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Because of that quality which more than any other lends dignity to life: the in- stinct for happiness in understanding, — whether it be by intellectual or emotional perception, — which is the most incomprehensible of the attributes of mankind, and which neither the brutalities of individual nor the bru- RATS, LICE AND HISTORY 45 talities of national competition have ever succeeded in annihilating. Among the impractical quests of man, none has been more alluring than that concerning the origin of life.

Out of the mud of the Nile, by the heat of the sun, were engendered frogs, toads, snakes, and mice — for could one not see them oozing out of it in the warm months? The sacred, coprophagous scarabaeus was mysteriously fashioned out of balls of dung, and bees sprang from the putrefying cadavers of cattle. He was followed in the same thoughts by Anaximander and Xenophanes. Rain water was added by Anaxagoras, which carried down fertile seeds from the infinite spaces. There seems to have been a general agreement on mud. But, in addition, new ones were being constantly added from the synthesis of sun-warmed organic matter.

Parmenides, Empedocles, and Diogenes of Apollonia favoured mud and moist earth as the sources whence life sprang. Democritus, Epicurus, and their recorder, Lucretius, started something new. Everything on earth has life. The earth is the mother who, in her youth, gave birth to all living things — performing miracles of fecundity which gave origin to plants and animals and even to man.

But as she grew old much of her power was lost, and only trivial things like insects, reptiles, and other inferior be- ings were begotten from decaying organic matter, with the help of warm rain and sunlight. Archelaus believed that the putrefying spinal cords of animals and man were transformed into snakes. Diodorus, about 30 b. Vergil seems to have believed the old story about the origin of bees from the dead bodies of steers. With the influence of Christianity, there was of course a considerable change in some of the views.

All through the Middle Ages, the same type of rea- soning persisted. There was a little less naivete in some of the theories, but many others were more fantastic than anything antiquity was able to produce. The great physi- cian Avicenna believed that intestinal parasites were all produced from putrefying materials and moisture, and he completely accepted the origin of animals from properly combined elements. Lippmann credits him with the state- ment that, as the result of a thunderclap, an incomplete calf dropped to earth from the sky. The pious William of Auvergne, Bishop of Paris, was quite willing to believe that worms and frogs were produced in this way, but questioned the matter in connection with horses.

A remarkable tale that kept cropping up again and again until relatively modern times was the belief in the origin of wild ducks and geese from barnacles. These birds came and disappeared and were never seen to breed, so that their origin became the subject of much speculation. One of the stories traced to Saxo Grammaticus was to the effect that the little geese came out of shells which grew on trees in the Orkney Islands. The tale persisted until the latter part of the sixteenth century, when a Dutch sailor penetrated to the Arctic Ocean, where he observed and reported the nesting and breeding of the birds.

Similar to this tale of the barnacle geese is the story of de Mandeville, who, in his Travels, speaks of a tree which bore huge, melon-formed fruit of which he him- self had eaten, and in which, when it was opened, he discovered a lamb. The descriptions of travellers who began to pene- trate, in the late Middle Ages and early modem times, into all corners of the earth are responsible for innumerable stories of the same kind. The story of the vegetable lamb was not completely exploded until Linne, in the eight- eenth century, examined specimens of the various plants that were supposed to blossom as lambs.

The ideas of Paracelsus were, in regard to the origin of life, not materially different from those of his contem- poraries. However, the of Hippocrates was as- sociated with the Christian belief in the soul in explaining the manner in which God infused life into some of his creatures.

Bacon was a firm believer in spontaneous generation, and Harvey, in , must be regarded as the first who clearly opposed the older views with his famous Ornma ex Ovo. Kepler, wise as he was, believed that plants could grow out of the earth without ancestors, and fish could be produced by spontaneous generation in salt water, just as comets could arise in the skies. The honours are with Redi, though the conclusions are the same. Leibnitz, in , expresses the conviction that spon- taneous generation is impossible, and that neither plants nor animals could have originated from a chaos of putre- faction.

Leibnitz was frankly agnostic in other expressions on this problem, Descartes, who was familiar with the work of Leeuwen- hoek and of all other important naturalists of his time, gave little thought to the origin of living things, but speculatively hit the nail on the head by taking for granted that there may be a world of minute living things from which life of other kinds can develop by a sort of evolu- tion. Between the end of the eighteenth century and the be- ginning of the nineteenth, an accumulation of accurate observations began to limit the field of speculation, and, indeed, in surveying the history of the thoughts of men upon this problem, it is quite apparent that here — as in all sciences — there has been an inverse ratio between speculation, on the one hand, and the accumulation of observations on the other.

Lippmann men- tions the amusing fact that one of the important observa- tions on this subject was made in by a chef in a Paris kitchen, Appert by name, who preserved foodstuffs by heating them and putting them into hermetically sealed pots — an observation which was in line with a similar one made by Scheele on the preservation of vinegar by boiling and sealing in vessels. There were throwbacks, like Needham, but the modern era had begun and the ex- perimental method was soon to take charge of the de- velopment of biological thought.

Modern biology was born when scholars began to concentrate their complete attention upon the study of the manner in which life existed, and limited speculation entirely to the construc- tion of trellises along which new experimentation might grow. The final demonstration, by Pasteur, that alleged observations of spontaneous generation were attributable to experimental error marked the ending of biological mediaevalism. Thus, biology began as it will end — as applied chemistry and physics.

