 In her 1996 novel, The Sparrow, Meridoria Russell tells of an expedition sent from Earth in 2021 to make first contact with the people of the Alpha Centauri world of Rakat. The crew of the Stella Maris had grown up full of the lessons of first encounters in Earth's history and they were determined not to interfere, not to leave a trace of themselves and yet even these most well-intentioned people found that things go terribly wrong, that the ways in which new encounters transform and even destroy the encountered cannot perhaps ever be completely imagined or anticipated. The all-too-non-fictional European invaders, explorers and colonists of the past five centuries often had less noble intentions than the fictional crew of the Stella Maris but even the worst never intended what they achieved in Espanola, in the Great Plains, in New South Wales, in the countless other places where old-world diseases such as smallpox virtually exterminated entire indigenous populations. Our next speaker, Alpha W. Crosby, Professor of American Studies at the University of Texas Austin has distinguished himself over the past quarter century as the historian of the impact of infectious diseases on the course of history. In his 1972 book, The Columbian Exchange, Biological and Cultural Consequences of 1492, he writes, migration of man and his maladies is the chief cause of epidemics and when migration takes place, those creatures who have been longest in isolation suffer most for their genetic material has been least tempered by the variety of world diseases. Among the major divisions of the species Homo sapiens with the possible exception of the Australian Aborigine, the American Indian probably had the dangerous privilege of longest isolation from the rest of mankind. End quote. Smallpox in particular had a devastating effect. The conqueror's biological ally of now almost unimaginable impact on people such as the Aztecs and Incas. Some of these themes were developed at greater length and with extraordinary eloquence and elegance in his ecological imperialism, the biological expansion of Europe 900 to 1900, which won the Ralph Waldo Emerson Prize of Phi Beta Kappa in 1988 and has been translated into many languages. In that stunning book, Professor Crosby describes the role of disease in the creation of neo-Europe in virtually every temperate zone on the planet. He traces the evolution from Pangaea, the one great land mass which was our planet millions of years ago, to a new Pangaea starting around 1400 as Europeans crossed the waters separating the pieces of the former land mass and brought their food crops and weeds, their domestic animals and their varmints and most of all their diseases to reunite ecologically what had been divided geologically millennia before. And he argues that European imperialism succeeded not so much because of European superiority in arms, organization and fanaticism but because of a biological and ecological component, the germs. While the subject of his work is often grim, Professor Crosby's books are anything but that. They are written with wit and elegance. On the pages of these deeply humane works we encounter botany, geology and epidemiology interwoven with the history of the crusades and the ghost dance and a few lines away will be citations from the poems of Walt Whitman and Langston Hughes or from Edgar Allen Poe's Perloined Letter and appropriately enough for a man planning to retire quite soon to Nantucket from Melville's Moby Dick. Professor Crosby's impending retirement comes after 22 years at the University of Texas. His professional career has included fellowships from the National Institutes of Health, the National Humanities Institute and the Guggenheim Memorial Foundation. Twice he has been Professor of American Studies at the University of Helsinki in Finland, most recently in 1997-98 where he taught, among other things, a course on the history of jazz. He will soon hold appropriately enough the Gustavus Adolphus Chair in Environmental History at the University of Umeå in Sweden. Professor Crosby is the first professional historian to be a Nobel conference lecturer. The discipline could not have a better representative than this great scholar and deeply humane writer. One can only hope that when he and his wife settle into their Nantucket home there will be more and still more books to come that he will, to quote Moby Dick, cry out, give me a condor's quill, give me Vesuvius' crater for an ink stand and write on for our education and great benefit. Please welcome Professor Albert Crosby. Goodness, that was quite an introduction. Most of us tend to think of human disease simply as a condition, as a condition that simply is like cold in winter or getting hungry or aging. That is to say something undoubtedly important, but something that cannot be usefully studied in terms of having a history. I would say the contrary is true. Infectious disease is a side effect of the efforts, that's in quotes, of microorganisms to exist and to propagate on and in human bodies. These microorganisms have spatial dimensions and weight, maybe we'd be more proper to say mass. They have geographical location, places of origin, periods of geographical advance and retreat, periods of adaptation to new conditions, sometimes successful, sometimes not. In all that, they're quite like human beings, that is to say they have histories. Infectious diseases are profoundly affected by human behavior. Are germs like our weed and rice and goats and horses, are the creations albeit unintentional in this case? Are given societies at given times? As those societies grow and shrink in numbers, expand and contract geographically, shift from hunting and gathering to agriculture, flow into cities or desert them, travel on photo by sailing vessels or jet planes, change in diet, change in sexual mores, etc., etc., they change the environments of microorganisms and thereby change the characteristics of infections. These characteristics are as historical as economies or religions. I want to drag you swiftly, even headlong, through a history of human, humanity and infectious diseases. I divide that history into four stages which are in chronological order. First, hunter and gatherer, second, agricultural, third, world integration, and fourth, the mind boggling present. These stages are not mutually exclusive. There