Enlightenment Now: The Case for Reason, Science, Humanism, and Progress

How do we explain the gift of life that has been granted to more and more of our species since the end of the 18th century? The timing offers a clue. In The Great Escape, Deaton writes, “Ever since people rebelled against authority in the Enlightenment, and set about using the force of reason to make their lives better, they have found a way to do so, and there is little doubt that they will continue to win victories against the forces of death.”¹ The gains in longevity celebrated in the previous chapter are the spoils of victory against several of those forces—disease, starvation, war, homicide, accidents—and in this chapter and subsequent ones I will tell the story of each.

For most of human history, the strongest force of death was infectious disease, the nasty feature of evolution in which small, rapidly reproducing organisms make their living at our expense and hitch a ride from body to body in bugs, worms, and bodily effluvia. Epidemics killed by the millions, wiping out entire civilizations, and visited sudden misery on local populations. To take just one example, yellow fever, a viral disease transmitted by mosquitoes, was so named because its victims turned that color before dying in agony. According to an account of an 1878 Memphis epidemic, the sick had “crawled into holes twisted out of shape, their bodies discovered later only by the stench of their decaying flesh. . . . [A mother was found dead] with her body sprawled across the bed . . . black vomit like coffee grounds spattered all over . . . the children rolling on the floor, groaning.”²

The rich were not spared: in 1836, the wealthiest man in the world, Nathan Meyer Rothschild, died of an infected abscess. Nor the powerful: various British monarchs were cut down by dysentery, smallpox, pneumonia, typhoid, tuberculosis, and malaria. American presidents, too, were vulnerable: William Henry Harrison fell ill shortly after his inauguration in 1841 and died of septic shock thirty-one days later, and James Polk succumbed to cholera three months after leaving office in 1849. As recently as 1924, the sixteen-year-old son of a sitting president, Calvin Coolidge Jr., died of an infected blister he got while playing tennis.

Ever-creative Homo sapiens had long fought back against disease with quackery such as prayer, sacrifice, bloodletting, cupping, toxic metals, homeopathy, and squeezing a hen to death against an infected body part. But starting in the late 18th century with the invention of vaccination, and accelerating in the 19th with acceptance of the germ theory of disease, the tide of battle began to turn. Handwashing, midwifery, mosquito control, and especially the protection of drinking water by public sewerage and chlorinated tap water would come to save billions of lives. Before the 20th century, cities were piled high in excrement, their rivers and lakes viscous with waste, and their residents drinking and washing their clothes in putrid brown liquid.³ Epidemics were blamed on miasmas—foul-smelling air—until John Snow (1813–1858), the first epidemiologist, determined that cholera-stricken Londoners got their water from an intake pipe that was downstream from an outflow of sewage. Doctors themselves used to be a major health hazard as they went from autopsy to examining room in black coats encrusted with dried blood and pus, probed their patients’ wounds with unwashed hands, and sewed them up with sutures they kept in their buttonholes, until Ignaz Semmelweis (1818–1865) and Joseph Lister (1827–1912) got them to sterilize their hands and equipment. Antisepsis, anesthesia, and blood transfusions allowed surgery to cure rather than torture and mutilate, and antibiotics, antitoxins, and countless other medical advances further beat back the assault of pestilence.

The sin of ingratitude may not have made the Top Seven, but according to Dante it consigns the sinners to the ninth circle of Hell, and that’s where post-1960s intellectual culture may find itself because of its amnesia for the conquerors of disease. It wasn’t always that way. When I was a boy, a popular literary genre for children was the heroic biography of a medical pioneer such as Edward Jenner, Louis Pasteur, Joseph Lister, Frederick Banting, Charles Best, William Osler, or Alexander Fleming. On April 12, 1955, a team of scientists announced that Jonas Salk’s vaccine against polio—the disease that had killed thousands a year, paralyzed Franklin Roosevelt, and sent many children into iron lungs—was proven safe. According to Richard Carter’s history of the discovery, on that day “people observed moments of silence, rang bells, honked horns, blew factory whistles, fired salutes, . . . took the rest of the day off, closed their schools or convoked fervid assemblies therein, drank toasts, hugged children, attended church, smiled at strangers, and forgave enemies.”⁴ The city of New York offered to honor Salk with a ticker-tape parade, which he politely declined.