Contagion: How Commerce Has Spread Disease

by Mark Harrison

Overview

A combined history of commerce and disease, and their disturbing propensity for traveling together

Much as we take comfort in the belief that modern medicine and public health tactics can protect us from horrifying contagious diseases, such faith is dangerously unfounded. So demonstrates Mark Harrison in this pathbreaking investigation of the intimate connections between trade and disease throughout modern history. For centuries commerce has been the single most important factor in spreading diseases to different parts of the world, the author shows, and today the same is true. But in today's global world, commodities and germs are circulating with unprecedented speed.

Beginning with the plagues that ravaged Eurasia in the fourteenth century, Harrison charts both the passage of disease and the desperate measures to prevent it. He examines the emergence of public health in the Western world, its subsequent development elsewhere, and a recurring pattern of misappropriation of quarantines, embargoes, and other sanitary measures for political or economic gain—even for use as weapons of war. In concluding chapters the author exposes the weaknesses of today's public health regulations—a set of rules that not only disrupt the global economy but also fail to protect the public from the afflictions of trade-borne disease.

Product Details

ISBN-13:	9780300123579
Publisher:	Yale University Press
Publication date:	01/08/2013
Edition description:	New Edition
Pages:	400
Product dimensions:	6.62(w) x 9.26(h) x 1.50(d)

About the Author

Mark Harrison is professor of the history of medicine and director of the Wellcome Unit for the History of Medicine, University of Oxford. His previous books include Medicine and Victory: British Military Medicine in the Second World War and The Medical War: British Military Medicine in the First World War, for each of which he was awarded the Templer Medal. He lives in Oxford, UK.

Read an Excerpt

CONTAGION

HOW COMMERCE HAS SPREAD DISEASE

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By MARK HARRISON

YALE UNIVERSITY PRESS

Copyright © 2012 Mark Harrison
All right reserved.
ISBN: 978-0-300-12357-9

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Chapter One

Merchants of death

Prior to the fourteenth century, much of Eurasia enjoyed centuries of freedom from epidemic disease. There had been no major outbreak of pestilence since the Plague of Justinian (AD 541–762), or First Plague Pandemic, which had fatally weakened many of the empires around the Mediterranean. After the plague died out, the populations of many parts of Europe, Asia and North Africa began to recover and by the thirteenth century Europe and Asia were enjoying great prosperity and an expansion of trans-continental trade. By the middle of the fourteenth century, however, many parts of Europe had become over-populated and food was increasingly scarce. Cattle murrains and famines brought many societies to the brink of ruin and when plague arrived from Central Asia in the 1340s, it pushed them over the edge. Around a third of Europe's population – and that of affected parts of Asia and Africa – perished within years or even months. In Europe, population collapse resulted in severe scarcity of labour; this increased its price and, in the longer term, dissolved feudal bonds, allowing capitalism to flourish. Coping with plague also stimulated state-building and administrative centralization, giving rulers the means to raise revenue for armed forces and commercial expeditions. Together, these changes paved the way for centuries of European expansion. But what, if anything, do these momentous events have to do with trade? To answer this question we need to consider the origins of the Black Death and the ways in which this and subsequent epidemics may have spread.

The geographical location and dissemination of the Black Death are questions which have generated rather more heat than light. As most interpretations are rather speculative, there is little to be gained by considering all of them but one of the most influential (and controversial) has been William H. McNeill's suggestion that the plague originated in or near China. In his famous work Plagues and Peoples (1976), McNeill claimed that the Second Plague Pandemic began in the khanate of Mongolia, where a terrible epidemic was recorded in 1331–2. He supposed that the plague bacterium (Yersinia pestis) might have been carried there after it was contracted from one of two hypothetical 'reservoirs' among wild rodents: the most likely one being on the Yunnan–Burma border, the other possibly on the Manchurian–Mongolian plateau. From China, the disease seemed to make its way west along caravan routes controlled by the Mongols to reach the northern shore of the Caspian Sea, infesting other rodent populations on the Steppe. The plague then appeared to move south to Azerbaijan and west to the Black Sea, again along caravan routes, from where it was conveyed by merchant ships to Europe and Africa.

