Respect for Science

I vaguely remember discussing some of this before, but anyway . . .

 

Throughout most of the 19th Century, despite the dramatic advances of science in many areas, nobody gained any useful understanding of human health and disease, and effective therapies were largely lacking. In fact, physicians -- medical school graduates -- advocated bloodletting and violent purging with mercury based emetics and laxatives. For obvious reasons, most  people preferred other healing methods, which didn't work either but at least didn't kill you. Hospitals were just places where poor people went to die.

 

So what happened to make the practice of medicine prestigious and lucrative? Back in the 17th Century the Dutch draper Antonie van Leeuwenhoek wanted to study the quality of thread, so he invented a superior microscope. He then used his instruments to make all sorts of discoveries. He was the first to observe microorganisms, including bacteria. Over the years people occasionally had the idea that microbes might be associated with disease in plants, animals, or humans, but the science of microbiology was really established by the French scientist Louis Pasteur, who was originally trained as a chemist, and his younger contemporary the German physician Robert Koch.

Pasteur is best remembered for a discovery he made fairly early in his career, that microbes are the cause of spoiling of wine, beer and milk. He found that by heating the product to 140 degrees, then quickly cooling it, the microbes would be killed and spoiling prevented. This process, which he patented in 1865 and still bears his name, would eventually prove extremely important to public health, but not for several more decades.

That microorganisms could cause spoliation apparently gave him the idea that they might also cause disease, which led the British surgeon Joseph Lister to start using carbolic acid to sterilize surgical instruments and wounds, with what were for those days astonishing results. Surgery and wound care were previously often unsuccessful due to what we now know was infection – that’s why all surgeons could do was saw off badly injured limbs. It took several years for Lister’s advocacy of sterile surgery to be generally accepted, as the germ theory of disease also became more widely believed.

Previously, while people had obviously noticed since ancient plagues that diseases could occur in clusters, even widespread and catastrophic plagues, it was not believed that they were transmitted from person to person, in other words the idea of contagion was unknown. In the Old Testament, plagues are attributed to God. From the time of Hippocrates people believed that plagues were caused by “miasma,” noxious air or mist emanating from swamps or decay. Some people also believed that microorganisms arose from “spontaneous generation” in rotting matter, though they did not attribute disease to this. Pasteur proved that when germs were completed excluded from a medium, spontaneous generation did not occur, putting an end to the dispute.

Armed with this new understanding, Koch went on to find the infectious agent of anthrax, and shortly thereafter, in 1882 and ’83, discovered the infectious agents of tuberculosis and cholera. At the same time, Pasteur made the discovery that strains of infectious agents could differ in virulence – the likelihood of causing disease or the severity of disease they cause. In 1881, he demonstrated that sheep inoculated with a non-virulent strain of anthrax became immune to more virulent strains, thus creating the first human made vaccine. (The smallpox vaccine, which had been known since 1796, made use of the lucky accident that inoculation with a related virus, cowpox, confers immunity to smallpox. Until the 20th Century however, nobody knew what a virus was or had any idea how smallpox vaccination worked.) Pasteur then went on to develop a vaccine for rabies.

It was a while before anyone discovered antibiotics with widespread application, so there weren't really effective treatments for most infectious diseases. Combined with the development of general anesthesia starting in mid-century, and further aided by the development of X-ray imaging in 1895, sterile technique enormously expanded the possibilities for surgery. Surgical technique advanced quickly as the human body was opened to intervention. Hospitals became places where you could actually get cured of problems amenable to surgical intervention, and doctors gained prestige because they actually knew something. With the development of antibiotics, vaccines for many additional diseases (notably polio which caused immense fear in the 1950s), open heart surgery, and much more, science based medicine really could save lives, forestall disability, and ease suffering.

 Sure, there were mistakes and doctrines that ultimately proved erroneous. Nevertheless, the science of medicine gained immense prestige. Doctors were routinely seen as heroes and were among the most respected of professions. There were always fringe groups that dissented -- homeopaths and what not -- but that's all they were, fringe. 

But now something has happened that I can't really account for. Maybe it started with Andrew Wakefield and the despicable Robert Kennedy Jr. and their maliciously false claims about vaccination. But now science denial has become a political identity that has something like 40% of the country as adherents. "They" are hiding the truth from you that hydroxychloroquine is a cure for Covid-19, that masks don't work for prevention, and that the vaccines are a plot to embed you with microchips. What the hell is this all about? Why would they do that? And why can't you look at the copious, compelling evidence? What is the motive for this nefarious plot? I am not getting it.