Plague's Progress
by Arno Karlen
Summary
Karlen's history proposes a simple, unsettling frame: infectious disease is not an interruption of the human story but a running commentary on it, each new way of living inviting its own new plagues. The book walks that bargain from the beginning: hunter gatherers with their sparse, chronic infections; the first farmers, whose settlements, stored grain, rats and domesticated animals opened the great age of epidemic disease, measles and smallpox arriving as gifts from the herds; the first cities, dense enough at last to keep the new diseases in permanent circulation; the trade routes and armies that globalised them, Athens, Justinian's plague, the Black Death; the oceanic exchange after Columbus, which emptied the Americas; and the industrial city, whose crowding and filth bred cholera and tuberculosis until sanitation fought them down.
The final movement turns the frame on the present. Written amid the shocks of AIDS, Ebola, Lyme and resurgent tuberculosis, the book argues that the postwar confidence that infection was finished, the era of the antibiotic and the closed infectious disease wards, was a brief illusion: new density, new mobility, new intimacy with animals and disturbed environments were already issuing the next invitations, and resistance was teaching the old enemies to shrug off the wonder drugs.
Karlen writes it fast and vividly, a synthesiser's book, organised by disease and by era.
Around two hundred and eighty pages.
Best for readers who want the whole co evolution of humans and microbes in one accessible sweep, written just before its warnings became routine.
Historical Context & Significance
Plague's Progress won the Science Book Prize in 1996, and its author is among the more unexpected figures in the prize's history: Arno Karlen was an American poet and psychoanalyst rather than an epidemiologist, a synthesiser writing from the literature, and too ill to attend his own award ceremony. The book appeared in America under the plainer title Man and Microbes.
It rode and fed the 1990s wave of emerging disease anxiety, alongside Laurie Garrett's The Coming Plague and the Ebola bestsellers, the moment when the field itself, through figures like Joshua Lederberg, was dismantling the postwar declaration of victory over infection; the book's civilisational framing, disease as the price of each human advance, descends from McNeill's Plagues and Peoples and passes on to the pandemic literature of the Covid era.
Read after 2020, its closing chapters are less prophecy than punctuality.