One Health

The Theory and Practice of Integrated Health Approaches

Jakob Zinsstag, Esther Schelling, Maxine Whittaker, Marcel Tanner, David Waltner-Toews

• Publisher: CAB International
• Year: 2015
• ISBN:
  9781789244281
• Topic: Medicine
• Subtopic: Public Health, Administration & Care

The One Health concept of combined veterinary and human health continues to gain momentum, but the supporting literature is sparse. In this book, the origins of the concept are examined and practical content on methodological tools, data gathering, monitoring techniques, study designs, and mathematical models is included. Zoonotic diseases, with discussions of diseases of wildlife, farm animals, domestic pets and humans, and real-world issues such as sanitation, economics, food security and evaluating the success of vaccination programmes are covered in detail. Discussing how to put policy into practice, and with case studies throughout, this book combines research and practice in one broad-ranging volume.

1 One Health in History

Michael Bresalier,* Angela Cassidy and Abigail Woods

Department of History, King’s College London, UK

^*E-mail: [email protected]

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Introduction

The purpose of this chapter is to outline the history of One Health. This task immediately raises the question of how to approach the history of a subject that only became known as ‘One Health’ a few years ago, and is still evolving conceptually under the influence of health challenges, scientific advances, and political, economic, environmental and professional priorities. While there were many precedents to One Health, they did not go by this term, and they occurred at times when health problems, scientific ideas and the wider world were very different to today. This state of affairs makes it impossible to impose a simple structure on to past events, or to link them, in linear fashion, to present-day One Health.

It is important to highlight this problem because existing histories of One Health usually gloss over it. These accounts are structured around key historical figures and scientific advances, whose contributions to health are used to argue for the importance of pursuing a One Health approach today. The achievements of Rudolf Virchow, Robert Koch, William Osler, John McFadyean, James Steele and Calvin Schwabe are routinely celebrated, along with the health benefits of vaccination, the germ theory and zoonosis control. While the importance of these individuals and activities cannot be denied, their roles within the history of One Health require more critical consideration. The accounts in which they feature are neither politically neutral nor historically well-grounded and have been assembled not for the purpose of understanding the past but for advancing the case for One Health today. While this strategy may be useful in justifying and winning support for One Health, it has resulted in an extremely partial and selective reading of the past.

Rather than analysing history retrospectively from the perspective of present-day agendas, this chapter adopts a neutral, prospective, evidence-based approach that pays due regard to historical context.¹ Drawing on an extensive body of historical literature and source material, we aim to effect a fundamental shift in the way that the history of One Health is popularly conceived. We take as our subject matter the constellation of ideas, practices and circumstances that brought human and animal health (and to a lesser extent, the environment) into alignment, the people and institutions involved and the reasons for change over time. This chapter will demonstrate that while at certain points in history, particular individuals made deliberate attempts to rally people and resources in support of an integrated agenda, there were often many people already working along these lines, in accordance with established scientific ideas and practices.

This account makes no claim to completeness, in part, due to space constraints. Only a brief summary is offered of very recent events as these are well described elsewhere (Lebouef, 2011; Cassidy, 2014). It also reflects the fact that many aspects of One Health history have yet to be subjected to the sort of systematic, contextualized analysis needed to make sense of individual observations. Amongst the neglected areas is the history of One Health in non-western contexts. Owing to the fragmentary state of this field, this chapter focuses overwhelmingly on western medical and veterinary traditions. However, it does acknowledge the importance of cross-cultural exchanges, which were often facilitated by international health organizations concerned with human and animal disease control.

The first section analyses intersections between human and animal health in the pre-modern era. It will reveal how deeply animals and animal health were embedded within human medicine and the importance of the environment to health ideas and practices. The second section extends from the late 18th-century foundation of the veterinary profession until the turn of the 20th century. It tracks the evolving relationship between the veterinary and medical professions, and how, as scientific ideas and practices changed, new links were forged between humans, animals and the environment. The third section extends this analysis into the 20th century, focusing particularly on the changing status of animals within medical research, and on international efforts to develop comparative medicine and veterinary public health. The conclusion reflects on the importance of these findings for history, and for One Health today.

Pre-Modern Connections

Looking back on the pre-modern era, commentators often highlight the existence of a fundamental, well-entrenched distinction between humans and animals, which derived from the Christian belief that only humans had souls (Hardy, 2003). In fact, this divide has been overstated, for the perceived boundaries between humans and animals were often blurred and unstable (Fudge, 2000). In health and medicine there existed historically three key points of intersection: (i) animals were used to work out the anatomy and physiology of human bodies; (ii) they were studied in comparison to humans in order to work out the relations between them; and (iii) the theory and practice of animal medicine attracted the attention of human doctors, usually as an end in itself, but occasionally as a basis for comparison with human medicine. Aspects of these connections can be identified in very ancient civilizations (Gordon and Schwabe, 2004). However, as all three featured in Ancient Greek thought, which exerted a powerful influence in the west until the 17th century, this will form the starting point of our survey.