It will be of profit,' in maintaining this thesis, to set forth, in the bare bone, the structure of biology as it has come down to our time. The reader of imagination will remember with sympathetic admiration the unnamed mul- titude of patient toilers, the unknown soldiers of the great struggle toward the truth, who helped to forge the tools for the hands of genius. Everyone who thinks about these matters can construct a table of significant achievements for himself, and no two will be alike.

But since this book is written more for our own amusement than for anyone who may possibly buy it, we set down in chronological order those conquests of understanding which seem to us to have most directly contributed to the modern views of the mechanism of living things. We give them without explanations, since those to whom such matters are unfamiliar may look them up in any up-to-date history of science.

Lavoisier demonstrates the indestructibility of matter. Quantitative chemistry begins; respiration is re- cognized as akin to combustion. KirchhofF finds that starch can be converted into glucose by the action of dilute sulphuric acid, which itself remains unchanged. Cuvier lays the foundation of palaeontology. Synthesis of an organic compound urea by Wohler. Discovery of the mammalian ovum by von Baer. The birth of modern embryology and the first great for- ward step in this direction since Harvey. Schleiden demonstrates the cell struc- ture of plants, and Schwann the cell structure of animals.

Cagniard de la Tour proves that fermentation is dependent on yeast cells. Von Mohl describes protoplasm. Die T hierchemie, and so forth, on the application of chemical methods to animal tissues j also containing the important conception of animal heat as combustion. The beginning of the application of biochemical and physiological methods to the living animal. Darwin and Wallace advance the ideas of or- ganic evolution, bringing in their train the energetic de- velopment of comparative anatomy, embryology, and ra- tional systematology.

Final refutation of the experiments on sponta- neous generation by Pasteur. The birth of colloidal chemistry by the studies of Graham. Pasteur defines the dependence of fermentation and putrefaction upon living organisms. It was the foundation of the science of ge- netics. Discovery of osmosis by Pfeffer.

Development of modern bacteriology and immunology, with the growth of technique for the study of life in its simplest available form. Rubner applies quantitative methods to the study of the heat value of food materials. Beginning of the syntheses of organic matter by Emil Fischer — glucose, fructose, and finally polypeptide, which is one of the higher cleavage products of protein. With the era of Fischer begins the true structural knowl- edge of the proteins.

Elucidation of the carbon-nitrogen cycle by Hell- riegel and Wilfarth. First discovery of an ultra- virus mosaic disease of plants , by Beijerinck. First discovery of ultra-virus causing disease in animals foot and mouth disease , by Loffler and Frosch. Beginning of knowledge of the effect of radiant energy X-ray, ultra-violet on life processes. Discovery of hormones or physiological messen- gers; internal secretions defined by Bayliss and Starling.

Those responsible: Sorensen, Loeb, Henderson, Clark, and many others. Vitamins discovered by Hopkins and Funk. Whether these substances are alive or dead is at present almost an academic question. Based on experiments of Steenboek and of Hess. The crystallization of enzymes, the credit for which goes to Northrop. All this may seem remote from the story of typhus fever; but only to those who are impatient for the sen- sational events in a turbulent narrative.

Without the de- velopments here recorded, we should now know little about the true nature of the subject of our biography. CHAPTER IV On 'parasitism in general, and on the necessity of consider- ing the changing nature of infectious diseases in the his- torical study of epidemics; with a brief consideration of syphilis as an illustration of this contention.

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T hese matters have direct bearing on our biography, since we must pro- ceed as though we were writing of a man for readers ignorant of the race of men I Nothing in the world of living things is permanently fixed. Evolution is continuous, though its progress is so slow that the changes it produces can be perceived only in the determinable relationship of existing forms, and in their palaeontological and embryological histories.

Though the processes which determine evolutionary change do not appear as simple to-day as they seemed when the Origin of Species was published, it would occur to no biologist to assume that any living form is perma- nently stabilized. On purely biological grounds, there- fore, it is entirely logical to suppose that infectious dis- eases are constantly changing, new ones are in the process of developing, and old ones being modified or disap- pearing.

Parasitism originated in dim primordial antiquity as a consequence of habitual contacts between different living things. Para- sitism, in its origin, means a breaking down of that opposition which, normally, every living cell complex offers to invasion by another living entity. They develop and remain free from invasion in a pond which is swarming with bacteria and Protozoa. A frost kills them overnight, and within a few hours their substances have become culture media for innumer- able micro-organisms. And once begun, the further evolution of parasitism can proceed in an almost unlimited variety of directions.

Parasitism represents that phase of evolutionary change which lends itself most easily to analysis. There are few parasites which cannot be traced with considerable clear- ness to some free-living ancestral stock, either still existent or available in fossil form. From this point of view, the study of parasitic adaptation is one of the most important buttresses of evolutionary theory. Each instance represents a miniature system in which the host is the world by which the parasite is moulded.

It would be surprising, therefore, if new forms of para- sitism — that is, infection — did not constantly arise, and if, among existing forms, modifications in the mutual adjustment of parasites and hosts had not taken place within the centuries of which we have record. But it is relatively easy to induce fatal infection with an organism of ordinarily low parasitic powers by reducing the resistance of an individual host. This has been repeatedly done since the time of Pasteur.

Such changes in both directions occur in the bodies of infected animals, can be produced at will in test-tube experiments, and can be correlated with morphological and chemical changes in the bacteria themselves. The subject is one of the most important fields of contemporary investigation, and the results achieved have profoundly modified conceptions of infection. To pursue it further would obviously lead us into technical discussions, more suitable for a text- book of bacteriology. The matter is mentioned in the pres- ent connection merely to support our contention that the historical study of infectious disease must, hereafter, take into account the fact that parasitic adaptations are not static, and that extraordinarily slight changes in mutual adjustment between parasite and host may profoundly alter clinical and epidemiological manifestations.

