James L. A. Webb, Jr is Professor of History at Colby College, Maine. His recent books include The Long Struggle against Malaria in Tropical Africa (Cambridge, 2014) and Global Health in Africa (2013).

'James Webb's The Guts of the Matter delves deep into how and where people have relieved themselves, how this has been related to one group of parasitic diseases and how important this has been - and still is - to developments around the world. It changes readers' outlook on toilets and life.' Iris Borowy, Shanghai University

• Introduction; 1. Pathogens and parasites; 1.1 Intestinal viruses, protozoa, and bacteria; 1.2 Intestinal worms; 1.3 Determinants of disease transmission; 1.4 Changing perspectives on childhood diarrheal diseases; 1.5 The microbiome; 1.6 Historical epidemiology and contemporary interventions; 2. Early change; 2.1 Rethinking the first epidemiological transition; 2.2 Patterns of vulnerability; 2.3 Zones of infectious intestinal disease; 2.4 Eurasian attitudes toward human waste; 2.5 Early urban sanitation; 3. Diffusion and amplification; 3.1 The early diffusion of infectious intestinal disease to the Americas; 3.2 The uses of human and animal wastes; 3.3 Preindustrial urban sanitation redux; 3.4 Urban crisis and the emergence of public health movements; 3.5 Global cholera; 4. Innovations; 4.1 The limited practical import of discoveries in epidemiology and bacteriology; 4.2 Early sewerage; 4.3 Death by sewage; 4.4 The 'dry earth' and 'tub-and-pail' systems; 4.5 Sewage farming and trenching; 4.6 Flies, household hygiene, and contaminated milk; 4.7 The typhoid fever vaccine; 4.8 Water filtration and disinfection; 5. Adoptions and adaptations; 5.1 Water and sanitation in Latin America; 5.2 European colonial military sanitation; 5.3 Water and sanitation in East Asia; 5.4 Water and sanitation in tropical Africa; 5.5 Water and sanitation in India; 5.6 Global sanitation at mid-twentieth century; 6. The struggle against hookworm disease; 6.1 Early control programs; 6.2 The Rockefeller Sanitary Commission for the Eradication of Hookworm Disease; 6.3 The Rockefeller Foundation's international programs; 6.4 International Health Board (1916–1927); 6.5 Anemia as a diagnostic conundrum; 6.6 The unmet challenges of human feces disposal; 6.7 Assessments of the hookworm campaigns; 7. An era of optimism; 7.1 Sanitary practices: soap, refrigeration, and screens; 7.2 Vaccines against poliomyelitis; 7.3 The revolution of oral rehydration therapy; 7.4 The World Health Organization and sanitation initiatives; 7.5 The first and second United Nations development decades (1960s–1970s); 7.6 The international drinking water and sanitation decade (1980s); 8. Global health and infectious intestinal disease; 8.1 The infant formula controversy; 8.2 The child survival revolution; 8.3 A new campaign to eradicate poliomyelitis; 8.4 Total community led sanitation; 8.5 Open defecation and the struggle for modernity; 8.6 Deworming the world; 8.7 Rotavirus vaccine; 8.8 The seventh cholera pandemic; 8.9 Infectious intestinal disease today; Conclusion; Bibliography.

James L. A. Webb, Jr is Professor of History at Colby College, Maine. His recent books include The Long Struggle against Malaria in Tropical Africa (Cambridge, 2014) and Global Health in Africa (2013).

'James Webb's The Guts of the Matter delves deep into how and where people have relieved themselves, how this has been related to one group of parasitic diseases and how important this has been - and still is - to developments around the world. It changes readers' outlook on toilets and life.' Iris Borowy, Shanghai University

