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Pathogenesis: A History of the World in Eight Plagues

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An account of how the major transformations in history—from the rise of Homo sapiens to the birth of capitalism—have been shaped not by humans but by germs

According to the accepted narrative of progress, humans have thrived thanks to their brains and brawn, collectively bending the arc of history. But in this revelatory book, Professor Jonathan Kennedy argues that the myth of human exceptionalism overstates the role that we play in social and political change. Instead, it is the humble microbe that wins wars and topples empires.

Drawing on the latest research in fields ranging from genetics and anthropology to archaeology and economics, Pathogenesis takes us through sixty thousand years of history, exploring eight major outbreaks of infectious disease that have made the modern world. Bacteria and viruses were protagonists in the demise of the Neanderthals, the growth of Islam, the transition from feudalism to capitalism, the devastation wrought by European colonialism, and the evolution of the United States from an imperial backwater to a global superpower. Even Christianity rose to prominence in the wake of a series of deadly pandemics that swept through the Roman Empire in the second and third centuries: Caring for the sick turned what was a tiny sect into one of the world’s major religions.

By placing disease at the center of his wide-ranging history of humankind, Kennedy challenges some of the most fundamental assumptions about our collective past—and urges us to view this moment as another disease-driven inflection point that will change the course of history. Provocative and brimming with insight, Pathogenesis transforms our understanding of the human story.

304 pages, Hardcover

First published April 18, 2023

About the author

Jonathan Kennedy

3 books124 followers
Jonathan Kennedy teaches politics and global health at Queen Mary University of London. He has a PhD in sociology from the University of Cambridge.

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Displaying 1 - 30 of 954 reviews
Profile Image for Martha.
347 reviews
May 4, 2023
First, the least of my complaints, which is that this is a misleading title. You'd think a history of the world in eight plagues would be organized by plague: a chapter on malaria, another on bubonic plague, cholera, influenza, typhus, AIDs, etc. This would be more accurately titled "a history of plagues in eight time periods," and also it's extremely Eurocentric for most of that history.

This book is not completely worthless; I do feel like I learned some things, particularly in regards to the plagues of the Roman Era. However, overall I found this book to overreach its argument, be facile in its analysis, and plain get things wrong whenever the author stepped out of his area of expertise.

On a broad level, even he admits in his conclusion that you can't explain everything via just microbes, that human choices play a part in what we do. However, he overlooks human choices at multiple points earlier in the book. He attributes the European ability to colonize Africa exclusively to the discovery of quinine in South America, and not because we'd spent the last two centuries removing tens of millions of their able bodied people to be slaves or how slaves were acquired through war which had destabilized the continent politically.

He continuously uses replacement language for when one population arrives and dominates another, even when some of the first group remains and passes on their genes that survive to this day. This is super problematic and I think he knows it because he doesn't use that language when talking about the indigenous peoples of the Americas and Australia. "Overwhelm" would be a better word.

In regard to his discussion of the Neanderthals and Denisovans, he repeatedly refers to them as "species" which is strange to me given that while they are geographically and genetically distinct from modern humans they were completely capable of interbreeding with us which should surely make them subspecies, correct? I think it's worth making that distinction because it counteracts the idea going back to Linneas that the "races" are subspecies, when they most certainly are not.

He also attributes the longtime scientific assumption that Neanderthals were a dead end to interference from the Catholic Church to make sure a "friendly" scientist did the evaluation of the original fossils. I found that so suspect knowing what I did about late 19th century French intellectual circles that I actually read the two articles he cites as sources for this and - surprise! - they say absolutely no such thing. Heck, they blame the Piltdown Man forgery for the long delay in identifying Neanderthals as part of the same lineage as us, not some nefarious Catholic plot that they would absolutely not have been able to carry out.

He does this again in his description of the Middle Ages, where he describes the Church as all powerful and able to stop anyone who disagreed with them. I think this must be a reference to the Cathars, and it is true that, at times, the Medieval Church could muster up forces to actually enact its will. But later in the same chapter he notes that the popes were in exile in Avignon and nobody listened to their edicts about the Black Plague. Because the Church was, in fact, just one of many powerful players at the time and not usually even the strongest. But I guess that would undercut the argument of the chapter that the Black Plague undermined church authority to free us all for the Protestant Reformation and the Enlightenment.

He also uses the Enlightenment interchangeably with capitalism sometimes, and here's where I get really frustrated with his analysis. He notes how the transition out of feudalism produced tremendous growth and wealth but also saw a massive drop in human living conditions and life expectancy. But it doesn't register to him that capitalism itself might be the problem there. That capitalism inherently involves the redistribution of wealth away from workers into the hands of capitalists. That this will necessarily lead to divisions in standards of living between the working class and the property-owning class. He even cites a Marxist in his notes on this topic, but only talks about capitalism positively! Which also explains his use of Frank Dikotter as a primarily source on China even though that guy is a right wing hack for Stanford's Hoover Institute who cannot admit the Communists ever did anything good in China.

Then there are the other little things he gets wrong about religion. He described Empire-wide persecutions of Christianity in the 2nd century, an idea that is widely rejected by most modern scholars, who think the persecutions at this time were much more local and sporadic. He describes the two horsemen in Durer's Book of Revelation as War and Plague, and uses the fact that they're both depicted as Ottomans to support his ideas about how plague was associated with the Turks. The only problem? The first horseman's association with plague is less than 150 years old, and isn't well-supported by the text; in the Reformation Era, this rider was associated with either conquest generally or the Antichrist.

