Günther Labes Foundation, both in Berlin.
John F. Murray, San Francisco, CA
Robert Loddenkemper, Berlin
Background Information about Essential Material
Murray JF, Loddenkemper R (eds): Tuberculosis and War. Lessons Learned from World War II.
Prog Respir Res. Basel, Karger, 2018, vol 43, pp 2–19 (DOI: 10.1159/000481471)
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History of Tuberculosis and of Warfare
John F. Murray
University of California San Francisco, San Francisco, CA, USA
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Abstract
It all started back in the Pliocene epoch, 5.3 million years ago, when Lucy and her primate accomplices first stood erect. That marvel launched a random, several million-years-long evolutionary upgrading that featured bigger brains, upright bodies, primitive weapons, and the management of fire. Our ancestor Homo sapiens started life about 200,000 years ago, but needed time to expand in sufficient numbers to leave Africa and start migrating to Eurasia. Accompanying this Great Expansion, around 70,000 years ago, Mycobacterium tuberculosis began to infect humans and cause tuberculosis (TB). Early human history was dominated by small groups of hunter-gatherers, who survived chiefly by foraging. Then 10,000 years ago, everything changed when H. sapiens switched from their nomadic pursuits to permanent lifestyles of farming and taming animals. Continued population growth, including a doubling of birth rates, brought new administrative and professional roles, royalty, and private property. With these furnishings of “civilization” came its opposite: war, the organized, deliberate killing of humans, with armies and weapons. Later, M. tuberculosis matured from a low-density to an epidemic disease and for several 100 years was the world’s most common cause of mortality. Together, the TB and war partnership has become a major cause of death and destruction.
© 2018 S. Karger AG, Basel
Two independent calamities – tuberculosis (TB) and war – usually rage on different paths without any connection to each other: TB causes disease and death; war causes destruction and death. But when the 2 disasters overlap, their partnership spreads disease, heightens misery, worsens suffering, and produces exceptional mortality. This introductory chapter tells the story about TB and war, which occur most often as separate tragedies, but at times combine with unprecedented catastrophe.
Robert Koch, discoverer of the bacterium that causes TB, Mycobacterium tuberculosis, declared in his famous lecture in 1882 that
If the importance of a disease for mankind is measured by the number of fatalities it causes, then TB must be considered much more important than those feared infectious diseases, plague, cholera, and the like. One in 7 of all human beings dies from TB.
That was famously true in 1882, but mortality from TB was actually much higher roughly 80 years earlier in Germany when death rates had already peaked and were steadily dropping. Around 1800, 1 in 4 deaths in the city of London was caused by the disease; and TB still causes more adult deaths than any other single infectious disease in the world, and has been doing so for a very long time. In Western Europe, during the 17th, 18th, and 19th centuries, TB was by far the most important cause of all human deaths, and during its 300-year swath of colossal mortality, is believed to have killed more than 1 billion people of all ages.
TB did not begin during the Neolithic Demographic Revolution (10,000–7,000 years ago), as previously believed. Moreover, it probably comes as a total surprise for many to learn that TB started roughly 70,000 years ago. This large gap of time has been partially filled in by advances in new techniques of genomic sequencing and genetic analyses that have greatly advanced knowledge about the transmissibility and pathogenicity of current and historical lineages of TB.
In marked contrast to the 70,000 years that TB has been causing disease and death, warfare is practically brand new. No one knows exactly when wars originated, but it was certainly long before recorded history could keep track of them. A reasonable estimate is sometime during the already mentioned Neolithic Revolution, when hunter-gatherers had almost finished switching to growing plants, domesticating animals, and commenced having political issues or territorial disputes to fight about. During their relatively short historical lifetime, wars have been virtually endless and increasingly deadly and destructive, and now, of course, they are crowned by nuclear weapons that threaten the end of civilization.
Evolution of Humans
Prehistory
From time to time, curious people, both young and old, ask the question “when did humans show up in the history of the world?” That’s a great question, but the answer is complicated and experts still are not certain about exactly how human evolution unfolded. A good place to start is the recently refined definition of hominids and their family tree, which includes modern human beings and several extinct ancient species plus their direct ancestors. Hominids originated during the Pliocene epoch, which began 5.3 million years ago, and is celebrated by the presence of the first primates who stood erect. This important discovery was made in 1974 by paleoanthropologist Johanson et al. [1] in Ethiopia, and included the spectacular finding of the nearly intact skeleton of a 3-foot-plus tall young adult female, who was promptly named Lucy and became widely famous. Four years later, Mary Leakey [2] discovered similar bony remains and numerous prehumen footprints more than 1,000 km away in Tanzania. Today, nearly 400 specimens of Australopithecus afarensis have been studied and securely dated from 3.9 to 3.0 million years ago.
A major transition from prehuman to human hominids occurred a few million years after the onset of the Pleistocene epoch, or last Great Ice Age, 2.6 million years ago. The new descendants were the first humans who warranted the name “Homo,” which means “man,” and were designated Homo habilis, or “Handy Man” [3]. H. habilis had both ape-like physical features and manner of walking, but the species knew how to make and use primitive stone (mainly flint) tools. Within the next half a million years or so, Homo erectus appeared showing off its human-like body and larger brain; moreover, it walked fully upright and probably could run [4]. H. erectus originated in Kenya and Tanzania in sub-Saharan Africa, but then migrated widely in Eurasia and as far away as Indonesia. A talented species, H. erectus invented specialized stone tools and weapons, hand axes, clubs, awls, harpoons, and cleavers. Though there was competition over who won the contest, H. erectus is often credited as discovering “the controlled use of fire.” Other precursor human species are known but less well characterized. Archaic Homo neanderthalensis, evolved more than 350,000 years ago and achieved “full-blown” structure 130,000 years ago [5]. H. neanderthalensis had genetic similarities with Homo sapiens, but was shorter, stockier, and had similar or even larger cranial cavities and brains [6]. Until becoming extinct around 30,000 years ago, H. neanderthalensis overlapped in time with H. sapiens, and DNA evidence suggests they may have interbred with modern humans.
The sole surviving species of humans, H. sapiens, first appeared in Africa around 200,000 years ago, but remained geographically isolated for the first 100,000 or so years, possibly owing to the prevailing and always menacing climatic upheavals. New evidence suggests up to 300,000