Professional Documents
Culture Documents
Species of Contagion: Animal-to-Human Transplantation in the Age of Emerging Infectious Disease Ray Carr full chapter instant download
Species of Contagion: Animal-to-Human Transplantation in the Age of Emerging Infectious Disease Ray Carr full chapter instant download
Animal-to-Human Transplantation in
the Age of Emerging Infectious Disease
Ray Carr
Visit to download the full and correct content document:
https://ebookmass.com/product/species-of-contagion-animal-to-human-transplantatio
n-in-the-age-of-emerging-infectious-disease-ray-carr/
More products digital (pdf, epub, mobi) instant
download maybe you interests ...
https://ebookmass.com/product/infectious-disease-management-in-
animal-shelters-2nd-edition-lila-miller/
https://ebookmass.com/product/infectious-disease-ecology-of-wild-
birds-jennifer-c-owen/
https://ebookmass.com/product/graphic-guide-to-infectious-
disease-brian-t-kloss/
https://ebookmass.com/product/the-unstoppable-human-species-the-
emergence-of-homo-sapiens-in-prehistory-john-j-shea-2/
The Unstoppable Human Species: The Emergence of Homo
Sapiens in Prehistory John J. Shea
https://ebookmass.com/product/the-unstoppable-human-species-the-
emergence-of-homo-sapiens-in-prehistory-john-j-shea/
https://ebookmass.com/product/diagnostic-pathology-of-infectious-
disease-2nd-edition-richard-l-kradin/
https://ebookmass.com/product/guardrails-empowering-human-
decisions-in-the-age-of-ai-gasser/
https://ebookmass.com/product/infectious-disease-ecology-and-
conservation-johannes-foufopoulos/
https://ebookmass.com/product/diagnostic-microbiology-and-
infectious-disease-elsevier-science/
HEALTH, TECHNOLOGY AND SOCIETY
Species of Contagion
Animal-to-Human Transplantation in the
Age of Emerging Infectious Disease
Ray Carr
Health, Technology and Society
Series Editors
Rebecca Lynch
Life Sciences and Medicine
King’s College London
London, UK
Martyn Pickersgill
Usher Institute
University of Edinburgh
Edinburgh, UK
Medicine, health care, and the wider social meaning and management of
health are undergoing major changes. In part this reflects developments
in science and technology, which enable new forms of diagnosis, treat-
ment and delivery of health care. It also reflects changes in the locus of
care and the social management of health. Locating technical develop-
ments in wider socio-economic and political processes, each book in the
series discusses and critiques recent developments in health technologies
in specific areas, drawing on a range of analyses provided by the social
sciences. Some have a more theoretical focus, some a more applied focus
but all draw on recent research by the authors. The series also looks
toward the medium term in anticipating the likely configurations of
health in advanced industrial society and does so comparatively, through
exploring the globalization and internationalization of health.
Species of Contagion
Animal-to-Human Transplantation
in the Age of Emerging Infectious
Disease
Ray Carr
Independent Scholar
Corrimal, NSW, Australia
© The Editor(s) (if applicable) and The Author(s), under exclusive licence to Springer Nature Singapore
Pte Ltd. 2022
This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether
the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of
illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and
transmission or information storage and retrieval, electronic adaptation, computer software, or by similar
or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specific statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or
the editors give a warranty, expressed or implied, with respect to the material contained herein or for any
errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional
claims in published maps and institutional affiliations.
This Palgrave Macmillan imprint is published by the registered company Springer Nature Singapore
Pte Ltd.
The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore 189721,
Singapore
For Maisie
Series Editors’ Preface
Medicine, health care, and the wider social meanings and management of
health are continually in the process of change. While the “birth of the
clinic” heralded the process through which health and illness became
increasingly subject to the surveillance of medicine, for example, surveil-
lance has become more complex, sophisticated, and targeted—as seen in
the search for “precision medicine” and now “precision public health”.