There is a wide range of delicate gradations between saprophytism and parasitism, and the biological and chem- ical properties along which adaptation changes progress are — to some degree — dependent upon whether an organism that causes disease in man and animals has re- tained the capacities for life in nature, whether it passes through intermediate hosts, or whether it is so closely adapted to an individual host that it cannot exist apart from him, and perishes when the host dies, unless trans- mitted to another.

In such cases, there is an un- interrupted transmission from host to host, the parasite is never subjected to environments other than those to which it is most perfectly adapted, and, in consequence, evolution may progress in a single direction — toward a more perfect mutual tolerance between invader and invaded. This condition exists, for example, in certain trypanosome infections of rats, in the spirochastosls and sarcosporidial infections of mice, and in a large variety of other conditions of animals and plants. In these, the in- fected animal shows practically no signs of discomfort or pathological change in reaction to the parasite.

The principles have been thoroughly discussed by Theobald Smith. In animal populations, the first impact of a new virus is upon individuals of all ages. The survival of some of them is a matter of chance, depending on genetic differences or the accidental overlapping of immunity derived from other — possibly related — diseases. The extinction of many species of animals in past ages is best explained by freshly introduced parasites.

In man, a condition which illustrates these principles is syphilis. There is little doubt that when syphilis first appeared in epidemic form, at the beginning of the six- teenth century, it was a far more virulent, acute, and fatal condition than it is now. Uninterrupted transmis- sion from one human being to another, without intervals of extraneous existence in the course of almost five hun- dred years, has led to gradual mutual tolerance, one of the consequences of which has been an increasing mild- ness of the disease.

If mankind could be kept as thor- oughly syphilized in the future as it has been in the past, another thousand years might produce a condition not unlike the present spirochsetosis of mice, in which a peri- toneal puncture of almost any bon vivant would reveal the presence of a treponema pallidum infection of which the host is all but unconscious.

Arsphenamin has probably ruined this prospect.

We omit reference to specific instances of this among our contemporaries only to avoid, for our publishera, the vulgar embarrassment of libel suits. Modern treat- ment, and the agilities of expert testimony, render legal proof of such contentions hopelessly difficult. Typhoid and dysentery bacilli, cholera spirilla, the streptococci and staphylococci which cause surgical infections, and many other micro-organisms can survive for longer or shorter periods separated from the hostj and the circum- stances under which this is possible, the length of time of survival, and the alterations which take place in them during such periods, are all of them of the greatest im- portance to the student of epidemics.

Yet even in such in- fections by half-parasites — if the infection is widely disseminated — the factors discussed above become active, and successive generations tend to develop increased resistance. For human infections, many examples of this could be cited — one of the most illustrative that of tu- berculosis, in which the high susceptibility of aboriginal peoples as compared with resistance of the thoroughly tuberculized populations of European origin is a well- known fact.

Rats, Lice, and History by Zinsser, Hans

Here, as in bacterial disease, there is a lively interchange of parasites between man and the animal world. Indeed, since we can neither see these infectious agents nor cultivate them, except in the pres- ence of living tissues, the only opportunity we have of subjecting any of them to systematic study is by finding some animal in which disease can be produced.

As a con- sequence of such study, it has appeared that these agents, even more than bacteria, are of an extraordinary biological plasticity, and can often be modified by simple labora- tory manipulation. The transformation of smallpox virus into vaccinia by passage through cattle is far more pro- found a change than the alteration which differentiates the plague of Athens from smallpox as we know it to- day.

The mere passage of the virus through another species has — in this case — so altered it that it w'ill no longer cause more than a negligible local reaction in man; but, nevertheless, it retains the fundamental bio- logical properties by which it immunizes him. In the same way, the passage of rabies virus through rabbits rapidly increases its virulence for these animals, slightly diminishing it at the same time for monkeys and man.

Yellow-fever virus, injected into the brains of mice, ceases to produce typical yellow fever, but causes a form of encephalitis which, thereafter, can be carried in series from mouse to mouse. Carried back to monkeys, even though passed through mosquitoes, it retains its affinity for the nervous system. While this process is probably continuing, it is too gradual and slow to be traceable from an established disease to its ultimate origin. There remain two chief sources of new diseases within historic periods: namely, the modifications of para- sitisms already existing in man by gradual adaptative changes in their mutual relations; and the invasion of man by parasites, well established within the animal king- dom, by new contacts with types of animals and insects to which mankind was not previously exposed.

The Australian X disease — a po- liomyelitis-like condition — was probably contracted by man from sheep, and tularaemia — a disease not recog- nized before , and at present spreading through the United States — is acquired from a number of animal sources. This is a large field, which we have no intention of discussing except in so far as it concerns the subject of our biography — typhus fever.

Entirely apart from the medical and sani- tary aspects of the typhus-fever problem, the circum- stances of its transmission are of extraordinary biological interest, because they give us — more than any other disease cycle — the opportunity of studying the evolu- tion of a parasitism which has taken different channels in various parts of the world, adapting itself to the diver- gent circumstances of local insect and rodent distribu- tion. Typhus fever is one of the Rickettsia diseases which form a closely related group. The minute, bacillus-like organisms which cause these conditions Rickettsiae — named after Ricketts, an American who died while in- vestigating typhus in Mexico are closely related to a number of similar and harmless micro-organisms which are habitually found in the bodies of many insects.

