In this sweeping approach to the history of disease, historian J. N. Hays chronicles perceptions and responses to plague and pestilence over two thousand years of western history. Hays frames disease as a multi-dimensional construct, situated at the intersection of history, politics, culture, and medicine, and rooted in mentalities and social relations as much as in biological conditions of pathology.  He shows how diseases affect social and political change, reveal social tensions, and are mediated both within and outside the realm of scientific medicine.

Beginning with the legacy of Greek, Roman, and early Christian ideas about disease, the book then discusses many of the dramatic epidemics from the fourteenth through the twentieth centuries, moving from leprosy and bubonic plague through syphilis, smallpox, cholera, tuberculosis, influenza, and poliomyelitis to AIDS. Hays examines the devastating exchange of diseases between cultures and continents that ensued during the age of exploration. He also describes disease through the lenses of medical theory, public health, folk traditions, and government response. The history of epidemics is also the history of their victims.  Hays pays close attention to the relationships between poverty and power and disease, using contemporary case studies to support his argument that diseases concentrate their pathological effects on the poor, while elites associate the cause of disease with the culture and habits of the poor.