EVOLUTIONARY ASPECTS OF DISEASE AVOIDANCE The Role of Disease in the Development of Complex Society

List of Tables

1. Disease Pressure Totals From All Sources

2. Behavioral Category Assignment

3. Genome Size and DNA Content

List of Figures

1. Endemic Plague Areas of the World

2. Effects of Bubonic Plague on Population

3. Ratio Diagrams of Fossil Hominids

4. Ratio Diagram for Dimensions of Behavioral Response to Disease

5. Distribution of Reports of the Belief That Jewish Individuals or Traders (Excluding Non-Jewish Traders) Had Poisoned the World (Brought the Plague)

6. Appearance of the Flagellants

7. Distribution of Reports of the Belief That the Devil was Responsible for Plague Either Directly or by Teaching the Production of Plague Poisons

8. Ratio Diagram for Dimensions of Behavioral Response to Disease – AIDS Compared to Bubonic Plague

9. Ratio Diagram for Dimensions of Behavioral Response to Disease – Smallpox Compared to Bubonic Plague

10. Ratio Diagram for Dimensions of Behavioral Response to Disease – Flu Compared to Bubonic Plague

11. Ratio Diagram for Dimensions of Behavioral Response to Disease – Cholera Compared to Bubonic Plague

12. Disease Pressure: Group Comparisons of Epidemics

13. Comparison of Incidents Linked Data Points

14. Scatter Graph of Incidents

15. Logs of Incidents

16. Percentage of Incidents

17. Comparisons of Chinese Examples

18. Comparison of Brain/Body Ratio

EVOLUTIONARY ASPECTS OF DISEASE AVOIDANCE

"It is only in time of epidemic that they pursue witches"

Ruth Benedict, on the Dobu

I. INTRODUCTION

Aims and Scope of Project

Avoiding disease certainly has value to the individual in escaping pain, suffering and death. It would seem obvious that mechanisms would evolve to enhance the ability of an individual to recognize and avoid contact leading to infection or exposure to infection. Social animals especially display evidence of behavior that avoid or limit disease and death, as in the grouped behavior of the water flea Daphnia where grouped animals give off more carbon dioxide than single ones and this extra CO2 can neutralize some toxic substances in the water (Allee, 1938). It is clear from animal research in the wild and captivity that behavior can play a significant role in infection and the spread of disease and the production of mortality (Loehle, 1995). Such behavior would then have a selective role to play in evolution. Hart (1988, 1990) has documented a variety of behaviors that can be described as sanitary, preventing the spread of infection among animals. Mary Douglas (1966) found that in studying the varieties of human religious practice, pollution and danger were often associated with a positive effort to organize the environment. She also found that …pollution has indeed much to do with morals.

Threats derived from the 9/11 attacks resulted in mass responses to avoidance of disease by taking medications (Davidson & Schevitz, 2002). The appearance of a new and deadly strain of coronavirus in China and Hong Kong resulted in a variety of mass behavior including wearing masks, fleeing urban centers and contact with crowds (Lyn & Kwong, 2003) paralleling responses seen during the 1918-19 flu. Recent images in the world press, for example, the Financial Times (January 12, 2006), show government workers spraying cars to prevent the spread of bird flu at frontier posts. A deluge of precautionary measures are recommended in the early stages of perceived serious pandemics, as the refusal to shake hands with a chicken farmer (Christopher Caldwell, in the Financial Times 15 January 2006), the avoidance of perceived gay waiters during the 1990s all seem familiar from past experience. In 2004 MRSA or drug-resistant Staph (Staphylococcus aureus) was found to be infecting healthy people (Johnson, 2004) and by early 2008 was recognized as a new public health problem no longer confined to hospitals (Russell, 2008).

The role of the media may have an important affect on mass behavior. Studies of exposure to suicide or attempts at suicide indicate that such experience may be protective and result in a lower risk of suicide (Mercy, et al., 2001). A number of scientists have written on the potential transformations of society by war (Toynbee, 1935-1961) and disease (e.g., Dols, 1977). It is the change in the survivors that matters in death and illness whether their reflection on life produces any change in social institutions or behavior. Influence of the social environment has significant effects on the individual in other species, for example, in bees. Amos Ives Root noted the fact that hives bees who become infected or ill will leave the hive to die alone, published in his studies of the bee in 1879 as The A B C of Bee Culture. Whether instinctual or a socially reinforced altruism, this act of a highly social animal is remarkable, especially in the context of the new disease, Colony Collapse Disorder, where the immature nurses of the bee hive have been found to abandon the hive before they are prepared, perhaps in response to a disease agent (Stipp, 2007). Chapter Eight investigates the relationship of complex society to epidemic disease in a comparative approach with other animal societies, mainly eusocial bees.

