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Colonialism and Psychiatry (review)

study raises many questions concerning why plague spread in different ways at different times over the course of the first half of the century. For example, Echenberg notes that in 1944 Georges Girard, who had directed the Madagascar plague institute for ten years, was dispatched to Senegal to evaluate antiplague measures. Among the questions Girard raised were: “Why was it that the plague followed the railway north but rarely east and never south? Why did plague never reach other colonies linked to Senegal by railway? Could it be linked to the flea populations found elsewhere?” (pp. 240–41). To these questions one might add, “Why did the plague never return to Senegal after 1945?” Yet Echenberg does not pursue such questions very far. Admittedly, the evidence needed to answer them is limited. Nonetheless, a more extended exploration of these epidemiologic questions might have increased the book’s value for those concerned with understanding more-contemporary disease processes in Senegal, as well as for historians of disease.