147. 疾病、新世界与现代大流行

欢迎收听《历史其余部分》，今天我们进入第二期，探讨疾病的历史，特别邀请到俄克拉荷马大学的杰出教授凯尔·哈珀。

Welcome to The Rest Is History and our second episode on the history of disease when we're joined by the University of Oklahoma's magisterial professor Kyle Harper.

凯尔，如果我们跳过几个世纪，回到你之前提到的一个关键点——哥伦布大交换，这是世界历史上一个极其重要的时刻：哥伦布先抵达加勒比地区，随后西班牙征服者进入墨西哥和秘鲁。这些故事，汤姆，你和我小时候读起来，都像纯粹的冒险小说。

So, Kyle, if we can jump on a couple of centuries from where we were before, but also kind of back to something you alluded to earlier, the Columbian Exchange, which is this absolute extraordinary moment in world history when, you know, Columbus arrives first of in The Caribbean, then you have the arrival of the conquistadors in in Mexico and Peru, the classic stories that, you know, Tom, you and I would have read as pure adventure stories when we were growing up as as boys.

但奇怪的是，这些儿童历史读物里，几乎完全没提后来造成的巨大死亡人数。

And there was virtually no mention of it at all, I would have said, in the kind of children's histories of the of the the subsequent kind of death toll.

那现在学界是怎么看待这个问题的？

So what's the the the thinking now?

当然，死亡人数确实惊人，但并没有人们常以为的那么灾难性。

Because you I mean, obviously, there is a colossal death toll, but it's not as cataclysmic as is often thought.

欧洲人带去了哪些疾病？

And what are the diseases that the Europeans are bringing?

而且，关键的一点是，‘交换’这个词本身就暗示着双向流动。

And what and, also, crucially, I suppose, you know, obviously, an exchange implies a two way process.

那为什么美洲原住民死得如此惨重，而欧洲人却几乎没受影响？

So how is it that the the the the indigenous Americans, as it were, are dying in such large numbers, but not the Europeans?

还是说欧洲人其实也死了，只是我们从来不提？

Or are the Europeans dying and we just don't talk about it?

是的。

Yeah.

这些问题都问得非常好。

Well, those are all great questions.

在六七十年代，甚至八十年代，学者们倾向于高估新大陆的人口，说美洲当时有上亿、一亿两千万人。

And I'd say there was a tendency in the maybe sixties, seventies, eighties among scholars to to exaggerate the population of the New World and to say there were hundred, hundred and twenty million people in The Americas, at the time of European arrival.

但现在看来，这种说法普遍不太靠谱。

That now seems, in general, probably, implausible.

具体数字我们其实不清楚，但更可能是在四千万左右，上下浮动一千万，而不是三倍于这个数。

The the real number, we don't know, but it's it's probably, you know, closer to 40,000,000, give or take 10,000,000, than it is triple that number.

如果真有一亿多人口，那就意味着天花之类的疾病在欧洲人还没真正抵达之前，就已经横扫了整个美洲大陆。

The the proposition that there were a 100 and something million people in The Americas at the time of the New World sort of required that the arrival of, say, smallpox just sort of swept over the the entire continent, or both continents, without before the Europeans could even get there in person, in many cases.

这种说法经过仔细推敲后，已经站不住脚了。

And I think that version of the story has really suffered from from a close look.

不过话说回来，我觉得我们也不能把这种历史修正做得过头了。

But with that said, I still think that we can overdo that, historiographical correction.

我们可能会对那个说法太过苛刻，

So we can we can be too critical of of that story and

以至于忘了这一点。

sort of forget Yeah.

生物学因素是实实在在的。

That the biology matters.

你刚才提到，我们谈到了征服者科尔特斯抵达阿兹特克帝国的事。

You you say about, so we we talked about the conquistadors and Cortes arriving in, the Aztec empire.

十六世纪墨西哥人口的锐减，是历史上最剧烈的人口衰退事件之一。

The the demographic crash of Mexico in the sixteenth century is one of the most extreme demographic events attested in history.