are still a few hunters and gatherers out there. But for the sake of brevity and clarity, I will speak of these ages as separate chronologically. For almost all of the hundreds and hundreds and hundreds of thousands of years that the genius Homo has been on this planet, one of the most important of its characteristics has been its small numbers, or were its small numbers. Demography, Massimo Livibaci estimates that 12,000 years ago there were only about 6 million of us, that is to say the population of a great number of cities today. Other important characteristics of us for 90-something percent of our time on this planet have been geographical dispersal and therefore epidemiological divergency. Livibaci estimates that an area of a bit more than 120 square miles, that is to say a circle, 12.5 miles in diameter, a bit more than 120 square miles of sub-tropical savanna, could have supported no more than 136 people. Roger Lewin, paleoanthropologist, estimates that 30,000 years ago in southwestern France and in Spain, northern Spain, a group of 50 humans would have needed more than 300 square miles to sustain themselves. Another of the characteristics of Homo erecti and its successors, most especially Homo sapiens, was to solve problems by migration, to adapt to population pressures, food shortages, drought, flood, war, diseases, what have you, by migrating, by substituting geographical movement for many of the adaptations we have made since we humans ran out of frontier. By at least 50,000 years ago, when we humans reached Australia, we were the most widely distributed large animal in the globe, and we hadn't even found America yet. We did that from 14,000 to 40,000 or so years ago, depending upon which expert you listen to. We have been hunters and gatherers for 90 something, 90 to 99 percent of our genuses and our species' time here. The majority of us, without permanent residency, we had no crowd diseases because we had no crowds. We suffered some, but not all, the diseases currently associated with parasitic and commensal creatures like rats and the yellow feet of mosquitoes because we were normally on the move. And we had no permanent dwellings. They didn't keep up with us. We had some, but not many of the worst of our current diseases associated with polluted food and water because, again, we were usually on the move, leaving much of our sewage and garbage behind. I am not trying to paint a prehistoric Eden. Prehistoric people died young, had internal parasites, had lice, were nibbled on by insects constantly, all of whom certainly carried microorganisms. The ancestors must have had diseases that could survive for a long time in the bodies like tuberculosis, but they didn't have a good many of the infectious maladies that have dominated our epidemiological history for the past few thousand years. They didn't have the affections that either kill or produce long-lasting immunity, that is to say the diseases that race through populations the way forest fires race through forests using up fuel quickly and then burning themselves out. Furthermore, because many humans, specifically those whom you might call, those on whom you might, what you might call the frontier, a species frontier, were moving into regions where humans had never lived before. Australia, America, Madagascar, Hawaii, for instance. When they did so, they often left important parasites behind and met up with few that were adapted to invade our bodies. The human micro-pathogen relationship was one of a sort of rough and ready stability with few epidemics. This is all relative. I really want to emphasize that relative to what came later. Again, I don't want to paint a prehistoric Eden. And it was a life for most of the past few hundred thousand years characterized by epidemiologically by rough stability relatively speaking, and at least significantly by geographical divergency. Infections we had certainly, but they were usually of a local character. The first Americans, the Proto Indians, for instance, had no malaria because they hadn't brought it in with them from Siberia, and there wasn't any waiting for them here. They eventually, however, had themselves Chargis disease, a product of the interaction of Native Americans and Native American microorganisms. What I am saying here is that humanity was by unintentional Darwinian processes protected against many infections not so much by genetically acquired immunological defenses as by their small numbers and movement from, for instance, mountain to shore according to the seasonal availability of food supplies from regions of growing population to regions of less or no population in flight from competitors or in pursuit of fresh opportunities. Humanity had vis-a-vis infection hedged its bets. A few thousand folks over there with this infection, a few thousand over there with that infection, a minimum of contact between the two groups and no pandemics for the same reason that you cannot have forest fires without forest. Humanity was not genetically prepared for the environment it started creating 10 or so thousand years ago. In fact, it isn't yet. One of the most important inventions of all time was agriculture. It was invented, evolve would be a much better word, in a number of places. When humans became farmers, they radically changed the way they lived and thereby the environments of the microorganisms they, so to speak, sheltered and provisioned. Humans increased in numbers and settled down in permanent villages and eventually in cities. They produced environments in which what we call civilization could develop. That was all well and good, you may say, but there was a heavy price to pay in the unending and boring labor of the peasant masses in imperial wars and the exhaustion of local resources. You know all that. And in the advent of diseases characteristic of heavy populations. Nature abhors a vacuum, so goes the old saying. Nature also abhors what might be described as the opposite, solid stands of a single species, wheat, cattle, humans. And nature tries vigorously to cut them back by assembling predators, macro predators, wolves, lions, cougars and micro predators, smut for wheat, rindipest for cattle and a wide assemblage of infections for human beings. Agriculture cost a lot in terms of human discomfort and misery. Hunters and gatherers had often suffered from