Abstract
In teasing out the diverse origins of our “modern, ecological understanding of epidemic disease” (Mendelsohn, in: Lawrence and Weisz (eds) Greater than the parts: holism in biomedicine, 1920–1950, Oxford University Press, Oxford, 1998), historians have downplayed the importance of parasitology in the development of a natural history perspective on disease. The present article reassesses the significance of parasitology for the “invention” of medical ecology in post-war France. Focussing on the works of microbiologist Charles Nicolle (1866–1936) and on that of physician and zoologist Hervé Harant (1901–1986), I argue that French “medical ecology” was not professionally (or cognitively) insulated from some major trends in parasitology, especially in Tunis where disciplinary borders in the medical sciences collapsed. This argument supports the claim that ecological perspectives of disease developed in colonial context (Anderson in Osiris 19: 39–61, 2004) but I show that parasitologists such as Harant built on the works of medical geographers who had called attention to the dynamic and complex biological relations between health and environment in fashioning the field of medical ecology in the mid-1950s. As the network of scientists who contributed to the global emergence of “disease ecology” is widening, both medical geography and parasitology stand out as relevant sites of inquiries for a broader historical understanding of the multiple “ecological visions” in twentieth-century biomedical sciences.
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Notes
On the development of virology, the identification of new disease agents, and the development of new detecting methods, see Méthot (2016a).
In a recent article, Anderson commented further that “the study of parasites often did not appeal to those committed to identifying and tracking bacteria” (2016, p. 245).
For example, Anderson writes that contrary to older medical geography, disease ecology is not “determinist” and postulates an “evolutionary time scale” and “integrative models” (2004, p. 42).
“We had never envisaged […] the dynamical evolution of infectious diseases in the course of history. One day, he [Nicolle] projected the extraordinary film of their development in time and space… He had the singular gift of deciphering […] the secret relations between the things he was interested in… […] It is the privilege of the genius” (Leriche, cited in Lot 1953, p. 65). According to Henri Mollaret, no other book was “more prophetic” than Destin des maladies infectieuses. “Each year, since the half century that went by has confirmed the correctness of his [Nicolle’s] grand vision of infectious diseases” (1986, p. 191).
This book is an augmented version of an earlier essay titled Naissance, vie et mort des maladies infectieuses [Birth, Life, and Death of Infectious Diseases] (1930).
Maurice’s career started when at the request of the Sultan of the Ottoman Empire Abdul Hamid II (1842–1918), Roux sent him to Constantinople directing the Imperial Institute of Bacteriology from 1893 to 1901. On the Imperial Bacteriological Institute of Constantinople and Maurice Nicolle, see Dedet (2000, pp. 151–154).
This career choice was not dictated by an actual interest in medical science but was foremost the result of his father’s wish. Nicolle was more inclined toward literature, philosophy, and history than natural sciences.
In 1895, Nicolle married Alice Avice and had two children, Marcelle (1896–1985) and Pierre (1898–1984), who went on to have a career in medicine and medical microbiology respectively.
The post was first offered to Maurice who had returned to Paris in 1901. Owing perhaps to his generally disappointing experience at the Imperial Bacteriological Laboratory in Turkey, he declined it and Roux convinced his younger brother to accept the post of director.
When typhus broke out in South America and Eastern Europe in the early 1930s, Nicolle’s research group was part of the international team composed of researchers from the United States, Mexico, and Poland. His view was that two forms of typhus existed and sometimes cohabited, namely: “new world” typhus (murine typhus) and “old world” (or historical) typhus (exanthematic typhus).
“Mon cher Collègue, je prends des dispositions pour que vous trouviez à votre arrivée à Tunis, fin juillet, un lot important de scorpions des espèces que vous désirez.” Letter (087804162600060) from Nicolle to Pavlovsky, June 7th (No year but certainly in 1914).
Nicolle and Duhamel exchanged over 450 letters, many of which have now been edited and published by Hueber (1996).
“The more I think about it, the more I am convinced that such a discovery [inapparent infection] has the capacity to overturn not only pathology, but also, and I would say principally, psychology.” Letter from Duhamel to Nicolle, October 25th 1924 (in Pelis 2006, p. 136).
Whereas Naissance, vie et mort des maladies infectieuses attempts to conceptualize infectious diseases as “biological phenomena,” which, Nicolle argued, must be studied with a “biological mind” (Nicolle 1930, pp. 28, 30), Smith tried to make students “think biologically” about disease (Smith 1931, p. 6).
Testing the hypothesis that lice on patients’ clothes were the vectors of the disease, Nicolle first inoculated a chimpanzee with blood from a patient suffering from typhus. Twenty-four hours later, the animal presented the typical signs and symptoms of typhus: it was febrile, had skin eruptions, and remained in a prostrate position. Drawing blood from the chimp, he injected a toque macaque that became ill 13 days later. Dropping lice on the ill-macaque, he transferred those a few days later to another group of macaques and recorded that these individuals also contracted the disease. On these experiments, see Schultz and Morens (2008).
