The Way We Live Now

Bibliographic Data

ID4175032
AuthorsWarwick Anderson (0000-0002-5545-9244)
Year2020
Volume111
Issue4
Pages834-837
Publication date2020-12-02
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueIsis (JOURNAL)
Journal identifiersISSN: 0021-1753 • E-ISSN: 1545-6994
PublisherUniversity of Chicago Press (PUBLISHER • US)
DOI10.1086/712234
OpenAlexW4247990529
LanguageEN
Citations received3
References cited5

Previous articleNext article FreeInvited ArticleThe Way We Live Now?Warwick AndersonWarwick AndersonUniversity of Sydney Search for more articles by this author PDFPDF PLUSFull Text Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinked InRedditEmailQR Code SectionsMoreHow tidy it would be if each century simply got the pandemic it "deserved," as though each event was neatly contained, analytically separate—ideographic, as we used to say. Yellow fever and smallpox in the eighteenth century; cholera in the nineteenth century; influenza and AIDS in the last century; and, suddenly, COVID-19 in our own times. There have been moments in the current crisis that might prompt us to believe that each epidemic makes its own history, that every instance is different, specific to its age, distinct unto itself, perhaps even incommensurate. But then, as I read again The Cholera Years, I felt the full force of Charles E. Rosenberg's argument—verging on nomothetic—explaining that continuities are present in how epidemic diseases stimulate and shape perceptions and reactions, in how they might reveal and transform our relations with one another and with the environment. Early in this classic text, Rosenberg wrote: "I have sought to make the cholera epidemics serve as sampling technique as well as subject."1 In later studies, he elaborated on how other epidemics similarly can be represented as social sampling devices, laying bare structural inequalities and cultural assumptions or discriminations in the societies they afflict—each pathognomonic and clearly defined, but sharing many indicative properties.2 Such was the case, Rosenberg showed us, with the AIDS epidemic. So too now, it seems, with COVID-19. Pandemics can display a nasty family resemblance.Much of what Rosenberg discerned in responses to cholera in the United States during the mid-nineteenth century is surprisingly pertinent to our contemporary predicament. He described the same white American presumption of special healthiness and virtue, "the unshaken conviction that the United States was the most prosperous, pious, and enlightened of nations" (p. 103). Inevitably, such national vanity leads the "innocently" afflicted to focus on external sources of their scourge: hence Asiatic cholera, the China virus, and always the immigrant or foreigner menace. There are other parallels. "New York seemed especially vulnerable [to cholera in 1832]," Rosenberg wrote, "the largest and filthiest, the most crowded and vice-disfigured of American cities" (p. 17). At the beginning, the city authorities proved "surprisingly negligent" (p. 23), and hospitals and undertakers soon were overwhelmed. It happened that "the equivocal statements of the Board of Health had been more inscrutable than reassuring" (p. 27). The disease mostly beset marginalized groups such as supposedly vicious and worthless Irish immigrants and "Negroes." The progressive young medical historian observed that "the extent of poverty revealed by the epidemic was genuinely disturbing" (p. 58). Experts bickered over whether cholera might be contagious to some degree. Quarantines routinely failed. For many, the subsequent 1849 epidemic was a "direct rebuke to scientific pretensions" (p. 128), with the result that superstition and moralism continued to inform assessments of pathological cause and effect. "Everyone wrote on cholera," Rosenberg noted. "Indeed, the subject seemed almost to have been exhausted" (p. 164). Nearly two centuries have passed, yet it appears that some things have not changed. As I turned the pages, I often wondered whether the social and political dimensions, at least, of COVID-19 in the United States could be cholera redux.But differences also are striking. Biological divergence of vibrio and virus makes for contrasting patterns of transmission, parasite–host interaction, and mortality rates, among other attributes. Moreover, population growth, ramifying urbanization and crowding, and greatly accelerated global communication and contact have massively amplified the speed and scale of the current crisis. COVID-19 in the twenty-first century is conspicuously more mediatized and scientized than cholera in the nineteenth century. The scientific and technical machinery