Recent studies have contradicted earlier theories of human behavior as randomly distributed in time. Barabasi (2005), for example, has demonstrated that many human activities follow non-Poisson statistics characterized by bursts followed by long periods of inactivity. Recent economic crises have reinforced this idea (Caldararo, 2009). It is obvious that some cultural practices can have direct relevance to adaptation to disease, for example, kinship and marriage patterns. The severity of the Black Death in Europe in the 14th century can be partly attributed to the prevailing marriage patterns (Coulton, 1925) after the collapse of the Roman Empire and the reduction of trade (Pirenne, 1933). As marriage was largely endogamous within the manors (Coulton, 1925) there would result a decrease in heterozygousity in immune genes and increased susceptibility to disease. Therefore, endogamy and exogamy can produce significant preconditions to epidemics as can isolation as the effects of isolation had on Native American populations limiting their exposure to Old World diseases and therefore immunity (Merbs, 1992). The arrival of an infectious disease acts as an invisible force causing not just death, but marking the living with the signs of disease: the pustules of Smallpox, and buboes of Bubonic Plague. Infectious disease must have played an important role in the role of religion in social control as an agent of the unseen, greater world of life giving and life taking spirits.

In the late 19th Century Adolph Bastian (1881), a German Anthropologist who traveled widely in the mid 19th century, argued that our understanding of mental life had to be placed within the context of ethnographic data. W.H.R. Rivers, who was medically trained, carried this idea out in practice in his research among the Torres Straits Islanders (1901) and on wounded soldiers in W.W.I. Sigerist (1951) produced a comprehensive history of medicine including examples from societies throughout history. Recently Fabrega (1999) has placed the concepts of disease and healing in an evolutionary perspective. It is obvious that the nature of psychological disease is both culture bound and affected by changing social definitions of disease over time and that biological forms of disease, both infectious and chronic have changed with changing social conditions (diet, daily regime, technological aspects of war & work) and our susceptibility to some disease agents has changed. However, except for the general outlines drawn by Canetti (1962) and a few others, the effects of social experience in both contemporary society and in the evolution of society and social institutions in response to disease, is a subject that has attracted little attention. There are two exceptions, in the new field of evolutionary medicine and evolutionary psychology, but neither has produced a synthesis of the cross-cultural research database with the literature of paleoanthropology and non-human aspects of health in evolution. Medical sociology has been concerned with both the history of medicine and cross-culture evidence, but seldom in an evolutionary context. I do not claim to produce such a synthesis, but to begin one. The purpose of my inquiry is to identify such evolutionary aspects of disease avoidance as can be gleaned from human and non-human interaction with pathogens regarding behavior.

This study looks at severe disease conditions that have produced social disturbances. I utilized five such disturbances but chose to focus on just two. The first is Black Plague that initially appeared in Europe in 1348; the other is the AIDS epidemic, which as a social scientist working in a health care clinic, I experienced first hand (Caldararo, 1995).

Recent research has shown that human population diversity is distributed by the effects of climate, pathogens and habitat diversity (Cashdan, 2001). Wolfe (2000) reported on studies with crops showing that resistance to disease could be increased with increasing plant diversity, thereby both increasing yields and reducing the need for pesticides. Also, Guegan (2001) found that human fertility increases with the diversity and structure of disease types. The human immune system as it shares features such as innate immunity with insects (Hoffmann, et al., 1999) and others with early vertebrates (du Pasquier, 1992), is much older than our species, yet it shows a remarkable degree of diversity which predates our Neolithic population explosion and the transition of humans to large populations living in dense, sedentary groups (Klein, Takahara & Ayala, 1993). Some biologists have proposed theories of the evolution of social systems based on patterns of selection (Wynne-Edwards, 1963; Wilson, 1975). This is a complex problem as it requires some consideration of the degree of complexity of societies and the possible differences in complexity have on avoidance and health in general. Certainly it is clear that the nature of disease changes with the change in lifestyle and diet as societies have become more complex, both Greaves (1999) and Fabrega (1999) have detailed some of these. Given the fact that there have also been cycles of simplicity and complexity in human history (Caldararo, 2004) and that because of this, coupled with changes in the nature of society, it has been argued that the adaptation to disease has changed as well (Alland, 1970) as has the response to healing and the effectiveness of healing methods (Fabrega, 1974; 2000). Certainly Fabrega’s argument that the regard and assessment of behavior and its results are colored by our interpretations regarding ideological systems as in the Eugenics movement of the 20th century. My study is designed to discover if disease behavior has resulted from selective patterning.

