4. Germs, parasites and humans

Question 1

Give a brief history of germ theory. 7

Answer 1

1. 1830s - scientists found evidence that yeast consisted of small spherules, which had the property of multiplying and were therefore living organisms
2. new microscopes, labs and experiments revealed new world of life
3. at this time, there was a general view that certain organisms caused putrefaction
4. 1850s - Louis Pasteur - fermentation depended on living forms/bacteria and proposed partial sterilization destroyed most bacteria, most enzymes and made milk, wine and food safe
5. Pasteur suggested that bacteria also caused human and animal disease
6. Called germ theory - developed in germany and france in 1880s
7. Koch applied germ theory to disease and his postulates are still used today to identify a disease causing microorganism

Question 2

What is germ theory? 4

Answer 2

1. The theory that disease was caused by microorganisms/germs, not climate, miasma or environment
2. robert koch was the first to devise the proofs to verify theory
3. Postulates first used in 1875 to prove anthrax (cattle disease affecting farming and leather industry) was caused by Bacillus anthracis
4. Discovered cholera vibrio in 1883

Question 3

Describe the impact of germs and vaccines. 7

Answer 3

1. Pasteur combined work of partial sterilisation and identification to develop vaccines
2. 1870s - applied immunisation method to anthrax
3. 1885 - rabies vaccine - a dreaded disease passed from animals to humans
4. vaccines and pasteruisation became keys of pasteurian science in 1880s
5. His science influences French public health, veterinary medicine, agriculture and the food industry
6. In europe, Pasteur Institutes did anthrax, rabies, TB and plague vaccinations, food preservation, agricultural, dairy and meat production and determined diet and nutrition
7. Britain had no Pasteur Institute, suspicious that vaccine and animal experiences could cause rabies

Question 4

How was the rabies vaccine invented? 7

Answer 4

1. Louis Pasteur in 1885
2. Disease affects nervous system
3. Took dead rabid dog and infected rabbit with spinal cord
4. Rabbit died
5. Took spinal cord of rabbit and infected another
6. Repeated until disease attenuated enough for vaccine
7. first vaccine acted as dried spinal cord in mixture

Question 5

Describe the new power that scientists gained with the acceptance of the germ theory. 5

Answer 5

1. Some, incl Pasteur, believed the victory of vaccines lay in the power of scientists over life
2. French power had been declining since 1815, but establishment of third republic in 1870 increased power and came with colonialism in Africa and Asia
3. This coincided with Pasteur’s achievements
4. Pasteurian science became dominant global paradigm
5. institutional and imperial expansion of germ theory and vaccination

Question 6

How did Pasteurian science relate to politics? 4

Answer 6

1. People came from around the world for Pasteur’s rabies vaccine
2. The pasteur insti in paris and others in franch demanded vaccination and pasteurisation of all farms to politicians
3. claimed for the country’s health
4. gaining political, not just scientific, power

Question 7

Pasteur institutes in the French empire. 5

Answer 7

1. Indo-china
2. North Africa
3. Sub-saharan africa
4. Shows expansion of imperial power
5. Pasteurisation of france and the world had huge economic implications

Question 8

What was the role of colonial Pasteur institutes? 4

Answer 8

1. Tunis and Morocco influenced mediterranean economy by promoting vaccination and pasteurisation in farming
2. trade couldn’t pass through without certificate of pasteurisation from Pasteur institute
3. french followers wanted a coalition of pasteur instis around med. for more coordinated and cooperative research, by developing business alliances across region
4. Charles Nicolle ran operation from Tunis and was called the emperor of the med. sea

Question 9

How did France use germ theory to try to change views of their colonialism? 3

Answer 9

1. France claimed their method of colonial civilization were based on science and modernity rather than missionary style
2. Pasteur instis built in colonies and transformation of them
3. W. Haffkine took the cholera vaccine to slums of Calcutta to help

Question 10

What was the importance of microbe hunters in the years following germ theory? 6

Answer 10

1. 1870s-80s were years of the microbe hunters
2. gave new scientists credibility and fame if they found a microbe
3. many travelled the world to find microbes
4. in a shot period, bacteriologists isolated and cultivated many pathogenic bacteria and viruses (1870s-1880s)
5. Some, incl. Koch, physically hunted animals to find microbes eg. Trypanosomiasis (sleeping sickness)
6. Scientific missions mixed with imperial culture of hunting - power of lab corresponded to imperial power