Both surveillance and health itself emerge as more provisional, uncertain,
and risk-laden as a consequence, and we might also ask what now consti-
tutes “the clinic”, how meaningful a concept of a clinic ultimately is, and
where else might we now find (or not find) health care spaces and
interventions.
Ongoing developments in science and technology are helping to
enable and propel new forms of diagnosis, treatment, and the delivery of
health care. In many contexts, these innovations both reflect and further
contribute to changes in the locus of care and burden of responsibility for
health. Genetics, informatics, imaging—to name but a few—are redefin-
ing collective and individual understandings of the body, health, and dis-
ease. At the same time, long established and even ostensibly mundane
technologies and techniques can generate ripples in local discourse and
practices as ideas about the nature and focus of health care shift in
response to global debates about, for instance, One Health and
Planetary Health.
vii
viii Series Editors’ Preface
The very technologies that (re)define health are also the means through
which the individualisation of health care can occur—through, for
instance, digital health, diagnostic tests, and the commodification of
restorative tissue. This individualisation of health is both culturally
derived and state-sponsored, as exemplified by the promotion of “self-
care”. These shifts are simultaneously welcomed and contested by profes-
sionals, patients, and wider publics. Hence they at once signal and
instantiate wider societal ambivalences and divisions.
This Series explores these processes within and beyond the conven-
tional domain of “the clinic”, and asks whether they amount to a qualita-
tive shift in the social ordering and value of medicine and health. Locating
technical use and developments in wider socio-economic and political
processes, each book discusses and critiques the dynamics between health,
technology, and society through a variety of specific cases, and drawing
on a range of analyses provided by the social sciences.
The Series has already published more than 20 books that have explored
many of these issues, drawing on novel, critical, and deeply informed
research undertaken by their authors. In doing so, the books have shown
how the boundaries between the three core dimensions that underpin the
whole Series—health, technology, and society—are changing in funda-
mental ways.
In Species of Contagion, Ray Carr focuses on an area that has galvanised
debate and analysis within biomedicine, the social sciences, and popular
culture: animal-to-human transplantation. This exciting monograph
considers compelling questions around what and who counts as “self ”
and “other”, and the technoscientific production and negotiation of “nat-
uralness” and “purity”. Through Species of Contagion, Carr illustrates the
complexities of understandings of hybridity and contagion within bio-
medical regulation and industry activities, and the transformations that
can happen both because of and to contemporary practices of xenotrans-
plantation. Accordingly, this monograph provides a bold and vital analy-
sis of the reconfiguring of (the relations between) forms of capital, logics
of power, and somas across diverse biological entities.
ix
x Acknowledgements
6 Conclusion205
Index217
xi
1
Introduction: Forms of Contagion
The surgeon completes the transplant of the pig heart into the baboon …
The pig heart initially becomes a healthy pink color as the recipient’s blood
flows through it. It begins to beat. But, after as little as two minutes, the
surgeon watches as it becomes a mottled, dusky blue color, and the con-
tractions become weak and irregular. Blood ceases to flow through the
organ as the small capillaries in the heart muscle become occluded by clots.
The blood vessels rupture, and the heart rapidly swells due to the leakage of
blood and fluid into the muscle wall. The heart stops beating. It is now an
ugly black mass. (D. K. C. Cooper and Lanza 2000, 55)
© The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2022 1
R. Carr, Species of Contagion, Health, Technology and Society,
https://doi.org/10.1007/978-981-16-8289-6_1
2 R. Carr
immune system as a mechanism that divides self from non-self recalls the
sovereign division between friend and enemy (Schmitt 2007). However,
contemporary immunology offers more than one understanding of
immune function, and accordingly different accounts of how the body
treats the presence of other species, whether in the form of microbes or
transplants. Immunological theories sometimes render immune system
activities as maintaining balance within cellular networks or as adaptive
systems. Even Burnet’s paradigmatic explanation of the immunological-
self had ecological aspects (Anderson and Mackay 2014).3 More strik-
ingly, in the 1970s, Niels Jerne’s “idiotypic network theory” proposed
that a destructive immune reaction is prompted by a disturbance in the
interactions within a network of immune cells, rather than being caused
by a transgression of the self/other boundary. Immunologist Klaus
Rajewsky explains that for Jerne “the antibody response is just an adapta-
tion to a new equilibrium” (Eichmann 2008, 162). Polly Matzinger’s
(2001) “danger theory” goes further in postulating that the immune sys-
tem responds to cellular signals of stress and injury, as “a flexible system
that adapts to a changing self ” (8). While these theories remain at the
fringes of immunology, medical historian Alfred Tauber (2000) argues
that most contemporary immunologists understand destructive immune
system responses as occurring within a network of cellular and molecular
interactions, dependent on context.4 Nevertheless, many theorists remain
attached to the concept of the immunological self (Tauber 2000).