The reason for choosing several other diseases than Bubonic Plague and AIDS to study, has been done to increase the reliability of the results from the main two samples. By dissecting the social conditions these epidemics affected I will attempt to derive from them an understanding of the forms of human behavior they elicited (both individual and mass behavior). This will be done with a view to finding patterns of response that might be qualified as epigenic or ethogram format. Epigenic models in this discussion, refers to Lumsden and Wilson’s studies of gene-culture translation. Ethograms, refer to Morris’ classificable action performed by the animal in question (Morris, 1969, p. 6). In seeking these patterns, I am attempting to test the theoretical perspective of human sociobiology using the stress of disease to uncover genetically based behavior. A number of other attempts appeared in the last two decades, an example is that by Boyer (1994), though he focuses on development.

The search for fundamental elements of behavior in humans has had a long history in the social sciences, and the pursuit of survivals (such as archaic forms) has been a common theme in anthropology as well as psychology since the 19th century (Lowie, 1937). Many more attempts have been made to study the role of behavior and the environment from multi-disciplinary approaches (e.g. AAAS Symposium, 1968), and lately inquiries have focused on genetic mechanisms that seem to mediate stress, and result in group behavior (Coates & De Bono, 2002; De Bono, et al., 2002). Recent efforts to find human universals can be found in works like Brown (1991) and are beset by the same problems that hampered those earlier efforts, that is, questions of origin, diffusion, independent invention and evolutionary sequences.

This study is concerned with an aspect of human behavior that is often described as hysterical or phobic, but to consider this phenomenon fully it must be situated within the context of the study of human behavior. Levi-Strauss (1962) noted that in the 19th and early 20th centuries Totemism and Hysteria were regarded as distinct species of behavior characteristic of certain rare peoples, the primitive on the one hand and the patient on the other. The more closely each was studied the more indistinct the boundaries of traits and diagnostic features became. Disease could be defined in more general terms and the transition from mental health to illness less defined and more common. Definitions of disease have therefore differed over time and must be considered in cultural and historical context; one may refer to Sigerist (1962) or Anderson (1996) for more details. . And yet, many of the residues of these diseases can be seen in remains from the fossil and archaeological record (Wells, 1964; Iscan & Kennedy, 1989).

There is considerable evidence that human societies have long recognized signs of disease and infection, but the association of the process has been lacking or identified with unspecific ideas of pollution and death (Douglas, 1966; Marshall, 2000). Archaeology has shown (James, 1957) that many societies changed burial practices to cremation from simple burial late in the Neolithic and early Bronze Age. This change comes over 200,000 years after we have clear evidence of human controlled fire (Caldararo,2002). Why did humans not burn their dead before this period? Do we interpret this change to avoidance of the dead, to the illness that ended life or to some spiritual belief? Is avoidance behavior structured to reinforce social stratification as in the case of charged spiritual power in the person of a ruler or class as in ancient Polynesia (de Waal Malefijt, 1968) or is it related to ideas of pollution, surrounding changes in social role or status as in isolation of women during menstruation in some societies (Gausset 2002)?

The transfer of a desired or a feared state is often associated with religious beliefs or magic (Durkheim, 1915) and so the idea of contagion must have an ancient origin. I will not debate here the distinction between religion and magic other than to agree with Hsu (1983) that they often appear to blend together in many examples. A similar thread may function in the custom among the Gikuyu to purify the feet of harvesters passing through various fields. Such practices can be often clearly differentiated from those more closely identified with disease as when the Gikuyu organized war against the spirits that cause illness or shaved, washed and then painted their children with red ochre (Kenyatta, 1938). We will discuss red ochre in another section as it is associated with various cults of the dead and certainly avoidance of the dead must be included as one of the first evidences of disease avoidance. But the state of illness is often not associated with the idea of contagion and in many cases the ill person, especially in the case of soul loss, is the focus of healing behavior that requires close contact, as in the case of the conjurers described by Boas (1925) among the Chinook. As we will see later in regards to historic examples of infectious disease, the idea of disease and how illness comes about determine avoidance behavior or caring.

To avoid catching a disease, many human societies have evolved standardized behaviors (Clements, 1932). These behaviors, which are at times, neither prescribed nor sanctioned, may be ritualistic, stereotyped or taken to extremes by individuals (Nelkin & Gilman, 1991). Understanding human responses to disease has many important applications to public health, as well as to the individual. Such a study can help answer questions such as How does individual behavior affect the transmission of infectious disease? While epidemiological study has resulted in techniques to control transmission and to identify patterns of disease transmission, the cross-cultural and historical study of the psychology of disease transmission has seldom been attempted.