Question 11

Describe the development of the healthy carrier theory. 7

Answer 11

1. During typhoid research, Koch proposed that there was a ‘carrier state’
2. Suggested healthy people could carry the diseases in gallbladder/intestines and infect others
3. Used this to explain endemic nature of disease among populations, who could also infect others
4. eg. all people of Bengal carry cholera - dangerous idea as it turns all people from one place into a threat
5. the human body became the focus of research as the site of germs - morbid anatomy studies
6. important implications for the 20thc racial pathology, public health and immigration policies
7. severe quarantines imposed

Question 12

Describe the french ‘mission’. 5

Answer 12

1. End 19thC, french officials, scientists and imperial governors descended on the colonies to civilise them and spread the messages and gifts of france
2. Became a movement to introduce french modernity to the colonies
3. french pasteur instis used the word mission as it implied humanitarian activities
4. this was continuous with earlier 1840s missionary efforts - similar tactics were used eg. spreading the word of god/pasteur, but now secular
5. scientists were the new missionaries, wearing white robes eg. charles nicolle in north africa

Question 13

How did pasteurian science impact Algeria? 7

Answer 13

1. Brothers edmond and etienne sergent were trained in french microbiology and joined pasteur insti in algeria in 1912
2. 1927- french colonial authority granted sergent brothers a 360 acre malarial marshland along railway line to do fieldwork
3. sergents researched how pasteurian anti-malaria work could transform algerian landscape and culture
4. dug drainage canals (local labour) planted trees and introduced predatory fish
5. marshes replaced with livestock and cereal crops and algerian farmers persuaded to settle
6. farmers taught modern farming methods and vineyards planted- good economically for french government
7. sergent brothers believed they humanised the once savage marshland

Question 14

How did germ theory impact civilisation? 7

Answer 14

1. Human carrier theory reinforced medical segregation based on race and class
2. removal of germs of disease by pasteurian missionaries became social and cultural reform, as they were removing filth, unclean habits and segregating races and groups
3. french bacteriologists determined to remove tropical disease and realities
4. late 19thC rio de janeiro - city elites used civilisation and germs to justify protecting own interests and isolating poor
5. poor identified as disease/dirt carriers and removed to outskirts, habits changed and mass vaccination enforced
6. australia - gvnmt wanted a white australia, and chinese immigrants seen as unclean and reservoirs of disease
7. quarantine procedures became strict to prevent entrance of foreign (chinese) germs)

Question 15

How did bacteriology make medicine scientific? 3

Answer 15

1. Breaks from traditional notions of humourology and climate
2. use of lab
3. universal and global medicine

Question 16

Where was mass vaccination enforced? 5

Answer 16

1. in colonies
2. in asia at pasteur instis
3. in developing countries eg. whole of costa rica inoculated against smallpox, measles and polio in 1967
4. new york in 1940s
5. routine childhood immunizations are now expected

Question 17

What was the significance of vaccines? 5

Answer 17

1. Marked break from traditional medicine
2. universality of germ theory - germs could grow anywhere and be treated by vaccine
3. new confidence in medicine - cannot conquer climate and environment, but can conquer germs through vaccines
4. New hope of global eradication of disease
5. became main mode of global health deliverance in 20thC

Question 18

What resistance was there to vaccination? 5

Answer 18

1. fighting germs is a constant battle, since germs mutate and new vaccines are constantly needed
2. miasmatic and climatic ideas have persisted after germ theory
3. many diseases have not been eradicated
4. It has become clear that vaccines alone can’t overcome poverty and dirty conditions that cause disease
5. vaccines have caused some side effects, raising ethical questions about mass vaccination

Question 19

give the story of Mary Mallon. 13

Answer 19

1. Civil engineer/disease detective geroge soper hired to investigate typhoid in rich house
2. realised their cook, mary mallon, had passed it on to them via peaches and ice cream
3. typhoid had occurred in other households she had worked in
4. koch’s theory of healthy carrier inspired soper to label mm as one
5. she took offence and could not understand how she was carrying invisible disease causing germs
6. as a cook, she had a good job, most important, respected and trusted of staff - didn’t want to give that up
7. Refused gallbladder surgery and a move out of state, and was imprisoned
8. after a court case, she was the only carrier of 50 to be detained - Irish prejudces
9. later released and given terrible job as a laundress
10. lost track of her in 1914
11. DoH realised there were many typhoid carriers, and unsuccessfully screened food handlers
12. mary found working in hospital kitchen and spread to others
13. recaptured to isolation island for life, day trips only, worked there as lab technician until death age 69

Question 20

Summarise the article Typhoid Mary strikes back, by J. Leavitt, 1992. Published in isis. 13

