Plagues and Peoples
Page 31
Another sort of epidemic disease whose fixture among mankind remains at least potentially significant is well illustrated by the influenza epidemic of 1918–19. Influenza has been around a long time, and is remarkable both for the rapidity of its spread, the brevity of the immunity it confers, and the instability of the virus that causes the disease.90 In 1918–19, the confluence of American with European and African troops in northern France provided the milieu for the emergence of an epidemic of unprecedented scope. New strains of virus were responsible, strains that proved unusually destructive to their human hosts. The disease spread throughout the earth, infecting almost the entire population of the globe, and killing twenty million or more. When the flu hit, medical personnel and facilities were immediately overburdened and health services generally broke down; but the acute phase passed rapidly because of the very infectiousness of the virus, so that within a few weeks human routines resumed and the epidemic faded swiftly away.91
A generation of research subsequent to 1918 established the existence of three distinct virus strains; and it is possible to create vaccines against all of them. The problem, however, is complicated by the fact that the influenza virus is itself unstable and alters details of its chemical structure at frequent intervals. Any new and widespread epidemic is therefore almost sure to originate with a virus that has changed enough to escape the antibodies last year’s vaccine can create in human bloodstreams.
Changes in the flu virus and mutations of other infectious organisms therefore remain a serious possibility. In 1957, for example, a new “Asian” strain of flu appeared in Hong Kong; but before it attained epidemic force in the United States, vaccine against the new variant had been produced in sufficient quantity to affect the incidence and intensity of the infection. This required, nonetheless, nimble footwork on the part of public health authorities and private entrepreneurs in recognizing the new influenza strain and starting vaccine manufacture on a large scale without delay.92
Even without mutation, it is always possible that some hitherto obscure parasitic organism may escape its accustomed ecological niche and expose the dense populations that have become so conspicuous a feature of the earth to some fresh and perchance devastating mortality.93 Recent cholera outbreaks in India and southeastern Asia, for example, are due to a new type of bacillus indigenous to the Celebes, which has been able to displace the “classical” cholera organism from nearly all of its original habitat in and around Bengal.94 Other recent examples of this sort of unpredictable biological fluctuation are the mysterious careers of Lassa fever in Nigeria and of O’nyong nyong fever in Uganda, referred to above.95
A third unpleasant possibility is that biological research aimed at discovering effective ways of paralyzing enemy populations by disseminating lethal disease organisms among them might succeed in unleashing epidemiological disaster on part—or perhaps on all of the world.
Apart from such conceivable catastrophes, it is clear that humankind remains subject to the limitations inherent in our place in the food chain. Galloping increases in human numbers that have resulted from the success of public health measures in the past 150 years create pressures on food supply. Other stresses created by population increases may manifest themselves in innumerable ways—sociological, psychological, and political, as well as epidemiological.
Skill and knowledge, though they have profoundly transformed ordinary encounters with disease for most of humankind, have not and in the nature of things never can extricate humanity from its age-old position, intermediate between microparasites attacking invisibly and the macroparasitism of some men upon their fellows. To be sure, the simple polarity of older ages, whereby human societies were neatly divided between food producers and those who preyed upon them, has been profoundly altered by the development of scientific farming and the services and supplies food producers now receive from others who do not themselves directly produce food. Nevertheless, in a more complicated form the old problem of adjusting relations between producers and consumers remains, even in our mechanized and bureaucratized age. Certainly, no enduring and stable pattern has emerged that will insure the world against locally if not globally destructive macroparasitic excesses. World War I and World War II both led to locally destructive results; and wars or revolutions, launched with different purposes in mind, may again, as in times past, inflict starvation and death upon large segments of the world’s population.
From the other side, the galloping increase in human numbers practically guarantees that existing margins between food supplies and human hunger will swiftly disappear, leaving less and less in reserve for times of unusual crisis. As that occurs, the skills of doctors, farmers, administrators, and all those who take part in sustaining the familiar yet enormously complex flow of goods and services characteristic of modern society become critical for the maintenance of existing levels of human population.
