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So Very Small: How Humans Discovered the Microcosmos, Defeated Germs--and May Still Lose the War Against Infectious Disease - Tapa dura
Sinopsis
The centuries-long quest to discover the critical role of germs in disease reveals as much about human reasoning—and the pitfalls of ego—as it does about microbes.
Two out of three soldiers who perished in the Civil War died of infected wounds, typhoid, and other infectious diseases. But no doctor truly understood what was happening to their patients. Twenty years later, the outcome might have been different following one of the most radical intellectual transformations in the history of the world: germ theory, the recognition that the tiniest forms of life have been humankind's greatest killers. It was a discovery centuries in the making that transformed modern life and public health.
This revolution has a pre-history. In the late-sixteenth century, scientists and hobbyists used the first microscopes to confirm the existence of living things invisible to the human eye. So why did it take two centuries to make the connection between microbes and disease? As Thomas Levenson reveals in this globe-trotting history, the answer has everything to do with how we see ourselves. For centuries, people in the west, believing themselves to hold God-given dominion over nature, thought too much of humanity and too little of microbes to believe they could take us down. When scientists finally made the connection by the end of the 19th-century, life-saving methods to control infections and contain outbreaks soon followed. The next big break came with the birth of the antibiotic era in the 1930s. And yet, less than a century later, the promise of the antibiotic revolution is already receding from years of overuse. Why?
In So Very Small, Thomas Levenson follows the thread of human ingenuity and hubris across centuries--along the way peering into microscopes, spelunking down sewers, traipsing across the battlefield, and more--to show how we came to understand the microbial environment and how little we understand ourselves. He traces how and why ideas are pursued, accepted, or ignored--and hence how human habits of mind can, so often, make it terribly hard to ask the right questions.
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Acerca del autor
Thomas Levenson is a professor of science writing at MIT. He is the author of several books, including Money for Nothing, The Hunt for Vulcan, Einstein in Berlin, and Newton and the Counterfeiter: The Unknown Detective Career of the World's Greatest Scientist. He has also made ten feature-length documentaries (including a two-hour Nova program on Einstein) for which he has won numerous awards.
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I
“God preserve us all”
Few facts remain from the life of good-woman Phillips.
We know this much: She was married. She and her husband lived in the parish of St. Giles in the Fields, just outside London’s city wall. The couple had some number of children. Mrs. Phillips fell ill late in December 1664 and died on Christmas Eve. As required, women hired by the parish to review local deaths examined her body. They reported their finding: Phillips, given name unrecorded, had succumbed to the plague.
The usual forms were followed. Her surviving family were shut into their home, given money to cover about a week’s worth of food, and quarantined from the community for thirty days. Outside that one household, Phillips’s death went almost entirely unnoticed except as an anonymous addition to the weekly Bill of Mortality, the regular report that tallied deaths and their causes parish by parish throughout the capital.
This single case of the plague in what is now the borough of Camden did not spark any immediate concern. In most years, a few cases in different sections of the city formed endemic sparks that then fizzled out. This time, however, the city had reason to stay alert. On the other side of the English Channel, an epidemic outbreak of the plague had been spreading since 1656, beginning in Italy then moving north and west. By the early 1660s it had reached the shores of both the North and Baltic seas—and the ports that traded regularly with England. In London, Charles II’s council imposed a quarantine on Dutch shipping in late 1663—but soon sailors were rumored to be escaping from ships at anchor to take their pleasures ashore.
Christmas came and went, and the rest of the Phillips family survived. St. Giles in the Fields recorded no further plague deaths that week, and none were reported in the rest of London. The capital’s inhabitants celebrated the holidays, and January began.
Especially for the well connected, London’s winter festivals heralded a year full of promise. That irrepressible diarist Samuel Pepys, a senior civilian member of the Navy Board and a confidant to the good and the great, thoroughly enjoyed himself that winter. On December 31 he tallied his accounts for the year and found that “by the great blessing of God, [I am] worth 1349l [pounds], by which, as I have spent very largely, so I have laid up above 500l this yeare above what I was worth this day twelvemonth.”
Thus enriched, he allowed himself some treats. On Friday, January 2, he enjoyed a tryst with a woman not his wife, flirted—at least—with another, and then arranged a romp with a third for the coming Sunday. Next came “a most noble French dinner and banquet,” after which he walked from Covent Garden to St. Paul’s Cathedral. On the north side of the cathedral yard, he found his favorite bookseller’s stall and browsed through the latest works. This was Pepys living his best life in the city he loved. He had plenty of ready cash, with more coming in. He relished his daily encounters with the powers in the land—up to and including James Stuart, the future King James II. Before, after, and around his working days, he traveled a constant round of entertainment: good food, fine drink, excellent conversation, a satisfactory marriage, and sexual sport outside that bond whenever (often) the mood took him, all lovingly recounted in his diary. Day after day that winter and into spring, the sheer joy of being Samuel Pepys leaps off the page.