that can be brought to bear on the pandemic is prodigiously more powerful than the paltry biomedical research enterprise of earlier eras. Our very own epidemic thus draws a revealing cross-section through modern times, as Rosenberg anticipated. Another eye-catching aspect of COVID-19 in the United States, compared to the previous irruption of cholera, is the widespread expectation that the federal government now carries much of the responsibility for guiding people through epidemics. In The Cholera Years, Andrew Jackson and Zachary Taylor remain happily offstage most of the time; these days, in contrast, a prancing orange pompadour constantly blocks the field of vision, preening for the camera while giving lip on Twitter. Not an inspiring reveal. Who would have thought that a description of devastating cholera epidemics could make one yearn for that simpler age, when presidents were rarely seen or heard?I first read The Cholera Years in the 1980s, failing to notice then that it is fundamentally a story of modernization and secularization—probably because I myself was still immersed in those modes of thinking. The slices of history cut by each cholera epidemic show the transition from a localist agrarian society to an industrial, largely urban civilization with bureaucratic public health organizations.3 There was progress in medicine too: the "absolute value of personal salvation was being replaced by that of nature as norm" (p. 132); and disease was becoming "more and more a product of the environment" (p. 133). Numerical methods or statistics turned rapidly into epidemiology. "The tools and concepts of an urban industrial society were beginning to be used in solving this new society's problems" (p. 193). Thus the "achievements of science" were minted into the "coin of public esteem" (p. 235). One picks up a faint, yet somehow altered or qualified, echo of the technocratic optimism of much 1950s American social science, with its proclamations of the end of ideology.4 There is little of Rosenberg's later interest in the dark side of modernization, the pathologies of progress.5 But then again, the conclusion is titled "The Way We Live Now," surely an allusion to Anthony Trollope's most mordant and satirical novel.Although received these days as a founding text in the social history of medicine, The Cholera Years should also be seen in relation to other studies in American cultural history. Rosenberg was, after all, a student of Richard Hofstadter at Columbia University when he wrote the dissertation that became, almost word for word, the book. Hofstadter was reputed to be an inattentive advisor, and he was turning into an increasingly rebarbative conservative, so his influence on his students at that stage may have been token or denotative, rather than directly molding. Hofstadter serves, in a sense, as a representative, even symbolic, figure. More than most historical study in the mid-twentieth century, his work emphasized irony, paradox, and anomaly; it fixed on identity, anxiety, stress, and strain; it carefully avoided moral absolutism; and it was shaped and informed by social psychology and cultural anthropology. Emerging out of the "consensus" school, Hofstadter rejected simple economic determinism, seeking instead to mobilize contemporary social science—especially the researches of Karl Mannheim, C. Wright Mills, and Robert K. Merton—in grappling with complexity. "The more the historian learns from the social sciences," he wrote in 1956, "the more variables he is likely to take account of, the more complex his task becomes." Social scientists offered historians "a host of new insights and new creative possibilities," as well as "methodological self-consciousness."6 While the sociologists and anthropologists that Rosenberg found compelling differed from those his advisor admired, Hofstadter and others at Columbia nonetheless provided models for interdisciplinary inquiry involving symbolic systems.7 But no one there had focused before on disease.Bringing together explanatory social science and historical narrative already had produced a "minor literature" within the pocket-sized field of the history of medicine.8 As an undergraduate, the Manhattan-raised Rosenberg learned this from Erwin H. Ackerknecht, his teacher at the University of Wisconsin–Madison. Classed as one of a distinguished group of émigré German physician historians, including Henry E. Sigerist and Owsei Temkin, Ackerknecht considered himself primarily an anthropologist, having trained in Paris during the 1930s with Lucien Lévy-Bruhl and Marcel Mauss. Later, in New York City, he befriended Ruth Benedict. Versed in what Rosenberg