Errors like this make me worry that even the parts I found good in this book might, actually, be bad because they might also be riddled with errors and I wouldn't know because it's not my area of expertise. Which it's certainly an intriguing concept, I just can't really strongly recommend this book.
Profile Image for Suzi Zak.
21 reviews365 followers
July 18, 2024
Jonathan Kennedy's Pathogenesis is an significant addition to the history of medicine, fully embedding epidemic diseases in global history. Kennedy's treatment of epidemic disease emphasizes its critical importance in the development of the human condition, and his extensive research and engaging narrative raise challenging questions about the nature of epidemic disease. While his argument at times suggests a level of certainty in his claims that is not convincing, overall Kennedy's argument is strong and persuasive, lucidly composed and non-specialist in its terminology while being deep in its approach.

The intellectual journey was substantial and engaging, as I followed Kennedy's well-argued prose through its paces from start to finish . If we can classify McNeill's Plagues and Peoples as a classic of epidemic disease, Kennedy's book is an equal in the canon, while breaking new ground in terms of presentation and concept.

This audiobook presented an overview of the relationship between politics, society, and infectious disease that spans centuries and invites a serious analysis of the consequences of outbreaks and pandemics. It is a message to policymakers in particular that we need to have a clear conscience regarding the need to protect the people on the planet and Earth as well as some form of future preservation beyond the selfish gains of the few.

Pathogenesis is a necessary book for professionals in medicine and social science, offering critical perspectives and a historical context for epidemic diseases that will help professionals shape the history, now. It is a book that must be read to inform the reader from the corner of the page that medical is public, and that our responsibility is long-term.

This entire review has been hidden because of spoilers.
Profile Image for Dax.
287 reviews160 followers
May 10, 2023
This should be required reading for every single politician, especially those who serve on the international stage. This bottom up re-telling of human history underscores how susceptible the human race is to pathogens and the role bacteria and viruses have played in shaping our world into what it is today.

History is traditionally centered around the accomplishments of great men and women. In reality, however, those great men and women were able to insert themselves into opportunities that were created by the upheaval that stemmed from the arrival of new pathogens. This view of history is truly eye opening.

But this book is not just a historical look back at the great plagues that drove those changes. Kennedy also highlights the implications that these past events have on our world today, and how we need to adjust our societies and cultures to best position our species to succeed in the future. You may not agree with all of Kennedy's suggestions, but this book will provide a great lens with which to study and understand the challenges we face moving forward.
Profile Image for Trish.
2,180 reviews3,678 followers
September 27, 2023
There are a lot of things we were all taught in school.
Like how advanced Roman civillisation was as evidenced by their impressive architecture and general hygiene. But WHAT IF those bathhouses had been cesspools for microbes and bacteria, spreading disease and ultimately helping in bringing the empire to its knees?
Equally, WOULD Christianity and Islam have become such dominant religions in the world if it hadn't been for them capitalizing on plagues decimating those of old beliefs and drawing people onto their side with the fear of death and what comes next or simply because the families had abandoned them due to an illness?
And what about the Black Death we have probably all heard about? WHAT IF it wasn't just the flees and7or rats but an evil volcano? Ok, obviously the volcano wasn't "evil", but there is still a case to be made for it having actually triggered the plague all the way from Indonesia. Not to mention that the Black Death, arguably, put Europe on the path to capitalism.

You get the idea.

The author of this book knows what he's talking about (he's a PhD in sociology (Cambridge) and taught political science) and he wrote one hell of a book here.

We start off with the fact that the only reasons we humans don't lay eggs is because of a change in our DNA made by a virus. For those that don't know, 8% of human DNA was put where it is by viruses, in fact (and if you think 8% isn't a lot, consider that it only takes about 2% to go from Bonobo to human 7% from pig to human so ... yeah).
We then go from Neanderthals to Ancient Rome, the Middle Ages, all the way through to modern-day humanity and see - via 8 very distinct plagues - how humanity pivoted and changed course several times - and every single time, it was due to a microbe using us as host and kicking our collective asses.

I learned long ago in various school classes that humanity is where we are thanks to Darwinism. Survival of the fittest. I was also told that means brains and brawns. Apparently, that is not really true. At least not 100%. It was those most adapted to surviving illnesses and co-live with the many microbes on this planet. You could say THEY are the dominant species here on Earth.

The foreword, talking about human hubris and the various forms we think we're the dominant species, was already intriguing. Delving deep into the 8 most significant plagues in human history, what they meant for our evolution and looking at them from a (to me) new perspective, was nothing short of fascinating. Add to that the fact that the topic was immaculately researched as well as tentalizingly written (which is not a matter of course, especially not for a science book) and you know why I loved this as much as I did.

Seriously, I loved this book so much that I'm getting the print version now, too.
Profile Image for K.J. Charles.
Author 63 books10.2k followers
Read
October 2, 2023
A look at the history of the world through diseases, including how epidemics/pandemics drove social change, scientific racism, exploitation, colonisation, and a bit (not much) social improvement.

It's an interesting thesis with a lot to consider. It think it might be more persuasive if the author didn't wear his politics so clearly on his sleeve. Then again, every book is informed by the author's politics and maybe we should just stop pretending they're not. However, I really did not need the condemnation of the 'what did the Romans do for us' bit of Life of Brian as Oxbridge educated white men applauding colonialism, because that sort of po-faced joke-missing is what gives liberal humanists a bad name. (Also did we need three separate and detailed Monty Python references? Weird.)