1516年，那里大约有八到一千万居民。

In 1516, there were perhaps eight to 10,000,000 inhabitants there.

到了世纪末，只剩下两到三百万了。

By the of the century, there were two to three million.

不过，汤姆，这可能也不全是疾病造成的。

But that might not just be because of disease though, Tom.

也可能是农业崩溃、社会动荡、战争，或者饥荒，或者其他各种因素造成的。

That might be because of the collapse of agriculture or disruption or war or all these or famine or all these other things.

对吧？

Right?

没错。

Right.

显然是所有这些因素共同作用的结果，关键只在于各自所占的比例和作用机制。

It's clearly all of it, and it's only a question of of in what proportion and through what mechanisms.

比如1520到1521年那场大规模的天花疫情，肯定夺走了大量生命。

I mean, there were there's a massive smallpox pandemic in the '15 in 1520, 1521 that must kill, a a tragic number of people.

1540年代又爆发了一次疫情，历史记录非常明确。

There's another disease outbreak in the fifteen forties, that is extremely well attested in the the evidentiary record.

我们还不完全清楚那到底是什么病，可能不止一种疾病同时传播。

We don't totally know what it was, and it may have been multiple diseases.

这还有一个特别有意思的发现：有一支团队对墨西哥中南部一处遗址中十五世纪四十年代遇难者遗骸的病原体进行了DNA测序。

This is also one really cool area where the ancient DNA there was a team that sequenced the DNA of the pathogen that killed a victim several victims from skeletons at a site in South Central Mexico in the fifteen forties.

结果发现是副伤寒。

And what they found was paratyphoid fever.

这并不是天花，但这并不意味着天花不存在。

So it wasn't wasn't smallpox, which doesn't mean smallpox wasn't there.

也不是鼠疫，但这不等于鼠疫没出现过。

It wasn't typhus, which doesn't mean typhus wasn't there.

但在这些集体埋葬的遗骸中，他们确实发现了一种通过粪口途径传播的细菌病原体。

But what they did find in a number of these mass burial, skeletal remains was a was a bacterial pathogen that is transmitted via the fecal oral route.

这是一种通过排泄物传播的疾病，显然是从欧洲、从旧大陆传入的。

So a a disease that is transmitted in waste that would have been introduced from Europe, from the old world.

这个发现非常有意思，而且出乎意料。

And this is a really interesting find, unexpected find.

它提醒我们，造成影响的不只是天花这类广为人知的疾病，而是整个生物环境的剧变——大量在新大陆从未出现过的病原体被引入了进来。

And it does remind us that it wasn't just these big notorious diseases like smallpox, but it's the the total biological change, the introduction of a large number of pathogens that would have been unfamiliar in the new world.

这真是个很好的例子。

So that's a that's a really good example.

十五世纪四十年代，然后又过了一代人，再过大约十年。

But fifteen forties, then again a generation later, and then again about a decade later.

在中美洲这片新大陆人口最密集的区域，接连爆发了四场大瘟疫，累积起来造成了极其严重的人口影响。

So there's these four really big pandemics that strike one of the most densely settled corridors of the New World in Central Mexico and really did have cumulatively a major, major demographic effect.

我对结核病特别感兴趣，你称它为人类历史上最重要的疾病。

I was really intrigued by, by tuberculosis, which you describe as arguably the great human disease.

据说在哥伦布到达之前，结核病就已经存在于新大陆了，那它是不是起源于东非？

That apparently was in the in the New World before Columbus arrived there because so it originates in is it East Africa?

后来它传播开来，海豹似乎也感染了。

It spreads, and seals seem to have caught it.

海豹游过大西洋，然后被人捕杀食用。

And they seem to have swum across the Atlantic and then been butchered and eaten.

而且

And

这简直太离谱了，但根据我们目前掌握的信息，这些线索似乎就是这么连起来的，当然随着考古遗传学家获取更多DNA数据，这个说法未来可能会改变。

This is this is the crazy this is the crazy story that, that seems to to be the the way that the dots are connected as far as we know now, and it may change as as, archaeogeneticists get more DNA.

