The paradox of the pill: Why scientific cures lag behind economic geography

“ The suffering and losses from infectious and epizootic diseases will decrease in direct proportion to the application of rational methods for their prevention. The organized efforts to do away with cruelty are more rational and more effective because they are based on scientific principles. The ideal conditions to be attained will come only through the growth of knowledge of the requirements of animals and a deeper consciousness of man's responsibility over dumb creation. ”

“ The recent history of sanitation in all civilized countries shows triumphs which may well fill us with wonder, did there not rise within us a far greater wonder that they were so long delayed. Amazing is it to see how near the world has come again and again to discovering the key to the cause and cure of pestilence. It is now a matter of the simplest elementary knowledge that some of the worst epidemics are conveyed in water. ”

“ But just in so far as it is time that economic facts lie back of and condition the progress of civilization, to that extent failure to meet the fundamental economic facts involved in advancing stages of industry must constitute or lead to the greatest social maladjustment and consequent degradation and misery. ”

“ At present I am chiefly concerned to drive home the fact that it is the great disparity between the rapid progress of the natural and technological sciences on the one hand and the slow progress of the metaphysical, so-called social “sciences” on the other hand, that sooner or later so disturbs the equilibrium of human affairs as to result periodically in those social cataclysms which we call insurrections, revolutions and wars. ”

“ Overwork, insufficient clothing, improper food, alcoholic excesses, lack of sleep, and other factors, so lower the antitoxine-forming power of the human body, as to greatly increase the dangers from infection. ”

“ It has been well established by observation and statistics that tuberculosis and pneumonia are the diseases most prevalent among persons living and working in unventilated rooms. But consumption and pneumonia are caused by specific bacteria, which for the most part gain access to the air passages by adhering to particles of dust which are inhaled, and it is probable that the greater liability to these diseases of persons living in crowded and unventilated rooms is to a large extent due to the special liability of such rooms to become infected with the germs of these diseases. ”

“ The opponents of vaccination and serum therapy deny that the use of vaccines and serums has served to check the spread of disease. They hold that epidemics are less prevalent and less virulent now than formerly because of improved sanitary conditions, such as drainage of the soil, municipal disposal of garbage, street cleaning, water and sewer systems, the consequent increased facilities for bathing and household cleanliness, etc.
A false theory of cause not only leads to a false theory of cure, but diverts attention from the real issue. ”

“ The country is so unevenly developed that the most diverse economic stages are to be found in regions which are geographically near each other, and everything goes on, as it were, under the scientific magnifying glass of the statistical student. ”

“ This, no doubt, comes about because it is in these phases of life that culture and geography are in most direct contact; language, religion, literature, art, family organization, etc., are less articulated with geographical phenomena, but geographers are quite given to sweeping them all into the economic category and claiming the most intimate contact throughout. It is clear, however, that the primary problem is to be found in the relation between man's material culture and the earth, which for convenience we shall designate as the environment. ”

“ It is a question of degree how much each man receives of influence from his neighbors; 44but (to use the new medical barbarism) we are never “immune” altogether from the contagion.
We may now approach our proper subject of the Education of the Emotions, carrying with us the important fact that no means are so efficacious in promoting good ones as the wise employment of the great agency of Contagion; and, further, that this contagion works only by exhibiting the genuine emotion to the person we desire to influence. Only by being brave can we inspire courage. ”

“ The prevention of diseases is an object as much deserving our attention as their cure; for the art of physic is at best but fallible, and sickness, under the best medical management, is productive of great inconvenience, and is attended with more or less mortality. The means of prevention are also more within our power than those of cure; for it is more in human art to remove contagion, to alter a man’s food and cloathing, to command what exercise he is to use and what air he is to breathe, than it is to produce any given change in the internal operations of the body. ”

“ We may, perhaps, sum up this chapter by saying that it is evident that the cure of poverty is not to be sought merely in certain economic rearrangements, but in scientific control of the whole life process of human society. This means that, in order to get rid of poverty, the defects in education, in government, in religion and morality, in philanthropy, and even in physical heredity, must be got rid of. ”

“ How will E-biomed avoid accentuating economic or language-based disparities in the access to the research literature? Some have argued that E-biomed would further limit the access to the scientific literature accorded to those who work under limited economic circumstances or understand only languages other than English. We acknowledge that such disparities currently exist, but we believe that free access to the scientific literature in electronic form has a much greater prospect of reducing the disparities than do other means. ”

“ If the cause of degradation and ignorance, of poverty, of contagious disease, or of any of the miseries which make a nation wretched, can be pointed out by scientific methods, then it is the stern duty of Science to step in and at least show the reasons, even if the remedy is not at once forthcoming. ”

“ Offering the international scientific community free, fast, and full access to the entire biomedical research literature is the most important goal of our proposal. As originally described, anyone, anywhere, who is connected to Internet can go to a single site at any time and look at the entire biomedical research literature—to search with pertinent terms, inspect the offerings of favorite journals, and download articles for subsequent study. ”

“ To interfere with or retard the progress of medical discovery is an inhuman thing. Within fifteen years medical research has made rapid progress, almost exclusively through the use of the lower animals, and what such research has done for the diagnosis and treatment of diphtheria it can probably do in time for tuberculosis, erysipelis, cerebro-spinal meningitis and cancer, to name only four horrible scourges of mankind which are known to be of germ origin. ”

“ THE doctrine that land forms have had a history chiefly distinguishes the new geography from the old. Geography, indeed, takes account of sea as well as land, of the phenomena of the atmosphere, the distribution of organisms, including man, of economic products and political divisions. But the new phase of geography, which is sometimes known as physiography, and later, as geomorphology, is not an isolated and formal element of the science; it rather underlies the whole, modifying or, more truly, controlling climate, organic distribution, and the history of man. ”

“ The residence, pursuits, successes, and failures of men are the things that give the geographic data their reason for inclusion in the material of instruction. But to hold the two together requires an informed and cultivated imagination. When the ties are broken, geography presents itself as that hodge-podge of unrelated fragments too often found. ”

“ And the answer is that the so-called sciences of ethics and jurisprudence and economics and politics and government have not kept pace with the rapid progress made in the other great affairs of man; they have lagged behind; it is because of their lagging that the world has come to be in so great distress; and it is because of their lagging that they have not now the needed wisdom to effect a cure. ”

“ Isolated from such ends, it is matter of indifference whether its disclosures are used to cure disease or to spread it; to increase the means of sustenance of life or to manufacture war material to wipe life out. ”

“ Climate change is a global problem, and it will require strong international leadership to secure cooperation among both developed and developing countries to solve it. America must help forge a truly global solution to this global challenge by galvanizing international action to significantly reduce emissions. By taking credible steps toward mitigation, the United States will also reap the benefits of early action, such as investing in low-carbon infrastructure now that will reduce the costs of reaching climate targets in the future. ”

“ As is discussed in Section II, economists who have studied the costs of climate change find that temperature increases of 2° Celsius above preindustrial levels or less are likely to result in aggregate economic damages that are a small fraction of GDP. This small net effect masks important differences in which some regions could benefit somewhat from this warming while other regions could experience net costs. ”

“ As long as we look to legislation to cure poverty or to abolish special privilege we are going to see poverty spread and special privilege grow. ”

“ Like some diabolical spirit, in the form of the epidemic, it leaves its native habitat, and with insatiate malignity, sometimes with slow but irresistible progress, and again by rapid flight, passes all barriers of mountain, sea, and distance in its pursuit of man, its only known object, and whose destruction is its only visible effect. ”