Sunday, 11 December 2011

Gods and Monsters on Disease

I caught up with Tony Robinson's Gods and Monsters on Disease.

The idea that illness could be spread by elfs with tiny arrows (elf-shot) was new to me but illustrated how our ancestors struggled to make sense of their own distant past. In this case, it was tiny Neolithic arrowheads, perhaps half an inch across, which formed the basis of the legend. Being stone in an age of metal as well, they must have seemed very strange indeed, and like the Iron Age Hill Camps, which became understood as "fairy forts", they were incorporated into the world view in such a way as to change them from anomaly to example.

There is, of course, a modern analogue, whereby strange phenomena in the sky in an age of science are incorporated into a system whereby far from being UFOs - unidentified flying objects - they become instead identified as alien incursions, "flying saucers" after Kenneth Arnold's description in June 1947. The skeptical reaction is to attribute these to atmospheric phenomena, or to misplaced identifications of real objects like weather balloons. But what is interesting in both cases, is that world views seem to abhor anything that can be labeled "unknown"; there is always an attempt to reduce it to the understandable, whether by incorporating it into an alien life scenario, or into a scientific reductionism that places it within the boundaries of known science. In that respect, we are philosophically very similar to our ancestors, only we regard our own explanations for the inexplicable - and our desire to have an explanation - as entirely rational!

It was good to see Owen Davies pop up on screen. I'd read his excellent studies of Cunning Folk, Charms and Charmers and witchcraft magic and culture from 1736-1951, so it was nice to put a face to the printed page. He was explaining to Tony Robinson about the notion that in the Middle Ages that disease is like a game of tag that leaves one person, then is caught by another, so as you get well, they get sick. In fact, on the surface, this is quite a rational explanation from observation - in our office, for example, with coughs and colds, you can see it all the time because the duration of the illness means that as another person gets the infection, the person who gave it to them is recovering. Indeed, last week several people were coughing, now I've caught their cough, but they will probably be getting better. For repetitive winter illnesses like that, the cycle of the disease strongly suggests a game of tag, rather than a person transmitting the illness and still retaining it.

But apply logic to that principle, and you end up with all kind of bizarre notions. Rather than just by accident, means can be taken to ensure than an infection can be taken away from someone by deliberately giving it to someone else, which is not a particularly good idea if it was plague rather than coughs and colds. Yet even there, those who survived would be recovering while others were being afflicted, suggesting that game of tag transmission of disease.

A stall was set up to demonstrate in a busy street the treatment of warts by snails. The idea was that you would rub the snail on the wart, and if left where someone would pick it up unsuspectingly, they would take on the wart, while it would leave you. Here is another odd notion by applying rigorous logic to the game of tag idea of disease - for it to leave you, you must give it to someone else.

It was interesting that the the young volunteers demonstrated non-medieval magical thinking by their way of trying to treat warts they had - a knife, the sharp end of a pen, and sandpaper! So much for medical knowledge and the age of science!

Hippocrates approach to disease, which Robinson explained was still current in the Middle Ages, was that disease was spread by "foul air", by a "miasma", usually caused by rotting bodies, or the smell resulting from the effects of disease like typhoid, or from cesspits. The germ notion of disease was, of course, completely unknown.

What he didn't mention was that it was also thought that astrological phenomena such as an alignment of humid Mars and fiery Jupiter could also cause vile, disease producing vapours in the atmosphere. One of the most significant pandemics was thought to have been caused by the orbits of Mars, Jupiter and Saturn lining up in the 40th degree of Aquarius. According to the Compendium de Epidemia, this was on March 20th 1345, and marked the beginning of the plague.

But in 1981, Astronomers Sir Fred Hoyle and Dr. N. Chandra Wickramasinghe wrote "Diseases from Space" in which they made a serious suggestion that interstellar transmission of virus or bacteria forms could in fact come from outer space:

"We noticed that epidemics and pandemics of fresh diseases, both in historical times as well as more recently, have almost without exception appeared suddenly and spread with phenomenal swiftness. The influenza pandemics of 1889-1890 and 1918-1919 both swept over vast areas of the globe in a matter of weeks. Such swiftness of spread, particularly in days prior to air travel, is difficult to understand if infection can pass only from person to person. Rather it is strongly suggestive of an extraterrestrial invasion over a global scale. We argued now that it is the primary cometary dust infection that is the most lethal, and that secondary person-to-person transmissions have a progressively reduced virulence, so resulting in a diminishing incidence of disease over a limited timescale."