hunger, but not usually from poor quality of diet over the long run because their diet was varied, consisting of all sorts of seeds, leaves and roots, plus different kinds of meats and fish. Farmers had monotonous diets, mostly barley, mostly maize, mostly rice, mostly whatever was the most plentiful staple. A monotony imposed upon them by the pressure of population on the land. Farming gave greater assurance of bulk foods than hunting and gathering so farming populations grew. And farmers were sedentary. They lived elbow to elbow and right on top of their accumulating wastes. The sites of many of humanity's first cities on the plains, the Tigris and Euphrates, can be spotted miles away because they are on high mounds. They are high mounds. The ruins of cities built on the ruins of cities and built on the wastes of those cities, wastes which sustained vermin and polluted drinking water. There have been vastly more rats and E. coli since civilization appeared than before. Because the farming populations produced surpluses and supported sedentary elites that coveted things, they, the farming, the peoples increasingly engaged in trade. In doing so, the elites acquired exotic goods intentionally and everybody acquired exotic diseases unintentionally. A little evidence from a number of farming systems in Eurasia, Africa and the Americas show evidence of the price people paid for agriculture and for civilization. The amount of dental carries and tooth loss soared and more important, the height of people very often decreased. Height is a decently dependent measure of health. I don't want to push that too hard being not quite five foot eight, but if a population is running, if the males are running on average five foot ten and then suddenly, suddenly in 200 years they're five foot six, it's not because they're healthy of them they were before certainly. The quality of diet declined with agriculture, not the quantity, but the quality of diet declined with agriculture and so did stature. And as people settled in villages and cities, they passed diseases back and forth most pertinently those so-called childhood diseases which can hamper childhood growth spurts. Such happened in the new as well as the old world but accelerated faster in the old world. For the historian of disease, the most important thing old world peoples did was to domesticate a number of animal species to maintain them in dense herds and flocks and to live amid these in unnatural concentrations. American Indians had domesticated dogs, some fowls, guinea pigs, but only one herd animal, a yama and not only in the Andean region. Old world peoples had dogs, cats, several kinds of foul horses, cattle, goats, sheep, pigs and so on. American Indians supplied the world very roughly with one-third of its important food plants, a proportion probably greater than their proportion to the human race, circa 1492. But the Indians did not do well as animal domesticators. Why nobody knows? Maybe because there were fewer domesticated animals in the new world. You can make moo cows out of wild cattle but nobody has ever successfully made a moo cow out of buffalo. It might be just a matter of luck. Anyway, for whatever reason, human Europeans when they arrived had a great advantage over American Indians in their supplies of meat, a high grade food, many kinds of fiber, fertilizer, leather, bone, speed of movement, and in power to move heavy objects. But the price for the advantage of domesticated animals was very high. By sharing environments with animals in order to utilize their services and their meat and bone, all world peoples found themselves also sharing diseases with them. Hunters and gatherers live among animals but live intimately with very few. Farmers live intimately with a number of species and live much more so in the past. Let me read you a quotation from an Italian physician, Carlo Levy. He was an anti-fascist in the 1930s and Mussolini exiled him up into the hills of Calabria in southern Italy and into a place where the peasants lived very much, not at all as you live, let's say, but very much as peasants had lived along the Mediterranean for thousands of years and very much as farmers had lived anywhere for thousands of years. Quote, the peasants' houses were all alike, consisting of only one room that served as a kitchen, bedroom, and usually as quarters for the barnyard animals as well. One side of the room was a stove. Sticks brought in every day from the fields, served as fuel in the walls and ceilings with blackened with smoke. The only light was from the door. The room was almost entirely filled by an enormous bed much larger than an ordinary double bed. In it slept the whole family, mother, father, and children. The smallest children before they were weaned, that is to say then until they were three or four years old were kept in little reed baskets hung from the ceiling just above the bed. When the mother wanted to nurse them, she did not have to get out of bed. She simply reached out and pulled the baby down to her breast and then put him back and with one motion of her hand made the basket rock like a pendulum until he had ceased to cry. Under the bed slept the animals and so the room was divided into three layers, animals on the floor, people in the bed, and infants in the air. When I bent over a bed, I listened to a patient's heart or when I bent over a bed to listen to a patient's heart or to give an injection to a woman whose teeth were chattering with fever or who was burning up with malaria, my head touched the hanging cradles while frightened pigs and chickens darted between my legs. Humans share more than 65 diseases with dogs and only slightly fewer with cattle sheep, goats, pigs, horses, and foals. We share tuberculosis with cattle. Smallpox was so closely related to cowpox that having the latter provided immunity to the former, hence vaccination. We transfer flu viruses back and forth with pigs and ducks and the whole menagerie. Measles is closely related to Rinderpest which is shared with dogs and cattle and so on and so on and so on. And of course lately there's been a great fuss about so-called mad cow disease. Edward Jenner, the first scientist, not the first person but the first scientist to utilize smallpox vaccination recognizes significance of living closely with domesticated animals 200 years ago. In