Until, on April 30, 1665, he wrote: “Great fears of the sickness here in the City, it being said that two or three houses are already shut up,” adding: “God preserve us all!”
God preserve them! For a brief while longer, this was merely an expression of conventional piety. Most of Pepys’s April 30 entry was consumed by a reckoning of wealth that revealed that he was now master of “above 1400£, the greatest sum I ever yet was worth.” In the world beyond his diary, though, the plague was on the move. Cases had been reported in the Netherlands the previous year, and English authorities had reimposed restrictions on vessels crossing the North Sea. Some Dutch ships and sailors had evaded those barriers, however, and in late 1664, a few plague deaths were identified at Great Yarmouth on England’s east coast. Even under quarantine, exceptions were made for the right people. If important enough interests were at play, Dutch ships that came to London that winter got permission (or were ignored) as they unloaded their cargoes, up to the moment the Anglo-Dutch wars resumed in March 1665. The flow of people and crates from the middle of the Thames to its banks meant that an isolated victim or two along the docks or in the poorer districts would surprise no one. Into April, Londoners had no reason to believe that this season would be any different from those of recent years, when minor flare-ups of disease had burnt themselves out.
The calm held for a few weeks more. A handful of cases turned up in scattered locations both within and outside London’s city wall. A few deaths were recorded in the official tallies, but the numbers remained reassuringly low: nine in the first full week of May, just three in the next. Crucially, each such case had been isolated, turning up almost exclusively in poorer neighborhoods. The metropolis seemed safe, so much so that the fire-and-brimstone minister Thomas Vincent wrote, “Fears are hushed and hopes take place, that the black cloud did but threaten . . . but the wind would drive it away.”
Then came the week of May 16–23, and a Bill of Mortality that listed seventeen plague deaths. Forty-two more Londoners died of the disease during the week ending June 6; more than a hundred followed in the next seven days. Worse news: the victims came from neighborhoods far from the initial outbreaks. By June, the plague had spread through the city and its suburbs, and the wealthy joined the poor in its path.
Pepys kept watch. “The plague is come into the City,” he wrote on June 10, reaching all the way into a friend’s house, “which . . . troubles me mightily.” Five days later he noted that “the towne grows very sickly, and people to be afeard of it.” Chasing a wisp of hope, he wrote on June 20 that “people do think that the number will be fewer in towne than it was in the last weeke!” He had his own scare when the driver of a coach he had hired in central London collapsed at the reins, forcing Pepys to hail another coach, “with a sad heart for the poor man and trouble for myself.” He escaped untouched that time, but soon enough his city and himself were utterly beset. “The sickness is got into our parish this week,” he wrote on July 26, “and is got, indeed, every where.”
Pepys was right. From the end of June, plague deaths reported in the weekly Bills of Mortality accelerated, doubling about every fortnight. The toll topped one thousand in the week ending on July 18, hitting 2,010 for the week ending on August 1, then reached almost four thousand by the fifteenth. It would not drop back below that number until mid-October. This was no mere episode but a true epidemic, a catastrophe that could swallow London whole.
That’s how it was felt in the moment. London’s plague year was an apocalypse, the divine judgment in which sin and virtue collapsed into the same pit. “Lovers, and friends, and companions in sin have stood aloof . . . lest death should issue forth,” Reverend Vincent wrote. Their fear: “that the grave is now opening its mouth to receive their bodies and hell opening its mouth to receive their souls.” The physician Nathaniel Hodges left the theology to the ministers, but his account of the peak of the epidemic in August painted the same end-of-days picture. “In some Houses Carcases lay waiting for Burial,” he wrote, “and in other Persons in their last Agonies.” The living “bewailed both their Loss and the dismal Prospect of their own sudden Departure.” Family life was destroyed: “Death was the sure Midwife to all Children, and Infants passed immediately from the Womb to the Grave; who would not melt with grief to see . . . the Marriage-Bed changed the first Night into a Sepulchre.” Some staggered to their deaths in the street, others collapsed and vomited as if poisoned, and some, like Pepys’s coachman, were struck suddenly and died “in the Market, while they are buying Necessaries for the Support of Life.”
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