As a history major I am often questioned about the validity and the usefulness of such a study. I could talk about the wars, politics, or even the societies that seemed to get it right and prosper, however; it is diseases and epidemics that truly impact societies the most. If one were to take the casualties of all wars in human history they would pale in comparison to those killed be disease. While many claim that science, war, or globalization has shaped human society the most. The most profound moments in human history are due to the invisible killers we know today as diseases.

One of the greatest examples would be the infamous Black Death. The disease later known as Yersinia Pestis would go on to kill millions, yet it would also create the greatest triumphs of human rights. Before the deadly pathogen destroyed almost one third of Europe, although some estimates put it closer to fifty percent, a majority of the population lived in conditions that were abysmal. After almost thirty, if not closer to fifty, percent of the population was wiped out by the disease the peasants became much more powerful. The sheer lack of people allowed for previously oppressed peasants to simply purchase new land and become the masters of their own destiny. This empowered many, allowing for them to break the cycle of economic and social depression created by a class of people that claimed power through an unseen god. Through an ironic twist a similar unseen force unseated them. The effects of this would later lead to a greater awareness of the rights of all humans and the limits of power that monarchs and those in power were restricted by.

After the huge impact that population loss had on the world many strived to prevent such a massive loss of human life. Scientist such as Sammelwies and John Snow would work tirelessly to prevent history from repeating itself. It was in the 20^th century that possibly one of the greatest achievements of man was carried out. In 1980 the world declared smallpox an eradicated disease, only existing in a select few locations. The possibility of a natural form of infection was eliminated and the world seemed to be united in an amazing effort to break down the barriers of nature. While flight, space travel, and the internet were achieved in the same century, all pale in comparison to the eradication of smallpox. The simple matter of the event from a historical context is that eradicating the disease saved millions of lives. For comparison about 8.2 million people died of cancer in 2012 alone, small pox would kill about 3 million per year in the 20^th century alone. The lack of smallpox in the world today would be almost comparable to curing cancer by mortality standards. This victory of man against nature is one that is monumental in principle. Mankind was able to willingly abolish a deadly organism by sheer volition and unprecedented cooperation.

When man had conquered one disease the future looked hopeful. If one of the most deadly diseases known to man was able to be defeated then how could similar diseases pose a threat? The HIV epidemic of the 70’s and 80’s awakened a new breed of social problems. The disease, while it did kill millions, was not as rampant in populations such as the black death and small pox. It was the stigma attached to it the disease that created a huge impact on societal norms and political life. It was originally thought to be a disease that only affected homosexual men, quickly becoming a focal point of religious organizations that opposed gay rights. The lethality of the disease turned into evidence of divine judgment for transgressions against the bible, equivalent to the arguments created by the church as a cause of the black death. Like many illnesses HIV only provided the ability to marginalize a minority group even more. While the social isolation of those afflicted by the disease was great, the lack of medical support was a deadly side effect. Doctors often refused to see patients for fear of contracting the deadly illness. The lack of information led children infected with the disease due to tainted donor blood to be excluded from school and isolated. The president only fueled the flames of ignorance when he chose to ignore and condone the ignorant actions of a misinformed public.

It is these examples, along with many others, that create the rich history of mankind’s coexistence with microorganisms. While these organisms are invisible to the naked eye, they have shaped almost every aspect of human history. Microorganisms have stopped invincible armies such as napoleon whose men became ill after crossing rivers in the brutal winters of Russia. They have crushed empires such as the Athenians who suffered defeat in the Peloponnesian war due to an outbreak of diseases. It is truly awe inspiring impact these organisms have on history that is often overlooked. Many choose to ignore the fact that every war, nation, and scientific discovery has been influenced in some way by the impact of these unseen organisms have on mankind.

The paradox of American politics is no better exemplified than through the reaction of the Reagan administration and conservative parties to the spread of HIV/AIDS virus.  The largest contradiction within the Republican and conservative party was demonstrated through the blatant paradox that was enforced, and encouraged, during the major outbreak of the 1970’s and 80’s.