his epical and inquiry into the causes and effects of cowpox, 1798, he noted, quote, the deviation of man from the state in which he was originally placed by nature seems to have proved him to be a prolific source of diseases. From the love of splendor, from the indulgence of luxury and from his fondest for amusement, he has familiarized himself with a great number of animals which may not originally have been intended for his association, unquote. Today, of course, we don't, most of us, certainly in this country, don't sleep in the same room with a great bunch of animals. And our domesticated animals are often raised in these cities, these massive concentrations of domesticated animals which I'm starting to think of as sort of guises of very interesting microorganisms. I found this in the Helsingen Sonomat which is sort of the New York Times of Finland last spring. And I don't know what I can vouch for these statistics or not, but anyway. According to this publication, in the United States we have seven billion chickens, 300 million turkeys, and 100 million pigs, and 60 million calves. These produce annually 1,400 million tons of manure, five tons per human in the United States per year, or 130 times more than each human produces. John, I'm impressed. I also am impressed with the fact that I read this first in a newspaper in another country. Anyway, that's just a big indication that there may be a lot going on, and particularly since a lot of these animals are pumped up with antibiotics, so they'll be heavier at market time. Well, different infections and strains thereof have been acquired from different animals in different places at different times. The eastern hemisphere's neolithic revolution, agriculture, cities, increased population, long-range commerce, empire building, transportation improvement, and so on. Guaranteed epidemics guarantee the migration of diseases. The Iliad, of course, starts off with an epidemic among the Greeks laying seeds to the city of Troy. The postular fevers that swept through the Roman Empire in the first centuries of AD may have been small plaques and measles imported from elsewhere by improved transportation. It may be significant that camels, a great improvement over jackasses and other animals for carrying loads through the desert, were introduced into the Mediterranean reason about the same time as the appearance of these postular fevers. 29 BC was the year of the first camel in Rome. Jet aircraft may yet bring as abla camels may have brought the Roman small plaques and measles. The standard account of the Justinians plague, the first appearance of bubonic plague, and I know bubonic plague is inverteble, but cut me a little slack. The standard account of the Justinians plague in the 6th century is that it came north from Egypt, probably having arrived there from the ancient focus in the Great Lakes region of Africa and then spread to Egypt and to the rest of the Mediterranean by boat. It could have come up the Nile by boat, too, but not around the cataracts. Maybe camels helped. Transportation improvements made their most horrendous contribution to epidemiological history when they enabled humans to build trans-oceanic empires and trading companies starting about the end of the 15th century. Humans spread out, had spread out on their two feet from Africa beginning long, long ago and crossing Beringia into Alaska and the rest of America no less than 15,000 years ago. As humans dispersed, they had tended to lose contact culturally and epidemiologically with each other, especially after the retreat of the continental glaciers and the rise of the oceans. By the end of the Middle Ages, several technologically advanced peoples of the world had developed watercraft capable of purposeful, not just accidental, but purposeful trans-oceanic voyages. Of these people, the Europeans were the most ambitious commercially, imperialistically, and evangelical. Their square and Latin rigged vessels were a good deal smaller and not more sea-worthy than China's junks, but they were owned directed by men who were anxious to pursue their ambitions outside of Europe. They were also collectively speaking among the world's most diseased people. Europe's cities specifically, her ports were hotbeds of infections from all over the eastern hemisphere. Death rates were so high that without constant resupply of immigrants from the countryside that cities would have disappeared. Those cities provided excellent media for the cultivation of pathogens. In the last decade of the 15th century, Western European ships created the first worldwide disease pool. Christopher Columbus, Vasco del Gamma, and the rest linked Europe, sub-Saharan Africa, tropical America, and tropical Asia together by 1500. The epidemiological effects have never been fully written up or even researched, but we can say that in America, the maritime skills of the Western Europeans initiated the worst demographic catastrophe of history. I restrict myself to one example, the arrival of the Old World's cattle-related smallpox in Mesoamerica. I would argue that Hernán Cortez did not conquer the Aztec Empire smallpox did, and he mopped up afterwards. The Spaniards first encouraged into Mexico City Tenochtitlan ended in disaster for the Spaniards. They had to fight their way out of the city and lost half their numbers, they did. When they emerged from the city, they were still hundreds of miles from the sea and from reinforcements and seemed that their life expectation was quite short. But new Spanish troops from the Greater Antilles, from Cuba and Espanyola, Puerto Rico, brought smallpox with them from the Greater Antilles where it had arrived from Europe at the end of 19... 