In the imaginations of commentators, both Asian and European alike, disease and Southeast Asia have long held a close association. For Chinese officials posted to the southernmost regions of the T’ang empire, it was a fearful place of miasmas and malarial fevers. To many Europeans, Southeast Asia was, like tropical Africa, a “white man’s grave.” In the chronicles of the inhabitants of the region, the reality of disease merged with that of other calamities, in a world populated with spirits that held sway over human life. Aside from biomedical considerations, there are clearly important political and cultural dimensions to these links between region and disease. This essay will examine some of the factors that have given disease such a prominent place in Southeast Asian history.

The Region

Following Anthony Reid (1988), Southeast Asia will here be taken to refer to the area of Asia lying between the southern regions of China and the northwestern extremities of New Guinea. This region encompasses both the land areas of mainland Asia draining the eastern Himalayas, characterized by large rivers and plains, and the many volcanic islands lying between the Pacific and Indian oceans. A feature of the region is its high temperatures and monsoonal rainfalls, which, prior to recent times, supported an abundant flora and fauna.

Human settlement also nourished in this environment from around 18,000 B.C., when the earliest hunter-gatherers are thought to have existed in the region (Higham 1989). Evidence suggests that village settlements developed from around the third or fourth millennium B.C., and more complex, centralized polities from the first century A.D. (Coedes 1975; Higham 1989).