Germs and Politics: A Response to Livesey and Lipsius
Labonte, Ronald, Canadian Dimension
Bruce Livesey's and Ellen Lipsius' article on AIDS is a refreshing break from the germ (HIV) theory gridlock over the mass media and public consciousness.
Unfortunately, their argument is overstated, factually simplistic, and throws the baby out with the bathwater.
Let me begin with theories of disease in the 19th century. There were more than just the germ and the environmental theories. There were also theories of divine retribution (punishment for sinning) and of personal malfeasance (a forerunner of the blame-the-victim lifestyle fad of the 70s and early 80s). All these theories continue to resonate in our times; they frequently overlap one another, and they characterize not only "allopathic" (scientific medicine") models of illness, but also so-called alternative forms of healing.
It is inaccurate to pose 19th century contagionist theory as the banner of the conservatives, and the environmental theory as the banner of the radicals, as Livesey and Lipsius do. Contagionism was accepted by many radical health activists, Rudolf Virchos among them, who once wrote that all diseases have two causes, "one pathological, the other politica". These early contagionists recognized that, yes indeed, germs did play a role in creating illness; the role was simply not an exclusive one. Thus, when making recommendations on the means to end a typhoid outbreak among Silesian coal-miners, Virchow urged strong loca; government, increased wages, housing and agricultural cooperatives, better and safer working conditions -- in short, a socio-environment in which the 'typhus would no longer flourish". Nonetheless, he recognized that typhus was a pathogen, exposure to which could lead to typhoid, the chances of which were dramatically increased if one was an overworked, undernourished and generally oppressed Silesian coal miner.
The same situation exists today: Native Canadians on many reserves have the same immunization saturation for diphtheria (around 90 per cent) but have 10 to 15 fold higher rates of the illness than non-Natives. Why? Poverty, malnutrition, the stresses and psychological strains of oppression. Yet, and this is important, their experience of diphtheria is significantly less morbid and mortal than it was before immunization. Thus, immunization is a partial block to the pathology of infectious disease.
Trade and disease
Similarly, there was ample evidence that many of the 19th century pandemics, notably cholera, were wreaking havoc because of mercantile trade. Capitalism and its early imperialism had the unintended effect of spreading rare pathogens around the globe. While the poor were disproportionately struck down, wealthy, healthy types were also infected and died. There does come a point when germs, in sufficient number, compromise the immune system beyond the coping point.
Radical proponents of the germ theory argued that, because of evidence linking trade with epidemics -- particularly that of cholera entering Europe via merchant ships travelling from India -- all cargo ships should be guarantined until it could somehow be determined that the goods were not contaminated. This was unacceptable to the merchant sector of the capitalist class, because any delay in the "flow" of goods meant a decline in their profits. Indeed, the sanitary reforms of 1848 in England specifically rejected the contagionist theory in favour of the environmental theory as a sop to pressures from the mercantile establishment.
theory of disease
In so doing, the sanitary reforms proved to be right for the wrong reasons. For, unlike Livesey's and Lipsius' contention that the environmental theory was grounded on an analysis of the stressful, malnourished and impoverished social conditions caused by capitalism, the environmental theory was predicated on "miasma". …