It's very readable and makes a good case as far as it goes, but left me with the same vague Ben Goldacre feeling ("I think you'll find it's a bit more complicated than that") that I got from Guns Germs and Steel, ie excellent points but surely not the be all and end all it's presented as. Also, the last chapter briefly touches on manmade pandemics (eg Shit Life Syndrome and obesity) but without mounting an argument as to whether they belong in a book about pathogen-based plagues, and I feel this either needed a lot more time on page, or cutting. Either would work but you can't just toss in 'btw obesity is a disease too' in a book about infectious diseases spread by germs.

Still, interesting, if profoundly depressing in its unrelenting depiction of people being unimaginably vile to one another.

Profile Image for Violet.
805 reviews37 followers
February 12, 2023
Really informative and easy to follow. I found some chapters stronger than others, for example the first part on Prehistoric diseases was really good and detailed, while I found the ones on more modern history, like Victorian England, a bit more vague despite presumably better historical sources. The chapters on colonisation and the role viruses and diseases have played in supporting the colonists agenda was excellent.

Free ARC sent by Netgalley.
Profile Image for Shaun.
284 reviews17 followers
March 9, 2023
I received a free advanced copy through a Goodreads Giveaway.

Enjoyed this. It's sub-title pretty much tells you what you need to know. Kennedy's argument that the history of the world was shaped by plagues (bubonic plague and cholera, for instance) is an interesting one and not one I'd really heard of or read about. It feels like a world history book, rather than an 'in the weeds' science book, which I also found interesting and engaging.
Profile Image for fourtriplezed .
513 reviews122 followers
February 4, 2024
A topical subject considering the pandemic and that I have long covid.
I listened to the author tell his own research via audio, and I have no problems with his tone of voice or the pace he spoke at.

First, the criticism of the book would be the use of Pop culture to use as analogies. I am never that keen on this as it tends to date the books that use it as a device and there are also those that have no idea who Monty Python, as an example, might be.

That one complaint aside, I have learnt a lot. I was reminded of Guns Germs and Steel in that that book along with this one will have me reading my history from a slightly different angle into the future. The Black Death did cause the change from Feudalism to capitalism, and just about everything I have read on that subject passes over this a little too quickly. It is like listening to complaints from my fellow Australians about inflation at the moment. One major cause was the Pandemic, but that hardly gets a mention. It should. The point the author made was that as pandemics go this one was handled very well and that the death rate by historical standards was low. Governments used measures to protect their population, and that included financial as well.

The chapter on Cholera in London and elsewhere in the British Isles was fascinating. Even when the researchers in the field said that the issue was a public one in that the water was not clean enough, some of the more conservative types refused to accept that public money should be spent on health outcomes that were good for society. For all Australia’s faults in our health care system, I have yet to hear anyone from any of the political factions say anything other than good health outcomes for the populace at large are good for the economy. Why some in other countries argue this point confuses me somewhat. The proof is London’s clean water in the excellent health and economic outcomes that were provided. The wiki is worth a read if one is not going to read this book.

https://en.wikipedia.org/wiki/1854_Br...

Recommended to those with an interest in the subject.
Profile Image for Peter Baran.
665 reviews51 followers
November 27, 2023
Big picture history is hard to write, particularly if what we are talking about is the scope of entire human history and even how we evolved. Pathogenesis takes this on as a topic, and tries to be as comprehensive as it can be. Its a solidly accessible read and one whose general thesis (that our entire history and evolution has been shaped by disease) is a relatively simple one to accept. The problem I had with it was the specifics. Not so much the swing at specifics, I understand the evidence of neo-lithic plagues that wiped out some Neanderthals is going to be contingent at best. But the tone of the book seems to prioritise his swings over those of previous writers in the field, and there seems to be more glee in pooh-poohing previous work. There are theories here that will probably be disproved, and from a perspective of scientific discourse, the book felt like it was falling into the fallacy of standing on the shoulders of giants, whilst stamping on those giants' heads.

The book is cheerily split into eight chapters based on different types of plagues from Paleolithic Plagues to Plagues Of Poverty. Kennedy is very clear-eyed about all of this, he's talking about plagues, there will be death. He is particularly interested in the early chapters about how plagues have forced people to move, or given one group with immunity or no contact advantage over others. Genetics has moved on incredibly since previous books in this field, so he talks with more authority about tracing genetic lineage, again needlessly disparaging those who did not have these tools. Things take a shift to the economic near the back half of the book, the way diseases moved with colonialism, epidemics which wiped out entire peoples, and of course bang up to date with Covid and attempts to stop its spread.

The annoying thing about Pathogenesis is that it is full of really interesting ideas that I want to push back on, or at least explore the science more, because the presentation riled me. The very opening paragraphs of the book take a Sigmund Freud quote, then has a pop at Sigmund being egoistical (likely true but so what) before retooling that quote for his own purposes. Its symptomatic of a book that is full of interesting arguments, but the personality of the advocate makes you want to push back.
Profile Image for Audrey H. (audreyapproved).
772 reviews220 followers
May 15, 2023
This was one of my most anticipated reads of 2023 - partly for the really, really cool cover (I like both UK/US versions, but the US hardback wins with raised nodules to represent a spreading plague), and partly because I thought the book blurb seemed intriguing. I was expecting Pathogenesis to cover the history and legacy of eight different plagues (Black Death, typhoid, cholera, etc.), but instead each section covers a different time period (e.g. Paleolithic, Medieval, Industrial). Kennedy walks the reader through the major historical events within each of these time periods, and lays forth his belief that disease lies at the heart of each historical outcome.