It is, for this reason, not unlikely that the original parasitism of these organisms was acquired by insects, and from them was passed on to some of the lower animals rodents and so to man. These conditions are discussed at some length in a later chapter. The more thor- ough the saturation, the more apparent the results. The simplest demonstration of such changes is the rapidity of spread and the virulence of a disease when it is first introduced into the reservoir of an aboriginal — that is, entirely susceptible — population.

When measles first came to the Fiji Islands in , as a result of the visit of the King of the Fijis and his son to Sydney in New South Wales, it caused the death of 40, people in a popula- tion of about , Another example is the terrific violence of smallpox when first introduced among the Mexican Indians by a Negro from the ship of Narvaez. The virulence of tuberculosis for Negroes, Eskimos, and American Indians living in contact with whites is another case in point. Any number of illustrations of this kind might be cited. But even among crowded, thoroughly in- fected populations, diseases have changed within relatively short periods.

Scarlet fever has become definitely milder throughout Western Europe, England, and America since about The same is true of measles and diphtheria, as regards both incidence and mortality. The change began well before modern preventive methods had exerted any noticeable influence. Perhaps it is not an accident, however, that, in the case of diphtheria, — in the control of which modern bacteriological methods have been most effective since the late nineties, thus creating interference with normal evolution, — we are just beginning to observe the return of excessively toxic and deadly cases, reported in increasing numbers from Central Europe.

Before the last decade of the fifteenth century, there are few reliable records of syphilis in Europe. The subject has been greatly disputed, and many passages — especially in ancient Hindu manuscripts — have been interpreted as signifying that venereal sores similar to those characteristic of syphilis were known in the ancient world. Medical historians have cited many observations which they regarded as indicating the ancient existence of syph- ilis; but most of these, on close scrutiny, turn out to be unconvincing.

Careful transla- tion of these sonnets, with particular scrutiny of the ex- pressions in them which are diagnostically significant, leads to the conclusion that they are merely very nasty poems, with no precise reference to the disease. It is not, of course, possible to exclude with certainty the ancient existence of a form of syphilis milder than that which swept over Europe in the early sixteenth cen- tury, and Haeser — who does not subscribe to the opin- ion of the American origin — believes that syphilis may have been prevalent to a limited degree and in a less virulent form since ancient times.

There are few descriptions, however, in which it is possible to trace the relationship of a venereal infection to secondary and tertiary consequences in other parts of the body. This Haeser is inclined to believe is due to the unwillingness of doctors and patients to attribute venereal origin to conditions occurring several weeks after infection and, similarly, he believes that the later and usually mild manifestations may have been overlooked, or described in unrecognizable form.

There are a few accounts cited by him which lend weight to his views. The American origin of syphilis forms the basis of a theory that has become widely prevalent, and although it cannot be proved beyond question that America was the source from which the disease reached Europe, it is more than likely that it existed in the Western Hemisphere and that early explorers may have been infected by inter- course with coastal Indians.

In this connection, much has been made of lesions on bones found in the graves of the mound builders of Ohio and other regions — notably. Pro- fessor Herbert U. Williams, who has recently sifted the evidence, with attention both to the antiquity of examined bones and to the trustworthiness of pathological examina- tions, believes that there is unmistakable evidence of syphilis in many of these lesions.

In the Life of Christopher ColumhuSy by his son, Ferdinand, there are included passages from the writings of a hermit of the order of Saint Jerome, — Pane, by name, — written at the time of the second voy- age of Columbus. From the manuscript of the last named writer, Williams quotes a paragraph not represented in the printed editions, — left out for unknown reasons, — which is of exceptional importance. And as it is a secret disease never seen.

The the- ory of American origin, however well-founded in other respects, meets with an almost unanswerable objection in the shortness of the period which elapsed between the return of Columbus and the syphilis epidemic which broke out in Naples in Moreover, Julien, a French naval surgeon, has recorded that syphilis was more common among the coastal tribes who were in contact with Euro- peans than among the Indians of the interior, even in the early days of exploration of the Western Hemisphere. It is not at all unlikely that a mild form of syphilis oc- curred all over the world, including China according to Dudgeon and Japan according to Scheube , long before the fifteenth century.

This is the view favoured by Haeser, Hirsch, and other learned scholars. While, thus, there remain legitimate differences of opinion concerning the problem of origin, there is no doubt whatever that syphilis flared up in a sudden, intense, and widespread manner shortly after the time when Charles VIII of France led his army through the South of Italy against Naples. The city was taken by the French in February , and the disease promptly appeared among the troops and the burghers. As the army dis- persed, deserters, camp followers, and demobilized sol- diers spread the infection far and wide, and, because of the malignancy and disgusting character of the malady, it was the custom of the day to blame it upon the enemy.

Some- thing must have happened at that time, apart from war and promiscuity, — both of which had been present to an equal degree many times before, — which converted a relatively benign infection into a highly virulent one. The history of the subsequent fifty years strikingly illus- trates the rapidity with which adaptive changes may take place.

It is probable that in all parasitisms these alterations of mutual adjustment begin with considerable velocity, the curve flattening out progressively with the increasing number of passages of the parasite through the same species of host. According to Scharfenberg, it was a feverless disease characterized by pustular and ve- sicular eruptions with extensive ulceration. Though the first ulcerations usually appeared on the genitals, this was not always the case.

Primary contact infections oc- curred on many other parts of the skin, and the disease was often transferred from mothers to children in ordinary association. Van Helmont, Ozanam tells us, believed that it was started by the intercourse of a man with a mare that had glanders. Linder thought that it started by a similar relationship with a monkey, and Manard thought it came from marriage with a leper. Crusts formed, and the sick presented so dreadful an appearance that their companions abandoned them and even the lepers avoided them.