In view of the truly extraordinary record of the past few centuries, no one can say for sure that new and unexpected breakthroughs will not occur, expanding the range of the possible beyond anything easily conceived of now. Birth control may in time catch up with death control. Something like a stable balance between human numbers and resources may then begin to define itself. But for the present and short-range future, it remains obvious that humanity is in course of one of the most massive and extraordinary ecological upheavals the planet has ever known. Not stability but a sequence of sharp alterations and abrupt oscillations in existing balances between microparasitism and macroparasitism can therefore be expected in the near future as in the recent past.
In any effort to understand what lies ahead, as much as what lies behind, the role of infectious disease cannot properly be left out of consideration. Ingenuity, knowledge, and organization alter but cannot cancel humanity’s vulnerability to invasion by parasitic forms of life. Infectious disease which antedated the emergence of humankind will last as long as humanity itself, and will surely remain, as it has been hitherto, one of the fundamental parameters and determinants of human history.
Appendix
Epidemics in China
A Check List Compiled by Joseph H. Cha,
Professor of Far Eastern History, Quincy College
T
he following list of epidemics in China is based on two much older compilations, one the work of Ssu-ma Kuang, a scholar who lived during the Sung Dynasty (960–1279), and the other the work of a staff of researchers, who compiled a general encyclopedia of traditional Chinese learning in the eighteenth century. These two lists of human and natural calamities were republished in 1940, but the editor made some errors in expressing traditional dates in the modern calendar. Professor Cha corrected such mistakes when he could, by checking against passages in ancient dynastic histories and other documents, whenever such sources were cited. In addition, he translated traditional place names into the modern provincial geography of China.
The result is not without faults. The choice of which modern province to equate with an ancient regional name that does not coincide with today’s provinces is sometimes arbitrary. Moreover, there undoubtedly remain additional references to epidemics in Chinese writings that escaped the previous compilers and are therefore missing here too. All statements about how many died are paraphrases of ancient texts, and Professor Cha made no attempt to assess the credibility of each such remark; and though some do deserve credence, others may be wide of the mark. Yet despite such defects, it is clear that the following list is more accurate than any published before in any western language, and it seems unlikely that major disease disasters escaped being here recorded. Crude indication of major turning points ought therefore to be detectable from the following list, and for this reason it seemed well to reproduce it here.
The printed text from which Professor Cha worked may be transliterated as follows: Ch’en Kao-yung, Chung Kuo Li Tai Tien Tsai Jen Huo Piao, 2 vols., Shanghai, 1940.
EPIDEMICS IN CHINA TO A.D. 1911
B.C. 243 Epide
mic throughout the empire
B.C. 48 Epidemic, flood and famine “east of the pass,” i.e., probably in Honan, Shansi and Shantung
A.D. 16 Epidemic; a general attacking barbarians to the south lost six to seven tenths of his troops from disease.
37 Epidemic in Kiangsu, Kiangsi, Anhui, Chekiang and Fukien
38 Epidemic in Chekiang
46 Famine and epidemic in Mongolia; two thirds of population died.
50 Epidemic, location undefined
119 Epidemic in Chekiang
125 Epidemic in Honan
126 Epidemic in Honan
151 Epidemic in Honan, Anhui, Kiangsi
161 Epidemic, location undefined
162 Epidemic broke out in ranks of army in Sinkiang and Kokonor; three or four out of ten died.
171 Epidemic, location undefined
173 Epidemic, location undefined
179 Epidemic, location undefined
182 Epidemic, location undefined
185 Epidemic, location undefined
208 Epidemic in an army in Hupeh; two thirds of troops died of disease and famine.
A.D. 217 Epidemic, location undefined
223 Epidemic, location undefined
234 Epidemic, location undefined
275 Epidemic in Honan; tens of thousands died.
291 Epidemic in Honan
296 Epidemic in Shensi
297 Epidemic in Hopei, Shense, Szechwan
312 Epidemic, locality undefined; following on earlier disasters from locusts and famine, northern and central China became a “great wasteland”; in Shensi only one or two out of a hundred taxpayers survived.