Nicolle first arrived at the concept of inapparent infection during his attempts at controlling typhus with convalescent serum. With Lebailly, he noted that certain guinea-pigs infected with typhus blood do not hitherto become resistant to the pathogen but were “inapparently” infected. 16 days after infection, blood taken from these animals was used to inoculate a monkey (Maccacus sinicus) that, 7 days of incubation later, showed a temperature curve typical of a typhus infection (Nicolle and Lebailly 1919–1920). Based on this concept, Nicolle mounted a critique of Koch’s postulates as he disparaged the claim that “the introduction of a pure culture of a microbe will reproduce, in susceptible species, a typical infection” (Nicolle 1925, p. 150).
For example, a priority dispute—which was later resolved—concerning the role of lice in transmitting typhus flared between him and the bacteriologists brothers Edmond (1876–1969) and Étienne Sergent (1878–1948) in Alger (Dedet 2013); he resented microbiologist Etienne Burnet (1873–1960), his préparateur, whose novels were more acclaimed than his own (Pelis 2006); his profit-oriented strategy in vaccine production clashed with Roux’s policy (Pelis 1997); Nicolle’s professional relations with Émile Brumpt in Paris were particularly difficult (Théodoridès 1977); and, finally, his personal relation with his brother Maurice fell apart in the 1920s, though Charles would be inspired by his brother’s work in immunology—even borrowing his evocative notion of “mosaic”.
For Koch, too, parasitology was a natural extension of bacteriology, although he never became much of an ecologist. See Gradmann (2010).
Anthropologist Arthur Bordier (1841–1910), for instance, claimed that colonization could “only be accomplished through science” (Bordier 1884, p. xiii, cited in Osborne 2000, p. 47; emphasis in original). Pointing to the benefits in terms of health garnered for colonized populations provided a rationale for political actions. On the support of colonialism by medicine, see Pelis (2006) and Anderson (2006). For an overview of French science in colonial context, see Osborne (2005).
Nicolle’s long-term assistant in Tunis, Habib ben Abdesselem, was bitten 6515 times by the lice without developing relapsing fever. Such “extreme experimentation,” as Pelis calls it, led Nicolle to “prove” a negative claim, namely: that louse bites do not transmit disease per se (Pelis 2006, p. 82).
Relapsing fever is now known to be caused by various spirochete species of the Borrelia genus. The epidemic form of the disease is transmitted by lice while the endemic form is transmitted by ticks (Meri et al. 2006).
“Les microbes qui causent la fièvre récurrente mondiale, les spirochètes, absorbés avec le sang du malade par le pou, seul agent de transmission de l’infection, subissent, dans l’organisme de l’insecte, un cycle de transformations. Ce cycle consiste dans la division des spirochètes en granules. Il aboutit à la production, à partir de ces granules, de nouveaux spirochètes très virulents. Leur siège exclusif est le sang du pou. Les spirochètes se trouvent donc embouteillés chez l’insecte. Normalement, ils n’en sortiront pas; logiquement, la raison les condamne à n’en pas sortir. L’évolution naturelle aurait donc pour conséquence la disparition du spirochète, égaré dans la circulation du pou comme dans un cul-de-sac; et, le retour à l’homme ne pouvant se faire que par l’intermédiaire du pou, non seulement l’existence de la lignée serait compromise, mais celle de l’espèce se trouverait condamnée. […] La succession des faits qui assurent la conservation de ces spirochètes dans la nature est une chaine d’accidents qui peuvent évidemment ne pas se produire, mais qui se produisent fatalement sur quelques poux, tout au moins. Il n’en faut pas davantage pour qu’une espèce microbienne et la maladie grave qu’elle détermine se conservent. De tels faits paraissent absurdes à notre logique. C’est notre logique qui est absurde, puisqu’ils sont” (Nicolle 1934, pp. 18–20.
Smith had claimed that “nature is continuously experimenting” and that “[e]xperiments are imitations of Nature with the unknown factors controlled or eliminated” (Smith 1921, pp. 1–2).
Exactly like Pasteur, Nicolle considered “history” and “laboratory” as main sources of knowledge about past diseases: “We have at our disposal two methods,” he writes, “the first […] is the historical methods” and “the second is offered by the experimentation, and allows us to come to see, if not new diseases, at least new modalities of disease, giving us some justification to suppose that events took place at some earlier time in nature in the same they take place today” (Nicolle 1930, cited in Pelis 2006, p. 186).
Nicolle’s book on the birth, life, and death of infectious pathologies makes no reference to Pasteur’s speculation about the origins of infectious diseases in history.
Elsewhere, Nicolle argued that “in the creation of new diseases, in the adaptation of a virus to a living being which was until then refractory, nature uses a slow and repeated effort, whose mechanism is close to the transformations of living forms, even if it does not identify with it; sometimes, however, all of a sudden, and with no apparent preparation, nature does so by a phenomenon analogous to the mutation” (Nicolle 1934, p. 131). For him, the adaptation of microorganisms to their hosts could either be “progressive” of the result of “sudden mutations,” and he saw those biological processes as analogous to the operations of the human mind in solving practical problems, namely: the slow progress of intelligence and the sudden intuition typical of scientific discovery (1934, 10).
