Jim Downs, "Maladies of Empire: How Colonialism, Slavery, and War Transformed Medicine" (Harvard UP, 2023)

Modern epidemiology originated from the confluence of war, imperialism, and slavery, which established the bureaucratic infrastructure necessary for large-scale disease surveillance. Historian Jim Downs argues that this field developed through the systematic collection of data across colonial and military environments long before the rise of bacteriology. Marginalized groups, including enslaved laborers and washerwomen, served as essential, though frequently erased, contributors to this knowledge production. By analyzing historical records through the lens of power and state-sponsored violence, the research reveals how surveillance tools—such as the "Negro Questionnaire"—codified scientific racism to justify social control. Ultimately, patient reporting remains a vital, often overlooked driver of medical discovery, as seen in historical instances of cholera and contemporary responses to HIV/AIDS and COVID-19, where ordinary individuals fundamentally shaped the understanding of disease transmission and pathology.