Birsen Bulmuş’s book opens with a comparative observation: The Ottoman Empire saw its first quarantines in the second half of the nineteenth century, long after their establishment in Europe. The conventional historiography of Ottoman medicine views the late introduction of quarantines as evidence of a passive, fatalistic attitude toward disease that persisted through the nineteenth century. Bulmuş sees it differently: in her view, Ottoman ideas about plague and its control were not much different from those in Europe at the time. What differed were the interest groups that wanted quarantines not only to control plague, but to limit the movement of cotton and other internationally trade commodities. In chapter 2, Bulmuş examines Ottoman plague treatises. Some writers indeed saw resignation to fate as the only proper response to epidemic; but there was also a “revisionist” strand of Ottoman thought, based on Islamic sources, that advocated more proactive measures. By focusing on this revisionist writing, which goes as far back as the turn of the sixteenth century, Bulmuş successfully refutes the traditional view that, “Islamic societies in general reacted to the plague passively” (p. 9). Her analysis of Hamdan's 1836 advocacy of quarantine reform in the Ottoman Empire shows that the quarantine reforms were not inspired and initiated by European medical literature (p. 10).

Chapter 3 demonstrates the role of economic interests in shaping quarantines in Europe. This part of the study might have benefited from a discussion of other potential explanations for the Ottoman approach; in particular, it does not explain why the Ottomans would not similarly establish quarantines during their active presence in the Indian Ocean and the Mediterranean in the sixteenth century. The Ottoman Empire was less urbanized and thus less susceptible to the spread of infectious disease, for example. She might also have considered why the Ottomans lacked the broader desire to establish mechanisms that require great social control, as quarantines do. That is, the author might have pushed harder to establish just why the Ottomans “remained outside such state-building movements, mechanical and social disciplinary ideologies” (p. 93).

Timing is important to Bulmuş’s argument. She argues that emerging mercantilist concerns led England to introduce quarantines as early as the sixteenth century. This view resonates with the secondary literature that juxtaposes European mercantilism with Ottoman “provisionism,” but it neglects alternative explanations for the observed “divergence” in thinking about disease. As early as the late fourteenth century, the Italian city-states saw new plague treatises emphasizing medical remedies and preventive measures (See S. K. Cohn. “The Black Death: End of a Paradigm.” The American Historical Review 107 [June 2002]: 703–38). Bulmuş mentions these early Italian quarantines, but argues that “[t]he gap between the European and Ottoman Muslim perceptions of plague only occurred between 1600 and 1800 with the rise of mercantilism and overseas commercial development in north-western Europe” (pp. 39–40). She supports this argument with the claim that early modern medical thinkers did not generally accept notions such as “contagious disease” until the sixteenth century (pp. 41–43). Yet, as Cohn points out, a new generation of plague doctors, explicitly critical of the ancients in the art of healing, emerged in Italy as early as second half of the fourteenth century. This evidence does not contradict Bulmuş’s main thesis that, “Europeans alone reacted to plague with measures based on experience and scientific observation” (p. 47). One could still wonder, however, whether mercantilist concerns in the European context came with other changes associated with the Renaissance.

Chapter 5 uses a wide variety of British and Ottoman sources to show how Ottoman reformers advocated quarantines in the nineteenth century in ways that are both similar to and different from the European experience. Ottomans justified quarantines as a tool for promoting economic development, just as their European precursors (pp. 98, 125). Yet these efforts did not include efforts at social control, efforts the British adopted by using quarantines selectively against the poor. Only British writers committed to a free trade agenda (such as DeKay and Maclean) stressed ethnic, social, and religious differences (p. 125) in their discussions of the Ottoman quarantine.

The last two chapters provide a quick but evocative overview of the empire's eighty-year experiment in quarantines and sanitary administration. The British and French first established a medical inspection and quarantine system in the empire's Arab provinces. Local bureaucrats such as Kasım Izzeddin (the head of Ottoman sanitation efforts in the beginning of the twentieth century) adopted their methodologies in an attempt to avoid colonization and consolidate the empire in the provinces.

Bulmusş’s work sheds light on the complex process of ideational shift with the geopolitical context of the nineteenth century. Bulmuş shows that the evolving attitudes of Ottoman statesmen in the empire's last two centuries emerged within the context of a modernization project, shaped by economic interests, colonial pressures, and the tension between imperial legacies and nationalist movements. This book, while not a history of the plague or its epidemiology or demography, serves as a welcome rethinking of the view that differences between Ottoman and Western public health measures reflected cultural attitudes alone.