describes as "Popular Front social science," Ackerknecht was a staunch partisan of Rudolf Virchow's political vision of social medicine. He had come out of the prewar cluster of thinkers who created, according to Rosenberg, "scholarship that provided a usable intellectual past for a younger generation of critical social historians."9 This framework, which supported The Cholera Years, showed how "the linked moral and cognitive claims of medicine could be thought of as tactics in the negotiation of professional status and the sanctioning of social norms—just one among many possible historically elaborated and culturally configured belief systems." Ackerknecht, Rosenberg writes, saw history of medicine as "a way of using social history to understand medicine, and of using past medical ideas and practices to help understand society."10Through Ackerknecht, Rosenberg was exposed to other historians of medicine receptive to social science. He greatly respected Temkin, ensconced at the Institute for the History of Medicine at the Johns Hopkins University, as "a believer in what might loosely be termed a gestalt approach to understanding disease as at once a biological and a social phenomenon." Like his sociological peers Norbert Elias and Ludwik Fleck, Temkin "sought to explore the interpenetration of socially situated ideas and value orientations in specific historical settings." Rosenberg recalls that "this situated approach was so congenial to me as a student."11 He was to find more inspiration from scattered historians of medicine than from mainstream historians of the United States. As the medical historian George Rosen put it, "the development of medicine in time can be studied best and comprehended most fully only by investigating it in relation to the changes of the social structure as a whole."12 Although born in New York City, Rosen had been forced to complete his medical degree in Nazi Berlin in the 1930s owing to quotas on the admission of Jewish students in the United States. Under the influence of Merton and Sigerist, he later undertook graduate studies in sociology at Columbia. Throughout his career, Rosen explored the historical dialectic arising from "the interaction of the microcosmic forces within the medical relationship and the macrocosmic forces of the external social environment." The history of disease, he wrote in 1940, is "the study of sick people located within a definite space-time setting under particular social conditions." Roused through his reading of Virchow, Rosen later observed that "a recognition of the social relations of disease leads to a realization of the necessity for a coordination of medical, social, and economic effort to cope with the problem of disease."13 In The Cholera Years, Rosenberg brilliantly demonstrated the affinities of such contextualized history of medicine with the American social and cultural history he had read at Columbia. Although previously separate, both styles of historical practice were experiments in interdisciplinary thinking, efforts to reach out to social scientists for guidance and illumination.Evidently, a few members of each generation of medical historians have discovered the social sciences they needed to explain complex configurations of epidemic disease—while most of their colleagues carry on composing narrowly focused ideographic narratives. At any rate, the benefit of such recourse to contemporary sociology and anthropology is for me the main historiographic lesson of The Cholera Years. This prompts the question: What are the new cultural insights and social theories we will need to do historical justice to the COVID-19 pandemic? Another way of putting this is: How will our intellectual engagement with this current predicament further reshape histories of science and medicine?NotesWarwick Anderson is the Janet Dora Hine Professor of Politics, Governance, and Ethics in the Department of History and the Charles Perkins Centre at the University of Sydney. He is now writing on the need to decolonize and "ecologize" histories of science after the pandemic. With Gabriel Soto Laveaga, he has edited a Forum in History and Theory on "Decolonizing Histories in Theory and Practice" (September 2020). Department of History, SOPHI, Quadrangle A14, University of Sydney, Sydney, NSW 2006, Australia; [email protected].Acknowledgments. I am grateful to Allan Brandt, Sophie Chao, and James Dunk for their advice on an earlier draft; Charles Rosenberg corrected some errors but refrained from further comment.1 Charles E. Rosenberg, The Cholera Years: The United States in 1832, 1849, and 1866 (Chicago: Univ. Chicago Press, 1962), p. 4. Subsequent references