This version of events ascribes an important role to commercial activity, yet there is no firm evidence to support it and other geographical origins have been proposed, ranging from Kurdistan to southern Russia. None of these alternatives can be completely ruled out but it seems likely that McNeill's original hypothesis was correct. It is generally acknowledged that China experienced major epidemics from the 1330s to the 1350s, resulting in a massive fall in population. This demographic collapse was comparable to that in Europe after the first visitation of plague in the 1340s and it is difficult to imagine any disease which could have caused similar mortality over such a long duration. Moreover, we now have good reason to suppose that a wild reservoir of plague did exist in the vicinity of China. The DNA signature of Yersinia pestis points to the bacterium evolving between 26,000 and 2,600 years ago, in or near China. After China was united under the Mongolian Yüan Dynasty (1260–1368), it would have been relatively easy for plague to spread from these remote locations to major centres of population. Indeed, if plague was present in China prior to the fourteenth century, it is likely that many infected rodents would have been displaced by the floods and earthquakes which were widely reported immediately before the Black Death. As a result of these calamities, marmots might have come into closer contact with domestic rodents, their fleas subsequently carrying the plague bacterium to humans.

These theories are plausible but we have no way of knowing for certain whether the great mortality which occurred in China was caused by the disease which gave rise to the Black Death. Once plague arrived at the Black Sea, however, there is substantial evidence from which to form an impression of how it may have been conveyed to other parts of the world. Most contemporary accounts start with graphic descriptions of the plague which raged at the Crimean port of Kaffa in 1346. The city was then besieged by the army of the Muslim Turkic ruler Kipchak Khan Janibeg, who had pursued Christian merchants from the city of Tana where they had been granted licence to trade. Kaffa was founded by the Genoese in 1277 as a trading post and it was regarded by them as a safe haven where they could purchase and store sought-after commodities such as silks from China, before selling them on to buyers in Europe. As long as the silk routes across Central Asia were protected by the Mongols this arrangement was viable but as the Empire began to disintegrate, and some of the khanates converted to Islam, Christian merchants found that they were no longer welcome. The slightest disagreement between Christians and Muslims had the potential to escalate into a major incident, as the Genoese found to their cost at Tana. But the plague set them free: its ravages among the khan's army broke the siege at Kaffa and provided the merchants with an opportunity to escape to Constantinople.

During 1347, the ancient Byzantine capital suffered severely from plague and many people fled from it, taking the disease with them. The Genoese merchants who had escaped from Kaffa were among them and many died of plague before they reached their intended destinations in the Mediterranean. They first set foot in the Sicilian port of Messina, where the merchants hoped to take on provisions before returning to their native city. This was the first European port at which plague was recorded, in October 1347. The rest of the Genoese ships continued westwards along the Mediterranean coast, the merchants hoping to sell the goods they had brought with them from Kaffa. One ship reached Marseilles in 1348 and the others made it as far as Spain. At this point, however, it becomes difficult to distinguish fact from fiction. There were tall tales of a single fleet of 'death ships' spreading the disease along the Mediterranean and far up the Atlantic coast. Many people refused to purchase the new season's spices from the Levant, fearing they might contract plague from them. Whilst they seem fanciful today, these rumours show the anxiety which then prevailed. Moreover, they tell us that plague and commerce had become closely intertwined.

Within two years of the initial outbreaks in Europe, merchant vessels had carried the plague along the Atlantic coast and into the Baltic and North Seas, reaching as far north as the Faroe Islands. In all these places, the disease found a hospitable environment. Most people lived in dwellings that were crawling with rats, whose fleas were subsequently to convey the disease to humans. The black rats which lived in close proximity to humans – unlike the less domesticated, indigenous brown rats – were themselves a legacy of trade with the Orient. They had arrived in Europe from the Levant, having probably originated even further east, in the rainforests of Burma and India. Infection and re-infection of local rodents by ship-borne rats and fleas were to be the major source of plague epidemics in most European ports and, although these connections were unknown at the time, merchant vessels were often held responsible for the arrival of plague. It was also known that plague travelled inland along the routes regularly traversed by merchants, such as major rivers like the Rhône, Loire, Rhine and Po, or via overland tracks like those used by Italian traders to cross the Alps into Austria and Central Europe. Pestilence connected the commercial centres of Europe like dots in a child's puzzle. A few major trading cities, such as Milan, managed to escape, but the association between disease and commerce was underscored repeatedly by the vulnerability of places which regularly received goods from the East.