1518 or the beginning of 1519. The... the utterly new... the new disease, utterly new to the Indians, spread swiftly among them, killed a fourth, a third, a half contemporary estimates vary of the Aztecs before the conquistadores even began their siege of Tenochtitlan. The conquistadores, veterans of Europe's pest holes were all or almost all immune. Smallpox in Mesoamerica had been for them childhood diseases. They can be argued persuasively, I think the pathogens like smallpox and viruses, like the... like the smallpox viruses, provide an explanation for the odd fact that the majority populations of Europe's former colonial empires in America are of all world origin while those of the former... Europe's former colonies in African Asia consist of what you'd expect them to consist of, Africans and Asians. My fourth category is modern times. Now, when shall I say now began? I choose the last half of the 18th century, the beginning, decades of what I entitled the Great Acceleration. The population explosion began then. There were no more than 850 million of us in 1750. When I was born, there were 2 billion of us. Next year, we're going to hit 6 billion of us. I am the member of the first generation ever to be able to say that population of the world tripled, not doubled, tripled in my lifetime. At the same time as this population explosion, we've had a technological and scientific revolution spurring and enabling more and more people to move around the world faster and faster, railroad, steamships, and now jet aircraft. We have set the scene for enormous pandemics and we've had some, most famously, the cholera epidemics of the 19th century. Among the factors that have saved us from worse are, this is a long range one, a more nearly total sharing of many of the most communicable diseases than ever before. So those of them who catch them and die of them do so in childhood when they are easily replaced or who acquire resistance to them. Second, a genetic mixing of previously isolated peoples so that genetic resistances, if they are significant, and I have my doubts about that, genetic resistances are spreading. For many populations, nutrition is more plentiful and more of better quality than ever before and most important, from at least 1850, there have been advances in medicine, public health administration, and sanitation. Cities of millions today are healthier places than cities of 10,000 were in the 18th century. At the end of that century, the ability of humans to defend themselves from communicable diseases took an enormous stride forward with Dr. Edward Jenner's publication in 1798. I was discovered that an artificially transmitted infection of cowpox, a mild disease, rented a patient immune to smallpox, a dangerous disease. Jenner's discovery signaled the beginning of an unprecedented advance in our ability to protect ourselves against infection. Signaled the beginning of the age, the century of snow, pester, and caulk, an age in which we learned more about infection than we had learned in the previous million. Professor Roy Porter states in his new general history of medicine, quote, in 21 golden years between 1879 and 1900, the microorganisms responsible for major diseases were being discovered at a phenomenal rate of one a year, unquote. In many cases, the discovery of effective vaccines against these diseases followed soon after. The progress since has been equally spectacular. There is, of course, a matter of diminishing returns. We produce vaccines for all the easy diseases, so to speak, but in the last half century, we made enormous progress in inventing cures. Sulfur drugs launched the antibiotic revolution in the 1930s. People started to use this phrase which seems so sad. Now, the Pax antibiotic, which I'm afraid is coming to an end. In the advanced nations, the chief killers are no longer infections, but degenerative diseases, cardiovascular, and cancer. None look forward to them. I certainly don't. But it's better to die that way at 60 or 70 or 80 than to die at scarlet fever of two, at two. By conquest of nature, a phrase which we until recently were comfortable, but conquest of nature has tended to be imperfect, defending ourselves against infection is like damning a river. That is to say, if you do it and then turn your back and say that job is done and walk away, you're going to get your feet wet and you may even drown. Our environment is unimaginably complicated. The last, the previous lecturer convinced me it's much more unimaginably complicated than the one I thought it was. He's given a whole new scale to this adjective of mine, unimaginable. And of course, the threats for us from it are endlessly renewing. At best, the dam is always leaking a little. A few years back, Milwaukee was stricken with a nasty tummy bug called cryptosporidium. Where did it come from? The world. We're engaged in a race between the enhanced possibilities for infectious disease, pro-multigation in the world we have created during the Great Acceleration and the means we have discovered at the same time and implemented to control infectious disease. The public health challenge of Mexico City with 16.5 official population and more likely, if you count the squatter towns, something close to 20 million is greater than the total populations of Norway, Sweden and Denmark together, one city. The epidemic, the public health populations in that mass of people are daunting. Such megalopoli are sprouting up all over the world, but most spectacularly in the regions where the facilities and the income are insufficient to take the latest and most effective measures to control infectious disease. We appear to have squandered much of the advantage of antibiotics. Physicians have over-prescribed them. The poor, too poor to consult real doctors, have dosed themselves with antibiotics purchased on street corners. A thousand years ago I was stationed in Panama and you could buy penicillin on every street corner or you could buy something called penicillin on every street corner. And people would, you know, if they get the sniffles they'd take penicillin. Farmers have mega-dose their livestock with antibiotics produced bigger and more profitable animals. The irresponsible sick have quit taking their prescriptions as soon as the symptoms of disease began to clear up and even the responsible sick if they have AIDS sometimes in spite of taking their medications faithfully maintained secondary infections for years. All this mishandling and bad luck has served to produce germs by a simple Darwinian process of the survival of the fittest microbes, right microbes, which are resistant to formerly very effective medications and in some case resistant to all known antibiotics. The most famous of this development is tuberculosis which was rampant in our cities in the 19th century, a barely discernible threat a few decades ago and today with the appearance of antibiotic resistant strains more frightening I think than media, such media hot threats as the Ebola