Answer 20

1. germ theory did not bring about widespread reductionism, as some people believe
2. C. Chapin claimed that sanitary measures were now pointless, and was much more concerned with healthy carriers
3. citizen’s responsibility to avoid them eg. hand washing
4. Mary Mallon’s case showed new importance of the lab in public health, yet was intrusive and unrealistic for all carriers
5. Mary’s continuous incarceration after appeal would have been impossible without lab reports and evidence
6. focus on killing bacilli rather than practical solutions to help mary prevent spread
7. c. chapin (public health official) believed imprisonment the wrong approach - it isnt useful
8. case shows narrow perspective - so focussed on bacteria they ignored mary.
9. 1916 - food handlers needed certificates to prove health, and lab tests were essential for this
10. carriers who handled food and violated were eventually let free as long as they did other work and took reasonable precautions
11. Shows other factors considered besides bacteriology
12. Bacteriology reports same for sick and healthy carriers, but recommended course of action different
13. Lab important in early 20thC but not all knowing, eg. mary’s imprisonment affected by her character

Question 21

Summarise the Pasteurisation of alergia? by J. Strachan, 2006. Published in French History. 10

Answer 21

1. Pasteur instis overseas initially struggled with lack of equipment
2. the algerian insti faced funding problems and its initial allowed areas of research were limited
3. this changed when governor-general Jonnart intervened in 1909
4. Edmond and etienne worked on malaria at algeria pasteur insti and took over in 1912
5. they realised indigenous people acted as a parasite resevoir and extended protection to them
6. stagnant water cleared/oiled
7. gauzes and protective clothing offered
8. ideas successful
9. later, the brothers investigated malaria in the armies at macedonia and write a good report - changes implemented successfully
10. heavily influenced by pasteur.

Question 22

Summarise the paper civilizing rio de janeiro by t. meade, 1986. Published by journal of social history. 15

Answer 22

1. 1904 - riots in response to forced vaccination against smallpox
2. some used the vaccination as an excuse to discredit the gvemt, others genuinely concerned
3. poor and wealthy separated to show a more civilised city to foreign investors, plantation owners etc.
4. sanitation, health, housing and transport were very poor, yet they were trying to be like a european republic
5. problems with beggars and prostitution, and health as susceptible to flooding, which damaged reputation
6. 1889 - first attempts at public health improvements, incl. building of streetcars with intercepting rail lines and demolition of dirty or dangerous housing
7. more measures taken in 1902 despite local opposition, incl building of canals, filling of marshlands and widening of streets
8. 1902 - gvnmt took control of public health
9. yellow fever plan borrowed from havana
10. 1903 code - inspectors could access and demolish any unsanitary buildings
11. lots of opposition, esp from poor
12. positivist church and working class centre led the opposition
13. mass vaccination called off
14. re initiated a few years later after bad small pox epidemic - little resistance

Question 23

Were modern public health measures based on germ theory intrusive or beneficial?

Answer 23

1. In response to pasteurian science, instis began research on diet etc - beneficial
2. however, koch’s healthy carrier theory led to severe quarantines on people from certain areas - intrusive
3. beneficial - C. Chapin encouraged hand-washing, which is not very intrusive but does help prevent disease spread
4. Case of mary mallon - both. beneficial as prevented her spreading disease when she refused to give up cooking
5. intrusive as they imprisoned her - took away from freedom. refused to train her for another good job
6. treatment not extended to other carriers, but food handlers had to submit for lab tests - a bit intrusive
7. eventually other carriers were let go, so less intrusive and gave some benefit if they switched professions
8. in algeria, edmond and etienne extended anti-malaria work to locals who showed signs of immunity on realising they were resevoirs and could suffer - carried out clearing of diseased marshland eg. removal of water, beneficial and gave quinine chocolate to children - intrusive
9. encouragement to move there somewhat intrusive, but did bring benefit of more malaria free land
10. brothers aided military sufferers in macedonia successfully
11. rio- very intrusive. demolition of houses belonging to poor as unclean, but ulterior motive of beautifying city for foreign investors
12. meant poor moved to outskirts where no measures!
13. beneficial to rich eg. filling in marshland but poor were on outskirts
14. 1903 code - any building could be deemed unsanitary and demolished
15. mass vax attempts would have benefited but called off - so less effective than the sanitary measures could have been if properly implemented, as discussed in other lectures
16. overall, depends on country and populations within country
17. ulterior motives must be considered
18. cannot be beneficial without being intrusive - many think any change is intrusive