The reaction of the current administration would be comparable to a man denying that the titanic was sinking, simply because his side of the boat was rising.  The majority of the American people, voters for that matter, were not afflicted by the illness nor were close to those afflicted.  This created the aforementioned illusion of a ship that isn’t sinking.  The reality though, is that in the end both sides end up in the same place.   As thousands died the White House was silent to the marches, protests and demonstrations of the gay community.  As children were excluded from school, despite the publications of the CDC stating there was no danger of contamination through casual contact, the president passively agreed to the fear mongering.

It was the social stigma that the “conservative” parties attributed to the disease that truly allowed for it to flourish.  An already segregated and discriminated group was now under attack with pseudo scientific claims stating the disease was only attributed to gay men.  The paradox lies within the pro small government stance that conservatives strive for, being replaced by calls to regulate the lives of citizens with increased government control.  Gun regulation brings about fear of government take over, yet there was little debate on government involvement in private matters of a citizen’s life. Calls to close the Gay Bathhouses that served as a way of sexual release for homosexual men were met with applause, while little was done to actually manage the disease.

It was only with the influence of other groups that the cause of the disease and the spread were regulated.  Using abstinence as a form of birth control is a method that has proven to be flawed, yet is still taught by more religiously inclined areas.  It was the condom campaigns and awareness adds that allowed for the public to come it its senses.  It was only the use of awareness for testing, prevention, and treatment, that the disease was finally regulated.  These cultural shifts caused by the realization that the disease was both a blood born and STD agent allowed for the gay community to shed some of its blame for the disease. While the increased awareness has its benefits, the gay community is still often used as the scapegoat for the pathogen.  Not only for the pathogen, but like the jews of the black death, many christian organizations still view the community as a source of “godly punishment”, using HIV AIDS as an excuse for increased discrimination.

Tuberculosis is a disease that has, for many ages, been associated with all groups of minorities, immigrants, and outcasts.  The effects of the disease have always had profound influences on society.  Like all diseases the societies they afflict are permanently changed.

One of the most difficult aspects of a disease is not the mortality rates, managing the spread, or even the treatment of the illness.  It has and always will be the the way humans react to the introduction of this invisible killer.  Tuberculosis merely reflects this damning phenomenon.  The response to TB was a perfect reflection of how even pseudo science can be still seen in the modern age.  From the bloodletting practices of the medieval ages, to the apparent cure by fresh air for the deadly symptoms of TB.  This along with the use of sanitariums out west in the continental US merely wasted both the money and precious last moments of those infected by the disease.  While it was not as harmful as the heat therapy used for smallpox, the sanitarium did little to actually help.  In reality it merely served as a nice place to slowly die for thousands.  One benefit of these institutions could be the almost accidental quarantine they created by instigating massive migrations of those infected out west.  Other than this phenomenon pseudo science only served to give hope to the dying and their loved ones, but did not help to understand or combat the spread.

The reaction of the larger percentage of the population, those not infected, often as an equal impact on the society as the actual disease.  For many cities in the US urban planning was improved by increasing the presence of parks and recreation areas that, according to the leading theories, would allow for clean air to treat those afflicted.  While it did not necessarily cure TB, parks served a key role in making city life much more bearable and provided many with fresh air, exercise, and recreation to occupy their time.  The other effects of TB included a fashion change, many considered facial hair to be a sign of masculinity and manliness, yet after TB struck cities it became a stigma to have one.  Many thought that a beard or mustache could harbor the disease and spread it.