virus. Our increasing population spread of cities and suburbs is creating more and more intimate contact between humans and parts of their environments than ever before. As the housing developments of prosperous Americans encroach on forests and meadows and swamps as they invade the so-called wilderness areas on their vacations they find themselves rubbing elbows so to speak with deer and mice in their ticks and catch Lyme disease. There are similar changes elsewhere which may explain the spread of AIDS, perhaps a disease previously so localized as to be inapparent. Africa may have other goodies for us, Rift Valley, fever, Ebola, etc. So may Minnesota. We are doing our level best to homogenize the world and we get more than we bargained for as we do. One last worry. The success has spoiled us. The triumphs of medical science have convinced a lot of us that science can solve all of our problems. I haven't come across any scientists who believe that but a lot of people who don't know anything about science believe it. Success made even those who should have known best quite giddy. In 1969, Surgeon General of the United States, William H. Stewart, told the American nation that the book on infectious disease was now closed. The West seemed to have conquered epidemics. Epidemiology seemed destined to become a scientific backwater. Not so as we need, as we realize now. I don't want to condemn the man for not having realized that AIDS was going to happen next. I mean, my hindsight is more accurate than his foresight, oh. But he was guilty of hubris. The whole community was guilty of hubris. That is to say of selective memory. In 1917, the life expectation in the United States was 60 years, just short of 60 years, enormously higher than it had been in the 19th century. The age of medical immodesty was upon us. But in 1918, that's within living memory, life expectation dropped from about 60 to 39 years. That was the year of an arrival of a new strain of influenza that killed absolute flat-out minimum of 550,000 Americans and no less than 25 million in the world, possibly 40 million in the world, depending on what went on in China that research hasn't been done yet. That disease flattened all our defenses and went on this way. We defended ourselves no more effectively against it than we would have 1,000 years before. It was a shocking memory, so we forgot it. Even some of the medical community did, as the United States Surgeon General Stuart indicated, as I quote, I just made up him, indicated. He doubtless had never read or heard what the Surgeon General of the United States Army, Victor Vaughn, wrote about the peak weeks of the 1918 epidemic. Quote, at that moment, I decided never again to pray about the great achievements of science. The deadly influenza demonstrated the inferiority of human invention. Today we know enormous, a lot more about the flu virus and viruses in general and about infection in general. But how much better are we prepared for new pandemics than we were in 1918? Our success in understanding AIDS is very impressive, but our greatest advantage in fighting HIV is the fact that it's a sexually transmitted disease. It spreads slowly. What if it were transmitted by breath, like influenza? You might say that was unlikely, but in 1970 everybody would have said HIV was unlikely. There has been, my point is finally going to get there, there has been over the last generation that a lot of money spent and a lot of words outed about mounting a Star Wars defense against incoming ICBMs. Maybe they aren't the real threat. Thank you. I'm moving to Nantucket permanently in September. And Nantucket. I'm sure they've sworn on it. And not at Bavis? Yes, yes. I go around, I know they're always marvelous watchers, especially the Jesuses. I mean, I think very much. Oh, very interesting. I think that it's nothing. See, I mean, it's transmitted kind of because the surface already changes throughout now. Why, you know, nauseous. Yes. It must be the last time. We're ready now to pose some questions of Dr. Crosby to expect the unexpected that sort of started with Dr. Holland. The members of the other speakers have any observations, questions, or comments of Dr. Crosby. Dr. Holland. Dr. Crosby has written some beautiful histories of influenza virus. And I'd like to have him tell us a little bit about you've gone back into the Middle Ages and pretty well identified influenza back then. Excuse me, I was busy wiping a fly out of my nose. What did you say? Tell us a little bit, you know, virologists have a short memory. We haven't gone back to about the 1918 epidemic. Tell us something about how far back you trace this. Influenza? You trace influenza because influenza is... What are the symptoms of influenza? It's a really lousy cold. Everybody gets fast all over the place. That's not a scientific description. But if a lot of people get a very bad cold all at once, then it's probably influenza. Going back through the record and trying to find out when that happened, then there's no question at all that what's happening in the 18th century, that there are epidemics of influenza that sweep across Europe and are called things like the Jolly Rant. It may have existed in the 16th century, but it's tricky to... Being a disease historian brings you to the edge of tears many times because you discovered that a lot of diseases had one symptom, fever. Well, yeah. They would describe symptoms as if they were separate diseases. A disease which produces a rash and fever, that's the name of the disease. So the chances are it was happening in the 16th century. Back of that, you just cannot tell what's going on. It seemed with all the pigs in Europe at the time in the Mediterranean and the contacts, particularly during the Mongol Empire era all the way across the Black Sea, the China Sea, it would seem very, very likely to me that there was influenza in the Middle Ages, but you can't nail it down. I have heard it said that the average person in the U.S. these days spends 90% of their lifetime indoors. And I'm curious as to whether you've ever looked at the proportion of time that we spend indoors versus outdoors, indoors where you would expect to have viruses and other infectious pathogens be more contagious in closer quarters if there's any correlation during the course of civilization between that statistic and the