结核病，不管从哪个角度看，都是人类历史上最重大的疾病之一。

But tuberculosis is, we can talk about it, is one of the the great human diseases by any measure.

这是一种慢性的呼吸道疾病。

It's a chronic respiratory disease.

它非常特别，给全球带来了巨大的病痛和死亡负担。

It's a very strange disease, and it causes a huge burden of morbidity and mortality.

过去有个很大的谜团：研究新大陆人骨的考古学家们一直坚信，结核病在哥伦布到来之前就已经存在了。

One of the big, like, mysteries was that, tuberculosis, the people who work on skeletons, archaeologists who work on New World skeletons, really believed that tuberculosis was was there.

结核病有个特点，因为是慢性病，它会在骨骼上留下痕迹。

And the one of things about tuberculosis, because it's a chronic disease, it can leave a mark on the skeleton.

大多数急性传染病，比如鼠疫或天花，发作太快，人很快就死了，根本不会在骨骼上留下证据。

Most of these acute infectious diseases, so like plague or smallpox, they kill you so quickly, they don't leave evidence in your skeleton.

但像麻风病、结核病、梅毒这类慢性传染病，却能在骨骼遗骸上留下非常典型的病变迹象。

But chronic infectious diseases like leprosy, tuberculosis, syphilis can produce, very diagnostic stresses in in skeletal remains.

所以那些研究骨骼的人说，结核病早就存在了。

And so the people who worked on neural burns were saying tuberculosis was here.

但如果你看历史记录，其实有不少理由让人怀疑这可能并不属实。

And if you're looking at the record, the historical record, there were various reasons to think that that was maybe not the case.

当我们开始获得基因数据后，发现如今美洲所有的结核病都源自欧洲的结核菌。

Certainly, when we started getting genetics, all of the new world tuberculosis today is descended from European tuberculosis.

这就造成了明显的矛盾。

So this caused a real, like, dissonance.

目前看来，问题的解决方式是：在哥伦布到来之前，美洲就已经有结核病了。

And the way it seems to be resolved at the moment is that there was so there was tuberculosis here before Columbus.

相关DNA已经被发现了。

The DNA has been found.

有趣的是，欧洲人到来之前美洲结核病的基因谱系，与海洋哺乳动物中常见的某种细菌分支关系非常密切，且由此演化而来。

What's interesting about the the lineage of the DNA of tuberculosis in the New World prior to European arrival is that it seems to be very closely related to and descended from a branch of the bacterial family tree, that is that is commonly found in sea mammals.

这暗示了一种可能性：这种原本属于人类的疾病，其实是从人类传给了其他动物。

So this suggests the possibility that that this ultimately human disease is going from humans into other animals.

结核病是我们熟知的人类疾病，但它也会感染其他动物。

So tuberculosis is a human disease as we know it, but it it also infects other animals.

人类可能直接，或者通过某些其他动物，把结核病传给了海洋哺乳动物，它们甚至在人类还没能跨越大洋之前，就帮着把这种病传播到了各地。

And it's possible that humans, either directly or through some other intermediate animals, gave it to sea mammals who have helped disperse it to places, across oceans even before humans could move.

这个说法相当惊人，但现有的证据确实能拼出这样一个合理的图景。

So it's a pretty wild, story that the puzzle pieces certainly can be fit together that way.

这正好解释了为什么在哥伦布到来之前，美洲就已经存在结核病这个问题。

And it it does resolve this big problem that there's tuberculosis in the New World before Columbus.

在骨骼上就能看出来。

You can see it in the bones.

但当欧洲的结核菌传入后，就压倒了当地的菌株，那些本地菌株现在彻底消失了。

But when European tuberculosis arrives, it sort of outcompetes the the local strains that don't exist anymore.

我可以问个问题吗？

Can I ask a question?

我们收到了听众提交的一些问题。

We had questions sent in by our listeners.

我和汤姆经常忘了问听众们发来的那些问题。

We haven't we've Tom and I frequently fail to ask any of the the questions that the listeners have sent in.

