BMCR 1992.01.15

History of AIDS: emergence and origin of a modern pandemic

, History of AIDS: emergence and origin of a modern pandemic. Princeton: Princeton University Press, 1990. xii, 279 pages. ISBN 9780691085524

Although this book is not concerned primarily with classical texts or the history of the Greco-Roman world, readers of BMCR will find in it discussions of the Hippocratics, Thucydides, Pliny the Elder, Galen, and other familiar figures. “Past and present,” as Grmek says, “clarify each other.” Give this book to your non-classicist friends. It will show them how a classicist can think about where we are, not merely where we think we have been.

G. is a classical scholar and a physician, whose Diseases in the Ancient Greek World (Baltimore, 1989) was one of the most important and challenging books of the last decade in the field of ancient medicine. History of AIDS is likewise informed by the virtues of the best classical scholarship: humanity, intelligence, and the combination of humility in the face of evidence with boldness in connecting phenomena. G. does not hesitate to characterize AIDS as “the first of the postmodern plagues,” a disease that deconstructs modern medicine’s nexus of knowledge and power. We know so much about AIDS. If knowledge is power, why can we do so little?

That postmodern dilemma, seen through another lens, becomes classical, even Sophoclean. G.’s preface deliberately invokes the Athenian fifth century and Thucydides: “In recounting the beginnings of this pandemic, in probing behind the scenes of official science, in explaining current research strategy and the vicissitudes of the struggle against an unexpected plague, and in reflecting on its biological and social causes, I hope not only to shed light on this problem for the contemporary reader, but to provide a testimony for the future historian.” His history falls into four parts, prophasis, crisis, archê, and aitia. Part One describes the beginnings, in the late 1970s and early 1980s, of our awareness of AIDS. Part Two traces the activities of scientists as they sought to understand and treat the disease. Part Three examines the remote past of AIDS, and Part Four explores the biological and social causes of the epidemic.

For most readers of BMCR, Parts Three and Four will be the easiest to assess, and Parts One and Two will present unfamiliar material and difficult going. Understanding at least something about such things as reverse transcriptase and DNA polymerases is, however, essential to following G.’s account, and his explanations are as clear as they can be made.

It is important to persevere in reading the unfamiliar parts of History of AIDS. Those of us who are trained in the humanities are comfortable thinking about our conceptualization of disease. We happily discuss the philosophical background of ancient medicine, the language in which disease is described, or the social factors shaping thought about disease. (Why—to take only one of many interesting questions raised by G.—is Africa so readily accepted as a cradle of new diseases?) Those trained in medicine or the sciences consider with equal ease the hard facts emerging from laboratory or clinic. The great merit of G.’s work, here and elsewhere, is that it forces each of these approaches to confront the other.

That confrontation is essential in understanding AIDS, which, as G. shows, is not a purely medical or purely social problem. AIDS is a disease made possible by the humans we have become in the last part of the twentieth century. To think about this disease is to diagnose our individual and collective humanity. In making this diagnosis, we must begin as we always do, with the Greco-Roman creation of our most fundamental modes of diagnostic and rational thinking.