This volume comprises eight individual contributions, framed by the editors’ preface and conclusions, which straddle the intersection of biology and history. Beginning with Woodrow Borah’s introduction, at once succinct and thorough, this volume provides a representative summary of current scholarship on the historical ramifications of disease in the Americas. The editors assert that precipitous Amerindian population decline occurred following European contact, attributable mainly to the introduction of Old World diseases among an “immunologically defenseless” population (p. xv). Thus they confirm, rather than question, the prevailing view among historical demographers that a large pre-Hispanic population fell dramatically—if at varying rates in different areas—after the Spanish conquest; and, fittingly, they dedicate this work to the memory of Sherburne F. Cook, Carl O. Sauer, and Lesley B. Simpson.

The editors have successfully established continuity among the disparate presentations from the symposium on epidemiological contagion and its historical consequences that was part of the 46th International Congress of Americanists, held in Amsterdam in July 1988. Five of the monographs included here construct a chronology of pandemics and epidemics in particular areas and discuss the probable identification of these diseases from contemporary descriptions and current medical opinion. Hanns J. Prem (central Mexico), W. George Lovell (Guatemala), Linda A. Newson (Ecuador), and Brian M. Evans (Upper Peru) concentrate on the sixteenth and early seventeenth centuries, while Juan A. and Judith E. Villamarín span the entire colonial period in their coverage of Sabana de Bogotá. Evans brings together demographic and ethnohistorical evidence in his observations concerning shifts in population and power between the two parcialidades of Aymaya. Those changes were provoked by several disease episodes as well as the burdens of colonial tribute and forced labor.

The last two chapters take a different course, turning more directly to issues of politics and ideology. Suzanne Austin Alchon (Quito) focuses on Bourbon policies for treating disease and safeguarding public health as manifestations of an assertive secular state. Fernando Casanueva (southern Chile) is the only contributor who examines the impact of epidemic disease on a nomadic frontier of the Spanish Empire—the interior plains and highland valleys through which the Mapuches (Araucanos) and neighboring tribal peoples moved between Chile and Argentina. Drawing on ethnohistorical data concerning the organization of Mapuche society, Casanueva discusses probable routes of contagion and indigenous responses to the smallpox epidemic of 1791, which ran its course on this armed frontier. Echoing Alchon’s theme of the expanding power of the Bourbon state, Casanueva argues that frontier authorities exploited the impact of the 1791 epidemic to extend their control “over colonial space” south of the Bío-Bío River (p. 186).

Each of the chapters that focuses on a defined region is built on solid archival research and enhanced by excellent maps. The editors and individual authors warn against making facile assumptions about the geographic spread of diseases based on their chronological appearance in different places. They take considerable care to distinguish among endemic disease environments, local epidemics, and cross-regional pandemics. Newson catalogs the known pre-Columbian diseases of the Andean area, a theme the editors reiterate in their concluding remarks on “Unraveling the Web of Disease.” Native American pathogens, generally spread by arthropods and parasites and associated with dysentery, tuberculosis, leishmaniasis (Carrion’s disease), and syphilis, were chronic and endemic rather than acute and epidemic (pp. 85, 223-32). Hence the devastating impact of Old World maladies. The contributors avoid the controversy of “high” versus “low” initial population estimates, but devote considerable attention to distinguishing among different disease episodes.

In some cases, the analysis of quantitative and chronological data presented in tables leaves the reader with lingering questions. For example, the linkage Lovell purports to establish between successive epidemics and population decline in Guatemala, convincing in itself, does not actually test alternative hypotheses, such as the magnitude of disruption in Maya society caused by slavery, encomienda, forced labor, and tribute. The Villamaríns’ discussion of the smallpox epidemic of 1802-3 in Santa Fé (Sabana de Bogotá) does not explain the higher morbidity and mortality of women reflected in Table 4.2 (p. 134). The editors’ final chapter presents a useful summary of known characteristics of the major European and native diseases that swept through colonial populations. But it does not analyze the separate authors’ findings, nor does it build a master chronology that—however tentative—might have created an overall picture of the historical impact of disease in Spanish America.