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  • Thomas C. Rosenthal MD

Germs and Doubt: Nothing New Here

Germs and Doubt: Nothing New Here

In December, as the United States once again fell behind other countries combating the coronavirus, the Buffalo News carried a story about a newly elected Virginia congressman addressing a mostly mask-less crowd. Some in the crowd carried signs declaring COVID-19 a hoax. Others cheered when the congressman called it a phony pandemic, ignoring the 300 deaths in his district. The congressman said it was ‘insane’ to force restrictions on people, discounting US and international public health data confirming infection rates and deaths plummet when leaders encourage social distancing and mask wearing.

Ignoring germs has a long history. In 1667 Antonie van Leeuwenhoek pleaded with the Royal Society to investigate the role of the ‘animalcules’ he found in everything from lake water to the crud between his toes. The Royal Society preferred to believe that ‘bad air’ from rotting organic matter in swamps, sewers and ditches caused illness. This ‘miasma,’ caused malaria, cholera, scarlet fever, and many other diseases when foul vapors permeated a community.

In the third century BC, Hippocrates promoted the ancient idea of bloodletting to cure disease and in the second century AD, Galen recommended bloodletting to correct the imbalance of humors produced by miasma. In his 1719 novel, Daniel Defoe describes Robinson Crusoe undergoing ‘venting’ of blood to correct the imbalances caused by years of isolation. Bleeding’s last great champion, Benjamin Rush, wrote in 1805 that patients bled to a faint could survive yellow fever. Finally, in 1836 science prevailed when Pierre Louis published the world’s first randomized controlled trial noting that while a few patients thought themselves improved after bloodletting, repeated bleeding increased mortality.

When cholera swept down trade routes of the Saint Lawrence River, Lake Champlain, the Hudson River Valley and the Erie Canal in 1832, it struck Buffalo’s dock hands, the poor, and the intemperate first. Governor Enos Throop of New York, proclaimed that, “God has seen fit to employ pestilence as one means of scourging the human race for its sins.” The Medical Society of New York State blamed miasmic vapors arising from modern society’s foul detritus for the pandemic. Little did it matter. Governments had no authority to establish standards for public privies or wells, nor clear streets of free ranging pigs. Any water a horse would drink was good enough for human consumption. Between 1832 and 1834 cholera killed as many as ten percent of New Yorkers. It took forty years for science to discover the bacteria Vibrio cholerae and disprove the miasmic theory.

The 1878 American Medical Association, held in Buffalo, followed an exciting decade of discovery. Pasteur had nailed the coffin on spontaneous generation, Tyndall proved that bacterial spores floated in the air, Edinburgh’s Lister toured America lecturing about dilute carbolic acid preventing post-operative inflammation, Koch proved that a bacterium caused anthrax, and science had become so basic to medicine that New York had passed new physician licensure requirements. Still debate at the 1878 convention was heated. Some attendees readily accepted Koch’s finding that a microscopic germ could cause anthrax. But there were others who doubted something so small could spread fast enough, multiply fast enough, or be diverse enough to explain the many types of contagious disease. Others rose to remind delegates that no one had found any bacteria, vegetative matter or minute organisms to explain the spread of smallpox, measles, chicken pox, or influenza. Contagions for those diseases would have to wait until the first virus, a particle even smaller than a bacterium, was seen under an electron microscope in 1930.

In 2020 some still doubt what the naked eye can’t see. Yet, unlike the1800s, instead of decades it took only weeks to learn that COVID-19 was caused by a virus. In a few more months science proved treatments like remdesivir and dexamethasone were helpful, and in less than a year produced a vaccine. Still, like some attendees at the 1878 convention, our president doubted the power of a submicroscopic virus, rebuffed scientists at the Center for Disease Control, and ended up making a germ a partisan issue.

As we begin 2021, we realize that science still follows a bumpy road. It is time to drop our rancor and embrace the victory, while acknowledging our debt to the nurses, doctors and scientists who cared for us along the way. We must also embrace those who have doubted the power of the coronavirus. Their doubt challenged the scientific method to greater rigor. In the months it will take to vaccinate most Americans, we can show our respect for science, and our neighbor, by wearing a mask and practicing social distancing.

By UB Emeritus Professor Thomas C. Rosenthal MD, author of Bloodletting and Germs: A Doctor in Nineteenth Century Rural New York.

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