Book Review: Chase-Levenson “The Yellow Flag”

17 Aug 2020

19th Century, Book Reviews, Britain, europe, Great Britain, medicine, Mediterranean, Mediterranean Sea

by Meaghan Walker

Alex Chase-Levenson, The Yellow Flag: Quarantine and the British Mediterranean World, 1780-1860. Cambridge University Press, 2020. ISBN: 9781108485548, Hardback,

By Sarah E. Naramore, Ph.D.

The Yellow Flag: Quarantine and the British Mediterranean World, 1780-1860 is a timely book. Far more timely, one can only assume, than Alex Chase-Levenson imagined. As a text firmly rooted in a distinct time and place – the Mediterranean Sea in the early nineteenth century – this might be surprising. However, without drawing unfair or sloppy parallels, the book’s central themes and arguments about the purpose, experience, and consequences of a European sanitary system are central to any pandemic cast as belonging to the “other.” For decades, Chase-Levenson argues, local boards of health from Spain to the Black Sea actively worked together forming a system of quarantine to prevent the unique threat of plague (and occasionally yellow fever and cholera).

The consequences of that systemic approach were profound on Britain as it emerged as a Mediterranean power and are of special interest to historians studying the histories of medicine, the Mediterranean, or the nineteenth-century nation-state.

The book focuses on what Chase-Levenson terms the British Mediterranean world. This world was shaped not only by British commercial interests or colonial possessions (notably Gibraltar, Malta, and the Ionian Islands) but by the European quarantine system which policed the movement of goods and people. This approach challenges previous discussions about quarantine which typically painted liberal nineteenth-century Britain as opposed to the practice and political characterizations of the period which privileged the nation-state over transnational partnerships. The practice of quarantine in British ports and collaboration across even hostile borders during the Napoleonic Wars break down these clean narratives.

The Yellow Flag presents its historiographic interventions in a primarily thematic format and is organized into four parts and nine chapters. Part I “Mediterranean Currents” defines the British Mediterranean world, describes the general outlines of quarantine, and Britain’s place within it at the end of the eighteenth century. Part II “Lazarettos, Health Boards, and the Building of a Biopolity” and Part III “Imagining the Plague” focus on the practices of quarantine and how it constructed a world in which “Europe” was understood as healthy and the “East” as unsanitary and dangerous. For the first half of the nineteenth century, quarantine was universally in operation and applied to both humans and cargo. Finally, part IV “Old Patterns, New Cordons” discusses the decline of quarantine by the mid-nineteenth century between the new threat of cholera, adoption of lazarettos in Egyptian and Ottoman ports, and the end of frequent bubonic plague outbreaks in the Eastern and Southern Mediterranean.

While the specific topics vary from political and medical debates and excellent discussion of the lived experience of quarantine for travelers (Chapter 4 “A Sort of Hospital-Prison”) the concept Chase-Levenson consistently returns to is that of quarantine as a European-wide system This is most striking in the context of the Napoleonic Wars during which time military movements and imperial rivalries took a back seat to preventing the import of plague to Europe. In the introduction, he addresses events in 1801 when France’s Armée d’Orient returned defeated from Egypt. The Marseilles lazaretto was prepared for the most ambitious quarantine effort of the era keeping an entire army isolated, feed, and moderately healthy for weeks. Chase-Levenson marks this as “a watershed moment in the history of the expansion of the modern state” (Chase-Levenson, p.22). Quarantine, as it functioned in the early nineteenth century, helped create an idea of “Europe” based on an assumed shared biological state rather than a political or religious union. The “East” became dirty and diseased for harboring plague and those touched by the biological dangers of North African and the Ottoman Empire were in a liminal space. He presents the lazaretto on the border of East and West and made that border physically real along with a narrative of Ottoman decline “proven” by their continued struggles with plague. The drive to find the line between sickness and health is one that we can see playing out in the Covid era. In 2020, as in 1820, Europe is drawing shared lines and policing the entry of people from regions considered diseased and outside; the modern successor to the cordon sanitare.¹ The lazaretto may be gone, but parts of the system remain.

Chase-Levenson’s book asks readers to consider the history of Britain’s Mediterranean Empire through the lens of quarantine. In doing so, he is able to tie together issues ranging from trade practices to othering the East to detailed medical debates on the nature of disease. The largest of these were the debates over the nature of contagion. He correctly notes that while most physicians were “contingent contagionists” the arguments over whether or not diseases were spread by human contact or some other means shaped the logic of lazarettos and the growing sanitary movement of the nineteenth century. The Yellow Flag places these debates in a larger context although may not be as technically detailed as some historians of science and medicine would expect. This does not, however, take away from the text’s contributions to a growing historiography of quarantine and public health in the wider British Empire. With this kind of scope, numerous scholars and students will find Chase-Levenson’s work interesting and useful from political, medical, and maritime perspectives.

Sarah E. Naramore is an Assistant Professor of History at Northwest Missouri State University.