Many of the goods purchased by traders in the Levant came from the interior of Asia. Although the disintegration of the Mongol Empire temporarily disrupted overland trade, it was revived during the fifteenth century by the Turco-Mongol rulers who controlled most of the region. As a result, silks, metals and other manufactured goods continued to be exported from China to South-West Asia. Europeans were marginal to this trade – especially after the conquest of Constantinople by the Ottomans in 1453 – but they were able to purchase Asian goods from enclaves in the Ottoman dominions. Plague-bearing fleas encased in cloth, grain and other produce could easily have been carried over long distances from Central Asia to the Crimea and from there, on rats, by merchant vessels to the Middle East, North Africa and Europe. In time, the Levant and Egypt came to be regarded as 'seats' of pestilence in their own right. If the disease was not actually endemic there, it occurred with sufficient frequency to identify the region as a major source of outbreaks in Europe. European physicians and natural historians enshrined this belief in their writings and it informed the precautions which some of the Mediterranean states subsequently took against infection.

It is less easy to determine whether trade had any role in spreading plague to other parts of the world. Even after the fourteenth century, the epidemiological history of China remains an enigma. There were further reports of mass deaths during the fifteenth century, for example, but they were ascribed to a variety of causes, including wars, floods and famines, as well as to disease. In all probability, China was afflicted by mixed mortality crises such as those which ravaged many parts of Europe in the three centuries after the Black Death, conflict and natural disasters paving the way for plague and other epidemics. Trade may have played some role in the distribution of disease at this time but there is no firm evidence that this was the case. However, there were certainly parts of Asia whose distance from the principal overland trade routes probably protected them. There are no records of plague reaching Korea or Japan in the fourteenth or fifteenth centuries, nor is there any evidence that it was transmitted to South East Asia.

The case of the Indian subcontinent is more intriguing, for India was once supposed to be the source of plague. In 1344, a Moroccan traveller, Ibn Battuta, witnessed a great epidemic in south-east India after leaving the service of the Muhammad bin Tughluq, Sultan of Delhi (r.1325–51). Some later writers took it that Ibn Battuta was referring to plague, and speculated that the disease later reached Central Asia from India. However, there is no good reason to suppose that the disease described by Ibn Battuta was plague, nor do there appear to be other accounts of plague-like diseases in India at this time. In some ways, it is surprising that India was spared the ravages of plague, especially in view of the many commercial ties which then existed between the subcontinent and Central Asia. Yet it is possible that the great cold of the mountain passes which separated India from the rest of Asia blocked the transmission of infected hosts and vectors. Of course, much would have depended on when plague was present on the northern and western side of the mountains, for if it had appeared there in summer there would have been no such impediment.

Over the next two centuries, there were further reports of epidemics in India, some of which might well have been plague. In 1443 there was an epidemic in which Sultan Ahmed I lost much of his army to ta'un, the Arabic term for a disease which closely resembles plague. In the 1590s there are also accounts of pestilence causing great mortality after famines, although this was referred to by the more generic term waba, meaning simply 'epidemic', and was just as likely to have been anthrax or typhus as plague in the modern sense of the term. But after the Mughal conquests and the establishment of Portuguese colonies during the sixteenth century, reports of plague-like diseases become more frequent. A deadly 'bubonic fever', known to the Portuguese as carazzo, was often reported along the northern coast of the Arabian Sea, afflicting Indian ports such as Bassein, Surat and Daman during the 1690s. The ravages of ta'un were recorded in Goa in 1681, Gujarat between 1681 and 1690, the Deccan in 1689, and in Bombay in 1689–90 and 1702. These epidemics probably originated in trade between India and Arabia or the Persian Gulf, for some later outbreaks in western India appear to have followed the same route, the plague returning with traders in cotton textiles.

