The Deadly Truth: a History of Disease in America.By Gerald N. Grob. (Cambridge, Mass., and London: Harvard University Press The Harvard University Press is a publishing house, a division of Harvard University, that is highly respected in academic publishing. It was established on January 13, 1913. In 2005, it published 220 new titles. , 2002. Pp. [xii], 349. $35.00, ISBN ISBN abbr. International Standard Book Number ISBN International Standard Book Number ISBN n abbr (= International Standard Book Number) → ISBN m 0-674-0081-2.) Rutgers University emeritus professor and prominent medical historian Gerald N. Grob does not present a utopian vision in his new book: the "deadly truth" he presents is that disease is here to stay. But Grob also maintains that disease is not only a biological fact; it is a social construction. Many diseases need certain conditions to thrive and fester fester /fes·ter/ (fes´ter) to suppurate superficially. fes·ter v. 1. To ulcerate. 2. To form pus; putrefy. n. An ulcer. , and Grob's book is most interesting when describing the historical contexts in which particular diseases prevailed. Today, as American health-care workers are inoculated for small-pox based on fears of biological warfare biological warfare, employment in war of microorganisms to injure or destroy people, animals, or crops; also called germ or bacteriological warfare. Limited attempts have been made in the past to spread disease among the enemy; e.g. , the argument that disease (even when "eradicated") is always with us takes on greater urgency. Grob warns us that research and vaccines can only go so far: there is no such thing as freedom from disease. Grob's book is a march through American history, examining disease outbreaks and their origins. Grob includes many different populations in his analysis, such as Navajos with diabetes and Civil War soldiers. He addresses health disparities between African American and white populations in the South and examines epidemiological differences among populations throughout. Occupational health hazards, especially as endured by coal miners and textile workers, are also explored. He uses an impressively wide variety of evidence to support his ideas, and though his book often relies on quantitative data, he accompanies his statistics with narrative text. The book is filled with stories of the links between disease, place, and time such as yellow fever in Philadelphia, malaria in the Carolinas, and milk sickness in the Midwest. He points out where reductions in morbidity and mortality Morbidity and Mortality can refer to:
 rĭzā`shən, -rīzā`shən), partial sterilization of liquids such as milk, orange juice, wine, and beer, as well as cheese, to destroy , and immigration immigration, entrance of a person (an alien) into a new country for the purpose of establishing permanent residence. Motives for immigration, like those for migration generally, are often economic, although religious or political factors may be very important. and
settlement patterns.
Grob is at his best when explaining paradoxes and challenging us to resist easy comparisons. History teaches us that a higher standard of living often leads to different (rather than better) morbidity patterns--what a population gains through clean water it may lose through occupational hazards. A main theme in Grob's book is that concomitant with the receding of infectious childbood diseases (such as measles) at the turn of the twentieth century came a sharp rise in the prevalence of chronic diseases among an aging American population. He discusses the rise of cancer, heart disease, diabetes, sexually transmitted diseases Sexually transmitted diseases Infections that are acquired and transmitted by sexual contact. Although virtually any infection may be transmitted during intimate contact, the term sexually transmitted disease is restricted to conditions that are largely , and mental illness while warning that the preoccupation with long-term illnesses disguises the still-real threat of infectious diseases. Grob urges us to reject the belief that disease is a mystery that can be solved. Grob's book will be of most interest to general readers since he travels across the country and across time too quickly to explore subjects fully. His exhaustive use of statistics should lead interested readers in profitable directions for future research. Though the ravages rav·age v. rav·aged, rav·ag·ing, rav·ages v.tr. 1. To bring heavy destruction on; devastate: A tornado ravaged the town. 2. of individual suffering certainly contain the specificity of germs and infection, Grob is more concerned with the general trends of diseases and how they move in and out of populations. Americans' experience with disease is influenced by region and socioeconomic status; by gender and age; by occupation and religion; by public health programs and government intervention; by what we eat as children and how many times we wash our hands; and by the noise we endure every day and the fumes fumes odorous gases and other volatile materials; inhalation of irritating fumes causes coughing and, if sufficiently severe, irreversible pulmonary edema. we breathe. Americans must grapple with Grob's central idea: disease is neither static nor eradicable. Health care is at the forefront of national debate, and we would do well to understand that disease is bigger than biology. As we continue to debate the benefits of stem-cell research, childhood vaccinations, and bioterrorism preparedness, Grob both makes his point and touches a nerve. SARAH Sarah or Sarai: see Sara. Sarah (flourished early 2nd millennium BC) In the Hebrew scriptures, the wife of Abraham and mother of Isaac. She was childless until age 90. A. LEAVITT National Institutes of Health |
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