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v2.1 Reference

A Modern Contagion

Imperialism and Public Health in Iran's Age of Cholera

Pandemic cholera reached Iran for the first of many times in 1821, assisted by Britain's territorial expansion and growing commercial pursuits. The revival of Iran's trade arteries after six decades of intermittent civil war, fractured rule, and isolation allowed the epidemic to spread inland and assume national proportions. In A Modern Contagion, Amir A. Afkhami argues that the disease had a profound influence on the development of modern Iran, steering the country's social, economic, and political currents.

Drawing on archival documents from Iranian, European, and American sources, Afkhami provides a comprehensive overview of pandemic cholera in Iran from the early nineteenth century to the First World War. Linking the intensity of Iran's cholera outbreaks to the country's particular sociobiological vulnerabilities, he demonstrates that local, national, and international forces in Iran helped structure the region's susceptibility to the epidemics. He also explains how Iran's cholera outbreaks drove the adoption of new paradigms in medicine, helped transform Iranian views of government, and caused enduring institutional changes during a critical period in the country's modern development.

Cholera played an important role in Iran's globalization and diplomacy, influencing everything from military engagements and boundary negotiations to Russia and Britain's imperial rivalry in the Middle East. Remedying an important deficit in the historiography of medicine, public health, and the Middle East, A Modern Contagion increases our understanding of ongoing sociopolitical challenges in Iran and the rest of the Islamic world.

About the Author

Amir A. Afkhami is an associate professor with joint appointments in psychiatry, global health, and history at George Washington University. He is also a lecturer at the US Department of Defense's Joint Counterintelligence Training Academy and the author of the US State Department's Iraq Mental Health Initiative.


"Easily the most definitive study of a sadly ignored episode of history. The narrative is bold in its claims, meticulous in its research, and seamlessly able to move from the minutiae of bacteriology to the machinations of Great Britain and Russia in the Big Game. I marvel at the author's acute erudition, his endearing humanism, and his ability to forge a narrative that is at once sobering and suspenseful, detailed in texture, but almost breezy in tone. Revelatory; a gem of a book."

- Abbas M. Milani, Stanford University, author of The Shah

"An original contribution to the history of epidemic diseases and the development of modern sanitary measures in Iran during the period of the Qajar dynasty. Scholars and students of Persian studies, the history of medicine, and sciences in Iran and the Muslim world will want to read this book. Warmly recommended."

- Fabrizio Speziale, School for Advanced Studies in the Social Sciences, Paris, Director of Perso-Indica: An Analytical Survey of Persian Works on Indian Learned Traditions

"This book masterfully fills a crucial gap in our understanding of Iran's modern history. Relying on an array of archival and other primary sources, Afkhami demonstrates how in the face of deadly transregional pandemics and a host of other health issues, the Qajar state's nascent public heath regime could only partially cope with depopulation, malnutrition, and endemic diseases that ravaged Iran in the nineteenth and early twentieth centuries."

- Abbas Amanat, Yale University, author of Iran: A Modern History

"Afkhami highlights an important (but often neglected) series of events in the history of human cholera. His tale of the arrival of pandemic cholera to Iran and the Persian Empire over the span of a century is a tour de force and represents a major contribution to the history of medicine literary cannon."

- Peter J. Hotez, MD, PhD, Baylor College of Medicine, author of Vaccines Did Not Cause Rachel's Autism

"Amir Afkhami has brilliantly broken new ground in the scholarship on epidemics and society. A Modern Contagion is a splendid and enlightening book."

- Howard Markel, MD, PhD, University of Michigan, author of The Kelloggs: The Battling Brothers of Battle Creek

"A thoroughly engrossing exploration of the transformative role of Iran's encounter with cholera in shaping European imperial rivalries, Iranian conceptions of governance, and the cultural politics of medicine. Richly researched and boldly argued, this is a compelling study of the making of sanitary modernity at the intersection of Europe and Asia."

- John Harley Warner, Yale University, author of Against the Spirit of System: The French Impulse in Nineteenth-Century American Medicine
Johns Hopkins University Press
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296 Pages
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