Such a scenario is plausible in view of the vigorous trade which then existed between western India and the Persian Gulf; a trade conducted largely, though not exclusively, by Indians. Textiles came not only from Western India but also from further south. Cotton goods made in the Coromandel region, for example, were often taken overland from there to ports such as Surat, from where they were shipped across the Arabian Sea. These complex trade routes may have allowed plague to extend into the interior of India, especially as there was an upsurge in plague in nearby Persia from the 1570s and further epidemics throughout the next century. Another route by which plague may have entered India was overland. The memoirs of the Mughal Emperor Jahangir (r.1605–27), or Tuzuk-i-Jahangiri, refer to a great plague in northern India between 1616 and 1619, which raged in the vicinity of Lahore before moving south-eastwards to affect Agra and Delhi. Its symptoms included buboes in the armpits and groin and there were reports of the death of rodents preceding that of humans. Jahangir was also told of an epidemic (waba) to the north, in the mountainous region of Kashmir. Although the emperor dismissed some of the wilder opinions on the causes of these northern epidemics, the reports suggest a pathway of infection between the north Indian plains and trade routes with Central and Western Asia. If plague appeared at the right season, it is conceivable that it could have passed through the mountains with caravans from the north.

The connection between trade and the spread of plague is therefore plausible if not always incontrovertible. With this element of doubt in our minds it is important to take account of the view – expressed by some historians and biologists – that the Black Death and some later outbreaks could not have been caused by plague. One problem in making a match between plague then and now is that the Black Death travelled quickly: the French historian J.-N. Biraben calculated that it moved at an average of four kilometres per day, faster than some more recent epidemics of plague. Other aspects of plague epidemiology also seem to be inconsistent, as do certain descriptions of symptoms. It is distinctly possible that some of the plague epidemics reported in the past were caused by different diseases or by a combination of infections. And yet, it seems likely that the core of these epidemics – at least those which occurred in Europe and the Middle East – was plague as we know it. In Arabian and Persian sources, many of the epidemics were known by the specific term ta'un, rather than the generic waba. Similarly, in Europe, the words pestis, peste and 'plague' came to have a fairly precise meaning which was often used to differentiate the disease from other epidemic fevers. Physicians sometimes speculated that plague might be related to other maladies but they generally regarded it as relatively distinct, on account of its characteristic swellings or buboes. The description of these and other plague symptoms became more detailed and consistent over time. Compelling evidence for the presence of plague in medieval and early modern Europe is also provided by analysis of ancient DNA, which shows that many medieval and early modern 'plague' victims were infected by Yersinia pestis. Nevertheless, plague has clearly behaved in different ways over time, perhaps as a result of genetic mutation or of the various social and economic conditions in which epidemics have developed.

The more important question, perhaps, is how these epidemics were understood by contemporaries. What did they think caused them and what action, if any, did they take to prevent them? As might be expected, many people interpreted the arrival of plague in religious terms, attributing it to a vengeful deity; others blamed itinerant groups and ethnic minorities, especially the Jews. Explanations were diverse and often ephemeral, yet some persisted over time. There was a pervasive and enduring understanding of what we might term 'contagion', of the transmission of plague by people and merchandise. Although such notions were instinctive and rudimentary, they were the basis on which governments acted to combat plague, isolating the sick and restricting the movement of merchants and their goods. Such measures date back to the Ordinances of Pistoia in 1348, which forbade access to persons from infected areas and to anyone carrying linen or woollen cloth. Similar dictates were issued in other Italian cities. In Venice, for example, a sanitary council was established in 1348 with powers to isolate infected ships, goods and people on an island in the lagoon. As the main point of entry for the profitable traffic with Asia, Venice was normally the first European port to receive vessels carrying goods from the Levantine coast. After the city experienced fresh visitations of plague, it developed a permanent infrastructure for public health, culminating in the formation of a Council of Health in 1485, which drew up detailed regulations governing maritime trade and the management of lazarettos to contain the sick and those suspected of infection.

(Continues...)

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Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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Table of Contents

Abbreviations and acronyms vi

List of illustrations ix

Preface and acknowledgements xii

1 Merchants of death 1

2 War by other means 24

3 The evils of quarantine 50

4 Quarantine and the empire of free trade 80

5 Yellow fever resurgent 107

6 A stranglehold on the East 139

7 Plague and the global economy 174

8 Protection or protectionism? 211

9 Disease and globalization 247

Conclusion: Sanitary pasts, sanitary futures 276

Notes 282

Bibliography 332

Index 364

What People are Saying About This

William Bernstein

'Mankind has for millennia conveyed trade goods over vast distances, and along with them, deadly pathogens. Understanding the resultant epidemics and, critically, the response to them requires a mastery of pathophysiology,  propulsion technology, and political economy, and Contagion seamlessly synthesizes all three. This compact, compelling volume is essential reading for the concerned citizen of an increasingly connected, interdependent, and vulnerable planet.'—William J. Bernstein, author of A Splendid Exchange: How Trade Shaped the World