It’s an interesting way to look back on history, but I think this argument is a hard sell. I don’t doubt that plagues played a role in major historical events, or that their impacts have been undervalued. But the author appears to hold that in every case, disease was the MAIN impetus for subsequent outcomes… and I just didn’t think I buy this. It’s just hard for me to believe that pathogens were the #1 reason behind the rise of Islam, the North winning America’s Civil War, and the medieval transition from feudalism to capitalism. 🤷‍♀️

An even bigger issue with Pathogenesis is that I found it pretty boring. Historical nonfiction is one of my favorite genres, but I found myself zoning and frequently had to push myself to finish. For these reasons, I can’t recommend Pathogenesis, and I’m super happy I didn’t buy a copy just for the cover!
Profile Image for Maher Razouk.
726 reviews217 followers
April 14, 2023
الفيروسات هي سبب عدم قدرة البشر على وضع البيض!!
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عندما تطورت الحيوانات لأول مرة ، كانت تتكاثر عن طريق وضع البيض ، ومازالت تستمر معظم الكائنات في المملكة الحيوانية في التكاثر بهذه الطريقة. بعد ذلك ، منذ ما بين 100 مليون و 200 مليون سنة ، طوّر كائن ما يشبه الزبابة ، القدرة على الحمل بالصغار داخل الجسد - وهو تقدم تطوري غير عادي لأن الجنين يكون أكثر أمانًا عندما ينمو داخل جسم أمه.

هذا ممكن فقط بسبب المشيمة ، وهي عضو مؤقت يتصل بالرحم ويسمح للمواد الغذائية والأكسجين بالمرور من الأم إلى الطفل ، وانتقال ثاني أكسيد الكربون والمخلفات في الاتجاه الآخر ، دون إثارة استجابة مدمرة من نظام مناعة الأم.

عندما نظر علماء الوراثة إلى الجين المسؤول عن تكوين المشيمة ، أدركوا أنه مطابق تقريبًا للجين الذي تستخدمه الفيروسات لإنتاج البروتينات التي ترتبط بالخلايا المستهدفة دون إثارة استجابة مناعية. لم يظهر بشكل تدريجي كنتيجة للتطور عن طريق الانتقاء الطبيعي ولكن تم اكتسابه فجأة عندما أدخَلَ فيروس ما الحمض النووي الخاص به في جينوم أسلافنا. لذلك لو لم يكن أحد أسلافنا البعيدين قد أصيب بهذا الفيروس الصغير منذ مئات الملايين من السنين ، لكان البشر يتكاثرون الآن عن طريق وضع البيض.
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Jonathan Kennedy
Pathogenesis
Translated By #Maher_Razouk
Profile Image for Isabel.
27 reviews3 followers
February 13, 2023
Thanks ever so much to @penguinrandomhouse for sharing this title with me on @netgalley!

Pathogenesis by Jonathan Kennedy, published by @penguinrandomhouse (Torva.)

Simply fantastic. If, like me, you enjoy romps through world history from an economic and epidemiological point of view (I know, I know), then I have great news for you. Not only do you have a ridiculously niche interest, but now you have this wonderful book to look forward to.

Kennedy's thesis is that germs, infectious diseases, viruses, plagues, you name it, have been the key advancers of human history, from the time of Neanderthals and Homo sapiens to our own ubiquitous Covid-19 in the present day. The book is divided into chronological accounts of plagues throughout history, covering all continents. Call me gullible, but I am sold on this idea. Kennedy's account of world history is accessible, persuasive, and fun, plus I'd much rather imagine our history being built and advanced by invisible germs than by a bunch of old white men.

I savoured every part of this book, but my favourite section was the discussion on how the Black Death triggered and/or set the scene for the emergence of capitalism. It's a period of history that simply fascinates me. One small qualm is that there was barely any discussion of the mistakenly called Spanish Flu, but perhaps the author doesn't think it changed the course of history sufficiently? There was also little attention given to SARS and MERS, making the ending seem a little rushed. Nevertheless, this doesn't tarnish my 5 star review and I cannot stress enough how much I enjoyed reading this. Right up my street? No, it's actually set up camp on my street and plans to live there permanently.
Profile Image for Hannah.
164 reviews9 followers
May 27, 2023
I just love it when a book falls into my lap and says "hello, here's an interesting and different way of looking at history, hope you enjoy." An incredibly passionate and thorough account of human interactions with epidemics, with a specific emphasis on the interaction between illness and social class.

The audiobook was amazing. Since it was read by the author, all the subtle shifts in tone and narrative came across perfectly.
Profile Image for Camelia Rose.
748 reviews102 followers
November 23, 2023
Historians have always known that a major societal turmoil often happens in conjunction with plague and/or natural disasters. In Pathogenesis, Jonathan Kennedy elevates the role of plagues played throughout human history from paleolithic age to modern day. He argues against views held by well-known historians such as Harari and Diamond. For example, the author says Neanderthals died out because of plagues, not because they were less intelligent or less artistic than Home Sapiens. Neanderthals left Africa long before Homo Sapiens did. Living in a colder climate didn’t prepare their immune system for the new pathogens brought from Africa by Home Sapiens.

Kennedy argues the fate of the Roman Empire was closely related to the various plagues (see The Fate of Rome: Climate, Disease, and the End of an Empire by Kyle Harper for details). It is fascinating how Catholicism rose to dominance because it gave a better answer, compared to Roman polytheism, to the question of death and afterlife when plagues ravaged the Empire, and how it became inadequate in the same task a thousand years later. It is not a coincidence that the medieval ages were sandwiched between two prolonged periods of bubonic plagues.

The author also argues that the end of European feudalism was a direct consequence of plagues, because the plagues reduced population and shifted the bargaining power to the remaining peasants. Following this line of thinking, I’d say democracy in countries like Britain and Germany is the result of bubonic plagues.

