Patient Zero and the Making of the AIDS Epidemic
Page 10
Poisons, and Potions: Plague- Spreading Conspiracies in the Western Alps, c. 1530 – 1640
(Manchester, UK: Manchester University Press, 2002).
17. Pullan, “Plague and Perceptions,” 113. On the importance of strangers to origin
stories for infectious diseases, see Anne Kveim Lie, “Origin Stories and the Norwegian
Radesyge,” Social History of Medicine 20, no. 3 (2007): 571– 73; and Wald, Contagious,
22– 23.
18. Ann G. Carmichael, Plague and the Poor in Renaissance Florence (Cambridge:
What Came Before Zero? 49
prostitutes and sodomites joined Jews in being required to wear yel-
low to warn other citizens of their suspect moral and public health sta-
tus.19 The capaciousness of the word sodomy also refl ects the conjuga-
tion of sodomites and prostitutes in the popular imagination: in some
parts of early modern Europe, the term defi ned a variety of sexual ac-
tivities between men, while in others it included all non- procreative sex-
ual acts between men, women, and, more rarely, animals.20 Sodomy it-
self was viewed as contagious by such medieval authorities as Albertus
Magnus; spread from person to person, it was very diffi cult to treat and
particularly affl icted the rich.21 Northern Italian religious authorities— in
Venice, Lucca, and Florence, among other locations— viewed the visita-
tion of the Black Death in the fourteenth century as a consequence of
unpunished sodomy.22 They were thus prepared to blame the arrival of
a new disease at the end of the fi fteenth century in a similar way. The
great pox, erupting in that region during the lead- up to the Battle of
Fornovo in 1495, would famously be blamed on many diverse groups—
chiefl y the French, but also Italians from Naples and Spanish Jews, with
fi ngers pointed as far away as the Indies and Ethiopia.23 As the disease
spread over the next century, some, such as the Lucchese, linked it spe-
cifi cally to sodomitical practices.24 Such linkages were solidifi ed by a pa-
Cambridge University Press, 1986), 99; Jon Arrizabalaga, John Henderson, and Roger
French, The Great Pox: The French Disease in Renaissance Europe (London: Yale Uni-
versity Press, 1997), 35– 36.
19. Carmichael, Plague and Poor, 124.
20. N. S. Davidson, “Sodomy in Early Modern Venice,” in Sodomy in Early Modern
Europe, ed. Thomas Betteridge (Manchester, UK: Manchester University Press, 2002), 66.
See also Jens Rydström, Sinners and Citizens: Bestiality and Homosexuality in Sweden,
1880 – 1950 (London: University of Chicago Press, 2003), 1– 25.
21. John Boswell, Christianity, Social Tolerance, and Homosexuality: Gay People in
Western Europe from the Beginning of the Christian Era to the Fourteenth Century (Lon-
don: University of Chicago Press, 1980), 53, 316.
22. See Guido Ruggiero, The Boundaries of Eros: Sex Crime and Sexuality in Renais-
sance Venice (Oxford: Oxford University Press, 1985), 113– 14; Mary Hewlett, “The French
Connection: Syphilis and Sodomy in Late- Renaissance Lucca,” in Sins of the Flesh: Re-
sponding to Sexual Disease in Early Modern Europe, ed. Kevin Patrick Siena (Toronto:
Centre for Reformation and Renaissance Studies, 2005), 240; Michael Rocke, Forbidden
Friendships: Homosexuality and Male Culture in Renaissance Florence (New York: Ox-
ford University Press, 1996), 28, 36– 44.