322 Epidemic; two or three out of ten died; location undefined.
330 Epidemic, location undefined
350 Epidemic, location undefined
351 Epidemic following rebellion in Honan
353 Epidemic, location undefined
379 Epidemic in Shensi
423 Epidemic in North China; in Honan two or three out of ten died.
427 Epidemic in Kiangsu
447 Epidemic in Kiangsu
451 Epidemic in Kiangsu
457 Epidemic in Kiangsu
460 Epidemic in Kiangsu
468 Epidemic throughout the empire; during a second outbreak later in the year in Honan, Hopei, Shantung, Hupeh, and Anhui 140,000 to 150,000 died.
503 Epidemic, location undefined
504 Epidemic in North China
505 Epidemic in North China
510 Epidemic in Shensi; 2, 730 died.
529 Epidemic in Shensi
546 Epidemic in Kiangsu
565 Epidemic in Honan
598 Epidemic in southern Manchuria during military campaign against Korea
612 Epidemic in Shantung and elsewhere
636 Epidemic in Shansi, Kansu, Ninghsia, and Shensi
641 Epidemic in Shansi
642 Epidemic in Shansi and Honan
A.D. 643 Epidemic in Shansi and Anhui
644 Epidemic in Anhui, Szechwan, and Northeast
648 Epidemic in Szechwan 655 Epidemic in Kiangsu
682 Epidemic in Honan and Shantung; land covered with corpses.
707 Epidemic in Honan and Shantung; several thousand died.
708 Epidemic in Honan and Shantung; one thousand deaths.
762 Epidemic in Shantung; more than half the population died.
790 Epidemic in Fukien, Hupeh, Kiangsu, Anhui, Chekiang
806 Epidemic in Chekiang; more than half the population died.
832 Epidemic in Szechwan, Yunnan and Kiangsu
840 Epidemic in Fukien, Chekiang
874 Epidemic in Chekiang
891 Epidemic in Hupeh, Kiangsu and Anhui; in Hupeh three or four out of ten died.
892 Epidemic in Kiangsu 994 Epidemic in Honan
996 Epidemic in Kiangsu, Anhui and Kiangsi
1003 Epidemic in Honan
1010 Epidemic in Shensi
1049 Epidemic in Hopei
1052 Epidemic in Hupeh, Kiangsu and Anhui
1054 Epidemic in Honan
1060 Epidemic in Honan
1094 Epidemic in Honan
1109 Epidemic in Chekiang
1127 Epidemic in Honan; half population of capital died.
1131 Epidemic in Chekiang and Hunan
1133 Epidemic in Hunan and Chekiang
1136 Epidemic in Szechwan
1144 Epidemic in Chekiang
1146 Epidemic in Kiangsu
1199 Epidemic in Chekiang
1203 Epidemic in Kiangsu
1208 Epidemic in Honan and Anhui
1209 Epidemic in Chekiang
1210 Epidemic in Chekiang
A.D. 1211 Epidemic in Chekiang
1222 Epidemic in Kiangsi
1227 Epidemics among Mongol armies in North China
1232 Epidemic in Honan; 90,000 died in less than fifty days.
1275 Epidemic with incalculable mortality, location undefined
1308 Epidemic in Chekiang; more than 26,000 died.
1313 Epidemic in Hopei
1320 Epidemic in Hopei
1321 Epidemic in Hopei 1323 Epidemic in Hopei
1331 Epidemic in Hopei; nine tenths died.
1345 Epidemic in Fukien and Shantung
1346 Epidemic in Shantung
1351–52 Epidemic in Shansi, Hopei, Kiangsi; 50 per cent mortality among troops in the, Huai Valley.
1353 Epidemic in Hupeh, Kiangsi, Shansi, Suiyuan; in part of Shansi more than two thirds of the population died.
1354 Epidemic in Shansi, Hupeh, Hopei, Kiangsi, Hunan, Kwangtung, and Kwangsi. In part of Hupeh six or seven out of ten of the population died.