Kennedy thinks that although Gerald Diamond lists germs as one of the driving forces in human history, he fails to give it its importance. In the author’s point of view, if not for smallpox and other infectious diseases, the Aztec empire would not have been destroyed so easily, perhaps not at all. He also argues that the reason persistent slavery developed in the American south but not in the north was because, in the beginning, the European plantation owners could not use indentured servants from Europe because they were much more susceptible to malaria than West Africans.

Overall, I find this book refreshing, although I am not fully convinced by his arguments. My only complaint is that it’s fairly Eurocentric. African history is viewed by the angle of “white man’s grave”. Asian history is not covered.
Profile Image for Megan.
242 reviews5 followers
May 5, 2023
The title of this book is a little misleading, it's not a history of the world in 8 plagues, it's more so a history of the world and the many diseases that were typical of the 8 time periods the author talks about. The chapters are Paleolithic Plagues, Neolithic, Ancient, Medieval, Colonial, Industrial, Plagues of Poverty (I'm missing a chapter but can't remember what it is haha).

At first I thought the book was quite boring and very Euro-centric. As the book progressed, I found it more and more interesting and it began to focus on other continents. I found some of the claims in this book very ambitious (such as plagues explaining the fall of Christianity and the rise of Islam). I don't doubt that sickness did play a part, but Kennedy makes it seem like it was the only reason, or biggest reason, for these huge world shifts in religion and politics.

I thought the most fascinating part was when he talked about the American colonies and their use of indentured servants and enslaved people. I didn't know it was actually preferred to use indentured servants because of Adam Smith's philosophies that free people are actually better investments because they aren't trying to plot to overthrow enslavers and thus is it better for the bottom dollar.

However, enslaved Africans became the preferred method of labor due to their partial immunity to some of the diseases that were brought over with the slave ships (yellow fever and malaria). The mosquitos ravaged the European population (who had no inherent immunity) and deaths from these diseases were enormous. Therefore, it made more economic sense to use enslaved labor, even with the associated costs reported by Adam Smith. Once enslaved Africans became the de-facto labor source for the colonists in the Americas, racialized rhetoric evolved to absolve enslavers of guilt (lies such as skin color relating to how human someone is, etc). Thus was born modern racism. This is in comparison to the Roman Empire who had Emperors of all skin colors since rulers were chosen from different parts of their vast lands, which included people from light to dark skinned.

Kennedy also talked about the civil war and why the south was more dependent on enslaved labor than the north, and he said it turns out that the Mason-Dixon line was actually about the line where the mosquitos carrying the deadly malaria and yellow fever could survive. So the north could use indentured labor and not enslaved labor. He also talked about how mosquitos killed vastly more numbers of Union soldiers than any weapons of the confederate soldiers.

He then went on to talk about how Africa's interior parts were hard to colonize due to disease, and it was only after a plant medicine was discovered that helped increase the survival rate of malaria, that colonizers could survive the journey up river and begin to exploit those countries.

Another part I found interesting was when he talked about how the Euros brought so much disease and death to the natives of North America (this is well known). The interesting part was when he talked about why this exchange of diseases didn't go both ways. If the ancient cultures of the Americas lived in cities as big as, or bigger than, European cities, why weren't they making their colonizer sick also? Kennedy says this is because the natives in the americas didn't have a ton of contact with domesticated animals, which were the source of diseases like smallpox (derived from cow pox). The American Natives really only had llamas or alpacas as herd animals, not the cows, goats, pigs, and sheep that the Europeans had, thus limiting their native diseases.

Also interesting how during the industrial age, life expectancy dropped dramatically, especially in Manchester and Liverpool, where life expectancy was 17 (!) due to the terrible and dangerous working conditions. Cholera was a huge problem due to lack of sanitation and eventually this led to the London sewers being established.

I'd say this book is worth a read if you like history. Some extremely interesting parts, but the first 1/3 I didn't love - I almost DNFd it based on the beginning parts. I also wish the author didn't narrate the audiobook because his pacing was very slow (I had to listen at 1.15 speed).
Profile Image for Alex.
346 reviews
June 14, 2023
Yeah, I mean, I wanted a history of plagues and pathogens and how they evolved and what they did to people and what the symptoms were and what public health measures were taken... not the history of the world with a couple of plagues sprinkled in.
I guess what I learned was that plagues often killed millions of people which then allowed colonizers to settle in these places. And that people use plagues as biological warfare.
Maybe people should read this book in high school as part of a history class?
I just yearned for more biology.
Profile Image for Kasia.
309 reviews51 followers
May 22, 2023
Easy and informative read.
Profile Image for Reading.
608 reviews12 followers
May 17, 2023
Exceptional and supremely engaging history. I was pleasantly surprised at how incredibly informative and eye opening this book and the author's perspective were. I have read a fair number of history books and though the better ones do attribute significant gravity and consequences to plagues, viruses, sanitary conditions, etc, none gave me such a deep appreciation for the true impact and significance they have had on the trajectory of history.

Nations rise and fall because of policy decisions, battles are won and lost as the result of bullets and bombs, BUT underpinning all of it is the health of the citizens. My eyes are now opened and I'm very grateful for the lessons and insights this book provided.

I did not expect the author to include poverty/economics and obesity/general health as 'plagues' but I allowed him time to weave their place into the history and there's no denying that perspective makes sense. Universal access to clean drinking water, sanitation, and safe affordable housing, plus overall poverty reduction, all contribute enormously to life expectancy as without any/all the population is vulnerable to disease, viruses, etc. Duh, right?! But somehow I had not given this truth the weight it deserves until reading this book grounded me.