The largest improvement we as a species have made against the ravages of nature have been the ability to not only treat, but to learn about the diseases that have taken so many lives.  For many it seems obvious that the eradication of these diseases should be an effort undertaken by all.  The sad reality is that while our science can answer what an antigen is, where it came from, and how to treat it for many these questions are inconsequential and mean nothing in comparison to political, cultural, and social dogma.  It is the fight against TB that governments and scientist from around the globe are beginning to realize that global politics can be just as inflexible and harsh as the persecution of Jews for the plague.  It is still a reality that instead of a microorganism being blamed for an epidemic the majority of the time it is perceived that it is “those people” that have brought the disease.  TB is no exception, for everywhere it afflicted fingers were always pointed at a being that could be seen, felt, or in many cases tortured.  It is often the consequences of the violence of human nature that condemns an infected area, not the disease itself.

The potato is arguably one of the most influential edible plants in all of human history.  It has saved countless lives, serving as a source of nutritional value that would otherwise be lacking in most rural societies.  The potato provides essential proteins, vitamins, minerals, and calories that make it a highly profitable product for farming.  These factors made it an essential source of food in Ireland during the 19th century.

The potato provides exceptional nutritional benefit per pound.  A poor family can have all the nutrients they need with minimal amounts of land easily by farming the crop.  In ireland for many this was the only source of food.  Famers were often too poor to afford a diverse diet of meats, vegetables, grains, and fruits that would provide the nutrients necessary.  Instead, the humble and hearty potato allowed thousands of tenant farmers to be relatively healthy for their economic situation.  The potato is a relatively easy plant to cultivate, maintain, and harvest.

The dependance on such a basic food was not an environmental necessity, it was a political and social consequence of England’s harsh rule of ireland.  After the transfer of religious authority due to a disagreement between English royalty and the Vatican.  This led to a schism where England created its own Anglican Christianity.  For the traditional catholics of ireland it only created increasing tension.  Along with this social discrimination the Irish were also a poor people who often were uneducated, landless, and destitute.  These factors created a very harsh and ruthless rule of English nobles that persisted well into the late 20th century with later revolts.

At the time of the Great Potato Blight the Irish were beaten and abused as ever.  The increasing taxes of a failing British Empire put even greater pressure on the tenant farmers to deliver on their rents.  When the blight infected large amounts of the necessary crop starvation wasn’t the first thought that weighed on many, it was the ability to pay rents.  It was only with the following harvest being tainted by the diseases that food began to become scarce.  Two bad harvests in a row did not just cause many to be evicted, it starved thousands more.  Those that didn’t starve became susceptible to a variety of diseases that burned their way through village after village.  Unheard of illnesses such as Scurvy began to afflict the population as food became a thing of the past.  The culprit behind such a massive scale of suffering, Phytophthora infestans.  The disease rots potatoes from the inside, rendering them inedible.  Due to the violence with which it spreads entire stores would be reduced to black mush within days of harvesting.

For those that could afford it, a passage to America offered hope of a better life away from the tyranny of the british.  At first the new labour force that could be exploited was welcomed in the newly industrialized cities of America, but soon the refugees of hunger became unwelcome.  With the passing years the Irish were seen as dirty, uneducated, and violent people that only brought with them disease and crime.  Signs saying “No Irish” were posted in major cities to deter new immigrants from applying for jobs.  It was this social ostracization that, like the Italians before them, led to the formation of crime syndicates and ghettos.  Without a legal job to pay the bills many turned the more illicit practices in large cities that allowed for a steady source of income.

Years later science provides a way to avoid such a devastating event from occurring.  Potatoes infused with the DNA of a resistant species have recently been approved for both production and consumption.  While this seems to arrive far too late for the thousands of people who starved during the famine, it marks progress in protecting both ourselves and our food from deadly pathogens that have and will kill thousands.  The fact that only potato DNA is being used eliminates almost all risks associated with other genetically modified organisms (GMO).

In 1980 the World Health Organization announced a momentous achievement, Smallpox had been eradicated from the world.  The outlook of the world was highly optimistic, one of the most terrible diseases that had killed millions would no longer afflict the innocent.  To understand why this effort was hailed with such fanfare one must understand how much damage the disease caused, how hard man strived to combat its fatal symptoms, and the effects of these processes.