“Je m’empresse de répondre à votre lettre du 23 février en vous disant toute ma joie de voir enfin la chaire d’Histoire naturelle de Montpellier sur le point d’être recréée […] En attendant le grand plaisir de savoir comment il me sera possible de vous aider, je vous adresse, mon cher Collègue, l’assurance de mes sentiments sympathiques et dévoués.” Letter from Brumpt to Harant, February 26th 1945. Source: Hervé Harant Papers, BPT.B4.
Trained under Brumpt in 1947, and educated in biology at Harvard (1948) and Paris (1953), Théodoridès held doctoral degrees in parasitology and humanities. He was recruited at the CNRS in 1949 and joined Grassé’s laboratory in 1955. In the 1950s and 1960s Théodoridès stood at the centre of a growing, international network of medical ecology that bridge the East and the West. In addition to knowing Brumpt, Harant, and Grassé personally, he had even met Pavlovsky during one of his trips and delivered a letter on his behalf to Marcel Baltazard in Teheran in 1959, in an attempt to facilitate communication between Pastorian and Russian biomedical scientists. “M. Théodoridès vient d’arriver de Paris à Téhéran et m’a remis la carte que vous avez bien voulu lui donner pour moi.” Lettre from Baltazard to Pavlovsky, Octobre 29th 1959. Source: Archives of the Pasteur Institute, Paris.
Letter from Chadli to Harant, January 26, 1966; Letter from Chadli to Harant, June 30 1966. Source: Hervé Harant Papers, Institut Pasteur, Paris. Box ARC 22.
“Je vous félicite d’organiser le centenaire de NICOLLE. Je pense pouvoir vous envoyer 5 ou 6 pages intitulées: ‘Nicolle, fondateur de l’Écologie Médicale’”. Letter from Harant to Chadli, February 7, 1966. Source: Hervé Harant Papers, Institut Pasteur, Paris, Box ARC 22.
Harant, “Unpublished manuscript.” Source: H. Harant Papers, Université de Montpellier.
Historians have long wondered whether the writings of Sorre had influenced Jacques May’s work on medical geography, and in particular whether the former “borrowed” the concept of “parasitic complexes” from the latter (Akhtar 2003). A recent article has shown that it was May who borrowed the concept from Sorre: “J’avais depuis longtemps le désir de prendre contact avec vous. J’ai lu, non seulement vos livres récents sur les Fondements de la géographie humaine, mais votre article original (je n’en connais point qui lui soit antérieur) paru dans les Annales de Géographie le 15 janvier 1933. […] C’est à vous, Monsieur, que l’on doit l’idée féconde de considérer la maladie comme un complexe pathogène.” Letter from May to Sorre, May 23rd, 1949, New York. Source: Simon (2016).
The glossary of Pavlovsky’s book on the “nidality” of disease lists a number of cognate terms such as “biopathocenose,” “parasitocenose,” “biogeocenose,” and “biocenology” (Pavlovsky 1966, pp. 246–250).
I thank Staffan Müller-Wille for insisting that I clarify this point.
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Acknowledgements
Versions of this article were presented at the Brocher Foundation in Geneva (2015); during a session at the International Society for the History, Philosophy, and Social Studies of Biology conference in Montreal (2015); at the conference “Making Microbes Complexe: Parasites, Epidemics and the Intellectual Origins of Disease Ecology” at Queen Mary University in London (2016); and as a keynote lecture on the occasion of the annual retreat of the Pasteur-Paris University (PPU) doctoral programme in microbiology at Le Touquet, Paris-Plage (2018). This article benefited greatly from the comments and feedback of the participants at these different events. I am especially grateful to Warwick Anderson, Jon Arrizabalaga, Christoph Gradmann, Mark Honigsbaum, Anne-Marie Moulin, Staffan Müller-Wille, and Kim Pelis for their constructive comments on earlier drafts of the manuscript. Thanks also to Susan Jones for directing me to the concepts of Pavlovsky and to Anna Amramina for her help in retrieving the Nicolle-Pavlovsky’s correspondence at the Academy of the Sciences in St-Petersburg. At the Pasteur Institute, I am grateful to Daniel Demellier and Geneviève Milon for guiding me through the papers and the thought of Charles Nicolle and Hervé Harant; and Michäel Davy for his permission to use the Nicolle photographs. In Montpellier, my thanks go to Jean-Pierre-Dedet for providing access to Harant’s collection of published and unpublished manuscripts and for his useful comments on an earlier draft. This paper was mostly written during research stays at the Institute for the Humanities in Medicine (IHM) in Lausanne in the summer of 2015, 2016, and 2017. I would like to thank Vincent Barras, director of IHM, and Maïka Casse, librairian, for her help in locating Nicolle’s and Harant’s articles. Generous financial support of the Fonds de Recherche du Québec – Société et Culture is gratefully acknowledge.
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Méthot, PO. ‘Birth, life, and death of infectious diseases’: Charles Nicolle (1866–1936) and the invention of medical ecology in France. HPLS 41, 2 (2019). https://doi.org/10.1007/s40656-018-0238-6
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DOI: https://doi.org/10.1007/s40656-018-0238-6