1356 Epidemic in Honan
1357 Epidemic in Shantung
1358 Epidemic in Shansi and Hopei; over 200,000 died.
1359 Epidemic in Shensi, Shantung, and Kwangtung
1360 Epidemic in Chekiang, Kiangsu, and Anhui 1362 Epidemic in Chekiang
1369 Epidemic in Fukien; corpses in heaps on the roads.
1380 Epidemic in Chekiang
1404 Epidemic in Hopei
1407 Epidemic in Hunan
1408 Epidemic in Kiangsi, Szechwan, and Fukien; 78, 400 died.
1410 Epidemic in Shantung (6,000 died) and Fukien (15,000 households perished)
1411 Epidemic in Honan and Shensi
1413 Epidemic in Chekiang
1414 Epidemic in Hopei, Honan, Shansi, and Hupeh
1445 Epidemic in Chekiang, Shensi, and Fukien
1454 Epidemic in Kiangsi and Hupeh
A.D. 1455 Epidemic in Shensi, Kansu, and Chekiang
1461 Epidemic in Hunan, Hupeh, Kwangtung, and Shensi
1471 Epidemic in Kweichow
1475 Epidemic in Fukien and Kiangsi
1480 Epidemic in Fukien
1481 Epidemic in Kiangsi and Kweichow
1486 Epidemic in Fukien
1489 Epidemic in Hunan; whole villages and towns perished.
1492 Epidemic in Chekiang
1495 Epidemic in southeastern China
1500 Epidemic in Kwangsi
1504 Epidemic in Shansi
1506 Epidemic in Hunan, Hupeh, Kwangtung, Kwangsi, Yunnan, and Fukien; extremely high mortality.
1511 Epidemic in Chekiang
1514 Epidemic in Yunnan
1516 Epidemic in Hupeh
1517 Epidemic in Fukien
1519 Epidemic in Hopei, Shantung, Chekiang
1522 Epidemic in Shensi
1525 Epidemic in Shantung; 4, 128 persons died.
1528 Epidemic in Shansi
1529 Epidemic in Hupeh, Szechwan, Kweichow
1532 Epidemic in Shensi
1533 Epidemic in Hupeh, Hunan
1534 Epidemic in Chekiang, Hupeh, Hunan
1535 Epidemic in Fukien
1538 Epidemic in Kwangsi
1543 Epidemic in Shansi
1544 Epidemic in Shansi, Honan
1545 Epidemic in Fukien
1554 Epidemic
in Hopei
1556 Epidemic in Fukien
1558 Epidemic in Kweichow
1560 Epidemic in Shansi
1561 Epidemic in Hupeh
1562 Epidemic in Fukien; seven tenths died.
1563 Epidemic in Kiangsi
1565 Epidemic in Hopei and Chekiang
1571 Epidemic in Shansi
1573 Epidemic in Hupeh
A.D. 1579 Epidemic in Shansi
1580 Epidemic in Shansi
1581 Epidemic in Shansi
1582 Epidemic in Hopei, Szechwan, Shantung, and Shansi
1584 Epidemic in Hupeh
1585 Epidemic in Shansi
1587 Epidemic in Shansi and Kiangsi
1588 Epidemic in Shantung, Shensi, Shansi, Chekiang, and Honan
1590 Epidemic in Hupeh, Hunan, and Kwangtung
1594 Epidemic in Yunnan
1597 Epidemic in Yunnan
1598 Epidemic in Szechwan
1601 Epidemic in Shansi and Kweichow
1603 Epidemic in Chekiang
1606 Epidemic in Chekiang
1608 Epidemic in Yunnan
1609 Epidemic in Fukien
1610 Epidemic in Shansi and Shensi
1611 Epidemic in Shansi
1612 Epidemic in Shensi and Chekiang
1613 Epidemic in Fukien
1617 Epidemic in Fukien
1618 Epidemic in Shansi, Hunan, Kweichow, and Yunnan; corpses lying side by side in Shansi.
1621 Epidemic in Hupeh
1622 Epidemic in Yunnan
1623 Epidemic in Yunnan and Kwangsi
1624 Epidemic in Yunnan
1627 Epidemic in Hupeh
1633 Epidemic in Shansi
1635 Epidemic in Shansi
1640 Epidemic in Hopei and Chekiang
1641 Epidemic in Honan, Hopei, Shantung, and Shansi; corpses lying side by side throughout.
1643 Epidemic in Shensi
1644 Epidemic in Shansi, Kiangsu, and Inner Mongolia