Science vs. Nature Theme Analysis

Ultimately, then, logic and observation failed to penetrate the workings of the body not because of the power of the Hippocratic hypothesis, the Hippocratic paradigm. Logic and observation failed because neither one tested the hypothesis rigorously.

Once investigators began to apply something akin to the modern scientific method, the old hypothesis collapsed.

Haskell County, Kansas, lies west of Dodge City, where cattle drives up from Texas reached a railhead, and belongs geographically to an, in 1918, not far in time from, the truly Wild West. The landscape was and is flat and treeless, and the county was, literally, of the earth.

In the days before antibiotics, an infection launched a race to the death between the pathogen and the immune system. Sometimes a victim would become desperately ill; then, suddenly and almost miraculously, the fever would break and the victim would recover. This “resolution by crisis” occurred when the immune system barely won the race, when it counterattacked massively and successfully.

But once the body survives an infection, it gains an advantage. For the immune system epitomizes the saying that that which does not kill you makes you stronger.

In the spring of 1918 death was no stranger to the world. Indeed, by then the bodies of more than five million soldiers had been fed into what was called the “sausage factory” by generals whose stupidity was matched only by their brutality.

The 1918 influenza pandemic, like many other influenza pandemics, came in waves. The first spring wave killed few, but the second wave would be lethal.

As the virus moved, two parallel struggles emerged.

One encompassed all the nation. Within each city, within each factory, within each family, into each store, onto each farm, along the length of the track of the railroads, along the rivers and roads, deep into the bowels of mines and high along the ridges of the mountains, the virus would find its way. In the next weeks, the virus would test society as a whole and each element within it. Society would have to gather itself to meet this test, or collapse.

The other struggle lay within one tight community of scientists. They—men like Welch, Flexner, Cole, Avery, Lewis, Rosenau—had been drafted against their will into a race.

This was influenza, only influenza.

In 1918 in particular, influenza struck so suddenly that many victims could remember the precise instant they knew they were sick, so suddenly that throughout the world news reports were common of people who toppled off horses, collapsed on the sidewalk.

Nature chose to rage in 1918, and it chose the form of the influenza virus in which to do it. This meant that nature first crept upon the world in familiar, almost comic, form. It came in masquerade. Then it pulled down its mask and showed its fleshless bone.

Lewis knew full well that little of what he was doing was good science. It was all, or nearly all, based on informed guesswork. He only worked harder.

As he worked, the society about him teetered on the edge of collapse.

While science was confronting nature, society began to confront the effects of nature. For this went beyond the ability of any individual or group of individuals to respond to. To have any chance in alleviating the devastation of the epidemic required organization, coordination, implementation. It required leadership and it required institutions follow that leadership.

Vaughan believed that the influenza virus came close to threatening the existence of civilization. In fact, some diseases depend upon civilization for their own existence.

The overwhelming majority of victims, especially in the Western world, recovered quickly and fully. This was, after all, only influenza.

But the virus sometimes caused one final complication, one final sequela. The influenza virus affected the brain and nervous system.

By World War I, the revolution in American medicine led by William Welch had triumphed. That revolution had radically transformed American medicine, forcing its teaching, research, art, and practice through the filter of science.

So the final lesson of 1918, a simple one yet most difficult to execute, is that those who occupy positions of authority must retain the public’s trust. The way to do that is to distort nothing, to put the best face on nothing, to try to manipulate no one.