Plagues and Peoples is an informative and very readable summary of the relationship between mankind and disease. The author consistently views disease as a parasite and describes the history of plagues in terms of a parasite interacting with a host population. The parasite and the host interact and, over time, reach an equilibrium within the population that allows the both the parasite and the host to survive.
The most interesting feature of the book is his portrayal of mankind not only as a host, but also as a parasite himself. He uses the term macroparasite to describe human institutions and phenomena that also drain energy and resources from producers. For example, very high taxes or rents, Medieval labor laws and practices, war, and forced migration all drain communities and nations as surely as disease. He provides excellent, while still brief, commentary on the interaction between microparasites and macroparasites and the resultant depopulation of certain areas during certain periods. One might argue that this is not a newly observed correlation, but it has certainly never been explained as clearly and succintly as it is done here.
McNeill covers a range of topics. There is, of course, discussion of the plague and mankinds response to it. There us also commentary on leprosy. Why for example, was leprosy, so common in Western Europe and the Middle East in biblical times, to dissapear in the Middle Ages. ( The answer is not what you think. ) Did syphillis originate in the Americas ? If so it may have been the Aztecs' revenge on the conquistadors. Why are there childhood diseases ?
McNeill's arguements are somtimes intuitive and are, in some cases, based on limited data, especially when he examines the history of disease in Asia and India. However, he is careful to couch his observations in limited terms and clearly points out the limitations of the data. I found this to be a refreshing break from, for example, Guns, Germs and Steel, where the author used very limited data to draw absolute conclusions.
The new introduction ( the book was first publised in 1986 )has an alternate viewpoint on AIDS. He argues that, at the moment, AIDS as an epidemic does not rank among the great killers of mankind such as the plague. He draws some interesting parallels between the current AIDS epidemic and the historical spread of syphillis. I am not sure if I agree with his position, but it was interesting to hear something other than the usual end of the world scenario that often comes out of discussions of AIDS.