Around one-quarter of the surviving works produced by the Greek philosopher Aristotle in the 4th century BC are devoted to animals, most importantly History of Animals, Parts of Animals and Generation of Animals. While Aristotle distinguished humans from animals through their possession of a rational soul, he also sought to relate them, by documenting differences and similarities in the form, function and purpose of their parts and drew up a taxonomic system. The numerous dissections he conducted in the course of this work illustrated the possibility of learning about humans from animals (Clutton-Brock, 1995). Taboos on the use of human bodies led the famous Greek doctor, Galen, working in 2nd-century Rome, to follow Aristotle’s lead. In an extensive and influential body of writing, he documented the results of his numerous observations and experiments on animals. The errors he made in extrapolating from animal to human anatomy were not discovered until Andreas Vesalius (1514–1564) revived human dissection at Padua University in the 16th century (Guerrini, 2003).

Vesalius, and several of his contemporaries and successors, also vivisected animals in their attempts to work out the differences between living and dead bodies and to describe and explain how body parts functioned (Shotwell, 2013). Vivisection was problematic: debates surrounded the value of knowledge drawn from animals and the suffering involved (Guerrini, 2003). Nevertheless, it enabled Realdo Columbo (1516–1559) and Fabricius (1537–1619) to identify the pulmonary transit of the blood and the function of the venous valves, respectively. After studying under Fabricius, William Harvey took up an Aristotelian programme of research on animals that resulted in his novel and, at the time, controversial proposal that the blood circulated. Meanwhile, as part of the wider investigation of nature, medical doctors followed Aristotle in dissecting dead animals, for example at the elite Paris Academy Royale des Sciences during the 1660s and 1670s. This activity, described as ‘comparative anatomy’, drew on animals derived from colonial conquests that were contained within European leaders’ menageries (Cunningham, 2010).

The health of humans and animals were defined by the same medical theory: humoralism. This awarded a significant role to the environment in maintaining, disturbing and restoring health status. Drawing on the ideas of Hippocrates and Galen, humoralism formed the dominant system of medical thought until the 18th century. It held that all bodies were composed of four humours, influenced by factors such as feeding, climate, ventilation, exercise and sexual behaviour. Disease of individual bodies resulted from an imbalance between the humours (Curth, 2002). In addition, the rise and fall of epidemics was attributed to changes in the wider environment, as described by the Hippocratic text, Airs, Waters, Places (Wilkinson, 1992; Nutton, 2004). These theories implied that similar interventions, such as bleeding, purging, lifestyle changes and improvements in air quality could restore or maintain the humoral balance in both human and animal bodies. Formally trained healers usually focused on one or the other. Physicians, surgeons and apothecaries treated humans, while animals received dedicated attention from medieval veterinarians at the Mamluk courts and from British farriers, French marechals, Spanish beitars and their equivalents in other countries (Conrad et al., 1995; Shehada, 2012). However, such healers were expensive and few in number. Consequently, most humans and animals relied on self-help, clergymen, gentry and the various self-styled healers that made up the ‘medical marketplace’. Here, the division between species was less well defined (Curth, 2002).

The 17th and 18th century movement away from ancient Greek thought brought humans and animals into even greater proximity. The new experimental philosophy of nature, and Rene Descartes’ (1596–1650) conception of animals as ‘automata’ (self-operating machines), resulted in the more extensive use of animal vivisection in medical research and teaching (Guerrini, 2003). For example, Swiss physiologist Albrecht von Haller (1708–1777) used live animals to work out human neurological functions (Eichberg, 2009). At Leiden in the Netherlands, and later in Edinburgh, Scotland, anatomy lecturers vivisected dogs and dissected humans simultaneously, in order to demonstrate to students the structure and the function of body parts (Guerrini, 2006). A new scheme of classifying animals, drawn up by Swedish naturalist Carolus Linnaeus (1707–1778), placed humans, apes, monkeys and bats within the same order of primates and brought humans and orang-utans together in the genus Homo, thereby challenging notions of a human–animal divide (Ritvo, 1995). Subsequently, in Paris, additional classification schemes were drawn up using dissected animals from the Versailles menagerie. Here, the key figures were George Buffon (1739–1788), the medically trained comparative anatomist, Louis Daubenton (1716–1799) and Georges Cuvier (1769–1832) (Cunningham, 2010).

One of Daubenton’s pupils, the physician Vicq d’Azyr (1749–1794), went beyond comparative anatomy to develop a truly comparative form of medicine. His initial concern was cattle plague or rinderpest. This disease was prevalent throughout Europe in the 18th century. It inspired much medical comment and attempts to control it by quarantine, modelled on responses to bubonic plague in humans (Wilkinson, 1992). After reporting upon this disease to the French government, d’Azyr was made secretary to a Royal Commission of Enquiry into epidemics and epizootics and steered its 1778 evolution into the Société Royale de Médicine. His investigation...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Contents
• Contributors
• Editors’ Preface
• FAO Foreword
• OIE Foreword
• WHO Foreword
• PART 1: THEORETICAL FOUNDATIONS
• PART 2: METHODS FOR THE ASSESSMENT OF THE ANIMAL–HUMAN LINKAGES
• PART 3: CASE STUDIES FROM RESEARCH TO POLICY AND PRACTICE
• Plates
• Index