Xenotransplantation can be thought of as a hybrid technology. It aims
to take live tissues from other animals and incorporate them into the
human body, co-opting the biological functions of other animals to sup-
plement human biology. Transplants can involve non-human animal
cells, tissues, or organs.5 Human clinical trials of cellular transplants have
been performed in several countries, using pig cells, in an attempt to treat
diabetes and Parkinson’s disease (LCT n.d.; Valdes-Gonzalez et al. 2005).
One company in New Zealand, Living Cell Technologies (LCT)/Diatranz
Otsuka, already secured government approval to commercialise its cellu-
lar xenotransplantation product for diabetes in Russia (LCT 2010).6
Other companies are attempting to develop technologies for transplant-
ing pig organs into humans; however, this is far more difficult because of
the radical immunological rejection of non-human organs, and these
1 Introduction: Forms of Contagion 3
experimental pig transplants are yet to succeed for any length of time in
non-human experimental subjects (usually baboons). To reduce the risk
of immune system rejection, some researchers are genetically altering pig
source animals to make them “more human”. In more than one way,
then, xenotransplantation technologies blur the biological boundaries
between humans and other animals (Brown 1999; P. S. Cook and
Osbaldiston 2010; Marie Fox 2005; Sharp 2013).7
Concern over the interplay between the self and other manifests in an
intriguing problematic in xenotransplantation. On the one hand, the
radical immunological rejection of tissues from other species presents an
obstacle to transplantation. And on the other hand, from a regulatory
point of view, the possibility that infectious disease might be spread by
the practice of xenotransplantation poses significant problems. The
extraordinarily intimate contact between live human and non-human
animal flesh opens the individual, and potentially, entire human popula-
tions, to novel viruses and other microbes lying latent in transplant tis-
sues. It is possible that a virus or other microbe might be transferred,
along with the transplant, into the human recipient, and onward from
there into the human population. (This kind of transmission of an animal
virus into the human population is called zoonosis, while the term xenozo-
onosis denotes this same process happening through xenotransplanta-
tion.) Infectious disease experts have warned that the technologies used
to overcome immune rejection, such as genetic engineering and immu-
nosuppression, could even facilitate a microbe adapting to better infect
the human population. Diminishing the boundaries between self and
other is thus posed as a public health risk as well as a potentially lifesaving
technology.
How is the immune system response to non-human tissues under-
stood in the xenotransplantation industry?8 Above I quoted xenotrans-
plantation researchers David Cooper and Robert Paul Lanza (2000),
describing the rejection of a xenograft. They continue by explaining the
baboon’s extraordinary immune response to transplanted pig tissues as
follows:
The surgeon has witnessed the most powerful immunological reaction that
the human body can mount, a response initially developed millions of
4 R. Carr
that it does not “attack” transplanted tissues, also called “inducing toler-
ance”. The term “tolerance” usually refers to the immune system’s lack of
reactivity to the organism’s own cells; techniques for inducing tolerance
aim to transfer the immunity from one’s immune system onto donor tis-
sues as well.