23. Arrizabalaga, Henderson, and French, Great Pox, 24.
24. Hewlett, “French Connection,” 244.
50
chapter 1
pal bull issued in 1566 that singled out sodomy as a chief cause of God’s
wrath.25
Christian responses to plague in late medieval and early modern
En gland demonstrated similar attempts to understand the reasons for
God’s displeasure. While some Christians stressed the role of provi-
dence, others sought to intuit the offensive provocations and then act de-
cisively, aiming to root out the sinners or social disorders to eliminate
the risk of pestilence and other divine scourges.26 Thus, during the in-
famous 1631 trial of the Earl of Castlehaven, who was found guilty of
sodomitical practices and executed, the prosecuting attorney referred to
the biblical plagues that were brought by “so abominable a Sin.”27 Sev-
eral decades later the preacher David Jones warned London parishio-
ners of the “abominable and execrable Sin” of male sodomy, which, he
noted, “is now grown so common, that several Persons have been lately
executed for it.” Reminding those listening of the devastation wrought
by the city’s great fi re several decades before, he emphasized that “if you
are guilty but of this one Sin alone, you do enough to provoke God to de-
stroy this whole City, as he destroyed Sodom and Gomorrah, with Fire
from Heaven.”28
25. Davidson, “Sodomy,” 67.
26. Paul Slack, The Impact of Plague in Tudor and Stuart England (London: Routledge
and Kegan Paul, 1985), 49.
27. “The Trial of Mervin Lord Audley, Earl of Castlehaven, for a Rape and Sodomy,
on the 25th of April 1631,” in A Complete Collection of State- Trials, and Proceedings for
High- Treason, and Other Crimes and Misdemeanours, 4th ed., vol. 1 (London, 1776), 391,
facsimile, Eighteenth Century Collections Online digital library, http://
fi nd .galegroup
.com/ ecco/ infomark .do? & source = gale & prodId = ECCO & userGroupName = cambuni &
tabID = T001 & docId = CW3325058195 & type = multipage & contentSet = ECCOArticles
& version = 1 .0 & docLevel = FASCIMILE. See also Cynthia B. Herrup, A House in Great
Disorder: Sex, Law, and the 2nd Earl of Castlehaven (Oxford: Oxford University Press,
1999). Herrup also describes English views of sodomy being an unwanted import brought
by European immigrants; House, 33– 34.
28. D. Jones, A Sermon Upon the Dreadful Fire of London, Preach’d in the Parish-
church of St. Dunstan in the West in London, on Thursday, September 2. 1703 (London,
1703), 26, emphasis in original, facsimile, Eighteenth Century Collections Online digi-
tal library, http://
fi nd .galegroup .com/ ecco/ infomark .do? & source = gale & prodId = ECCO
& userGroupName = cambuni & tabID = T001 & docId = CW3321184722 & type = multipage & contentSet = ECCOArticles & version = 1 .0 & docLevel = FASCIMILE. Despite Jones’s fi ery
language, it appears that seventeenth- century English courts took a negligible interest in
prosecuting sodomy cases, let alone sentencing guilty parties to death; David F. Greenberg,
The Construction of Homosexuality (Chicago: University of Chicago Press, 1988), 326.
What Came Before Zero? 51
Former British colonies including the United States and Canada
traced much of their legislation to English statutes, and religious mem-
bers of these societies would similarly link infectious disease with God’s
judgment on the practice of sodomy.29 Gradually, over the course of the
nineteenth century, same- sex offenses began to be seen more as acts of
medical deviancy than crimes against God, a view which, in its turn, was
challenged over the course of the twentieth century.30 Nonetheless, there
was a rich and well- established tradition upon which religious leaders
li
ke Jerry Falwell could draw when AIDS made its appearance in the
1980s and was heralded as the “gay plague.”
Geographies and Genealogies of Blame:
Tracing the Origins and Spread of Disease
The fi rst cases in both New York City and Los Angeles could be linked to Gaetan, who
himself was one of the fi rst half- dozen or so patients on the continent . . . 31
Attempts to understand plague and the great pox offer useful examples
of a widespread fascination with disease origins, providing parallels to
the reception of AIDS. For some observers, determining a disease’s or-
igin and how it spread through society was a matter of intellectual curi-
osity; for others it was motivated by a need to maintain order; for others
still it was rooted in a desire to be found blameless of the misfortune.32
Given the desperate amount of death and suffering caused by both dis-
eases, many people who lived through times of pestilence attempted
to locate specifi c secular causes for them and to identify and punish
perpetrators.