Warning to any Austrian School of Economics fans, Mr. Kennedy clearly is not a fan so you may find yourself pulling your hair and harrumphing during segments, especially the last ¼ - ah well, suck it up, you can always learn something new and/or appreciate alternative perspective.

Wish there had been charts, maps and timelines vs the pretty pictures in the center.
74 reviews2 followers
January 14, 2023
This is a fascinating read even if a little unexpected. The main title Pathogenesis suggested to me a close look at pathogens and the diseases they caused but closer attention to the subtitle “how infectious diseases shaped human history” really would have given things away. I am far from a history buff but this really was an exceptionally interesting read. All the characters remembered from school are here, Alexander the Great, Attila the Hun, Charlemagne among so many others. However this time their exploits are placed in the context of pathogenic diseases that were prevalent at the time.
This is a book for all history buffs without a doubt but also for anyone interested in science, medicine and indeed politics. A big take from this book is how society works so much better when the health of their population is considered but also individual nations cannot act alone anymore.
Well worth a read and highly commended.
Thanks to Netgalley and the publishers for this ARC in exchange for an honest review.
Profile Image for Scott Humphries.
117 reviews
May 24, 2023
This is one of the more fascinating books I’ve read lately. As a student, I was taught history loosely along the “great man theory,” but Pathogenesis provides a convincing alternative, or at the very least a useful supplement, to that view. The impact of plagues and infectious diseases on our history should not be underestimated. For example, Kennedy explains how Christianity was able to gain its first meaningful foothold in the population by selling “life after death” in the wake of the Antonine and Cyprian Plagues in the second and third centuries. How the racialization of slavery developed as a result of demand for slaves with natural immunity to malaria. How the ultimate success of the Haitian revolution depended largely on the destruction by disease of the French reinforcement brigades. And much, much more. There’s a lot to learn about the past here, and surely about the future…
Profile Image for Ava.
51 reviews
May 25, 2023
This is one of my favorite non-fiction books I've read period and certainly my favorite of the 5 or so I've read this year. Kennedy's thesis that infectious diseases have shaped history, politics, and civilization was compelling and convincing; in particular, it made clear that without frequent epidemics (from the Paleolithic period to now) the trajectory of history would have been considerably altered.
I'm going to be thinking abut this book for a long time - I not only got refreshers on some of the history that I already knew but I also gained new perspectives on how certain events unfolded (pathogens! microbes!) as well as history that I was previously unaware of.
Highly recommend this book to anyone interested in the intersections of health, sociology, and politics!
Profile Image for Alexandra.
638 reviews26 followers
May 5, 2023
Reads like Yval Noah Harari's "Sapiens" - but for germ nerds! I thoroughly enjoyed this, and I like how Kennedy translated a lot of the concepts into analogies using popular culture. It was fun without being heavy handed or ridiculous.

Though the book isn't really here to delve extremely deeply into any of the arguments Kennedy makes, he does a good job of examining history "through disease" - i.e., really proposing ideas about why certain things happened. He points out that it is not only because of disease, of course, but has convincing commentary on ideas we should be looking at, and how it should help us in the future. I loved this.
Profile Image for Heather.
533 reviews13 followers
July 18, 2024
I enjoyed this book a lot and felt it really offered a lot to learn. I was on my way to a 5-star review until the last section on Covid. I don’t understand how anyone can take China’s death toll numbers at face value and then deduce that China’s handling of Covid, and China’s non-free market, non-democratic approach to the virus was vastly superior. I found that somewhat enraging that the author could reach any conclusions based on those purported numbers.

On a more positive note, I felt the overview of world history to actually be superior to the entire “world history” great course I listened to. While his conclusions at the end made me then question everything else he said, it’s hard to argue with much of the historical facts and events as presented.
Profile Image for Ali.
288 reviews
December 21, 2023
Pathogenesis is an alternative reading of human history like Graeber and Wengrover’s Dawn of Everything. It challenges Harari’s Sapiens centric reading or Jared Diamond’s Gun, Germs and Steel, identifying “germs” as the primary factor in most significant historic changes. Although it is a very intriguing read with interesting scientific findings (retrovirus contribution to evolution of placenta, or immigrant Anatolian farmers building Stonehenge, or Roman bath and toilets aid to contagions, or bacteria helping Europeans in colonization), tying everything to pathogens seems to be a stretch. Probably would look later for rebuttals or revisions on this theory.
Profile Image for Yvonne.
1,546 reviews129 followers
January 18, 2023
This was a brilliant book to read and it was one that took me through the history of the world from the emergence of humans through to the present day.

Starting at the beginning the author tells how humans were hunter-gatherers, they would move and travel. It was when they settled that disease began to make itself known. As people lived close and began to cultivate the land, and breed animals this closeness was something that encouraged any pathogens, diseases, viruses or plagues to multiply. As people from different areas and regions began to mix then so diseases would travel. One group may be immune to a certain strain having built upon their immunity over time. Coming into another group may not have had the immunity and so things were able to spread.

Using the history of the world and how humans moved and travelled is a great way to understand how diseases or plagues were able to travel. History has shown how some indigenous populations were wiped out due to European travellers bringing in diseases. Where the Europeans had built up an immunity over time, indigenous peoples were coming into contact with it for the very first time. The results were deadly.

As humans have gradually spread, become more industrialised and shaped the earth then so plagues and diseases have also changed. Being in closer contact with animals has allowed some pathogens to change and they have made the jump from infecting animals to humans. Many people think of the Black Death when the word plague is mentioned. The bacteria Yersinia Pestis is responsible for the plague, it has been around long before the 1348 or 1665 outbreaks. The bacteria has been found in the DNA of ancient humans from the neolithic age.

