degrees of power and affluence. However, food production itself is not a proximate cause. In a one-on-one fight, a naked farmer would have no advantage over a naked hunter-gatherer. Instead, one part of the explanation for farmer power lies in the much denser populations that food production could support: ten naked farmers certainly would have an advantage over one naked hunter-gatherer in a fight. The other part is that neither farmers nor hunter-gatherers are naked, at least not figuratively. Farmers tend to breathe out nastier germs, to own better weapons and armor, to own more-powerful technology in general, and to live under centralized governments with literate elites better able to wage wars of conquest. Hence the next four chapters will explore how the ultimate cause of food production led to the proximate causes of germs, literacy, technology, and centralized government. Ine links connecting livestock and crops to germs were unforgettably 1 ustrated for me by a hospital case about which I learned through a physi- n tnend. When my friend was an inexperienced young doctor, he was I 9 6 •GUNS,GERMS, AND STEEL called into a hospital room to deal with a married couple stressed-out by a mysterious illness. It did not help that the couple was also having difficulty communicating with each other, and with my friend. The husband was a small, timid man, sick with pneumonia caused by an unidentified microbe, and with only limited command of the English language. Acting as translator was his beautiful wife, worried about her husband's condition and frightened by the unfamiliar hospital environment. My friend was also stressed-out from a long week of hospital work, and from trying to figure out what unusual risk factors might have brought on the strange illness. The stress caused my friend to forget everything he had been taught about patient confidentiality: he committed the awful blunder of requesting the woman to ask her husband whether he'd had any sexual experiences that could have caused the infection. As the doctor watched, the husband turned red, pulled himself together so that he seemed even smaller, tried to disappear under his bedsheets, and stammered out words in a barely audible voice. His wife suddenly screamed in rage and drew herself up to tower over him. Before the doctor could stop her, she grabbed a heavy metal bottle, slammed it with full force onto her husband's head, and stormed out of the room. It took a while for the doctor to revive her husband and even longer to elicit, through the man's broken English, what he'd said that so enraged his wife. The answer slowly emerged: he had confessed to repeated intercourse with : sheep on a recent visit to the family farm; perhaps that was how he had'lf contracted the mysterious microbe. This incident sounds bizarrely one-of-a-kind and of no possible broader significance. In fact, it illustrates an enormous subject of great importance: human diseases of animal origins. Very few of us love sheep in the carnal sense that this patient did. But most of us platonically love our pet animals, such as our dogs and cats. As a society, we certainly appear to have an inordinate fondness for sheep and other livestock, to judge from the vast numbers of them that we keep. For example, at the time of a recent census, Australia's 17,085,400 people thought so highly of sheep that they kept 161,600,000 of them. Some of us adults, and even more of our children, pick up infectious diseases from our pets. Usually they remain no more than a nuisance, but a few have evolved into something far more serious. The major killers of humanity throughout our recent history—smallpox, flu, tuberculosis* malaria, plague, measles, and cholera—are infectious diseases that evolved LETHALGIFT OF LIVESTOCK • 197 from diseases of animals, even though most of the microbes responsible for our own epidemic illnesses are paradoxically now almost confined to humans. Because diseases have been the biggest killers of people, they have also been decisive shapers of history. Until World War II, more victims of war died of war-borne microbes than of battle wounds. All those military histories glorifying great generals oversimplify the ego-deflating truth: the winners of past wars were not always the armies with the best generals and weapons, but were often merely those bearing the nastiest germs to transmit to their enemies. The grimmest examples of germs' role in history come from the European conquest of the Americas that began with Columbus's voyage of 1492. Numerous as were the Native American victims of the murderous Spanish conquistadores, they were far outnumbered by the victims of murderous Spanish microbes. Why was the exchange of nasty germs between the Americas and Europe so unequal? Why didn't Native American diseases instead decimate the Spanish invaders, spread back to Europe, and wipe out 95 percent of Europe's population? Similar questions arise for the decimation of many other native peoples by Eurasian germs, as well as for the decimation of would-be European conquistadores in the tropics of Africa and Asia. Thus, questions of the animal origins of human disease lie behind the broadest pattern of human history, and behind some of the most important issues in human health today. (Think of AIDS, an explosively spreading human disease that appears to have evolved from a virus resident in wild African monkeys.) This chapter will begin by considering what a 'disease' is, and why some microbes have evolved so as to 'make us sick,' whereas most other species of living things don't make us sick. We'll examine why many of our most familiar infectious diseases run in epidemics, such as our current AIDS epidemic and the Black Death (bubonic plague) epidemics of the Middle Ages. We'll then consider how the ancestors of microbes now confined to us transferred themselves from their original animal hosts. Finally, we'll see how insight into the animal origins of our infectious diseases helps explain the momentous, almost one-way exchange of germs between Europeans and Native Americans. Naturally, we're disposed to think about diseases just from our own point of view: what can we do to save ourselves and to kill the I 9 8 •GUNS,GERMS, AND STEEL microbes? Let's stamp out the scoundrels, and never mind what their motives are! In life in general, though, one has to understand the enemy in order to beat him, and that's especially true in medicine. Hence let's begin by temporarily setting aside our human bias and considering disease from the microbes' point of view. After all, microbes are as much a product of natural selection as we are. What evolutionary benefit does a microbe derive from making us sick in bizarre ways, like giving us genital sores or diarrhea? And why should microbes evolve so as to kill us? That seems especially puzzling and self-defeating, since a microbe that kills its host kills itself. Basically, microbes evolve like other species. Evolution selects for those individuals most effective at producing babies and at helping them spread to suitable places to live. For a microbe, spread may be defined mathematically as the number of new victims infected per each original patient. That number depends on how long each victim remains capable of infecting new victims, and how efficiently the microbe is transferred from one victim to the next. Microbes have evolved diverse ways of spreading from one person to another, and from animals to people. The germ that spreads better leaves more babies and ends up favored by natural selection. Many of our 'symptoms' of disease actually represent ways in which some damned clever microbe modifies our bodies or our behavior such that we become enlisted to spread microbes. The most effortless way a germ could spread is by just waiting to be transmitted passively to the next victim. That's the strategy practiced by microbes that wait for one host to be eaten by the next host: for instance, salmonella bacteria, which we contract by eating already infected eggs or meat; the worm responsible for trichinosis, which gets from pigs to us by waiting for us to kill the pig and eat it without proper cooking; and the worm causing anisakiasis, with which sushi-loving Japanese and Americans occasionally infect themselves by consuming raw fish. Those parasites pass to a person from an eaten animal, but the virus causing laughing sickness (kuru) in the .New Guinea highlands used to pass to a person from another