Michael Worboys

A book of impressive range and originality, well researched and well written.—Michael Worboys, co-author of Mad Dogs and Englishmen: Rabies in Britain, 1830–2000

Paul Slack

'Mark Harrison brings unrivalled expertise as a medical historian to his masterly account of how contagion and commerce have marched ahead together over the centuries. He shows that the weapons we use against the spread of infection have grown ever more sophisticated without becoming any more effective. Far from protecting mankind in general, they have often been manipulated to give extra advantage to rich over poor nations. This is genuinely global history, powerful and provocative, and a work of remarkable range and originality.'—Paul Slack, author of From Reformation to Improvement: Public Welfare in Early Modern England

Stephen Porter

'Mark Harrison's fascinating and thoroughly researched study traces the connections between trade and infectious diseases, exploring the diplomatic and political ramifications of quarantine and other measures taken to limit the spread of disease. It shows that such measures could be applied competitively for economic gain, as well as for prevention. A discussion of the impact of globalisation brings the subject entirely up to date. The book provides a complete and satisfying account of a complex series of issues, which have not been tackled so comprehensively before.'—Stephen Porter, author of The Great Plague 

Editorial Reviews

…offers a fresh historical overview of the interplay between disease and commerce, politics and international diplomacy. The author, Mark Harrison, is a professor of medical history at Oxford University and knows this material inside out. Both his scholarship and his reach are impressive.

The New York Times - Bryan Burrough

Recent scares relating to food-borne illnesses such as SARS, swine flu, bird flu, and mad cow disease have focused attention on the tension between public safety and global trade, but as Harrison, an Oxford professor of the history of medicine, points out, that has almost always been the case. In his exhaustively researched account, he illuminates the connection between commerce and the spread of disease dating back to the 14th century when the plague traveled the trade routes between Europe and Asia. What followed, through cholera outbreaks and yellow fever epidemics, has been a centuries-old effort to manage the spread of disease through regulation and restrictions, and a history of using these restrictions to gain market dominance. As awareness of how disease spread met public outcry against the inhumanity of quarantines, global trade demanded global solutions, spurring the growth of international regulatory bodies. But as recent violations of World Trade Organization and World Health Organization guidelines during the swine flu scare have evidenced, efforts to manipulate public health policy for economic benefit remain unchanged. While the overabundance of dates and names and a heavy academic tone make for a daunting read, the story is a compelling one. Agent: Clare Alexander, Aitken Alexander Associates (UK). (Jan.)

Publishers Weekly

'Mankind has for millennia conveyed trade goods over vast distances, and along with them, deadly pathogens. Understanding the resultant epidemics and, critically, the response to them requires a mastery of pathophysiology,  propulsion technology, and political economy, and Contagion seamlessly synthesizes all three. This compact, compelling volume is essential reading for the concerned citizen of an increasingly connected, interdependent, and vulnerable planet.'—William J. Bernstein, author of A Splendid Exchange: How Trade Shaped the World

William Bernstein

'Mark Harrison's fascinating and thoroughly researched study traces the connections between trade and infectious diseases, exploring the diplomatic and political ramifications of quarantine and other measures taken to limit the spread of disease. It shows that such measures could be applied competitively for economic gain, as well as for prevention. A discussion of the impact of globalisation brings the subject entirely up to date. The book provides a complete and satisfying account of a complex series of issues, which have not been tackled so comprehensively before.'—Stephen Porter, author of The Great Plague 

Stephen Porter

"A book of impressive range and originality, well researched and well written."—Michael Worboys, co-author of Mad Dogs and Englishmen: Rabies in Britain, 1830–2000

Michael Worboys

'Mark Harrison brings unrivalled expertise as a medical historian to his masterly account of how contagion and commerce have marched ahead together over the centuries. He shows that the weapons we use against the spread of infection have grown ever more sophisticated without becoming any more effective. Far from protecting mankind in general, they have often been manipulated to give extra advantage to rich over poor nations. This is genuinely global history, powerful and provocative, and a work of remarkable range and originality.'—Paul Slack, author of From Reformation to Improvement: Public Welfare in Early Modern England

