Cholera to Climate Change

I overheard a group of men talking about climate change being a hoax.  That the sudden emergence of rain in Southern California and the cold snap of weather proved their claim.  I found their laughter and mockery of scientific data obnoxious but instead of spouting any facts, could only quip, “It’s called global warming, not regional warming.”

Ugh.

That night, as I dwelled on the encounter, it made me think about the history of epidemics.  How humankind collectively has a tendency to be notoriously shortsighted.  We have rebound from every epidemic to hit us but most epidemics move regionally.  And, most epidemics throughout history were caused by pathogens, the plague, influenza, cholera— now, we can control or curb the spread of pathogens, mostly.  Weather, not so much.

So I thought:

Those who support climate change: if we are wrong, where is the harm in investing in renewable energy sources and attempting to preserve the planet’s resources?

Those who deny climate change: if you are wrong, then we’re all f***ed

 

Where am I going with this?  Pardon my rambling.  Let’s look to history.

I was perusing a friend’s book called Medicine: An Illustrated History by Albert S. Lyons, M.D. and R. Joseph Petrucelli, II, M.D. and when I came to the 19th century, I stopped at a couple pictures.  The pictures appeared to be efforts of public health advocates attempting to convey to people the importance of hygiene and disease prevention.  Skeletal apparitions loomed over children in a market and one even dispensed water to the public.  Cholera ravaged Europe and America.  In 1854, London, there were 14,000 documented cases and 618 deaths.  In America, three outbreaks swept across the country.

 (“A hint to the Board of Health on how the city invites the Cholera” (1864). Department of Health, City of New York and Satirical woodcut (1866) indicating that pollution was an acknowledged source of disease even before bacteria were discovered to be the cause.)  

When you think of the 19th century, you probably think of slums and soot, the Industrial Revolution, expanding cities with little room for refuse and sewage.

Before the discovery of bacteria, public health officials focused on sanitation, the dispersal of potable water and the removal of sewage and refuse from the streets.  Sanitation was (and still is) important in preventing epidemics.  But it didn’t necessarily catch on right away.  And Germ Theory was only that, a theory.

I can imagine 19th century naysayers spouting, “There is no definitive proof that microorganisms exist!  Humans have no effect on disease!”

The dominate theory at the time, which had existed for centuries, was Galen’s Miasma Theory.  That disease came from bad air, or night air, a poisonous vapor that spread from rotting organic material.  While not a terrible theory, it was the biggest obstacle for 19th century scientists to overcome.  Time for the 1,500-year-old theory to be put to rest.

Enter the scientific method.

Johann Peter Frank, a German physician, used statistics to produce a milestone accomplishment.  System einer Vollstandigen medicinischen Polizey (A complete system of medical policy), written from 1777-78 and first published in 1779.  It emphasized the importance of hygiene and public health, covering issues from public sanitation to sexual hygiene, maternal and child welfare, food safety, and prostitution.

Unfortunately, his work did not lead to a revolution in public health care and was considered influentially negligible.

However, Ignaz Semmelweis (1818-65) found Johann Peter Frank’s volumes informative.  While overseeing the obstetrical wards of the Allgemeines Krankenhaus in Vienna, he proved that postpartum infection was contagious.  He required physicians and students to scrub hands with soap and water and soak hands in a chlorinated lime solution before entering the ward and after each exam.  Over the next few months, his instruction resulted in a decreased obstetrical death rate, from 18% to 1%.  He reported his results to the Medical Society of Vienna but the majority of medical scientists and practitioners did not support him.  He completed a book in 1861, ten years after his work overseeing the obstetrical ward, but the profession hardly took notice and prominent scientists opposed his ideas.

I feel horrible for Ignaz Semmelweis, he died in 1865 in an asylum from a blood infection very much like the one he was trying to prevent.

He is credited with having created, for the first time, a system of asepsis— keeping germs away from patients— before germ theory was recognized.

In 1867, Joseph Lister, inspired by the work of Louis Pasteur, published a report showing antiseptic treatment of wounds prevented post-surgical infection from “disease-dust.”  Despite this, the majority of American and European surgeons refused to recognize infection coming from something foreign introduced during surgery.  At least the idea of antiseptic treatments began to take hold.

Louis Pasteur, in 1851, was the first to discover bacteria and its behavior.  He viewed Anthrax bacillus and its reactions on two different tartaric acid crystals.  He proved microorganisms grew anaerobically and aerobically and were responsible for fermentation.  In 1870, after returning home from vacation, found cultures of chicken cholera organisms that he had left out.  When he injected the cultures into healthy hens, no disease was produced and when he injected the same hens with virulent cultures, they were protected from the disease.  Pasteur set out and treated bacterial cultures until he discovered microbes grown in a particular temperature range became harmless and could protect from disease.  In 1881, he proved his results to the public by injecting livestock with a vaccine for anthrax.  When exposed to the pathogen, cattle that had been vaccinated survived and those that did not, died.

Bold Louis Pasteur even tackled rabies and developed the first vaccine for the fatal disease.  In 1885, he used rabies inoculations to save the life of a boy who had been attacked by a rabid dog.  Pasteur’s success resulted in public accolades.

From then on, bacteriology and immunology flourished.  Germ Theory was finally recognized as relevant.

What does this have to do with climate change?  To me, the struggle of Germ Theory’s recognition is a robust example of the shortsightedness of humankind, an inherent stubbornness to cling to old ways and reject reform, even in the face of scientific evidence.  It makes me worry that man’s effect on the climate will only be universally recognized once it is too late.  The biggest difference is that we could recover from the dark ages of public health but I don’t think the same will be true for climate change.

 

We are at the end of an era.  What we do today will have an effect on us tomorrow.

 

 

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