Tag Archives: Disease

Difference and Disease: Excellent new book on medicine and race in the 18th century British empire

Suman Seth is associate professor in the Department of Science and Technology Studies, at Cornell. He is an historian of science, and studies medicine, race, and colonialism (and dabbles as well in quantum theory). In his new book, Difference and Disease: Medicine, Race, and the Eighteenth-Century British Empire, Seth takes on a fascinating subject that all of us who have worked in tropical regions but with a western (or northern) perspective have thought about, one way or another.

As Europeans, and Seth is concerned mainly with the British, explored and conquered, colonizing and creating the empire on which the sun could never set no matter how hard it tried, they got sick. They also observed other people getting sick. And, they encountered a wide range of physiological or biosocial phenomena that were unfamiliar and often linked (in real or in the head) to disease. A key cultural imperative of British Colonials as to racialize their explanations for things, including disease. The science available through the 18th and 19th century was inadequate to address questions that kept rising. Like, why did a Brit get sick on his first visit to a plantation in Jamaica, but on return a few years later, did not get as sick? If you have a model where people of different races have specific diseases and immunities in their very nature, how do you explain that sort of phenomenon? How might the widely held, or at least somewhat widely held, concept of polygenism, have explained things? This is an early version of the multi-regional hypothesis, but more extreme, in which god created each type of human independently where we find them, and we are all different species. (Agassiz, with his advanced but highly imperfect geological understanding, thought the earth was totally frozen over with each ice age, and repopulated with these polygenetic populations of not just humans, but all the organisms, after each thaw).

Seth weaves together considerations of slavery and abolition, colonialism, race, geography, gender, and illness. This is an academic book, but at the same time, something of a page turner. Anyone interested in disease, colonial history, and race, will want to re-excavate the British colonial world, looking at disease, illness, and racial thinking, with Suman Seth as your guide. I highly recommend this book.

Seven Stories Of Science Gone Wrong

What, with all the attacks on science and scientist these days, we may not want to be focusing on those times when science goes off the rails and makes a huge mess of things. But, science at its best and scientists at their best, will never shy away from such things.

Dr. Paul Offit just wrote a book called Pandora’s Lab: Seven Stories of Science Gone Wrong, which not about an evil black dog that escaped from a box, but rather, seven instances when the march of scientific progress headed off a cliff rather than in the desired direction. People died. Many people died. Other bad things happened.

Note: I interviewed Paul Offit about his book on Atheist Talk Radio. This interview will be aired on Sunday, May 28th, and will be available as a podcast. It should be HERE.

Readers will have different reactions to, and ways to relate to, each of the seven different stories, because they are far flung and cover a great deal of time, diverse social settings, and a wide range of scientific endeavors. Some readers will get mad because he talks about DDT and Rachel Carson, though I assure you his argument is mostly reasonable (I did disagree with some parts). All readers will be amazed at the poppy plant and all it can do and has done, and astonished at the immense apparent ignorance displayed by that plant’s exploiters, from back in the early 19th century to, well, yesterday. Those interested in race and racism, the use of poison gas to kill people, will find things you didn’t know in Offit’s carefully researched histories. Also, don’t forget to take your vitamins. Or, maybe, forget to take your vitamins.

The chapter “The Great Margarine Mistake” is a great example of the very commonly screwed up interface between food science, food production and marketing, and the shaping of food preference among regular people. You know, that thing where “They tell us not to drink coffee. Then they tell us to drink coffee. They don’t know nothin'”

My biggest disagreement with Paul is over malaria. He did not incorporate an often overlooked fact about the disease into his discussion, and had he done so, may have written a somewhat different chapter. Briefly, in zones where there are two wet seasons (or one long wet season and a very short dry season) there has never really been success in curtailing malaria. In zones where there is a very long dry season but it is wet enough for part of the year for the mosquito that carries malaria to exist at least most years, malaria is relatively easy to beat down using a wide range of techniques, no one of which is supreme. So, for example, today, the distribution of malaria in South Africa, where it is not actually that common (thousands of cases in a normal year among tens of millions of people) is determined mainly by how wet the eastern wet season is, integrated with the movement into that area of people, usually refugees, who are a) infected and b) not getting medical treatment. (See this.)

Malaria was wiped out in country after country prior to the use of DDT, then the DDT came in and helped a great deal, in those relatively dry countries. But the wet countries, not so much. Indeed, in a place like Zaire, there are absolutely no reliable statistics on how common Malaria is or ever was over most of the country, but when I lived there in the 1980s, it was as common as the common cold in New Jersey, and DDT was theoretically in use. (That is a second correlation with causation: the wetter the equatorial country, the less we actually know about disease. I recall leaving the deep rain forest to visit the “city” to get hold of a few courses of leprosy medicine for a handful of people who visited our clinic who had it, where I had dinner with a guy from the UN who was on his victory lap for having wiped out leprosy in Africa.)

In some ways, Offit’s final chapter is the most interesting, the eighth chapter (combined with the Epilog) in which he does two things. One is to identify the kind of reasoning mistake, or methodological mistake, each of his seven examples exemplifies. Such as failure to pay attention to the data, or failure to pay attention to the man behind the curtain. The other is to go quickly through what may end up being similar stories of science gone wrong just starting to brew today or in recent decades, such as the long term unintended effects of widespread use of antibiotics.

A question that Offit’s book raises, indirectly, is this: When a Pandora-like box opens and some sort of monster creeps out, why did the box open to begin with? Sometimes it is jostled open, like in the case of unintended negative outcomes from the use of antibiotics. Sometimes it is opened because someone can’t resist the treasures that may be inside. Sometimes it is opened because science is an open process and must always seek knowledge etc. etc. I wonder if the recent development of an engineered polio virus (three instances), or the Spanish Flu, is an example of such. Sometimes it is opened because of (Godwin Warning!) HITLER. Seriously.

