This book’s many strengths include its extensive use of primary sources, especially medical authorities, and a thorough bibliography. It offers a powerful model of interdisciplinary argument, balancing literary criticism, cultural theory, and history of medicine in each chapter, which would make it especially useful in the classroom. Some chapters--such as the one on Romantic medical geography or colonial military disease narratives--are more historical.

One of the book’s most compelling chapters gains its force from its historical argument, although it includes literary analysis as well. Bewell articulates the toll of disease on colonial soldiers and shows that the order or decision to go abroad was, more often than not, a death sentence. He argues persuasively that the colonial front thus became useful in domestic politics, since the most troublesome demographic--the poor young white male--was disproportionately likely to be sent abroad as a soldier or sailor (voluntarily or through impressment) and never to return.

Another chapter offers a detailed examination of how debates over the 1832 Reform Bill and attempts to reform the sanitary conditions among poor urban workers drew on fears of the Asiatic cholera and perceived similarities between the disease-ridden, filthy living conditions in both cases. Other chapters feature a more forceful literary argument, as in his brilliant use of climatological theory to explicate Jane Eyre. The book also discusses genre and disease, including the romantic tendencies of a colonial discourse and Keats’s attribution of his feverishness to his overindulgence in poetry. In each chapter, Bewell offers a fresh and often unexpected combination of texts and issues to analyze--Coleridge, laudanum, and cholera?--with provocative, and productive, results.

Bewell uses Sander Gilman, Mary Douglas, Julia Kristeva and others to theorize the social meaning of colonial disease and its pressure on cultural boundaries. He adapts the theories of Mary Louise Pratt and Homi Bhabha to discuss the pathogenic exchange in the contact zone and how it affected both colonizers and native populations. The tropical invalid, for example, returns home to escape the pitiless barrage of tropical disease on his British body, "naturally" unsuited to the torrid climate, but he finds he has lost the ability to withstand Britain’s own changeable weather; he has in fact imported his so-called "colonial" ill health. As a return of the repressed, the hybridized tropical invalid thus makes visible the dangers of colonization and the threat that Britain may lose its own native identity.

Although the book’s argument is consistently relevant to an understanding of West-East relations and the colonialist residue in contemporary health policy and politics, the chapters on Percy Bysshe Shelley and Mary Wollstonecraft Shelley are the most explicit in drawing connections between social patterns and colonial disease, both in the Romantic era and today, as Bewell shows how the Shelleys argued that political and social norms made any given region "healthy" or "sick."