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GREAT AMERICAN
DISEASES
This page intentionally left blank
GREAT AMERICAN
DISEASES
Their Effects on the course of North
American History
IAN R. TIZARD
JEFFREY M.B. MUSSER
Academic Press is an imprint of Elsevier
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Publisher (other than as may be noted herein).
Notices
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ISBN 978-0-323-98925-1
Acknowledgments xi
Introduction: How infectious diseases have shaped American History xiii
v
vi Contents
Glossary 369
Further reading 373
Index 377
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Acknowledgments
The authors thank the assistance provided by Dr. Suzanne Burnham and
Robert Tizard in reviewing and correcting the text. As always, this book
would not have been possible without the support of our wives, Claire
and Karen.
xi
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Introduction: How infectious diseases have
shaped American History
Ian R. Tizard and Jeffrey M.B. Musser
Department of Veterinary Pathobiology, College of Veterinary Medicine, Texas A&M University,
College Station, TX, United States
It is now more than 100 years since the great influenza pandemic of 1918
killed more than 600,000 Americans. It has been more than 50 years since
Jonas Salk’s polio vaccine began to eliminate that scourge from the conti-
nent. Diseases that had killed thousands and caused widespread despair
and death have been largely eliminated or controlled. Therefore, the emer-
gence of the coronavirus that causes COVID-19 came as an ugly reminder
that infectious diseases have not been eliminated. They have simply been
controlled temporarily. Infectious diseases will continue to return and kill
because they are an integral part of life on earth. In this microbial world,
humans and other animals are merely a resource to be exploited by microbes.
The history of the Americas has been defined by infectious diseases: from
the depopulation of Native Americans by European smallpox, to diseases
that determined the course of the War of Independence, and to the major
engineering projects designed to provide citizens with clean water and sew-
age treatment. Disease has defined and in a large part controlled our history.
The Americas are not unique in this respect. Other countries and continents
have also been profoundly affected by infectious disease outbreaks.
That said, there has been a perception that those diseases were behind us.
Infectious diseases were no longer considered a threat. Many believed that if
more arrived, they could be handled. Certainly, the history of the 20th cen-
tury suggests a progressive and inexorable improvement in our health. On
the face of it, we appeared to have won; we beat the microbes.
This of course was an illusion. First, we must not extrapolate the situation
in the developed world to the less developed areas of the world. Second, we
are beginning to see cracks appearing in our own medical defenses, ranging
from antibiotic resistance in bacteria to vaccine refusal by large segments of
the population. Most importantly, the results of overpopulation, encroach-
ment on wilderness areas, and climate change have increased disease insta-
bility and transmissibility and provided bacteria and viruses with hitherto
unexpected opportunities to spread.
xiii
xiv Introduction
In rich countries such as the United States, life expectancy, which had
hovered around 30–40 years for hundreds of years, began to increase; by
1900, it had reached 50, and by 2010, it had reached 80. We long outlive
the lifespan of our grandparent’s generation. This increase is predominantly
due to the control of infectious diseases. Antibiotics, water chlorination, pas-
teurization, adequate sewage treatment, and above all, vaccination have pro-
foundly changed the human condition. This has occurred not only in the
United States but also worldwide. The great diseases described in this book
are largely features of a distant past.
Prior to the development of microbiology, most disease treatments were
useless or worse. The introduction of variolation at the beginning of the
18th century was the first occasion where a medical treatment was shown
to be effective. Even up to WWII and the discovery of antibiotics, doctors
had few effective cures for infections.
Notwithstanding the massive increase in life expectancy and an effective
doubling of our lifespan, what we have seen over the past 75 years has been
no more than a temporary lull in hostilities, a pause where we hopefully
shored up our defenses and waited for the war to recommence. Victory
has not been total. As with real human wars, we appear to be entering a
period of asymmetric warfare where our major weapons may be circum-
vented by more subtle forms of microbial invasion.
Another feature of our current expectations of prolonged good health is
an intolerance of massive casualties. Recent disease outbreaks such as SARS
or Zika virus have killed only a few thousands, a far cry from the massive
pandemics of the past. Nevertheless, they resulted in a panic that subsided
once the threat was removed. This “panic-and-forget” pattern was a feature
of American responses to infectious diseases for many years until COVID
arrived. Therefore, it is appropriate to remind ourselves of that overused
adage that “those who do not remember history are doomed to repeat
it.” If we are to maintain our improved status with respect to infectious dis-
eases, we need to remember another cliche: The price of freedom (from dis-
ease) is also eternal vigilance.