Extensive losses of tissue in the nose, throat, and mouth followed the skin mani- festations, and in the train of these came painful swellings of the bones, often involving the skull. The disease it- self, or secondary infection, caused many deaths. In sur- vivors, emaciation and exhaustion lasted for many years.

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Within a little more than fifty years, the disease had already changed. The poem was finished in its earlier form in , and presented to the Sainte-Beuve of his time, Bcmbo. Within the next five years it was rewritten and enlarged, and a third book was added, which deals chiefly with the treatment of syphilis with guaiac. However, in both the earlier and the later versions, Fracastorius indicates in an allegorical manner that mercury is the best remedy.

I mean that, within the last twenty years or so, fewer pustules began to appear, but more gummata; whereas the con- trary had been the case in the earlier years. Moreover, in the course of time, within about six years of the present genera- tion, another great change has taken place.

I mean that pustules are now observed in few cases, and hardly any pains — or much less severe — but many gummata. CHAPTER V Being a continuation of Chapter IV, but dealing more particularly with so-called new diseases and with some that have disappeared I It is obvious that when one searches the ancient and mediaeval literature for the existence of maladies in which differential diagnosis is difficult even to-day, one is likely to make many mistakes.

Accurate descriptions are rare and, even when details of symptoms and courses are as accurate as those to be found in Hippocrates, there is a total lack of the laboratory evidence which is often in- dispensable for certainty. The problem is particularly confusing in connection with epidemic infections of the nervous system, many of which are generally regarded as new diseases at the present time.

We are inclined to believe that a few only of these conditions are new in the sense that a virus is involved which had never in- fected man before. It seems more than likely that in many cases the diseases are new in that they represent a pre- viously unknown biological relationship between parasite and host. What we have said in the preceding chapter about the changes which can be experimentally produced in some of the filterable virus infections bears upon this point. Ozanam mentions a condition of like nature occurring in Germany in the last decade of the eighteenth century, in Lyons in , and in Milan in After this time no reliable evidence of any disease of this kind can be found until In that year, synchronous with the first considerable outbreak of influenza, a group of encephalitis cases occurred in Vienna.

Soon after that others appeared in France, Great Britain, and Algeria j then during the latter half of cases were seen in North America, and by May had been reported from twenty states — the largest number from Illinois, New York, Louisiana, and Tennessee. To all intents and purposes, this was a new disease to our generation, and up to the present time the virus of this form lethargic encephalitis has never been successfully transferred to animals. During the sum- mer of , an outbreak of encephalitis occurred in Cincinnati and in certain parts of Ohio and Illinois, which cannot at present be classified, but in the summer of again a similar disease started in the neighborhood of St.

Louis, attacking over a thousand people within several months, killing 20 per cent of them. And the virus of this disease, unlike any of the others, could be transferred to mice. It appears, therefore, as though, within the course of less than twenty years, at least three new types of severe virus infections of the central nervous system had appeared among us.

Vaccination has been practised on millions of people since the time of Jenner, and never before the present generation has the practice of vaccination been associated with any kind of nervous disorder. This condition de- velops in such a disappearingly small percentage of the vaccinated that it has practically no importance and certainly is not an argument against the practice of vac- cination. On the other hand, it appears to be a new disease and for that reason is cited in this place.

For the most part, the dancing manias present none of the characteristics which we associate with epidemic in- fectious diseases of the nervous system. They seem, rather, like mass hysterias, brought on by terror and despair, in populations oppressed, famished, and wretched to a degree almost unimaginable to-day. To the miseries of constant war, political and social disintegration, there was added the dreadful affliction of inescapable, mysterious, and deadly disease.

Mankind stood helpless as though trapped in a world of terror and peril against which there was no defense. God and the devil were living conceptions to the men of those days who cowered under afllictions which they believed imposed by supernatural forces. In the earlier days of the Black Death mass aberrations became apparent in the sect of the flagellants, who joined in brotherhoods and wandered by thousands from city to city.

Later, for a time, it took the form of persecution of the Jews, who were held guilty of the spread of disease. The criminal proceedings instituted against the Jews of Chillon were followed by a degree of barbarism throughout Central Europe that can only be regarded as a part of the mass insanity of which the dancing manias were a manifesta- tion. These manias are, in many respects, analogues of some of the political and economic crowd hysterias which have upset the balance of the civilized world in modern times.

In some parts of Europe the World War was followed by famine, disease, and hopelessness not in- comparable to the conditions which prevailed in the Mid- dle Ages. For obvious reasons, in the reactions of our own day, economic and political hysterias are substituted for the religious ones of earlier times. Jew baiting alone seems common to both. Although it is likely that the overwhelming majority of these outbreaks were purely functional nervous de- rangements, a certain number of them may have repre- sented early traceable beginnings of the group of epidemic infectious diseases of the nervous system, in which we now include infantile paralysis and the various forms of en- cephalitis.

In , in the German village of Kolbig, there was. Hecker has given a detailed account of most of the reliable historical records. In Erfurt, in , over one hundred children were taken with a dancing and raving disease which, again, in many cases led to death and permanent tremors in the survivors.

The most severe dancing mania began in , in the wake of the Black Death, at first at Aix-la-Chapelle, soon in the Netherlands, at Liege, Utrecht, Tongres, and Cologne. Men, women, and children lost all control, joined hands, and danced in the streets for hours until complete ex- haustion caused them to fall to the ground. They shrieked, saw visions, and called upon God. The movement spread widely, and undoubtedly the numbers of the truly afflicted were enhanced by multitudes of the easily excited, in a manner not unlike that observed in modern camp meet- ings and evangelistic gatherings.