'Mankind has for millennia conveyed trade goods over vast distances, and along with them, deadly pathogens. Understanding the resultant epidemics and, critically, the response to them requires a mastery of pathophysiology,  propulsion technology, and political economy, and Contagion seamlessly synthesizes all three. This compact, compelling volume is essential reading for the concerned citizen of an increasingly connected, interdependent, and vulnerable planet.'—William J. Bernstein, author of A Splendid Exchange: How Trade Shaped the World

'Mark Harrison's fascinating and thoroughly researched study traces the connections between trade and infectious diseases, exploring the diplomatic and political ramifications of quarantine and other measures taken to limit the spread of disease. It shows that such measures could be applied competitively for economic gain, as well as for prevention. A discussion of the impact of globalisation brings the subject entirely up to date. The book provides a complete and satisfying account of a complex series of issues, which have not been tackled so comprehensively before.'—Stephen Porter, author of The Great Plague 

"A book of impressive range and originality, well researched and well written."—Michael Worboys, co-author of Mad Dogs and Englishmen: Rabies in Britain, 1830–2000

From the Publisher

An important book for a wide audience.”—Choice

Choice

'Mark Harrison brings unrivalled expertise as a medical historian to his masterly account of how contagion and commerce have marched ahead together over the centuries. He shows that the weapons we use against the spread of infection have grown ever more sophisticated without becoming any more effective. Far from protecting mankind in general, they have often been manipulated to give extra advantage to rich over poor nations. This is genuinely global history, powerful and provocative, and a work of remarkable range and originality.'—Paul Slack, author of From Reformation to Improvement: Public Welfare in Early Modern England

Paul Slack

"A book of impressive range and originality, well researched and well written."—Michael Worboys, co-author of Mad Dogs and Englishmen: Rabies in Britain, 1830–2000

MIchael Worboys

Harrison (history of medicine, Oxford Univ.; The Medical War: British Military Medicine in the First World War) traces the history of contemporary plagues back to the 14th century and ties them neatly into the history of trade and human mobility. Yellow fever, cholera, the plague, and anthrax all make an appearance in the world travels and wars that make up the course of human history. A particularly interesting chapter on quarantine talks about how it has been used throughout modern history as both a legitimate attempt to stop the spread of disease and a commercial tool to seize others’ businesses. Ending with a discussion of mad cow disease, SARS, and bird flu, Harrison astutely points out that although some things have changed in our ability to predict and defend against pandemics, globalization and competition for markets will always be a factor.

Verdict Though this book is well written, most general readers won’t be fascinated by the subject enough to stick with it. Recommended for scholarly and professional readers only.—Elizabeth A. Williams, Manatee Cty. Lib. Syst., Bradenton, FL

(c) Copyright 2013. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.

Library Journal

AIDS probably began in Africa and the influenza of 1918 in Europe. Modern transportation spread them across the world, but pre-modern transportation did the same with surprising efficiency, according to this detailed, scholarly examination of the politics of pandemics. Harrison (History of Medicine/Oxford Univ.; Medicine and Victory: British Military Medicine in the Second World War, 2009, etc.) begins in the 14th century with bubonic plague, carried west from central Asia by sea and land commerce. He also examines yellow fever, carried from Africa by slaves after 1500. No other disease appears until the author reaches the 19th century, when cholera first appeared. Steam-powered ships, railways and then airlines accelerated the spread of human, as well as plant and animal, diseases, leading to our century's increasing collection of oddities, from SARS to mad cow disease to AIDS to the mundane but often-deadly influenza, hepatitis and malaria. Until a century ago, quarantines seemed vital, so the subject dominates the book's first half. Traders hated to lose money, and their governments were often sympathetic, so science--even when correct--still often took a back seat to national interests. Thus, during the mad cow disease panic, countries prohibited beef imports with an eye to eliminating competition with local ranchers. Harrison devotes little time to the diseases themselves, focusing more on public health tactics (usually useless until the late 19th century) and how governments and traders responded. While a valuable contribution to the history of epidemiology, the book contains more than average readers may want to know about sanitary laws over the centuries and the accompanying diplomatic and medical quarrels.

Kirkus Reviews