study to fit the received understanding of epidemic violence partially came with the smallpox epidemic of 1880. Cohn chronicles 72 separate episodes in which people murdered smallpox patients or burned down the medical stations, churches, or hospitals that sheltered them in order to keep the infection from spreading to their communities. This happened in the high age of lynch mobs, and it comes as no surprise to learn that a disproportionate percentage of those murdered were black. 
Cohn admits that he does not know what made the reactions to these diseases so much more explosive than reactions to equally virulent pandemics like Yellow Fever, though he does suggest that the 19th century setting—a time when disease was known to be caused by contagious bacteria, but in which trust in governments and doctors was low—plays a part. I speculate on some possible reasons in my review and encourage you to read my speculations over at the Washington Examiner. Here I would like to raise a few ancillary points that did not fit inside its confines.
First: the encyclopedic, comparative, and quantitative nature of Cohn’s study makes it extremely useful, but in some ways painfully limited. Cohn castigates other historians for not checking their generalizations about diseased societies against comparative data. He is right to do so. But reliance on broad yet shallow sweeps means that Cohn is unable to even attempt answers to some of the interesting questions posed by his study. Smallpox did not universally lead to hatred, violence, or abandonment. The peak for this sort of thing was the 1880s, and most specifically, the United States in the 1880s. But why? What about American society in that decade led Americans to treat smallpox victims so viciously, yet respond to a Yellow Fever epidemic that same decade so nobly? Why was the response to smallpox more measured later and earlier in the century? Answering this question would require a deep dive into the era, a dive deeper than Cohn’s methods allow. Hopefully some graduate student looking for a dissertation topic might pick up Cohn’s book (or my review of it!) and spend a few years trying to figure this out.
Second: the other striking thing about this 1880 wave of violence is that no one has reported on it before. There are no monographs on this particular smallpox epidemic, and no secondary source before Cohn has described the violence that came from it. Findings like these make it difficult for me to take books like Peter Turchin’s Ages of Discord seriously. Folks like Turchin try to measure and model cycles of “sociopolitical instability” in American life. The 72 violent attacks that accompanied this smallpox epidemic seem like a necessary data point in any attempt to quantify social violence, but no one had any idea that this wave of violence even happened until Cohn published his book two years ago. How many other waves of violence are out there, real but not yet known?
Third: In the face of disease and disaster, the historical norm is solidarity and selflessness. Most disasters bring societies closer together. I recall William Yang‘s many tweets from Wuhan at the peak of the outbreak there, each a testament to the bravery and sacrifice to the people of that city. There, at least, the coronavirus was a “pro-social” event. I am disturbed by America’s failure to reap the same benefits from disaster. It is true that we have not seen mass panic or violent scapegoating of the sort feared back in March (one can hear Cohn reply in the background, “well of course you haven’t, violent, disease-inspired scapegoating of minorities has only happened a few times all of human history!)” But the great crisis of our times has not brought Americans together. It has not increased our sense of solidarity or occasioned regular, spectacular acts of selflessness that cross over lines of race, class, and creed. We have seen bravery from emergency responders, nurses, and doctors—but those are people we pay to be brave. Their spirit has not spread. Shared suffering has not bound us together. America stands more divided now than at any time in living memory.
These are the hallmarks of a sick society. This is an affliction of the spirit, not the lungs. All the worse for us. There are no vaccines for sickness of the soul.
 Tanner Greer, “Do Plagues Make us Hate?” Washington Examiner (29 October 2020).
 Writes he:
So the annihilation of hundreds of communities down the Rhine in 1348–9 with men, women, and children burnt alive on islands or in their synagogues, ending medieval Jewish civilization in its heartland, was the equivalent of burning one house in Arcadia, Florida, where no one was injured?
Samuel Cohn, Epidemics: Hate and Compassion from the Plague of Athens to AIDS (Oxford: Oxford University Pres, 2018), 547,
 ibid., 557.
 ibid, 550-557.
 See Norris R. Johnson, “Panic and the Breakdown of Social Order: Popular Myth, Social Theory and Empirical Evidence,” Sociological Focus 20, no. 3 (1985), 171–83; Lee Clarke, “Panic: Myth or Reality?,” Contexts 1, no. 3 (2002), 21–26; Erik Auf der Heide, “Common Misconceptions About Disasters: Panic, the ‘Disaster Syndrome’ and Looting,” in The First 72 Hours: A Community Approach to Disaster Preparedness, ed. Margaret O’Leary (Lincoln: iUniverse Publishing, 2004), 340–80; Anthony R. Mawson, Understanding Mass Panic and Other Collective Responses to Threat and Disaster,” Psychiatry: Interpersonal and Biological Processes 68, iss 2 (2005), 95-113; Ben Sheppard et al., “Terrorism and Dispelling the Myth of a Panic Prone Public,” Journal of Public Health Policy 27, no. 3 (2006), 219–45; Lee Clarke and Caron Chess, “Elites and Panic: More to Fear than Fear Itself,” Social Forces 87, iss 2 (2008), 993–1014; Chris Cocking, John Drury, and Steve Reicher, “The Psychology of Crowd Behaviour in Emergency Evacuations: Results from Two Interview Studies and Implications for the Fire and Rescue Services,” The Irish Journal of Psychology 30, no. 1–2 (2009), 59–73; Drury, Cocking, and Reicher, “Everyone for Themselves? A Comparative Study of Crowd Solidarity Among Emergency Survivors,” British Journal of Social Psychology 48 (2009): 487–506.
Rebbeca Solnit’s A Paradise Built in Hell: The Extraordinary Communities That Arise in Disaster (New York: Penguin, 2006) covers many of the same themes from a more historical, and less sociological perspective.
 Greer, “Do Plagues Make us Hate?”