Yet there must have been a physical disease in many of the cases, because throughout the accounts there is frequent reference to abdominal swelling and pain, for which the dancers bound their bellies with bandages. Many suffered from nausea, vomiting, and prolonged stupor. The condition was sufficiently widespread and important to warrant a long dissertation by Paracelsus, who tried to classify the malady into three subdivisions by a system not of suf- ficient modern importance to warrant review.

It probably had little rela- tionship to spider bite. The descriptions left behind by Perotte, in the middle of the fifteenth century, and by Matthiolo and Ferdinando in the sixteenth and seven- teenth centuries, are quite clear in indicating that many of the cases of tarantism represented a nervous disease of probably infectious origin. Some of them have much re- semblance with hydrophobia. Melancholy and depression, followed by maniacal excitement and motor activity, ended in death, or less fatally in semiconsciousness, with alternating laughter and weeping. By the middle of the seventeenth century, the disease as an epidemic menace had practically disappeared.

When it came upon them, they rushed about aimlessly, and many dashed out their brains or drowned themselves. In others, renewed at- tacks followed periods of exhaustion. Many never recov- ered completely. In great part, no doubt, the outbreaks were hysterical reactions of a terror-stricken and wretched population, which had broken down under the stress of almost incredible hardship and danger. But 84 RATS, LICE AND HISTORY it seems likely that associated with these were nervous diseases of infectious origin which followed the great epidemics of plague, smallpox, and so forth, in the same manner in which neurotropic virus diseases have followed the widespread and severe epidemics which accompanied the last war.


But no reliable account of the former exists in Western medical history until Dutertre described the out- breaks at Guadeloupe and St. Kitts in , and Moseley reported the epidemic on Jamaica in Since that time, the disease has appeared in many parts of the world — though not all — where the responsible mosquito ex- ists or can survive.

With smallpox, as Audouard makes clear, it was probably widely distributed by the slave trade, and, in view of the discovery of yellow-fever foci in West Africa, we shall probably never know whether it came to the Americas from there or vice versa. A serious modern problem is that arising from the automobile and aeroplane traffic now developing across the Sahara be- tween Mediterranean North Africa, where the appropri- ate mosquitoes are plentiful, but which is not yet infected. As far as dengue fever breakbone fever is concerned, there is no information of any corresponding epidemic malady until the last twenty years of the eighteenth century.

From to , the first great epidemics were reported from India and from the West Indies and the Caribbean coast, respectively. Since that time, it has been prevalent, in varying intensity, in most of the tropical and subtropical regions of the world. It is not at all impossible that dengue is not in any sense a new disease of the eighteenth century, but was present much earlier, though unrecognized and wrongly regarded by early Spanish writers as a mild form of yellow fever.

Can man acquire a novel type of infection, so late in the history of a crowded planet as the twentieth century, by contact with infectious agents long established in insects and wild animals? In a curious plaguelike infection in ground squirrels was found by McCoy and Chapin. After a great deal of dif- ficulty, they managed to isolate a bacillus roughly similar to the plague bacillus, but still quite easily distinguished from it by appropriate methods.

It was not until that the first proved infection of man was reported. On becoming thoroughly familiar with the symptoms in man, he discovered that cases had been reported in from Arizona and in from Utah, Since that time, the disease has been found in every state except Maine, Vermont, and Connecticut. In nature, it is an infection of the ground squirrels of the Rocky Mountain states; of wild rabbits and hares; of wild rats in Los Angeles; wild mice in California; quail, sage hens, and grouse in Minnesota; sheep in Idaho; wild rabbits in Japan, Norway, and Canada; water rats in Rus- sia; sage hens and grouse and wild ducks in California and Montana, Many animals that are not naturally infected are experimentally susceptible.

Man acquires the disease by direct contact with the infected animal tissue — es- pecially hunters, butchers, and all who handle, skin, and dress infected animals. The Infection passes through small wounds in the skin and may be rubbed into the eye with an infected hand. Almost all investigators of tularaemia have acquired it. Among animals, the disease is trans- mitted by blood-sucking insects, chiefly ticks and flies. It may be transmitted to man by the horsefly and the bite of the wood tick.

In ticks, the disease may be hereditary, so that it is not necessary for a tick to bite an infected animal in order to become dangerous to man. Thus we have another disease of animals which may have caused human infections in small numbers for a long time, and has probably existed in animals for centuries, but which did not become a menace to man until the beginning of the twentieth century.

Fevers of clinical similarity were known to Hippocrates, and Malta fever itself was de- scribed in the early eighteenth century as a diagnostic differentiation of familiar fevers, probably of ancient existence, from similar conditions like malaria and the true enteric fevers. And it was not until that bacteriological methods enabled in- vestigators to determine that the milk of infected cattle and the handling of hogs or their fresh meat may produce a disease not unlike that transmitted in the Mediterranean basin with the milk of goats.

Since then, these diseases have become public-health problems on our continent and in many parts of Europe. Never- theless, even our very superficial discussion of these 88 RATS, LICE AND HISTORY problems may have supported our thesis that infectious diseases are not static conditions, but depend upon a con- stantly changing relationship between parasite and in- vaded -species, which is bound to result in modifications both of clinical and of epidemiological manifestations. The principle is illustrated with considerably more pre- cision by a survey of infections which, once widely prev- alent, were well described, and which have either be- come modified or have actually disappeared regionally or altogether.

