Hektoen International

A Journal of Medical Humanities

Book review: Foreign Bodies: Pandemics, Vaccines and the Health of Nations

Arpan K. Banerjee
Solihull, United Kingdom


Cover of Foreign Bodies: Pandemics, Vaccines and the Health of Nations by Simon Schama

Simon Schama, the eminent historian and broadcaster, has turned his attention to medical history. His new book, gestated and born during the COVID pandemic, is a chronicle of three pandemic diseases that have afflicted humans for centuries: smallpox, cholera, and plague.

He opens the book with a quote from Pliny the Elder: “In the end all history is natural history.” This emphasizes the interplay between biology and ecology that has resulted in pandemics.

The opening chapter sets the scene with a discussion of SARS, avian flu, Ebola, and other modern infectious diseases before the inevitable mention of the COVID pandemic and the different speculations as to its origins. The interplay between humans and their environment has played a part in all these disease outbreaks.

Smallpox is then given the focus of attention. This section of the book chronicles the advances of the Ottomans with inoculation and the work of Lady Mary Montagu, who “denounced the Knavery and ignorance of physicians” and deserves better recognition for her work on inoculation in England. Thomas Nettleton’s work on inoculation in Yorkshire rubs shoulders with skeptics such as William Wagstaffe, a prominent physician at St. Bartholomew’s Hospital, London who warned of the dangers of inoculation.

Smallpox was a scourge worldwide in the early eighteenth century. In Pisa, the professor of medicine Angelo Gatti was a champion of inoculation against smallpox in Italy. In France Charles Marie de la Condamine, a former soldier, traveler, and mathematician promoted inoculation against this terrible disease that left people terribly scarred for life.

Section Two of the book covers cholera and introduces us to the brilliant French physician and epidemiologist Adrien Proust (father of the famous writer Marcel Proust) and his tireless efforts to contain cholera and convince people of its infective origin. In the first half of the nineteenth century, people did not believe cholera was caused by a bacterium and thought it was due to miasma or bad air. Cholera was a major killer worldwide with pandemics waxing and waning throughout the nineteenth century and beyond. These affected not just European cities like London and Paris, but also cities throughout the British Empire such as Calcutta. There was a worldwide denial that the disease was of infectious origin. In 1854, the same year Dr. John Snow did his famous study of cholera in London, an Italian professor of anatomy in Florence, Fillipo Pacini, published his research from autopsies showing the bacterial origin of this disease. Today he is largely forgotten, as the German Robert Koch is given the credit for describing the bacterium that caused cholera almost thirty years after Pacini’s description. The contributions of the Ukrainian bacteriologist Waldemar Haffkine to the discovery of cholera vaccine and his work in India is covered in depth. The stories around the personalities of the time, such as the brilliant scientist Elie Metchnikoff (Nobel Prize in Medicine 1908) who discovered phagocytosis, portray the human aspects of these early pioneers.

The third section of the book covers the story of the plague and attempts to find a vaccine and deal with the plague pandemics of the nineteenth century with the spread of the disease being facilitated by trade and increased travel. The section is littered with stories of the pioneers of early bacteriology from the nineteenth and early twentieth centuries. The story moves from Robert Koch (who discovered the bacterium Vibrio cholera) and workers at his Institute in Berlin to the Pasteur Institute in Paris, another mecca for bacteriologists. The contributions of Waldemar Haffkine in India are described in some detail. He created a plague vaccine in 1897 and set about testing it in patients around Mumbai and Calcutta. He also founded the Haffkine Institute in the Parel district of Mumbai. Lord Lister, the famous British surgeon, called him the “savior of humanity.” The contributions of Calmette, Yersin, Kitasato, Choksey, along with politicians, administrators, and other personalities worldwide are interwoven like a detective novel.

The book is Simon Schama’s first foray into the field of medical history. It is magisterial in scope and written with the eye of a brilliant historical scholar. Yet in places the book almost reads like a novel. The detailed historical research from both primary and secondary sources are chronicled in the notes and appendices for further reading and the work is accompanied by a comprehensive index. Reading the book has been a pleasure and has provided much valuable insight into the field of infectious diseases, bacteriology, and the pioneers of vaccination.


Foreign Bodies: Pandemics, Vaccines, and the Health of Nations
Simon Schama
Simon and Schuster, 2023
ISBN 978147116989



DR. ARPAN K. BANERJEE qualified in medicine at St Thomas’s Hospital Medical School, London. He was a consultant radiologist in Birmingham 1995–2019. He was President of the radiology section of the RSM 2005–2007 and on the scientific committee of the Royal College of Radiologists 2012–2016. He was Chairman of the British Society for the History of Radiology 2012–2017. He is Chairman of ISHRAD. He is author/co-author of papers on a variety of clinical, radiological, and medical historical topics and seven books, including Classic Papers in Modern Diagnostic Radiology (2005) and The History of Radiology (OUP 2013).


Summer 2023  |  Sections  |  Infectious Diseases

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