I don’t know what knowing these reasons gets us, but one possibility is this: when we find ignorance as a root cause of calamity, perhaps an appreciation of knowledge is gained. That is certainly the lesson of Offit’s review of the products of opium, their invention, intensification, deployment, and use. Apparently addiction was simply not understood at all until fairly recently, and that lack of understanding caused science, medical technology, and medical practice to do the exactly wrong thing over and over again.

And of course, lobotomies. The invention of the latter method of doing this useless and horrible procedure is something that, if put in a movie as a plot element, would kill the movie because it is not possible to suspend disbelief to the degree necessary to stay seated in the theater.

Pandora’s Lab: Seven Stories of Science Gone Wrong is a great read and a necessary addition to the bookshelf of any practicing skeptic or science enthusiast.

Paul Offit, who is a pediatrician and the inventor of a rotavirus vaccine (see this for an interesting podcast on a related topic), is the Maurice R. Hilleman Professor of Vaccinology and Professor of Pediatrics at the Perelman School of Medicine, University of Pennsylvania. He is also chief of Infectious Diseases and director of Vaccine Education at the Children’s Hospital of Philadelphia.

Aside from Pandra’s Lab, he also wrote Do You Believe in Magic?: Vitamins, Supplements, and All Things Natural: A Look Behind the Curtain, Deadly Choices: How the Anti-Vaccine Movement Threatens Us All, and Bad Faith: When Religious Belief Undermines Modern Medicine.

About that disease outbreak in the US #Enterovirus #EV-D68

This is the time of year parents start scanning their facebook feeds and other sources of information for what to expect our children to get sick with, how badly, and when. For a couple of years in a row, a few years ago, we were getting hit with a norovirus, causing diarrhea, vomiting, and a lot of lost daycare or school days. This year we are seeing reports of an outbreak of the scary-sounding “Enterovirus EV-D68.” Hundreds of kids are sick enough to get treatment in several states, currently Colorado, Iowa, Missouri, Kansas, Oklahoma, Illinois, Ohio, North Carolina, Georgia and Kentucky. (By the time you read this more will probably be added to that list.)

This virus is part of a large family of viruses that includes a lot of diseases, some pretty benign and some more serious. But the best common name for this particular virus, the one that includes this type of virus as well as several others, is the dreaded “Common Cold.”

This is probably a bit worse than the regular common cold for some people, indicated by the number of hospitalizations, some of which include pretty serious cases. The peak season for this type of virus is September, though it is sometimes called a “summer cold” because it starts to spread earlier in they year. It also seems like this particular virus is spreading quickly and hitting communities with large percentages. But, it is not clear how different than usual this is. CNN quotes Dr. Mary Jackson, an infectious disease expert, “It’s worse in terms of scope of critically ill children who require intensive care. I would call it unprecedented. I’ve practiced for 30 years in pediatrics, and I’ve never seen anything quite like this.” She is based at a hospital in Kansas City, Missouri, where about 15% of the patients who came in have been placed in intensive care, of about 475 treated as of a couple of days ago.

So there are two things you need to know. First, this is probably a normal cold spreading more widely and quickly than other years. Second, there is probably a higher incidence of more serious infections with this cold, so be more vigilant and go ahead and set your parental trigger for calling in your child’s sickness to a more sensitive level.

Image above from here.

And, there are a few things you need to do. First, update your kid’s “cover your mouth when you cough” training. Second, update your kid’s “wash your hands a lot” training. Third, keep your kid home when sick to the extent that you can.

Just to be clear. EV-D68 is not common. When I say it is a version of the “common cold” I mean that it is one of many viruses, a diverse group, that are on the list of things that cause what we call “a cold.” The specific enterovirus EV-D68 might be pretty rare, which may be why reactions to it can be worse. There is a very small number, up until now, of confirmed cases of it world wide, but only a tiny percentage of instances of the common cold are ever tested to see what the exact cause is.

This is the time of year kids (and teachers) go back to school to learn new things and exchange pathogens. Expect a lot more of this over coming weeks.

Personally, I think everyone in the whole world should stock up of food and water and quarantine themselves form all other humans for 14 days. Inside, with a good mosquito net. Imagine how many human-reservoir or insect-human reservoir disease would go extinct!?!? Of course, then no one would have a well developed immune system after a while and we would all die but for a while it would be great!

Global Warming and Disease: Marine Mammal Parasites

Global warming, shifting ecozones and changing the climatology of large reasons, is expected to, and has already shown the ability to, affect distribution and incidence of various diseases. The brain-eating Ameba comes to mind. As it were. There is some new research by Michael Grigg of the NIH that addresses a different change.

Along with melting Arctic ice comes an erosion of natural barriers that once separated parasites from hosts.

That erosion has allowed at least two pathogens to infect marine mammals they were previously unknown in…

A newly identified parasite was once frozen safely away from grey seals (Halichoerus grypus). It has now infected some with disastrous consequences. In 2012, about 20 percent of healthy-looking grey seal pups born on Hay Island in Hudson Bay mysteriously died. The cause turned out to be a parasite that destroyed the livers of 404 pups and two adults, Grigg said.

Grigg and his colleagues found that the parasite… also infects about 80 percent of ringed seals (Pusa hispida) but doesn’t make them sick. The parasite, … Sarcocystis pinnipedi, invades cells and can cause inflammation that damages tissues…

The research was presented at the recent meeting of the American Association for the Advancement of Science, and is reported here, though it may be behind a paywall.

There are other examples. Beluga whales north of Alaska have been infected by Toxoplasma, previously unknown in the region.

Photo Credit: brydeb via Compfight cc