AS people have moved and adapted then so have the bacteria responsible for plagues. As we are freer to travel then so are the bacteria. The recent pandemic has shown our generation how quickly a plague can move and we are constantly being told of new strains of Covid. We also live in a world where certain antibiotics are not as effective for treating bacterial or viral infections.

Using history as a way of showing how people lived, worked, moved and developed their knowledge and understanding of the world is a great way of showing the history of plagues as well. One evolves alongside the other and this is a book that is easy to read and understand.

The author has done a brilliant job and I really found this book amazing to read. I learnt so many things and also understood certain things a lot more. Laid out well and referencing things that I knew of was a great way of laying out history and plagues.

This is a fabulous book and if you enjoy reading history, about plagues, deaths, living conditions and the general history of the world and its people then I do think this is a book you would really enjoy. I did and I would definitely recommend it.
Profile Image for Christian Ekman.
43 reviews23 followers
May 15, 2023
I really liked most of the book. Very interesting that the book covered such a vast number of different topics while still always keeping it relevant for microbiomes and pathogens.

However... It annoyed me to no end when the author, toward the end of the book, talked about covid-19. Firstly, he just blindly trusts the official numbers given by China. Secondly, he very briefly states that "yeah I suppose all their human rights violations weren't great". And then lastly continues to laud China for handling covid-19 so much better than everyone else, and lands in the conclusion that no country would ever want to be like the US or European countries anymore because China had fewer covid-19 cases.

Absolutely couldn't believe what I was hearing. He blindly trusts China's official numbers, then briefly acknowledges that their human rights violations weren't cool, and then basically concludes that China has the right idea about how to govern a country.

This book would have been a 4, but I can't bring myself to give a rating that high when the author spouts this garbage at the end.
Profile Image for Scott Lines.
95 reviews1 follower
May 10, 2023
An excellent book that was really easy to follow and insightful.
May 30, 2024
Historical content with no bias 5/5
Social Justice Scholarship throughout the book 1/5

The Enlightenment has put some lucky people on what seems like a -perpetual path of progress-, but much of the world’s population lives in what must feel like a dystopia.
- Jonathan Kennedy

This single quote can define the spirit of the book. I bought it because I thought I was going to read something written by a medical doctor, a virologist, or epidemiologist. Turns out, that the author has a Ph. D in Sociology. This is why, we see him quoting Marx, Engels, and Michel Foucault (which by the way no one mentioned a single fuck when rumors of Foucault's sexual abuse of children came out).

Social Justice Scholarship was born in Academia. This is why we now have books on astrophysics and systemic racism; about genetics and white supremacy, why BBQ is racist, and why we now have more than 70 genders and pronouns that do not make sense at all. This is why I cringed when I had to read a book on evolutionary medicine that said that men can get pregnant. I tried, I really tried not to be a critic of it, but what am I supposed to do when I read this kind of stuff?

Look at this one:
“A modern-day equivalent might be a right-wing U.S. milita 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.”

Of course, it is ALWAYS the right-wing for invading anything. He mentions this while comparing Hernán Cortés and Francisco Pizarro conquering both the Aztecs and the Incas. I am Ecuadorian, the capital of Ecuador is Quito, an important place for the Inca Empire. I don’t give a fuck about what happened, I don’t seek vengeance, nor I want Spanish people to ask for forgiveness. One major problem with this kind of people, is that they see history judging it with the moral standards of today, and not only that, they pursue retribution or reparations for every thing that most of what “white males” have done. This does not apply to any other culture. The problem with this kind of thought, is that it denies human nature. At the moment these people judge like that, they turn themselves into the High Priests of Morality. This is why I hate SJW. The fallacies of reparations are greatly explained by both Douglas Murray and Thomas Sowell.

Another gem:
“Michel Foucault saw the shift in the focus of states from controlling territory to governing people’s bodies as a key feature of the modern world.”

Foucault appears along with his theory about biopower.
Please, tell me once again the Chinese Communist Party managed to control their people? This is mentioned in the last chapter concerning Covid. At some point, you can feel how he managed to give credit to China (although he says he does not, I don’t know why he has to clarify this exact thing), while saying that Covid outbreak in the US was all because of Donald Trump. There is an app in China in which, literally George Orwell’s 1984 came true. He even mentions that “tragically, Li Wenliang died”. Come on. The guy died because the CCP wanted to. Quote Foucault on that.

This is another gem on white supremacy, or “white studies” or “whiteness”:

“There is, however, something unsettling about a group of white, Oxford-and Cambridge-educated men entolling the virtues of colonialism, albeit for comedic effect.”
I don’t need to say more.

Chapter Six, called “Revolutionary Plagues”, starts with the narration of George Floyd’s murder (another SJW saint). This is the start on what I call “racist pathogenesis”:
In chapter 6, we can read stuff like::

“In August 2019 the New York Times launched its 1619 Project, with the aim of ‘placing the consequences of slavery and the contributions of Black Americans at the very center of the United States’ national narrative’.
Why the FUCK am I reading about the stupidest thing that did not work, called “The 1619 Project”?
Why the FUCK am I reading about the murder of the SJW Patron and Saint in a book about GERMS?

Or this one:

“It is specifically racial nature of modern American slavery that distinguishes it from pre-modern forms of forced labor. But once Black Africans had become inextricably linked with slavery in the European imagination, modern ideas about race were developed in order to justify this iniquitous situation.”

