Disease, insects and broadaxes – a tale of an old book

By Jonas Waldenström

With three kids, and the youngest a toddler, there isn’t much room for daring adventures. At least not for a few more years. But I don’t mind, in fact I have learned to appreciate the adventures that take place on a smaller scale. Instead of twitching a rare bird in a remote place, I do patch birding in the garden. Instead of climbing steep mountains (as if I ever did), I climb up and down ladders painting and repainting old windows. But the best for sure is to see the world through the kids’ eyes, where a strangely shaped little rock, a big spider or a bee can be absolutely enthralling.

One thing we do, however, is to visit flea markets. One our favorite is in a nearby village, just 15 minutes by car from our summerhouse. The kids skim through the baskets with old toys, my wife scouts for various decorative things, and I search for old everyday stuff, such as forged nails, handmade wooden planes or broadaxes. (Especially broadaxes, but they are rare). Today was no exception, and after half an hour we have gathered a little hoard of stuff that appealed to our various interests. In my pile was a hundred years old pitchfork, some wrought hooks and a little book with the title Insekter och sjukdomar.

That book turned out to be a nugget. It was originally published in 1910 by the entomologist Rennie W. Doane, and my copy was a translation published in Swedish in 1912 by Ivar Trägårdh. The full title is Insects and Disease – A Popular Account of the Way in Which, Insects May Spread or Cause Some, of Our Common Diseases. Perhaps not a title for everyone, but for me that do research on infectious diseases it had much promise. And yes, better than expected, reading this book turn out to be a fantastic journey back in time to when modern medicine was in its infancy. I was mesmerized, and read it in one go, cover to cover.

Rennie W Doane (downloaded from XXX)

Rennie W Doane (downloaded from Bishop Museum’s list of dipterist, [hopefully under fair use])

You see, we tend to take things for granted, and although we know that things change and new knowledge unfolds, it is still far too seldom we think about how the world was just a hundred years ago. Yes, we read about WW1 in school, and yes, we sort of understand that it was poorer, more rural, more potatoes and turnips, but we (or at least I) don’t really think about the state of medicine around the turn of the second last century. There are exceptions, of course, such as the growing literature on the Spanish Flu, or Maryn McKenna’s excellent texts on pre-antibiotic medicine. And I have through my teaching read up a little on the old scholars, such as John Snow (the founder of epidemiology, the Broad Street pump-handle remover), or Edward Jenner and variolation of cowpox and smallpox, but there is so much more to reread and learn.

So what does this book tell us? Written in 1910 it was published in a time when great medical breakthroughs came one after the other. The idea of foul air, or miasma, as cause to diseases had lost to the germ theory some decades before. Bacteria and protozoa could be studied under the microscope and the experimental and critical thinking inspired by Koch’s postulates led researchers to discover more and more etiological agents to diseases. Anthrax and tuberculosis were known, and the life cycles of the blood parasites Plasmodium (malaria) and Trypanosoma (sleeping sickness and nagana) had been studied in detail (although they seemed not to have realized the asexual schyzogony part that takes place in the liver).

The most striking part is actually what is not in the book. Today we know that viruses cause some of the worst insect borne diseases, such as Dengue, Yellow fever, or Chikungunya – but there is not a single description in the book of an insect borne viral disease. Yellow fever is discussed in length, but the causative agent was not identified; it was by many presumed to be bacterial, but the author raise the hypothesis that it may be a protozoan, perhaps related to spirochetes (which is, in the rearview mirror a double fault, as spirochetes such as Borrelia are indeed bacteria, and the causative agent of Yellow fever the aptly named Yellow fever virus). It has to be remembered that virology is one of the youngest medical disciplines, viruses were simply too small to be seen with the microscope. Actually, Tobacco Mosaic Virus – the first described virus in 1898 – was described based on the fact that it was infectious after being filtered through a porcelain filter that excluded bacteria. They couldn’t see TMV, but they could observe the disease it caused in tobacco leaves and prove that it was contagious. It wasn’t until 1927 that Yellow fever virus was identified and described.

Another notable thing in the book is the very strong belief in science as a way of reducing the suffering of mankind. Scientific progress didn’t come lightly, and many of the scientist that tried to identify and find cures to diseases actually succumbed to the very disease they studied. Moreover, human ‘volunteers’ – often convicts – were used to establish disease causality. The methods were grizzly and morally questionable (even in that time), involving exposure to sneezes, coughs, bodily fluids, blood or vomits from sick patient to healthy study people. Abhorring methods, but they stemmed from believed necessity in a time when infectious diseases caused devastating outbreaks, and where no counter measures except quarantine and hygiene were available.

And even in our age there are lessons to be learned from 1910. In the last century humanity invented vaccines and antibiotics to fight disease, and pesticides to fight the insect vectors. It worked brilliantly to start with, but the once powerful tools became blunt when the pathogens and the insects evolved resistance. It is interesting to be reminded that the Yellow fever scourge that stopped the Frenchmen to build the Panama Canal was effectively fought by rather simple means by the Americans later on. Knowing that it was an insect borne infection (but without knowing the causative agent), clear-cutting the forest around the canal and targeting the specific mosquito that transmitted it by limiting standing water sources in and around houses, Yellow Fever could be managed down to a very low level. These are methods that work well today too, for instance for West Nile virus eradication in the US, or for limiting malaria transmission in rural Africa. When the big guns don’t work, we need to look for other means.

Finally, and a clear example of a rapidly changing world, I found out that the book has been digitalized and can be accessed for free. Go ahead; download it to your computer, or even your Kindle. And the next time you go to a flea market, don’t forget to look for books. And broadaxes.

One cannot simply have too many axes...

One cannot simply have too many axes…

 

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