dissemination of infectious diseases. That's an angle I never thought of. I read it, of course, because the flu epidemics tend to go up in the North and South depending on winter. And it's not the cold that gives you influenza or the cold that gives you a cold, for that matter. It's being in contact with somebody with a disease and, of course, in a closed room in an elevator or subway train. That's much more likely. Certainly the peasants, 500 years, 1,000 years ago, spent a lot more time out of doors but not in the winter. I'm thinking with my mouth open. But not in the winter. They were just, I'm thinking of farmhouses I visited in Russian, Karelia, and Estonia where they have a gigantic stove that people would sleep on top of in the winter. And they wouldn't go outside except very, very briefly for a month at a time because the cold was so desperate. But it then stayed with my mouth open. That would be a wonderful situation that could change the disease with people in that house but how much contact was there between houses? Not much, I suspect, except visits to the wood pile or something like that. That's a question which I'll think about. I'll think about a lot. There's a question that was asked earlier this afternoon from the audience that I think fits into this. Deals with viruses and population control as a natural population control. Is there a threat for the future of humanity of virus as serving as a population control kind of a Lothusian influence? Well, anything can happen. I often said to me, population problem age will fix that. It takes too long. You've got age for much too long for it to be a really good population control. You need something like smallpox and not speak a lot in a week or less. I don't want to get into ideological battles but I am a profound believer in controlling population because the world population has tripled in my lifetime and the closer we get to being elbow to elbow in this world, the more likely it is that something truly nasty is going to happen and science performing close to miracles and the gathering of knowledge and the producing of purism, vaccine and so on. But with populations of this size, it takes... I'll be arbitrary about it. New variants of influenza shows up in China. It takes a month to really decide that's what it is. It takes another month for the rest of the world to get examples of this and try them out in their labs. It takes months and months and months to get the vaccine after it's developed in people's arms. It isn't somebody jumping up in a lab and saying, Eureka, the time lag between Eureka and getting the vaccine into the arms of 8 billion people is considerable. The logistics is an enormous difficulty even if you know what you're doing. Another question from the audience focuses on some of the research that you did for your very interesting book on the pandemic of 1918-1919 in which it spread like wildfire. It started out like a little fire flamed out and then wildfire spread across the world and then disappeared and was not seen again. Any speculation as to how it finally disappeared? Well, it didn't disappear. It contacted most of the people on Earth had at least subclinical cases of that disease in 1918-1921-1922, something like that. And then it sort of sputted around the usual inter-epidemic, inter-pandemic sort of flu for years thereafter. I just came back from a conference on the 1918 flu in a conference in Cape Town, South Africa where I got to talk to Jeffrey Taubenberger and several other people who are doing research trying to sequence the genome of the 1918 virus and they've sequenced much of it by no means all of it and what's confusing them thus far is it looks just like another variant of influenza. If that turns out to be true, then maybe there is some sort of awful crossing of awful combination of bacterial infection and influenza epidemic at the same time. So intellectually one hopes that was not the case because it would make it almost impossible to understand. It's like everything goes exponential on you when you get in three and four causes of something at the same time. And anyway, that's all long before they're... got to the point where they can sequence the whole genome. They're collecting bits of people from... hopefully were buried in permafrost. People in Spitzburg proved not to be buried in permafrost. They were only down about eight inches and not awfully good condition after 80 years. But there are some samples, lung samples coming in from Alaska that are apparently were buried in the permafrost and might prove to be very fruitful. We shall see. But I'm going to get my flu shot. Let me tell you that. Could I just comment on that? Sure, go ahead. Yes, I agree there's something very odd about that 1918 flu. It was an H1N1 and there's other H1N1s that don't behave nearly as virulently. There's the well-known case of a young Dienese painter who painted his wife. Do you know that story? He painted his wife one evening and she was a lovely girl. She was dead the next morning. So it was extraordinarily virulent and I think your suggestion that there might have been some other infection at the same time is very plausible. That's a question that maybe... I think it's very hard to look at the sequence of a negative strand virus for which you have no model and say it doesn't look like it's virulent or not. I mean we don't know that much about what's encoding virulence. And I think if you look at the clinical picture of the people who died, a large number of these people died very abruptly, very quickly with pleural effusion and a lot... And I think personally, my guess is the different flu strain with the different pathogenesis. Now a lot of these people dragged on and they died with bronchial pneumonia in these huge autopsy series from the Army Hospital, like McCollum's series and so on. Those are probably dual causation but I think there's something there that's real, highly virulent and moved very quickly. It's a genome with a segment, it's a virus with a segmented genome so I mean it's quite possible that some other flu genes, in addition to H1N1 also, were present there, yeah. It is the great mystery of this century. And the other thing is your flu shot's not going to help you. No, because it won't be... It's a wrong... Yeah, it won't be the one that comes out of the sky. Ribovirin might work, Someone