The diseases that we have chosen to explore in this text are those we cons-
ider the most historically significant. After all, many of the outbreaks we des-
cribe have been covered previously with entire texts dedicated to individual
diseases or epidemics. Nevertheless, we believe that a holistic approach serves
to place the North American infectious disease history in perspective.
This book follows, in part, the curriculum of our introductory microbi-
ology course at Texas A&M University titled “Great Diseases of the World.”
That course was conceived as an introductory course in microbiology. Rat-
her than teach the rather dry topics of biochemical reactions and microbial
Introduction xv
diseases, we chose to focus on the “cool bits” of microbiology and the lurid
history of many infectious diseases. Therefore, this book is not designed to be a
comprehensive list of all the major infectious and parasitic diseases that have
affected Americans over the years. Rather, it is a look at the most important
and, in our opinion, the most interesting. We hope that you will agree.
This book does not need to, nor is it intended to be read in a linear man-
ner from the first to the last page. The reader or instructor is free to pick and
choose the disease of interest and topics within each chapter. Most aspects of
biology and history are not linear but convoluted and often times circular.
However, the order of the disease chapters in this book is chronological
based on when they were first identified and began to cause problems in
North and Central America.
One consistent feature of the history of medicine is an ongoing debate
regarding specific diagnoses prior to the modern era. Until about 150 years
ago, diagnosis was a subjective art. Disease diagnosis was a matter of physician
opinion rather than science. For this reason, it is appropriate to retain some
skepticism regarding the specific causes of many historic epidemics: was it
smallpox or really measles; was it typhus or typhoid; was it influenza or coro-
navirus? This intrinsic uncertainty has given rise to a minor academic industry
of those seeking to “second guess” widely accepted disease attributions. Some
of these claims are wildly speculative. Many have been dismissed by recent
discoveries as, for example, the unequivocal identification of Yersinia pestis
as the cause of the early plague pandemics. On the other hand, some early
pandemics attributed to influenza may really have been due to coronaviruses!
The cause of some historic outbreaks will likely never be established unless
molecular evidence can be adduced by new studies. It is also abundantly clear
that many epidemics were likely a result of multiple diseases occurring at the
same time. However, experience has shown that in most cases the original
diagnoses were correct. Therefore, we have tried to resist the temptation to
ascribe new causes to old epidemics. That said, science and history advance
hand in hand and no doubt some surprises still remain in store.
In January 2020, news emerged of yet another coronavirus outbreak in
Wuhan, China. Within a remarkably short time, it became apparent that
the world was in for a pandemic, the likes of which had not been seen since
the great influenza pandemic in the fall of 1918. The disease caused by this
coronavirus, COVID-19, is likely to be with us for a long time and the story
has scarcely begun. We have sought to place COVID-19 in its historical con-
text. The pandemic has many features in common with epidemics of the past.
Technology may change but human behavior does not. Likewise, neither his-
tory nor science stop when we send our manuscript to the publisher. If it was
not COVID, it would have been some other disease. But that is another story.
xvi Introduction
Infectious diseases have had, and continue to have, profound effects on the
course of American history. Historically they killed millions, caused untold
suffering, and played a key role in the colonization and development of
both the United States and Canada. And they have not ceased. In 2020
the SARS-2 coronavirus, the cause of COVID-19, escaped from China
and spread around the world. It killed millions of people and caused enor-
mous social disruption.
In addition to social factors, the impact of infectious disease outbreaks,
epidemics, and pandemics is determined largely by two key factors. One
is the ability of an organism to cause serious disease—its virulence. The other
is the ability of humans to combat these infections, in other words, their
immunity. The outcome of such diseases is determined by the balance
between virulence and immunity. The decline in the apparent importance
of infectious diseases over the past 100 years has been a direct result of
improved sanitation practices as well as our growing ability to prevent
and treat these infections through the use of vaccines and drugs such as anti-
biotics. In the absence of vaccines and drugs, organisms may spread
unchecked, especially in large, dense populations [1]. That is the case in
our present outbreak of COVID-19. It was certainly the case in the past
before modern medicine achieved its successes and it will remain the case
in the future.
While the idea that some diseases were caused by invisible microorgan-
isms was floated from time to time, this was mere speculation until Antonie
van Leuwenhoek in the Netherlands learned how to make lenses capable of
magnifying up to 275 times or greater. He used these in single-lens micro-
scopes to examine a diverse mixture of biological specimens. As a result, he
was the first to observe bacteria and protozoa [2]. When he examined the
gunk from between his teeth, he saw all sorts of small organisms that he
called kleine diertjens— Dutch for “small animals.” This word was translated
into English as “animalcules.” These creatures were swimming around and
he drew and described their shapes. He also examined his own feces and
found a parasitic protozoan that we now call Giardia. Van Leuwenhoek
reported this finding of oral bacteria in a letter to the Royal Society in Lon-
don in September 1683.