During outbreaks of plague from the late Middle Ages onward, many
29. James R. Spence, “The Law of Crime against Nature,” North Carolina Law Review
32, no. 3 (1954): 312– 24.
30. D’Emilio and Freedman, Intimate Matters, 122.
31. Shilts, Band, 439. Shilts based his misleading claim about Dugas’s relative prior-
ity among North American patients with AIDS on a mistaken reading of the Los Ange-
les cluster study and a New York health offi cial’s discussion of known cases within the gay
community. See Bob Sipchen, “The AIDS Chronicles: Randy Shilts Writes the Biography
of an Epidemic and Finds More Bunglers Than Heroes,” Los Angeles Times, October 9,
1987, V9.
32. Sander L. Gilman, “AIDS and Syphilis: The Iconography of Disease,” in Crimp,
AIDS, 100.
52
chapter 1
attempts to act decisively focused on preventing travelers from plague-
affl icted regions to visit others. The quarantine provisions emerging at
this time for ships in Mediterranean ports are well known.33 Perhaps less
so was the the occasional willingness of contemporary chroniclers to
single out and name individuals for their perceived transgressions. Lu-
cia Cadorino, for example, and her lover Matteo Farcinatore, were al-
leged to have brought plague to Venice from the Trento region in 1575.
A Milanese soldier, Pietro Antonio Lovato, traded garments with the
German army and stood accused of bringing plague to his home city in
1629.34 There is the suggestion of moral condemnation in these examples
too: the perhaps illicit relationship between the two lovers from Trento
or the possibly reckless trading of the Milanese soldier. These efforts to
lay blame add a layer of complexity to one historian’s observation that
plague, with its complex ecology, can have “no human carriers . . . like
a ‘Typhoid Mary,’ continually shedding the bacterium.”35 While techni-
cally true, this now- known fact did not stop people in the past from try-
ing to attribute the plague’s spread to human actors.
In addition to the widely held view that miasmatic airs were the
main source of epidemics, ideas of contagion and infection have existed
through the ages from Galen to Fracastoro, expressed through various
explanatory models over time.36 At the turn of the sixteenth century, the
growing belief that the great pox might be spread through sexual con-
tact coincided with and contributed to a gradual shift in conceptualizing
disease causation. The emerging model viewed disease as owing less to
communal transgressions and more to those of individuals.37 Certainly,
the propensity to identify single persons for the arrival of disease to a
community existed before individual behavior became the general focus
of condemnation. However, this tendency became more pronounced as
the shift toward individual culpability gathered momentum, a develop-
33. George Rosen, A History of Public Health, expanded ed. (Baltimore: Johns Hop-
kins University Press, 1993), 43– 45.
34. Pullan, “Plague and Perceptions,” 112.
35. Carmichael, Plague and Poor, 5.
36. Nutton, “Seeds of Disease.”
37. Jon Arrizabalaga, “Medical Responses to the ‘French Disease’ in Europe at the
Turn of the Sixteenth Century,” in Siena, Sins of the Flesh, 52; Laura McGough, Gender,
Sexuality, and Syphilis in Early Modern Venice: The Disease that Came to Stay (Basing-
stoke, UK: Palgrave Macmillan, 2011), 67.
What Came Before Zero? 53
ment which the rise of bacteriological science would further consolidate
in the late nineteenth century.