Smallpox is a disease that has afflicted mankind for hundreds, maybe even thousands of years.  An egyptian mummy was found to have the tell tale scarring of the disease on the face.  The oldest confirmed existence of the disease would be the discovery of a child in Lithuania that contained DNA of the deadly smallpox virus.  The child is dated to the early 1500’s and the DNA is closely related to the strain combated in the 1970’s.  Back in the 1500’s one can imagine the disease left a wake of death in any village unlucky enough to become a host.  With the percentage of fatal cases so high in the modern age, 30% for the most common strain variola major.  The disease most likely had a much higher mortality rate due to the lack of knowledge on how to combat the systems, but also the nutritional and sanitation benefits many enjoyed by the mid 1900’s.

The residents of this time period sought a variety of ways to combat the illness.  More crude methods, more mythology than science, such as red therapy and heat therapy often killed those that would have lived.  The method of these treatments involved subjecting an already fevered person to intense heat.  The belief being that the disease would be killed, or seep out of the victim.  It was later ingenuity that helped rescue many victims from being killed by the doctors trying to cure them.  It was the brilliant minds in the Ottoman empire  that discovered that by taking infected fluid and scratching it into the skin one could prevent a more severe infection of the disease.  Lady Mary Wortley brought this method to the west, violating tradition, but saving lives in the process.  The next innovation came with the work of Jenner who coined the term Vaccine, as well as the use for the cowpox disease as a form of immunity to smallpox.  Cowpox was a distant cousin, but far less deadly and rendered the infected immune to smallpox for a duration of time.

Even with these steps forward the disease was still killing in the thousands across the globe.  Finally, after hundreds of years humanity decided to see how far science could take humanity in the fight against smallpox.  By using a method of rooting out infected individuals ,by countless hours of surveillance, and then giving the vaccine to those within a radius of that individual the disease slowly become extinct when it could no longer find a viable body.

With this success story there has been many other efforts to replicate the success of the program.  The main problem with this is the ever changing geopolitical landscape.  The polio vaccination campaign failed largely due to the cultural divides of east and west.  Rumors of American aid workers sterilizing muslims with the vaccine and other rumors that fostered violence against the movement.  It is this example that reflects the increasing challenges of a culturally diverse world unifying itself.

The classic moral dilemma of the runaway train is one that pits the good of the many vs the good of one.  In the dilemma a train is headed for two tracks: one has 5 people on it and the other has only 1 person on it.  You are positioned at the lever that will determine which direction the train will take.  What do you choose and why?

For many this situation is one that is wrestled with daily.  The only difference is that this train is an infectious disease and choosing to spare the many, can violate the fundamental rights of the one.  Scientist and government officials are confronted with this problem when the issue of how to preserve the rights of life, liberty, and the pursuit of happiness can cost millions of lives due to an infectious disease.  This has given rise to various debates about how to quarantine, isolate, and research infectious diseases.  One debate that is close to home involving these issues is the right to choose vaccination.  While the studies of Andrew Wakefield have been retracted and proven wrong on many fronts, the principle of the issue remains prevalent.  Who has the right to choose the level of health care and control over their own body, the government or the individual.

For those who seek to increase vaccine laws and regulations the concepts of herd immunity and solid scientific evidence serve as a solid foundation for support.  Many point to the massive decrease, and almost elimination of measles in children in the United States as firm evidence of the success of vaccines.  This principle of the common good is also relatable to the stance of many on quarantine and isolation.  The personal beliefs of one person should not put the lives and health of thousands in danger.  The science behind these innovations against diseases is both proven in concept and practice for many years.  The only problem is the element of human nature in this system.  While science is an unbiased weapon against diseases, many examples show it can be manipulated and abused by those in power.