A team of researchers based at Harvard Medical School, led by immu-
nologist David Sachs, has been exploring methods of inducing tolerance
in both human-to-human transplantation and animal-to-human trans-
plantation. Sachs (2011) defines tolerance as “the specific absence of a
destructive immune response to a transplanted tissue in the absence of
immunosuppression” (p. 501). The lack of a damaging reaction does not
mean that the immune system does not respond at all, as is often pre-
sumed under the self/non-self model. The immune system does respond
to “tolerated” tissues, but it is not strictly destructive; from this perspec-
tive, the immune system is capable of positive reactions as well as damag-
ing ones:
Jean failed to decipher the look which crept over his face—a
tired self-questioning look—a look which she had always
associated, and always would associate, with Evelyn Villiers.
Jean could never slay this association of ideas. It had begun
vaguely in her childhood, had taken definite shape in her
girlhood; had survived until now. She no longer counted
Jem to be in love with Evelyn. Observation and judgment
both told her that he had or must have overcome the old
romantic fancy—"if it had only been a fancy!" And the idea
of Jem marrying, seldom occurred to her mind.
Still she was conscious of a certain power possessed by
Evelyn over Jem's spirits—like the power of greater or less
air-pressure on the mercury of a thermometer. Evelyn
herself did not know it; but her touch in a moment sent his
mercury up or down. When this particular look came, a look
of strain and weariness, with indented hollows in cheek and
brow, Jean never could resist an instinctive recurrence of
thought to Evelyn. Had Evelyn said or done something to
worry him?
Aloud Jean said nothing, and Jem went back to his writing,
but the effort of work was manifest. Twice there was a
renewed break; and she saw his hand steal over the thick
hair, already streaked with grey.
"I wish you would give in, and take an hour's rest," she
murmured.
"It shows the shape of her head so nicely. Jean has such a
well-shaped head. The bumps are all in good proportion."
Jean could not in the least have told what it was in the
utterance which made her colour deepen. She was not
given to blushing; and till this moment she had firmly
believed that no human being beyond their two selves knew
of the state of affairs between herself and Cyril. Jean had
never breathed a word on the subject; and she had no idea
of what Cyril had impulsively said to Miss Devereux.
So until now she had been able to speak of Cyril easily and
without a blush, because she never supposed anybody to
suspect how matters lay. Indeed, Jean herself was by no
means sure how things did or would lie. Cyril wrote her
constantly and freely; but they always had corresponded
from childhood; and Cyril did not use lover-like terms. He
had attempted it at first, and Jean had made no response,
being determined to leave him free; so he had dropped the
attempt. That was now over two years ago; and two years
are a long time under the age of twenty-four.
Whatever amount of questioning had gone on below the
surface with Jean, she had till this instant shown no
consciousness in connection with Cyril. And now, all in a
moment, without warning, at the sound of his name,
uttered in a tone of peculiar meaning, her cheeks flamed.
Miss Atherstone's sharp little eyes ran all over Jean. "Yes?"
she said, and waited, as if most willing to act feminine
confessor. "Yes? It has been a long separation!"
"And one may hope—" she said. "One may hope—! Travel
does improve the mind! At least, people say so. Sir Cyril
was so young—painfully young, poor boy, before he went
out! One cannot but hope, at least, that his most
unfortunate attachment to that little Miss Lucas—a merely
passing fancy, no doubt—"
Another wave of colour swept into the first, and Jean was
wroth with herself. She sat resolutely upright, her eyes
shining with an angry gleam. Was that tale known too?
Could nothing ever be hidden in Dutton? But she only said,
"Miss Lucas?"
"Oh, I thought you were sure to have heard! And, after all,
it might be a mistake. Some have said that he was engaged
all the time—elsewhere!" significantly. "Pray do not be
annoyed, Miss Trevelyan. I sincerely hope it may be untrue.
No one could wish such a connection for Sir Cyril! So very
objectionable! I merely allude to what everybody remarked
—the way he haunted that house for weeks. But probably,
poor youth, he became aware of his danger, and wisely fled
from it. If only it has not been an exchange for something
worse!"
Jean's colour did not deepen further; nor did it fade too
fast.
The satire was lost upon Miss Atherstone. "Not Dutton," she
said. "A friend of mine has a sister out in Melbourne."
