Understanding a disease. The story of pellagra
The book Food, Misery and a Medical Mystery (In Swedish 2024) is about pellagra, a nasty, now almost unknown disease that affected millions of people in 19th-century southern Europe and the early 20th-century United States. Patients suffered from sore skin, exhaustion and severe stomach problems. Many went insane. Hundreds of thousands died. The disease only affected the poor, exploited people in rural areas. What caused it was long a mystery.
Only after more than 150 years of scientific research was the riddle of pellagra answered. It was a deficiency disease, caused by too little vitamin B3 (niacin) in the diet of the poor. Ultimately, it was caused by poverty and exploitation in areas characterised by a single crop -– corn in Italy, cotton in the US. The daily struggles of the researchers, the knowledge they had access to, the dead ends they faced – but also their groundbreaking research – are portrayed in the book against a background of political conflict and wide-ranging economic change.
Blood flows
I have been fascinated by the medical, social and political importance of blood in society. In my book Strange Blood (2020), I describe a strange medical treatment – lamb blood transfusion –and its rise and fall in the 19th century. How could blood from lambs to humans be seen as, it was claimed, ‘enlivening, despite its repulsive animality’? The therapy was adopted by doctors in many countries in Europe, including Sweden, and also in the USA, hoping thereby to cure desperately ill patients. How did this strange transfusion work, how did the patients feel, did they survive? And what happened to the lambs? The book gives detailed insights into the work of physicians – on the battleground, at the bedside, in the laboratory and in the public eye –- addresses the arguments and controversies and reveals why the practice was eventually abandoned.
Today, human-to-human blood transfusion is a routine part of medical practice. It takes place in thousands of hospitals and blood centres around the world, involving millions of donors as well as a multi-billion dollar international industry for life-saving blood products. At the centre of all this activity is the selfless giving of individuals to others. I have analysed this flow of blood through the body of society in my 2012 book Blood Flows (in Swedish) and in several subsequent articles. They describe the technological transformations and economic conditions of blood donation, its medical risks and cultural meanings from the 19th century to the present day.
The politics of blood
At the turn of the 20th century, it was discovered that people's blood was different –- they had different ‘blood groups’. This was important for blood transfusions but also had political and social implications. The Interwar “politics of blood” involved attempts by scientists and politicians to link knowledge of blood groups to ethnic differences, both in Sweden and internationally. At this time, knowledge about the inheritance of blood groups also began to be used in the legal system in paternity cases concerning children born out of wedlock – another politically and socially controversial story. In the 1980s, the politics of what was “in the blood” took another turn, when the risk of HIV contamination via blood transfusion made for difficult and controversial decisions about excluding, especially, gay men from donating blood.