In such instances we possess premises for rea- soning of considerable accuracy. An interesting example of this is the vanishing of bu- bonic and pneumonic plague from Western Europe. It is estimated by Hecker that about one quarter of the entire population of Europe was destroyed by the disease — that is, at least 25,, It carried in its wake moral, religious, and political disintegration. This epi- demic is an excellent example of the biological phenomena which accompany the process of what the Germans call Durchseuchung, which, as we have said, means thorough saturation of a population with an infection.

One of the most detailed accounts is that of Sticker. Resistance to in- fectious disease, an acquired characteristic, is not hereditary — except in the evolutionary sense of the selective sur- vival of the more resistant. And such increase of resistance by natural selection is not noticeably active, unless the infection continues uninterruptedly throughout centuries and is of such an order that a majority of the infected survive.

The Black Death, spreading in Europe, there- fore, found an entirely susceptible population, which ac- counts for its terrific ravages. When its first sweep across the Continent was exhausted for want of victims, it re- mained endemic, smouldering until relighted by the ac- cumulation of new fuel; and thus it broke out again in , , and These successive calamities, cover- ing only thirty-four years, illustrate the manner in which an epidemic disease can become progressively less fatal, when it occurs repeatedly in populations that have been thoroughly saturated in immediately preceding years.

Statistics are of course incomplete, but the records left behind by Chalin de Vinario, whom we cite from Haeser, are particularly instructive in this regard. In , two thirds of the population were afflicted, and almost all died; in , half the population contracted the disease, and very few survived; in , only one tenth were sick, and many survived; while in , only one twentieth of the population became sick, and almost all of these sur- vived. Had the disease continued, constantly present, and attacking a large proportion of the new generations as they appeared, it might gradually have assumed an en- demic, sporadic form, with relatively low mortality.

There was an outbreak in Turkey in , which spread first to the coast of Greece and the Greek Islands, then traveled rapidly westward and, more slowly, in an east- ward direction. In , it reached Amsterdam, where it killed 10, out of a total population of less than , In the following year it gained velocity, killing about 24, in Amsterdam, spread to Brussels and Flan- ders, and thence to London.

In the first week of Decem- ber, , two Frenchmen died in a house in Drury Lane. No other cases occurred for six weeks. On the twentieth of February, , there was another case; then a pause until April. By the middle of May, the epidemic was in full swing. It put me into an ill conception of myself and my smell, so that I was forced to buy some roll- tobacco to smell and to chaw, which took away my apprehension. King Charles, rejoicing in the victory over the Dutch fleet, saw more and more houses marked with the terrifying cross, and removed the court from town.

The epidemic remained several years in Flanders, passed thence to Westphalia, down the Rhine, into Nor- mandy, Switzerland, and Austria, which it reached in Throughout the remainder of the seventeenth century, trailers of the disease continued, and lasted well into the eighteenth century. Another wave spread from Marseilles across Provence in and After that, the disease, in severe but localized outbreaks, continued through the second half of the eighteenth century, but was gradually pushed eastward, so that the considerable epidemic which occurred in Russia and the Balkans between and failed to make headway in a westerly direction.

Russia and the Caucasus con- tinued to suffer up to , but since that time no great plague epidemic has swept beyond Russia, and no wide- spread outbreaks have occurred anywhere in what is spoken of as the Western World. This disappearance of epidemic plague from Europe presents one of the unsolved mysteries of epidemiology. The disease has been introduced into various parts of Europe and America again and again during interven- ing years, but has never shown any tendency to spread in epidemic form.

Similar small group infections have occurred in a number of the South American harbors. Adding considerably to the mystery of the situation are such instances as the infections that occurred in Sydney, Australia, in In January, a dock laborer died of plague; and on February 14, dead rats were found on the quays. Another laborer came down with plague on the fifteenth of February, after traceable contact with rats; another on February Within the next few weeks, the keeper of a hotel close to the harbour was found to have plague, and by the end of June isolated cases occurred in the suburbs of the city.

Comparable conditions existed in Melbourne in April of the same year, with scattered cases. In Adelaide the same thing happened, and plague-infected rats were found, both in the suburbs and in the city itself. Still no epidemic oc- curred. In , the disease was carried to New York, again without serious results.

The existence of plague among the Chinese in San Francisco was discovered in ; and cases in different parts of California, widely scattered, occurred from then on until the end of the first decade of the twentieth century. As late as , twenty-four Chinese of San Francisco came down with plague, with thirteen deaths, and a few cases were found in Oakland and Berkeley.

In the same way, harbours of England and the larger cities of Central Europe have occasionally had plague cases, and plague rats have been discovered in one of the large European capitals as lately as Yet no epidemics have resulted. That this is not the case is apparent from the susceptibil- ity of Europeans living in India and other plague centres of the East. We cannot, moreover, attribute the change to any success in the destruction of rats. As for fleas, any- one who has not travelled too luxuriously in Central and Southern Europe during the flea month — September — knows well that there is no dearth of fleas.

When all is said and done, we have no satisfactory explanation for the disappearance of plague epidemics from the Western countries, and we must assume that in spite of the in- fectiousness of the plague bacillus, the plentifulness of rats, their occasional infection with plague, and their in- variable infestation with fleas, the evolution of an epi- demic requires a delicate adjustment of many conditions which have, fortunately, failed to eventuate in Western Europe and America during the last century.

The most reasonable clue lies in the increased domestication of rats. Plague epidemics in man are usually preceded by wide- spread epizootics among ratsj and under the conditions of housing, food storage, cellar construction, and such, that have gradually developed in civilized countries, rats do not migrate through cities and villages as they formerly did.