For too many the examples of a government abusing the trust of the public with their health is an all too recent event.  The Nazi regime was infamous for carrying out ruthless experiments in the hope of bettering mankind in the fight against diseases.  Thousands were dissected, abused, and killed without consent or knowledge of the procedures.  While this example seems to be a distant memory, the Tuskegee Experiment proves it can happen close to home.  In 1932 was a blatant abuse of government power.  The men involved were unknowingly infected with syphilis and allowed to die without treatment or knowledge of what was actually happening.  100 men died due to the disease, infecting their wives, and children with the terrible blight.  The study was unethical and racist in nature, yielding results that were too saturated in prejudice to give any scientific knowledge.  This model of experimentation without consent was repeated in Guatemala with much of the same results.

The abuse of power of government health officials can be as deadly as the diseases they claim to attempt to cure.  Public fallout and distrust with any government involvement in health can keep legitimate vaccines, treatment, and experiments from being seen as credible.  These examples of abuse only feed into conspiracies of  government euthanizing muslims in foreign countries, pharmaceutical companies seeking to cause autism, and shady government undertakings to sedate the population.  The fact that these abuses are most common in minority populations, african americans, jews, and immigrants, only serves to further marginalize a population and leave millions susceptible to both infectious diseases and social abuses.

When one examines the most influential epidemic in recorded history, the Black Death, the most important things to know is how it got started, what happened during it, and the effects of such an event on human history.

The first was the massive trade routes created between east and west by the mongol empire, which at this time had conquered more than twice as much land as the roman empire.  The trade routes that were once dangerous and scarcely traveled were given new life as merchants could safely travel with their goods across vast distances.  The disease had been around, but did not have the means of transportation until this massive increase in trade.  Infected rats quickly took advantage of ships filled with spices and produce to ferry them to the squalour that many Europeans lived in.

Upon arriving in Europe the deadly combination of poor diet, sanitation, and overcrowding provided the perfect environment to thrive.  Rats had always been a vermin in the cities and were often eaten and never exterminated in large numbers.  This further increased the rapidity of both transmission and infection.  The average peasant often only ate a diet of bread, mead, and other grain based food.  Meat, fruit, and vegetables were a luxury few could afford.  This led to many having a weakened immune system due to poor diet.  These factors made the disease spread like wildfire throughout cities. The trade routes established only facilitated the fleeing citizens and the deadly passengers they carried with them.

The response to this biblical plague is what one would expect from a highly theocratic society.  Churches filled with scared citizens, only spreading the plague more as hundreds crammed into the small churches that stood in the centers of towns.  The establishment of cults happened rapidly as people lost faith in the church that seemed helpless to stop the plague.  One of the more infamous examples would be the Flagellant.  This organization believed that the only way to stop the punishment from god was to punish themselves for their sins.  This punishment involved self mutilation and later led to violence, orgies, and public executions.  This violent response was also shared by panicked nobles who quickly rallied armies together to secure increasingly scarce food, water, and other resources.  The lack of a peasant farming force, due to huge population losses, led to famines compounding the instability and death.

The lasting impact of the plague is something of a paradox.  The massive loss of life in the lower classes greatly increased the value of a skilled farmer and decreased the value of land.  The tenant farmers that were abused and oppressed by their forming land owners could purchase their own land and lead much better lives.  This led to the greater emphasis on individual rights for all classes of citizen.  As said in the song “Beat the Devil’s Tattoo”: “Everyone’s a king when there is no one left to pawn”. This quote describes the situation quite well, without a large population to serve as a means of food production nobles lost power, while peasants gained.  The church lost much of its hold on government and public life as well for much of the same reasons.  Peasants realized their value and refused to be taxed to death.  The innovations in public health, sanitation, and education were largely delayed due to the lack of technology.  The publication of germ theory to provide a better explanation then god or miasmas would arrive much later.