to this work are indicated in the text by page number. I focus here on the original edition of The Cholera Years, from 1962, though a new edition with an afterword appeared in 1987.2 See Charles E. Rosenberg, "Cholera in Nineteenth-Century Europe: A Tool for Social and Economic Analysis," Comparative Studies in Society and History, 1966, 8:452–463; and Rosenberg, Explaining Epidemics and Other Studies in the History of Medicine (Cambridge: Cambridge Univ. Press, 1992).3 Richard Hofstadter described a similar transition occurring at a later date in The Age of Reform: From Bryan to FDR (New York: Knopf, 1955).4 Mark Solovey and Hamilton Craven, eds., Cold War Social Science: Knowledge Production, Liberal Democracy, and Human Nature (New York: Palgrave Macmillan, 2012).5 Charles E. Rosenberg, "Pathologies of Progress: The Idea of Civilization as Risk," Bulletin of the History of Medicine, 1998, 72:714–730.6 Richard Hofstadter, "History and the Social Sciences," in The Varieties of History: From Voltaire to the Present, ed. Fritz Stern (New York: Meridian, 1956), pp. 359–370, on pp. 364, 361, 362. Hofstadter and Mills had taught at Maryland and both went from there to Columbia in 1946, while Hofstadter and Daniel Bell conducted a faculty seminar together around 1960. In his misjudged criticisms of Rosenberg's later work, Roger Cooter seems to imply that the author of The Cholera Years never quite shook off the consensus school; see Roger Cooter, "'Framing' the End of the Social History of Medicine," in Locating Medical History: The Stories and Their Meanings, ed. Frank Huisman and John Harley Warner (Baltimore: Johns Hopkins Univ. Press, 2004), pp. 309–337.7 The sociologist Erving Goffman and the anthropologist Anthony F. C. Wallace are obvious influences on Rosenberg, but from the late 1950s Clifford Geertz also was writing on ideologies as cultural systems; see Clifford Geertz, "Ideology as a Cultural System," in Ideology and Discontent, ed. David E. Apter (New York: Free Press, 1964), pp. 47–76.8 The concept is from Gilles Deleuze, Kafka: Toward a Minor Literature (Minneapolis: Univ. Minnesota Press, 1986).9 Charles E. Rosenberg, "Erwin H. Ackerknecht, Social Medicine, and the History of Medicine," Bull. Hist. Med., 2007, 81:511–532, on pp. 525, 531. Coincidentally, both Hofstadter and Ackerknecht had been adherents of Trotskyism in their youth—Ackerknecht fervently so—and both became reactionary and cranky in old age. For other readings of Rosenberg's intellectual development and influence see Naomi Rogers, "Explaining Everything? The Power and Perils of Reading Rosenberg," Journal of the History of Medicine and Allied Sciences, 2008, 63:423–434; and Nancy Tomes and Jeremy Greene, "Is There a Rosenberg School?" ibid., pp. 455–466. Tomes and Greene briefly mention "an anthropological sensibility" in his intellectual formation (p. 461).10 Rosenberg, "Erwin H. Ackerknecht," pp. 525, 521.11 Charles E. Rosenberg, "What Is Disease? In Memory of Owsei Temkin," Bull. Hist. Med., 2003, 77:491–505, on pp. 495, 495n, 496.12 George Rosen, "A Theory of Medical Historiography," Bull. Hist. Med., 1940, 8:655–665, on p. 660. See Charles E. Rosenberg, "George Rosen and the Social History of Medicine," in Healing and History: Essays for George Rosen, ed. Rosenberg (New York: Science History, 1979), pp. 1–5.13 Rosen, "Theory of Medical Historiography," pp. 662, 665; and George Rosen, "Disease and Social Criticism: A Contribution to a Theory of Medical History," Bull. Hist. Med., 1941, 10:5–15, on p. 15. See also Bernhard J. Stern, "The Health of Towns and the Early Public Health Movement," CIBA Symposium, 1948, 9:870–876; and Stern, Historical Sociology: The Selected Papers of Bernhard J. Stern (New York: Citadel, 1960). An "independent Marxist" and cofounder of Science and Society, Stern completed a Ph.D. in the historical sociology of medicine at Columbia and taught there until his death in 1956. On Rosen, Stern, and other votaries of social medicine see Susan Reverby and David Rosner, "Beyond the Great Doctors," in Health Care in America: Essays in Social History, ed. Reverby and Rosner (Philadelphia: Temple Univ. Press, 1979), pp. 3–17. Previous articleNext article DetailsFiguresReferencesCited by Isis Volume 111, Number 4December 2020 Publication of the History of Science Society Article DOIhttps://doi.org/10.1086/712234 Views: 958 © 2020 by The History of Science Society. All rights reserved.PDF download Crossref reports no articles citing this article

Art · Historical and modern epidemiology studies · Historical Economic and Social Studies · Yersinia bacterium, plague, ectoparasites research

Tools

Open DOI