"No doubt. But I don't see why he should not wait to marry
her, and bring her home."
"Well, I can see that you will not omit to give a welcome to
the bride of your old playfellow," said Miss Atherstone, with
a touch of something like spite, because she was conscious
of failure. She found her feet awkwardly, as she spoke.
Jean rang the bell, tranquilly shook hands, and smiled Miss
Atherstone out of the room. Then she stood still—to think.
She did not finish the sentence, but pulled herself together,
and went to the study.
"She would like a call after tea. I met her before lunch."
"She does not look well, or happy. This is for yourself only.
You might be some help."
"I don't see how. Why doesn't she go to you for advice?"
"If you go after tea, I will call an hour later to walk home
with you."
"Yes, do. That will be nice. I hear the tea going into the
drawing-room. Oh—another interruption!"
This time Captain Lucas was shown into the study. He had
become a frequent visitor there, and Jem's strengthening
uplifting influence had worked wonders with the man. Not
only had he fought through more than two years without
another breakdown; but the very fight had become easier,
the craving less keen and more controllable. Jem kept him
employed in many ways, found him new interests and
pleasures, and exercised, busy as he was, a constant
watchfulness, which gave invaluable help to the wife and
daughter.
Then the two gentlemen retired to the study, and Jean sped
away to the Park.
CHAPTER II.
• • • • •
Evelyn herself was not narrow, rather the reverse. Since her
husband's death, however, she could not patiently endure
aught which might seem to be levelled at his memory. This
made Miss Moggridge peculiarly liable to tread upon
Evelyn's corns; and with all her devotion to Evelyn, Miss
Moggridge was clumsy in her manner of walking.
The two ladies had rubbed on together for three years, and
might rub on a good deal longer; but such "rubbing on" can
hardly mean present happiness, however much it may be
expected to improve one's spiritual shape in the end.
Moreover, though friction does commonly wear away
corners, it may be so applied as only to sharpen the angles.
Jean had been into Evelyn's boudoir, one may safely assert,
hundreds of times; yet she rarely entered that room without
at least a transient recollection of a certain snowy day,
years since, when she had witnessed the last parting
between General Villiers and his young wife.
"Sit down here by me, Jean. Sit down, and talk me into a
better frame of mind. I am feeling wicked. Nothing is worth
doing or worth living for; and I am sick of everything and
everybody. Except—yes, of course, there are always
exceptions. Does it sound very dreadful?"
"It sounds dyspeptic. You had better see Dr. Ingram," Jean
said the words in jest; and then she wondered if she ought
not to say them seriously. Jem had remarked that Evelyn
was not looking well. Not well! The little hand, lying on her
knee, was transparent; and the fair face seemed to have
shrunk, lending unnatural largeness to the eyes. Had this
come suddenly? It dawned upon Jean in a flash.
"My dresses have all grown too big. Things stretch so!"
"Only—"
"And he said—"
"Jem cold!!"
"Did I call him 'cold'? No, 'cold' is hardly the word. It means
repulsion, and he does not repel. He wins one's confidence
somehow—in an abstract sort of way. But his manner is so
entirely self-mastered—as if he had reached a height
beyond all passion of feeling. Almost as if nothing that
merely touched himself could never ruffle him again. It is
beautiful, of course; only a little chilly. That was what he
was this morning—very kind, but just a degree chilly. He
listened to me with such intense patience, and looked most
gentle—as he does, you know—yet when he spoke, he was
stern . . . He said life ought to be something better for me
than drifting down the stream, and getting myself bruised
among jagged rocks. He told me to take my oars, and row
up the stream . . . And, of course, he is right—he is
perfectly right! . . . If only I had energy to obey!"
"Jem is not stern or cold! Evelyn, what can you mean? You
don't understand Jem."
"None. Jem thinks that the last before they started must
have gone astray—perhaps not been posted. And they may
for once have skipped over a mail or two before that. Once
really off, we must of course expect a long break. We shall
hear in good time, I dare say."
"To—whom?"