The Fourth Edition of 'Natural History of Infectious Disease'

Author: P. Pennywagon, Ph.D.
Copyright © 2014 Mednansky Institute, Inc.

"It is almost an axiom that action for short-term human benefit will sooner or later bring long-term ecological or social problem which demand unacceptable effort and expense for their solution.  Nature has always seemed to be working for a climax state, a provisionally stable ecosystem, reached by natural forces, and when we attempt to remould any such ecosystem we must remember that Nature is working against us … It will always be desirable to understand the natural equilibrium, the more or less stable ecosystem, that determines the form of any infectious disease of man in the absence of deliberate human interference.  Only with such a background is it possible to judge the practicability of proposed measures of prevention" - from Natural History of Infectious Disease, Chapter 1: The ecological point of view

Natural History of Infectious Disease by Macfarlane Burnet was first published in 1940 under the title Biological Aspects of Infectious Disease, and was revised at approximately ten-year intervals.  The Cambridge University Press fourth edition of 1972, which was under the joint authorship of Sir Macfarlane Burnet and David O. White, was extensively revised and two new chapters added (chapter 13: Hospital Infections and Iatrogenic [caused by medical practice] Disease, and chapter 20: Hepatitis, Kuru and Slow Viruses).

Macfarlane Burnet (1899-1985) conducted research at the Walter and Eliza Hall Institute of Medical Research of the University of Melbourne, Australia, where he served as Director from 1944 to 1965.  In 1960, he was awarded the Nobel Prize in Physiology or Medicine jointly with Sir Peter Brian Medawar for 'discovery of acquired immunological tolerance'.  He was a fellow of the Australian Academy of Science, which he served as president from 1965 to 1969¹.

David O. White (1931-2004) was Professor of Microbiology at the University of Melbourne from 1997 to 1994.  He authored several books on virology including the classic Medical Virology with co-author Frank J. Fenner.  In 1992, he was appointed an Officer of the Order of Australia for 'service to education, particularly in the field of microbiology'.

¹Macfarlane Burnet became a fellow of the Royal Society in 1942. He was also a foreign member of the National Academy of Sciences, the American Academy of Arts and Sciences, and the American Philosophical Society

The Clonal Selection Theory of Acquired Immunity: Preface

"I like to think that when Medawar and his colleagues showed that immunological tolerance could be produced experimentally the new immunology was born" - MacFarlane Burnet, Nobel Lecture, December 12, 1960

The fourth edition of Natural History of Infectious Disease is aimed, as mentioned in the preface, at stimulating scientific interest "for young people contemplating a career in medicine or related spheres" and presenting "a consistently biological account that, hopefully, could be helpful to anyone, scientist or layman, who has a real but peripheral interest in human infectious disease".  Due to some astute oversimplifications, the layman can greatly improve his understanding of what an infectious disease is, and how man has combated (and from time to time eradicated) the lethal infectious diseases of man.

Gradual fall in mortality from diphtheria resulting from immunization of school children

Historical and statistical information of much value for epidemiologists, ecologists and microbiologists is masterly analyzed.  Concepts of immunology are outlined in Chapter 6 (Infection and immunity) to show how they "throw light on the phenomena of infection and facilitate its control".  Many of human pathogens are discussed in detail throughout the book and within dedicated chapters.  Detailed descriptions of the natural history of several infectious diseases (from Chapter 14 to 20) illustrate the principles already established in the previous chapters of the book, beginning with diphtheria, and further influenza, tuberculosis, plague, malaria, yellow fever, hepatitis and, as stated, the most extraordinary of all the infectious diseases of man 'kuru' whose agent "has not yet been proven to be a virus" (the mystery behind kuru will be unraveled much later on with the discovery of the prions by Nobel laureate Stanley B. Prusiner).

The sick child succumbing to tuberculosis by Norwegian artist Edvard Munch

Edvard Munch's sister Johanne Sophie died of tuberculosis in 1877

The ecological approach to infectious disease is a significant theme throughout the book with the underlying principle "that for every organism there is a certain density of population which makes best for survival of the species" (Chapter 1: The ecological point of view).  To prevent diphtheria, the authors wrote, "We have to find a way of imitating nature's method of harmless contact and immunization, without the liability to serious infection which is inherent in it".  Nature's method is illustrated by the book Figure 23 (reproduced below) showing the results of a famous investigation made before the use of artificial immunization.  The successful application of the ecological approach to infectious disease is further exemplified with the account of yellow fever (Chapter 19).  "One might almost say that it was this success which made ecology respectable", the authors conclude.

The Schick test is the simplest method of finding out whether or not there is diphtheria antitoxin in the blood

In the final chapter: Perils and possibilities: an epilogue, the authors enforce the argument "that the most dangerous aspects of overpopulation will come from human conflict in various forms rather than from famine or infectious disease".  They further state, "It is an evolutionary necessity that a species must find an approximately stable population level in any ecosystem of which it is part.  In the long run this must hold for man".

Miscellanea:

Frank Macfarlane Burnet 1899-1985 by Frank Fenner, 1987, in Historical Records of Australian Science, 7(1) 39 - 77

Biographical Profile at the American Association of Immunologists (AAI), Frank Macfarlane Burnet joined AAI in 1961

A Modification of Jerne's Theory of Antibody Production using the Concept of Clonal Selection by F. M. Burnet, in CA: A Cancer Journal for Clinicians 26 (2): 119–121, March/April 1976 (reprinted from The Australian Journal of Science 20 (3): 67-69, 1957)

A History of Epidemics in Britain by Charles Creighton (1847-1927), volume I and II available at Project Gutenberg (E-Book #42686 and 43671)

The Letters of Horace Walpole, Earl of Orford are referred to in Natural History of Infectious disease, Chapter 15: Influenza as follows: In Horace Walpole's letters he speaks of 'these blue plagues'.
In volume 3 (1759-1769) of the letters of Horace Walpole there is reference to the 'plague fixed in the walls': "There is a horrid scene of distress in the family of Cavendish; the Duke's sister, Lady Besborough, died this morning of the same fever and sore throat of which she lost four children four years ago.  It looks as if it was a plague fixed in the walls of their house: it broke out again among their servants, and carried off two, a year and a half after the children.  About ten days ago Lord Besborough was seized with it, and escaped with difficulty; then the eldest daughter had it, though slightly: my lady, attending them, is dead of it in three days.  It is the same sore throat which carried off Mr. Pelham's two only sons, two daughters, and a daughter of the Duke of Rutland, at once.  The physicians, I think, don't know what to make of it".


Clipping from Daily Alta California, Sunday January 19, 1890
The newspaper can be found at CDNC (California Digital Newspaper Collection)

Suggested Performance:

Concerto for Violin and Orchestra by Alban Berg (1935) performed by WDR Sinfonieorchester Köln conducted by Hans Vonk, violinist Ivry Gitlis
This concerto was dedicated 'To the memory of an angel', Manon Gropius, daughter of architect Walter Gropius and Mahler’s widow Alma, after she died from the infectious viral disease polio at the age of eighteen.  "Since about 1920, …, polio epidemics in the advanced countries have always involved older children, especially the five to ten age group, and with the years there has been a proportion of young adults, a group which everywhere shows an abnormally high death rate", from Natural History of Infectious Disease, Chapter 7: Susceptibility and resistance

"…anyone who has read the life of Florence Nightingale will know of the lethal spread of wound infection from one patient to another in the war hospital of the Crimea", from Natural History of Infectious Disease, Chapter 9: Epidemics and prevalences

British nurse Florence Nightingale (1820-1910) in Crimean hospital by Victorian painter Henry Barraud (1811-1874)

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