The significance of these microscopic animalcules was not readily appar-
ent at the time and while other thoughtful individuals such as Cotton
Mather in Boston, made statements speculating that invisible organisms
were the cause of disease, it was not until the science of microbiology devel-
oped in the mid-19th century that specific organisms were recognized as
causes of specific diseases. In 1838, Gottfried Ehrenberg in Germany called
these animalcules bacteria, from the Greek bakteria, meaning “a little stick”
since they were rod-shaped.
Robert Koch in Germany was the first to link a specific bacterium with a
disease when he identified the anthrax bacillus [3]. Koch was a physician
working in practice in W€ ollstein, in eastern Germany. As the district medical
officer, he was confronted by an ongoing outbreak of anthrax. A disease that
had killed hundreds of people and thousands of cattle. On examining the
blood of dead animals under a very primitive microscope, Koch observed
rod-shaped structures. He also showed that blood from a sheep that had just
died of anthrax, when injected into a mouse, would kill the mouse within
24 h. Then he found the rod-shaped structures in the blood and tissues of the
mouse! Spleen tissue from the dead mouse, when injected into another
mouse would give the same result—rapid death. Koch determined that
the rod-shaped structures were bacteria. He eventually developed a method
Infectious diseases and their causes 3
of growing the bacteria in culture and was thus the first to link a specific
bacterium to a specific disease. His paper demonstrating that anthrax was
caused by the bacterium, Bacillus anthracis was published in 1876.
As a result of his growing reputation, Koch moved to Berlin and joined
the Imperial Health College. Here he made more significant advances. He
found that he could “fix” bacteria to a glass microscope slide by drying them
from a liquid solution; he could stain them with aniline dyes; he worked on
improving microscopes; and was the first to publish photographs of bacteria.
Others in his laboratory also made significant advances. For example, the
plate technique of growing bacteria in pure culture was developed in his lab-
oratory. Two of his assistants, Walter and Fannie Hess discovered that agar, a
gel obtained from seaweed, could be used to make a nutrient medium on
which bacteria could be cultured. Another of his assistants, Julius Petri
designed a shallow dish (now called a Petri dish) to hold the agar-based
medium and permit bacteria to grow without contamination. Subsequently,
Robert Koch went on to describe other disease-causing bacteria such as
Mycobacterium tuberculosis in 1882 and Vibrio cholerae in 1883. Koch, as the
founder of the science of bacteriology, received the Nobel Prize for Med-
icine in 1905.
From the point of view of history, it is important to emphasize the dates
of Koch’s discoveries. Any disease diagnosis prior to the 1870s must be con-
sidered speculative. Physicians could diagnose some very obvious diseases
such as smallpox or yellow fever but in many other disease outbreaks
reported prior to the 1870s, their causes must remain speculative. This is
especially true of diseases with nonspecific clinical signs such as fever or
diarrhea.
As a result of Koch’s discoveries, bacteriology rapidly developed as a dis-
cipline, and competing scientists sought to be the first to identify the cause of
specific diseases. It was not until the end of the 19th century that protozoan
parasites, also visible under the microscope with suitable stains, were
detected and associated with specific diseases such as malaria and Texas
Fever. Fungi were also identified as a cause of some diseases around the
same time.
Bacteria are not the only organisms that can cause disease. Viruses can
invade and destroy cells and cause many serious infections. Viruses are small
molecular complexes that cannot be seen under a light microscope. It was
not until 1938 when the first virus was observed by electron microscopy.
Prior to that time however their existence had been inferred by filtering
body fluids to remove bacteria and demonstrating that the filtered material
Another random document with
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The Project Gutenberg eBook of When the birds
fly south
This ebook is for the use of anyone anywhere in the United States
and most other parts of the world at no cost and with almost no
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you are located before using this eBook.
Language: English
By STANTON A. COBLENTZ
Copyright 1945
by
The Wings Press
To
F. B. C.
whose eyes
have followed with mine
the flight
of the birds southward
Contents
PART I DRIFTING LEAVES
I The Mountain of Vanished Men
II The Verge of the Precipice
III Welcome To Sobul
IV The Weaving of the Spell
V Yulada
VI Foreshadowings
VII Yasma
VIII The Birds Fly South
IX In the Reddening Woods
X The Ibandru Take Wing