Immediately upon the appearance of the great pox at the end of the
fi fteenth century and in the centuries following its rapid spread across
Europe, medical experts posited their explanations for the origins of this
seemingly new disease. In 1736 Jean Astruc, the French royal physician,
published De morbis venereis, his own scholarly contribution to the dis-
cussion, which went through several subsequent editions and translations
during his lifetime. In his treatise, Astruc provided a catalog of the pro-
posed causes ventured by generations of his predecessors. The physician
recited and then refuted each claim before expounding the explanation
he thought most reliable: “that the Venereal Disease was brought from
Hispaniola into Spain before the Year 1495, by the Spanish Soldie[r]s
who served under Gonsalvo Fernandez in Italy, and communicated to
the French and Neapolitans by promiscuous Venery.”38 In his catalog-
ing efforts, the physician listed several writers who emphasized the dis-
tant infl uence of the stars, or the miasmatic “Indisposition of the Air,”
before outlining diverse “particular causes.”39 These causes included a
theory dating from 1525 of “an Harlot of Valencia who had lain with a
Leper,” which appeared in several variations, including one discussed in
this chapter’s next section.40 Others held that Spanish soldiers poisoned
the wells and bribed Italian bakers within the enemy’s army to mix lime
with their bread.41 Astruc dismissed the suggestion of Francis Bacon
that “certain dishonest Merchants, who sold human Flesh, new killed in
Mauritania, pickled and put up in Vessels, instead of Tunney; and that
to this abominable and heavy Food, the Origin of the Venereal Disease
ought to be ascribed.”42 He also scorned two origin theories that may ap-
38. John Astruc, A Treatise of Venereal Diseases, in Nine Books; Containing an Ac-
count of the Origin, Propagation, and Contagion of This Distemper, vol. 1 (London,
1754), 67–
84, quotation at 84, facsimile, Eighteenth Century Collections Online digi-
tal library, http://
fi nd .galegroup .com/ ecco/ infomark .do? & source = gale & prodId = ECCO
& userGroupName = cambuni & tabID = T001 & docId = CW108536016 & type = multipage & contentSet = ECCOArticles & version = 1 .0 & docLevel =
FASCIMILE. Cynics might note
that this conclusion would remove the blame for the “French pox” from Astruc’s own
country.
; 39. Ibid., 69– 70.
40. Ibid., 70.
41. Ibid., 71.
42. Ibid., 74.
54
chapter 1
pear familiar to modern- day AIDS researchers. One was put forward in
1640 by the “credulous” Flemish physician Jan Baptist van Helmont, in
which he proposed that the great pox had arisen as a variant of a disease
that primarily affected horses. In this manner, at the siege of Naples,
“some wicked Person had defi led himself with a Horse of that kind, and
thus (by divine Permission) transplanted it into the human Race.” As-
truc was equally dismissive of the theory of the Swedish physician Jo-
han Linder, who had asserted in an early eighteenth- century disserta-
tion that “the Venereal Disease had its Origin in the Americas ‘from
Sodomy sometime committed between Men and “large Monkies or the
Satyrs of the Antients [ sic].”’” Of this theory, Astruc wrote that “noth-
ing can possibly be more foolish or absurd, so nothing can be invented
more affected or far fetched.”43
More recently, questions about the origins of HIV have summoned
concerns about bodily transgression and contamination that strongly
resemble their seventeenth- and eighteenth- century forebears. Popular
tendencies toward creating explanatory legends combined epidemiologic
ideas of disease transmission with stories of primordial landscapes, ex-
otic cultural practices, and political confl ict to make sense of the dis-
ease’s origins.44 Three main scientifi c theories of origin were repeatedly
posited for HIV: a disease previously existing in another animal species
that had recently managed to transfer to humans; a mutation or wider
transmission of a much older and previously unrecognized human dis-
ease; and a disease caused by a synthetic virus that was created either
deliberately or accidentally in a laboratory. The overlap between and in-
termingling of the three basic theories served as a foundation for various
popular explanations for the origins of HIV.45
Given the widespread consensus among researchers that now locates
43. Ibid., 74.
44. Diane E. Goldstein, Once Upon a Virus: AIDS Legends and Vernacular Risk Per-
ception (Logan: Utah State University Press, 2004), 79; Wald, Contagious, 1– 28. For more on the persistence of origin myths for venereal disease, see Marie E. McAllister, “Stories