The exemption of many may be directly dependent upon the greater domestication of rats, which remain contentedly at home, and, as a consequence of this, plague foci among them remain restricted to individual families and colonies. This disease, well known in ancient times, in- creased immensely in mediaeval Europe. It is assumed that it was widely distributed in Europe by the returning Crusaders, although there are indications that it was present to some extent in France in the sixth century.

By the end of the eleventh century, institutions for the segre- gation of lepers — leprosaria — were common, the first one founded in in Spain by Ruy Diaz de Bivar, commonly known as El Cid. Under the auspices of the church, similar institutions grew in number and size, so that by the time of Louis VIII, Haeser tells us, there were as many as nineteen leprosaria in the diocese of Troyes alone.

The story of leprosy is a chapter as extensive as that of plague, and would require a volume in itself. The point of interest in our present discussion is that after the middle of the fifteenth century leprosy began to decline, and leprosaria gradually became unnecessary. By the middle of the sixteenth century, only a few centres of the disease remained.

In the seventeenth century, it had practically disappeared. Medical histories have attributed this decline to all kinds of vague conceptions, based upon assumptions of improved sanitary conditions, and so forth, but none of these are adequate.

The most likely solution of the prob- lem was suggested to us in conversation by Professor Sigerist, who connects the disappearance of leprosy with the immense mortality that occurred at the time of the Black Death and its secondary waves. It is not impossible, as Dr. Sigerist sug- gests, that most of the lepers of Europe were wiped out by the plague, and that the few who survived were too scattered and represented too meagre a spark to revive the disease. This seems especially likely in view of the relative noncontagiousness of leprosy, the manner of transmission of which we do not yet understand, but about which we know that prolonged and intimate contact alone gives rise to new cases.

There is no mention of a similar fever before or after After the battle of Bosworth, in which Henry VII gained the ascendancy in England, there broke out in the ranks of the conquering army a disease that completely put a stop to the procession of the victorious troops. With disbanded soldiers, it was carried into London. The speed of spread can be estimated from the fact that the sick- ness reached its height in London by September 21, the battle of Bosworth having been fought on August In London it killed, within the first week, two Lord Mayors and six Aldermen.

It attacked the young and robust, this being one of the points in which it was similar to the Picardy Sweat, of which we shall have something to say presently. In Oxford, where Thomas Linacre — who later founded the College of Physicians — was then a student, it was so severe that professors and students fled the University, which was closed for six weeks.

This first outbreak remained entirely in England, not even spreading to Scotland or Ireland. The symptoms of the disease have been described by many writers, and, though minor differences occur, the accounts are in the main consistent. Particularly important is the description by John Kaye, whose famous pamphlet on The Sweate was published in The disease began without warning, usually at night or toward morning, with a chill and with tremors. Soon there was fever, and profound weakness. Accompanying this were cardiac pain and palpitation, in some cases vomiting, severe headache, and stupor, but rarely delirium.

Death came with astonishing speed. It is stated that many cases died within a day, and some even within a few hours. A single attack did not immun- ize, since a number of people had two or three attacks in brief succession.

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After a short and violent career, the disease completely disappeared, and we find no mention of it from until The second epidemic was apparently much like the first, but there is not much reliable information available. It again started in the summer — this time in London — and, as Senf suggests, it is not improbable that it may have remained endemic in that city during the inter- epidemic quiescence. In , the disease appeared for the third time, and with enhanced severity. Again it spread over England, again sparing Scotland and Ireland. But this time it reached the Continent, advancing only to Calais, where — strangely enough — none but the English inhabitants are said to have contracted it.

Again it killed many pa- tients within two or three hours, and it brought death to many important men in Oxford and Cambridge; in some towns from a third to a half of the population was wiped out. The disease swept across the sea to the Continent, where it was first reported in Hamburg, which it reached in July, probably with a ship returning from England. In the same month it spread across Eastern Germany to Lubeck and Bremen j by August, it had reached Mecklenburg; in September it came to Konigsberg and Danzig; thence it traveled southeastward to Gottingen, where the mortality was so great that five to eight corpses had to be put into a single grave.

A curious fact noted by many who described it at this time is the lateness with which the disease reached the Netherlands, — that is, four weeks later than its ap- pearance in Hamburg, — although active communication by sea was carried on equally between both places and England. In Marburg, the epidemic interrupted the Coun- cil of the Reformation.

In Augsburg, 1 5, fell sick in the first five days. It reached Vienna during the siege of the city by the Sultan Soliman and, probably ravaging the Turkish army, may have had some effect on the raising of the siege. This work tells the story of the struggle between man, the highest and most complex form of animal life, and his deadly enemies, the organisms of disease, throwing light on how disease and epidemics have shaped human history. Read more Read less. No customer reviews. Share your thoughts with other customers.

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All About Parasites In Rats!

June 20, - Published on Amazon. Verified Purchase. This book changed my life I suspect. It was a required read on the summer reading list somewhere along the way when I was in high school in the mid 's. I was recently sharing its importance with a young relative still in high school. Whoa, now that I'm retired after 40 some years as a college professor I return to see how it influenced me.


Not an easy read, but knowing a bit more about the history of the sciences I'm enjoying the reread! I doubt very much I got any of the "humor" in it back then May 10, - Published on Amazon. My all-time favorite history-and-disease book. First read it as a teen many many years ago, and it probably played a part in focusing my interest in biology. Dr Zinsser shines through on every page, making it highly readable as well as good science and sociology history.

I highly recommend it. October 18, - Published on Amazon.