This theory was provocative, and was initially treated with skepticism, because bacteria would be heated to about 500 degrees Centigrade on their way through the Earth's atmosphere. But Dr. Shirwan Al-Mufti, an astronomer at the University of Wales conducted an experiment in which he stuck tubes of bacteria into hot ovens (between 300 and 700 degrees). He noted that:

"After withdrawal from the furnace, each tube was broken open and its contents transferred to a nutrient broth...In all cases up to the highest temperatures for which the furnace was accurately calibrated, growth occurred, eventually back to normality."

So there may be something in the idea of cometary debris, for example, as a portent of disasters and plagues after all, and while the notions themselves were enfolded in an astrological world view, the initial ideas may have come from observation.

Regarding the miasma theory of disease, I'm also not totally convinced. While it is true that disease is not transmitted by bad smells, particulate matter is (because that's how smells travel) and I think that could lead to respiratory problems like allergy and asthma which might weaken the bodies immune system. Several recent papers have stressed this kind of link. For example, "Particulate matter and heart disease: evidence from epidemiological studies" (2007) tells us that "evidence is suggesting not only a short-term exacerbation of cardiovascular disease by ambient particle concentrations but also a potential role of particles in defining patients' vulnerability to acute coronary events. While this concept is consistent with the current understanding of the factors defining patients' vulnerability, the mechanisms and the time-scales on which the particle-induced vulnerability might operate are unknown." So while plague may not be transmitted by "bad smells", they may still have long term effects on the human body.

An experimental study saw Tony Robinson's body immersed in a bath of blood and entrails to recreate the story of an Irish warrior who was wounded in battle, and whose followers slaughtered cattle to give him the life giving properties from the blood. In fact, while this idea was present in paganism, it was also present in Judaism, where the Bible has such texts which prohibited the custom of eating blood.

But flesh with the life thereof, which is the blood thereof, shall ye not eat. And surely your blood of your lives will I require; at the hand of every beast will I require it, and at the hand of man; at the hand of every man's brother will I require the life of man. Whoso sheddeth man's blood, by man shall his blood be shed: for in the image of God made he man.

And whatsoever man there be of the house of Israel, or of the strangers that sojourn among you, that eateth any manner of blood; I will even set my face against that soul that eateth blood, and will cut him off from among his people. For the life of the flesh is in the blood: and I have given it to you upon the altar to make an atonement for your souls: for it is the blood that maketh an atonement for the soul.

One would expect that the failure of blood letting to magically transfer life energy in most cases (except where by accident the victim survived) would lead to skepticism, but magical thinking does not always work like that. In the case of sacrifices, the general rule has often been that the sacrifice was simply not enough to ensure the efficacy of the cure, and more would have worked.

The placebo effect was also mentioned as one of the main drivers behind the success of Medieval medicine. What Robinson didn't mention was recent studies which suggest that placebos not just cause the person to think pain is less, for example, but also alter the neurochemistry of the brain.

An example is where you control the pain with morphine until the final day of the experiment, when you replace the morphine with saline solution. The saline - as a placebo - takes the pain away. Fabrizio Benedetti of the University of Turin in Italy carried out the same experiment, but added a final twist by adding naltrexone, a drug that blocks the effects of morphine, to the saline. As New Scientist reported, the result was that the pain-relieving power of saline solution disappeared, indicating that it is not just suggestion that is at work, but possibly some deeper neurochemical changes.

The last section was on trepanning and its connection with modern brain surgery. The idea is to cut a hole in the brain to release the cause of epilepsy or mental illness etc. I was a little concerned about Tony Robinson saying that the idea was to "let out the evil spirit", because of course with Neolithic examples, no written records exist, and any consideration as to the ideas behind the practice must be speculative, and not firm. Trepanning could also be used in cases of brain injury which again might release pressures inside the skull. It is also interesting to note that prehistoric and premodern patients had signs of their skull structure healing, so perhaps they survived.

This was, of necessity, a brief excursion into diseases, and Tony Robinson didn't have time to mention the very prominent notion of the four humours, derived via Galen - "sanguine", "choleric", "melancholic" and "phlegmatic" and practices derived from that like the use of leeches, which survived until well into the 18th century. The notion of temperaments which derived from the four humours actually surfaces in modern psychology in personality profiling - for example in the work of Hans Eysenck who noted how his results were similar to the four ancient temperaments.


1 comment:

Alane Wallace said...

This is remarkable, Tony. Much to think about.