This is Critical Race theory in its pure form. If you are black living in the US, YOU MUST ACCEPT THAT YOU WERE SLAVE; THAT DEFINES YOUR LIFE. This is even worse than “the capital sin” that was imposed in the Middle Ages. There’s no way you can be free, there’s no way things have changed. Tell that to Thomas Sowell, Candace Owens, Allen West, and we can debate on that. Just look at this brat:
https://www.youtube.com/watch?v=o68OW...

Or this another gem:
“…although the United Stated abolished slavery at the end of the Civil War, it never rid itself of white supremacy and Black subjugation”. Notice the capital letters on “black” and how “white” is written.

Another form of CRT.

“The murder of George Floyd and the massive BLM 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.”

The chapter ends with this gem:
“The ten poorest countries in the world are all former colonies in sub-Saharan Africa. It is not unreasonable to conclude that these societies would have been better off if Europeans had never discovered a moderately effective treatment for malaria and the region had remained a white man’s grave”.
This is based on the grounds of one of the pillars of the Social Justice Scholarship, called “post-colonialism”.

The last chapter, is about structural racism, and a hate to the West:

“In the West we celebrate Edward Jenner as the pioneer of vaccines, but the Chinese have been inoculating their population against smallpox for over 1000 years”.

I mean, did we benefited from the former Chinese empires having vaccines? I don’t think so. I live in Ecuador, and we do not produce vaccines. I was, thanks to the West, vaccinated with Pfizer. The fact that Jenner somehow “discovered” vaccines in the West, was a good thing. The news spread quickly in these countries and bam, people like me, in Ecuador had the opportunity for that. This “hatred” for the West is beautifully depicted by Douglas Murray in “The War on the West”. The theme of vaccination is gracefully written by Siddartha Mukherjee in his book “The emperor of all maladies”.

It can be considered a “classic” by saying that Steven Pinker sucks:

“But in the most reductive way, liberal optimists like Pinker are right when they claim that the world is getting healthier. If one looks at data from the World Bank, its clear that global average life expectancy has improved markedly, from about fifty years in the middle of the twentieth century to almost seventy-three today”.

This is because of the book “Enlightenment Now”. You know. White-cis-christian-males are bad for society. This is the moment in which you feel hatred for the West and towards white people.
Another gem on CRT:

“The stress of existing in a racist society has a devastating impact on both psychical and mental health.”

Really?

One more gem on drugs:

…”the fastest way to escape the North American version of Shit Life Syndrome in the early twenty-first century is alcohol, crystal meth or fentanyl.”
But he does not mention who consumes drugs, or the macroeconomics surrounding the issue. He does not mention thousands of people from my country, from Venezuela, from Cuba, from Guatemala crossing La Selva del Darién, exposing their lives to death, just to cross the border and arrive to the US. None of them want to go to Venezuela, Cuba, Haiti, North Korea or China. Why is that? Would someone care to answer me that? He does not mention that Russian and Latin cartels bring drugs such as fentanyl and scopolamine to the US, but, it is always the US to blame. (Biden is not even mentioned a single time in the whole book).

And finally:

“…we should take inspiration from the fact that, throughout history, pandemics have driven momentous political and economic transformations. They shine a light on corrupt and incompetent leaders, reveal and exacerbate pre-existing social divisions, and encourage people to question the status-quo. The Covid-19 pandemic has highlighted many of the problems that blight modern society. It is now up to us to seize the opportunity to address these inequities and to build a happier and healthier world.”

As I mentioned before, one of the most used words of a SJW, is “status-quo”. Probably the influence of French philosophers. And also, by "incompetent leaders", he refers to neoliberalists such as Daniel Noboa, Javier Milei, and the most tyrant of all, Nayib Bukele.

Now, please, I am not saying that we should not fight injustice. Doing that is in our genes. We are hardwired for certain responses. The key is to do that with facts, both economical, historical and biological, not turning history into a simple story of “oppression” and “capitalism”. The reason why socialism and communism fail, is because those ideologies deny human nature. Capitalism, on the other hand, is like a mirror that reflects human nature on both its pros and cons. I am saying that after reading a lot of books on the subject, and really trying to understand why we behave like this, throughout history. At some point in the book, he mentions something related to “vaccine colonialism”, because of the fact that low--income countries do not receive vaccines for covid. Whose fails is that? Big Pharma? The CCP? Donald Trump? Ideology? Which one?

The first chapter and the introduction, LOVED IT. Because it mentions a lot of evolutionary sciences, human species. But you start feeling some high ground morality, when he mentions that “some scientists stated that Homo Sapiens was superior to the Neanderthal species”. Ok, who the fuck is alive then? And why? Do we really need to question why? Why the need to turn evolution into a political statement? Evolution does not care about politics, FUCK OFF!

The content of viruses great. I mean, the author is really informed. But unfortunately, you can sum up by saying that everything is fault of the “wealthy ones”. And whatever “good deed” done by them, is counterbalanced by everything wrong we’ve done.
Profile Image for Poppy || Monster Lover.
1,149 reviews205 followers
August 6, 2023
This book was informative and fascinating. I enjoyed looking at history through the lens of epidemiology. The call to action was unexpected, but appropriate when considering how epidemiology, by nature, studies public health. I appreciated improving my understanding of the role malaria and yellow fever played in the formation of chattel and race based slavery.
I could tell the author has done a lot of work on deconstructing the exceptionalism and white supremicist world view that comes from being raise in the western world. However, this book rarely touched on the impact of plagues on nations that were not European or former colonies. The bubonic plague, for example, impacted more than just European countries, yet the author barely touched on Asia. He mentioned that it originated in Asia, but didn’t talk about how it impacted the social structures in any of the contemporary nations. Overall, the tone of the book was Eurocentric, even when addressing plagues that primarily impacted non-European nations.
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