• Introduction; 1. Pathogens and parasites; 1.1 Intestinal viruses, protozoa, and bacteria; 1.2 Intestinal worms; 1.3 Determinants of disease transmission; 1.4 Changing perspectives on childhood diarrheal diseases; 1.5 The microbiome; 1.6 Historical epidemiology and contemporary interventions; 2. Early change; 2.1 Rethinking the first epidemiological transition; 2.2 Patterns of vulnerability; 2.3 Zones of infectious intestinal disease; 2.4 Eurasian attitudes toward human waste; 2.5 Early urban sanitation; 3. Diffusion and amplification; 3.1 The early diffusion of infectious intestinal disease to the Americas; 3.2 The uses of human and animal wastes; 3.3 Preindustrial urban sanitation redux; 3.4 Urban crisis and the emergence of public health movements; 3.5 Global cholera; 4. Innovations; 4.1 The limited practical import of discoveries in epidemiology and bacteriology; 4.2 Early sewerage; 4.3 Death by sewage; 4.4 The 'dry earth' and 'tub-and-pail' systems; 4.5 Sewage farming and trenching; 4.6 Flies, household hygiene, and contaminated milk; 4.7 The typhoid fever vaccine; 4.8 Water filtration and disinfection; 5. Adoptions and adaptations; 5.1 Water and sanitation in Latin America; 5.2 European colonial military sanitation; 5.3 Water and sanitation in East Asia; 5.4 Water and sanitation in tropical Africa; 5.5 Water and sanitation in India; 5.6 Global sanitation at mid-twentieth century; 6. The struggle against hookworm disease; 6.1 Early control programs; 6.2 The Rockefeller Sanitary Commission for the Eradication of Hookworm Disease; 6.3 The Rockefeller Foundation's international programs; 6.4 International Health Board (1916–1927); 6.5 Anemia as a diagnostic conundrum; 6.6 The unmet challenges of human feces disposal; 6.7 Assessments of the hookworm campaigns; 7. An era of optimism; 7.1 Sanitary practices: soap, refrigeration, and screens; 7.2 Vaccines against poliomyelitis; 7.3 The revolution of oral rehydration therapy; 7.4 The World Health Organization and sanitation initiatives; 7.5 The first and second United Nations development decades (1960s–1970s); 7.6 The international drinking water and sanitation decade (1980s); 8. Global health and infectious intestinal disease; 8.1 The infant formula controversy; 8.2 The child survival revolution; 8.3 A new campaign to eradicate poliomyelitis; 8.4 Total community led sanitation; 8.5 Open defecation and the struggle for modernity; 8.6 Deworming the world; 8.7 Rotavirus vaccine; 8.8 The seventh cholera pandemic; 8.9 Infectious intestinal disease today; Conclusion; Bibliography.

James L. A. Webb, Jr is Professor of History at Colby College, Maine. His recent books include The Long Struggle against Malaria in Tropical Africa (Cambridge, 2014) and Global Health in Africa (2013).

'James Webb's The Guts of the Matter delves deep into how and where people have relieved themselves, how this has been related to one group of parasitic diseases and how important this has been - and still is - to developments around the world. It changes readers' outlook on toilets and life.' Iris Borowy, Shanghai University

• Introduction; 1. Pathogens and parasites; 1.1 Intestinal viruses, protozoa, and bacteria; 1.2 Intestinal worms; 1.3 Determinants of disease transmission; 1.4 Changing perspectives on childhood diarrheal diseases; 1.5 The microbiome; 1.6 Historical epidemiology and contemporary interventions; 2. Early change; 2.1 Rethinking the first epidemiological transition; 2.2 Patterns of vulnerability; 2.3 Zones of infectious intestinal disease; 2.4 Eurasian attitudes toward human waste; 2.5 Early urban sanitation; 3. Diffusion and amplification; 3.1 The early diffusion of infectious intestinal disease to the Americas; 3.2 The uses of human and animal wastes; 3.3 Preindustrial urban sanitation redux; 3.4 Urban crisis and the emergence of public health movements; 3.5 Global cholera; 4. Innovations; 4.1 The limited practical import of discoveries in epidemiology and bacteriology; 4.2 Early sewerage; 4.3 Death by sewage; 4.4 The 'dry earth' and 'tub-and-pail' systems; 4.5 Sewage farming and trenching; 4.6 Flies, household hygiene, and contaminated milk; 4.7 The typhoid fever vaccine; 4.8 Water filtration and disinfection; 5. Adoptions and adaptations; 5.1 Water and sanitation in Latin America; 5.2 European colonial military sanitation; 5.3 Water and sanitation in East Asia; 5.4 Water and sanitation in tropical Africa; 5.5 Water and sanitation in India; 5.6 Global sanitation at mid-twentieth century; 6. The struggle against hookworm disease; 6.1 Early control programs; 6.2 The Rockefeller Sanitary Commission for the Eradication of Hookworm Disease; 6.3 The Rockefeller Foundation's international programs; 6.4 International Health Board (1916–1927); 6.5 Anemia as a diagnostic conundrum; 6.6 The unmet challenges of human feces disposal; 6.7 Assessments of the hookworm campaigns; 7. An era of optimism; 7.1 Sanitary practices: soap, refrigeration, and screens; 7.2 Vaccines against poliomyelitis; 7.3 The revolution of oral rehydration therapy; 7.4 The World Health Organization and sanitation initiatives; 7.5 The first and second United Nations development decades (1960s–1970s); 7.6 The international drinking water and sanitation decade (1980s); 8. Global health and infectious intestinal disease; 8.1 The infant formula controversy; 8.2 The child survival revolution; 8.3 A new campaign to eradicate poliomyelitis; 8.4 Total community led sanitation; 8.5 Open defecation and the struggle for modernity; 8.6 Deworming the world; 8.7 Rotavirus vaccine; 8.8 The seventh cholera pandemic; 8.9 Infectious intestinal disease today; Conclusion; Bibliography.