Today the same bacteria that caused so many millions of deaths, yersinia pestis, is still around.  Many people are still afflicted by the black death in much the same way as those hundreds of years ago.  Luckily due to the advances in microbiology we have the ability to contain and fight the terrible disease.  No longer do doctors fill masks with herbs to prevent evil gasses and spirits from infecting them, today antibiotics make it a highly survivable disease if treated early.  In more poor reigons of the world, such as the slums of madagascar, the plague is still a prevalent threat.  A lack of basic healthcare and cultural practices are allowing the disease to make a comeback.  The practice of unburying a loved one for council in Madagascar only increases the number of people infected. These factors only expose the importance of not only learning from history, but seeking to learn from the mistakes of our ancestors.

What Changed:

Before the agricultural revolution humans were migratory creatures that only carried the bare necessities for survival.  It was not uncommon for these small packs of humans to go weeks, if not months, without any contact with others outside of the tribe.  This hindered our population, but also prevented diseases from proliferating as well.  It was only with the advent of the domestication of crops, such as wheat, barley, and other grains, that we began to settle down and build permanent residence. As technology for crop production increased our sedentary lifestyle became more prominent and a large increase in population is observable.

What This Means:  

Our nomadic lifestyle may have limited both birth rates and lifespan, but it also prevented diseases from spreading to more than a dozen persons due to environmental barriers.  Agriculture introduced animal fecal matter, dense population centers, and an increase in travel between communities.

Animals were a pivotal component in the progress of agricultural technology due to the fact that heavy loads could be added onto them, increasing food production and job specialization.  Plows were a revolutionary concept that allowed for fields to yield more crops and more land to be cultivated.  This relationship had its downside though; diseases such as measles (that would later go on to kill millions) is theorized to have been a bovine disease originally.  It was the close proximity to fecal matter that facilitated this deadly step in evolution.

Population density increased exponentially with the permanent settlements established by farmers only increased the rapidity of disease communicability.  This was largely to due with a lack of sanitation measures in houses such as: running water, ventilation, food preservation, and the ability to sanitize clothing and bed material.  These factors led to not only a high rate of contagion, but also allowed for many diseases to travel with a family if they moved to avoid a plague.

Movement along rural roads has played an integral role.  The domestication of horses allowed for quicker and more efficient travel, increasing the radius of available land and contacts for the average farmer.  This travel was facilitated by the advent of job specialization, a consequence of the surplus of food produced by agriculture.  Diseases now had a greater reach of infection as well as perfect environments awaiting them.

The New Revolution:

Many call the age of exploration a pivotal moment in human history.  The blank edges of the map beguin to take shape and humans are traveling at unprecedented speeds around the globe.  This progress of course carried the same problems as the ancestors of these explorers faced when they first planted the seeds of farms.  With increased speed of travel for humans, infectious diseases also traveled just as quickly.

While sail boats have been replaced by aircraft and horse and buggy by automobile, the effect remains the same.  Diseases today are combated by new advanced in medicine, but as Ian Morris discussed in his book “War, What is it Good For” the “Red Queen Effect” is created.  This phenomenon is the relationship of offensive and defensive tactics, when one side builds a wall the other builds a siege engine to knock it down and the cycle perpetuates.  This concept can be attributed to diseases today, each side advances to counter the other in an endless arms race where victory is only temporary.

The rules to this arms race are constantly changing due to the environmental factors that each side is heavily effected by.  The recent changes in ocean temperatures has caused for varying weather patterns that have aided diseases in spreading.  Mild winters with hot, humid summers, allow for mosquitoes carrying diseases such as Zika, Malaria, and Lyme disease to breed in different regions.  The movement of these diseases into North America from deep in South American countries is signaling an alarming spread.

To combat this new advances in medicine are employed, but do little to tip the scales in favor of humans.  With each new antibiotic a new, stronger, strain is discovered.  This is the paradox of progress against diseases, with every advancement there is no gain in the long run.  This perpetual arms race of man and germ is a relatively new, yet endless battle that will be waged for many years to come.