Other questions than may be answered include: How dependent is disease avoidance on culture? and What types of intervention can best be assumed to influence behavior, affect transmission and increase aid to the infected? The nature of human consciousness and its reactivity, is a major issue in social science research that can be addressed in this inquiry. For while it is logical to assume that avoiding disease might be destructive to social bonds and association, another aspect of this stress could be of a unifying nature - the origins of the structure of the kind of human social behavior whose root some theorists like Fabrega (1999) have argued, lies in the mutual aid extended to the sick and injured. He points out (1974) that the cultural definitions of the sick role also pattern withdrawal of the person identified as ill as well as avoidance by those defined as well. Thus in the appearance of a new disease, one which a people has no prior experience or cultural knowledge may often produce a chaotic response, especially if it is rapidly fatal or disfiguring. Levy-Strauss (1961) gives an example of this among the Nambikwara in 1929 with influenza. We might theorize that the existence of interlocking social institutions based on organized knowledge of medical science and utilizing the authority of the state through mass media along with the comparatively slow natural history of the disease prevented similar outbreaks of chaotic panic during the first polio and AIDS epidemic outbreaks. The lack of mass panic, or its limited nature during the 1918-1919 flu epidemic seems to support this conjecture.

Various philosophers and scientists have put forth proposals where the basis of human solidarity lies in similar scenarios, for example, where social displays are epidiectic serving as feedback to adjust or restore the balance between population density and consumable resources (Wiens, 1966) through processes of group selection (Wynne-Edwards, 1962) and cooperation (Alllee, 1951; Kropotkin, 1902), others have produced more comprehensive, but elusive explanations , such as forms of social effervescence (Durkheim, 1915) and mass bonding which is thought to be the foundation of complex society (Canetti, 1966). Nevertheless, even these seem to have parallels in animal societies, as when Wilson (1975) gives examples of behavioral scaling in animal societies where the social organization specific to one species can change dramatically given changes in climate, season, daylight, or other factors. We see this same process in humans as in the case of the Prophet Cults and millenarian movements of Melanesia that I will discuss later in the book in more detail. What is important to reflect on here is that a typical social organization based on ritual warfare between adjacent groups that was long established was transformed into mass organization based on cooperation to oppose European pressure.

My general approach is to investigate the effects of stress on the idea of disease and avoidance, for example, during the Middle Ages, where we might interpret its pressure produced the Witches Hammer. This document, Malleus Maleficarum was a Bull of Innocent VIII, 1484, describes crimes of devil worship (Veith, 1965). Sigerist (1962) has argued that the plague produced a distinct reduction of tolerance for variation in behavior and appearance. The Witches Hammer was a device to aid local authorities to determine how to identify what behavior or appearance of men and women could be acceptable and that to be condemned. This took place at the same time discussions of new ideas of national character were underway as we see, for example, in those reported by Castiglione (1528), and in all cases these factors act to produce uniformity in social behavior and norms.

The question of how plastic human behavior is, has been argued on many theoretical points for 3,000 years (see Wendt, 1956 for a summary) and basically encompasses two seemingly irreconcilable ideas: (a) that human behavior is free of genetic influence, or (b) instinct or some genetic component guides human behavior to a certain extent.

The sociobiological perspective has come to define the second of these ideas and impinges on this discussion in a central fashion (Lumsden & Wilson, 1981). These steps are postulated as: a) from genes to epigenesis, b) from epigenesis to individual behavior and c) from individual behavior to culture (Lumsden & Wilson, 1981:343). Recently, this argument has been applied to the attack on cultural relativism (Boyer (1998). A number of studies have appeared since the 1960s attempting to prove the existence of what are considered to be human universal behaviors. Spiro (1965) tried to resolve differences over the idea of universalism and cultural relativism by contrasting biological variations in behavior, like pathologies from culturally patterned behavior. He proposed contrasting absolutism with relativism and universalism with particularism. He demonstrates how one particular type of social environment reinforces some individuals to learn extreme forms of behavior (Burmese monasticism) that are categorized in our society as pathological.

Brown (1991) couches his argument on the basis of a conspiracy by some biased cultural relativist anthropologist of the early 20th century (Boas, Mead, Benedict, etc.) to establish a dogma in Anthropology on this point. I will discuss this charge in a later section, but one example here should be sufficient to show how an attitude of argument,