wants to know any predictions about future colonization of outer space and disease transmission? I wonder if they read an article I had in a very strange book about 15 years ago. I was invited to a conference on interstellar migration at Los Alamos, paid by your money. And there were rocket scientists and astrophysicists and one anthropologist and one historian and we sort of ran around waving our arms saying, I said, okay, we'll go out into space and in 10,000 years or 20,000 years they're talking numbers like this. We'll meet each other again. When we meet each other everybody's going to die because we'll have different microorganisms and that didn't watch, it didn't work at all. The anthropologist waved his arms around and said that languages will change. Thousands of years in space you won't understand each other when you come back together. And one of the rocket scientists said, we'll take languages. Then we tried to say, look, the French have been trying to nail down French for 200 years, it isn't working. If we do this experiment of getting out and settling colonies and different galaxies and so on, then we can, and then getting contact again we can re-run the whole Columbian exchange thing again, it'll be gassed but it's not even going to happen unless we figure out how to fly faster than light that happens. There's a controversial question that I think will pose to the whole panel here. It's a question of bioterrorism. The question of the use of viruses as a tool for making a political point as opposed to using explosives or poisons. Here in the state of Minnesota, Dr. Michael Osterholm in the Department of Health has made some very strong statements in Congress, speaking partly as officially from the American Society for Microbiology. Do any of you all have some reflections on that? I tend to just slip into a fetal position and stay that way until the sun will change. I thought I was the only one that felt that way. You know, I think it depends very much on who's doing the terrorism. It's some disaffected guy who has the microbiological knowledge to make beer in his basement. You could have a lot of fear and a few casualties with some relatively easily obtainable organisms. I think as you begin to move into an area of state-sponsored terrorism where specialized microorganisms are available, where specialized knowledge about how to disseminate them is available, then I think you could have some significant casualties. And if you move over into the area that I know that Dr. Jocklick doesn't like to move into, but if the stories about the Russian stockpiles of smallpox are true, which I think they probably are, and if some of those scientists left these installations for better-paying jobs in areas where they have to have an Arabic translator, which I think they have. I think it's fairly well established. And if they took smallpox with them, which I doubt that they did, but I don't know, then you have a situation where smallpox becomes a self-perpetuating organism that once you start it, it's going to spread. Vaccine stocks are inadequate to protect more than a few million people, air travel, etc. That could be extremely serious. That's a real serious scenario, I think. To a certain extent, I agree with you with your statement. It depends on who's doing the terrorism. I think in many cases, the terrorist really likes a big bang to have a major effect. But what's the name of the guy in where it was who sent out the bombs? What's his name? Do you know Barbara? Yes, right. I mean, he sent bombs, but he could, if he'd been a virologist, he could have easily sent viruses, you know, just to make some personal revenge statement or something like that. I think the reason that we haven't had bioterrorism with viruses yet is because virologists are such nice guys. I do think that despite the fact that we are such nice guys that it has been tried. I think clearly in Japan, not with viruses but with anthrax and fortunately the wrong strain, it has been something that's crept into the minds of terrorist groups. And my thinking on this actually has changed over the years. I think particularly as we see that there is more and more that we can do proactively to prevent outbreaks or to have more rapid mobilizations in response to them. I think for example the fact that we now are beginning to develop rapid throughput technologies like DNA vaccines that might give us a chance to immunize against certain pathogens. I think that we need to look at it seriously, that there are constructive ways that we can do to keep it from becoming a problem and I think that it may require more rigorous surveillance than we've had in the past. Not only for viruses but for bacteria. In the book Plagues in People doesn't it mention I don't know if this is true but the British used blankets with smallpox on it and gave it to the Indians and tried to destroy Indians that way. If viruses as the tool I think it would be bacteria and there are much better cases for bacteria and also once smallpox gets started it's going to be hard to keep within a population and not have it come to you but I think things that give rise to toxins that are acute and sudden and that could wipe out an army are the things that people would be thinking about or something that would be paralytic even temporary as was worked on by the United States actually. And on an up note here so I will tell you thank the speakers for their contributions today and we are finished with the lecture portion of the Nobel festivities I'd like to remind you of some evening activities. 6.30 to 9.00 in the art center there will be the aid series of drawings and paintings by Sue Coe on the south side of campus 7.30 in Christ's Chapel is the Nobel concert Misa Bandari a world music celebration which will consist of choral music as well as instrumental music at 9.00 are the firing lines in the firing lines the speakers will be in a much smaller venue and will be there to answer questions that you may have of them. They will be in Wallenburg Auditorium at the Nobel Hall of Science on the middle of campus just south of the chapel and the other is in the room 103 in Olin Hall which is right across the street from Nobel Hall of Science we invite those who are staying in St. Peter for the evening to join us for that. Thank you for your attendance and for your attention.