所以我们应该问一下。

So we should ask

对，问吧。

them.

内科医生。

Internist.

所以我们还是问一下吧。

So we should ask.

你真是太客气了。

Well, you're very kind.

有几位听众问到了关于神罚的问题。

So a couple of them sent in questions about divine punishment.

约书亚·特里和S.W.雅各布斯都问，人们是在什么时候不再把疾病看作神的惩罚了？

So Joshua Terry, s w Jacobs, they both said, at what point do people stop seeing disease as divine punishment?

黑死病就是一个很好的例子，对吧？

So with with the black death is a is a is a great example, isn't it?

那时候很多人说，这是上帝因为我们犯了罪而降下的惩罚。

Because there were lots of people at the time who said, we have been punished for our sins by God.

但随着时间推移，这种想法逐渐减少了。

And, obviously, over time, that dwindles.

不过你觉得，是在什么时候发生的呢？比如早期现代时期？

But at what point do you think I mean, early modern?

是更早一点，还是说到了十八世纪、维多利亚时代？

What's the point or or or later, you know, eighteenth century Victorian.

人们到底是在什么时候，不再把病因归咎于上天了？

What's the point in which people stop looking, as it were, to the heavens for the causes?

是的。

Yeah.

但说实话，这种想法从来都没完全消失，想想艾滋病或者新冠刚爆发时的那些反应。

Well, I mean and, obviously, it never completely stops, right, think of some of the the responses to AIDS or even COVID nineteen.

所以它并没有完全消失。

So so it doesn't completely stop.

但这个问题的核心很好，我觉得真正的答案应该指向十八世纪。

But, the the point of the question is a good one, and the way I would would get to to the real answer, I think, is the eighteenth century.

我认为这是科学文化，包括医学科学的一个关键转折点。当然，理性医学从古希腊时期就存在了。

And I think this is a really seminal moment in the culture of science, and that includes medical science where, of course, there's rational medical science going back to antiquity.

但在十八世纪，经验主义的思维方式变得普遍得多。

And yet in the eighteenth century, there becomes a much more pervasive one empirical mindset.

这其实是摆脱教条主义的一部分——不管是宗教教条，还是传统的希波克拉底或盖伦医学。

So it's sort of part of the triumph of of, of let's not trust dogma, whether that's religious dogma or received, you know, Hippocratic Galenic medicine.

我们必须对一切进行验证。

We have to test everything.

我认为人类智慧的一项伟大成就，就是爱德华·詹纳在1798年发表的疫苗发现。

And look at look at, you know, one of, I think, the great, accomplishments of the human mind is Edward Jenner's 1798 publication of the the discovery of vaccination.

这正是十八世纪经验主义的完美体现，因为它完全不盲从教条。

It is it is a perfect reflection of eighteenth century empiricism in that it's very undogmatic.

我的意思是，他其实并不清楚疫苗为什么有效。

I mean, he doesn't really have a theory of why vaccination works.

他更关注的是动物和人类健康与疾病之间的关联，这很明显。

He sort of is interested in connections between animal and human health and disease, obviously.

这其实是一系列病例研究的积累。

But it's a series of case studies.

他的疫苗假设能不能成立，完全要看实际数据怎么说。

I mean, you know, his his proposition, his hypothesis about vaccination is only gonna stand or fall on empirical record.

这真是了不起的成就，但在我看来，它恰恰体现了实证思维的精髓。

It's a really cool it's an amazing accomplishment, but it's a to me, a a kind of symbol of the the empirical mindset.

同时，这也体现了一种乐观精神——认为传染病是可以预防的。

But also combined with that is a kind of optimism that infectious disease can be prevented.

而且他们当时甚至都不觉得这是传染病。

That and they don't think of it as infectious disease even.

在真正理解细菌和微生物之前，人们就已经意识到，大量人类疾病的根本机制，关键在于观察和实证。

Just that, a large number of human diseases before they even understand germs, microbiology really is the the key to understanding the mechanisms of disease.

人们总觉得，人类社会和个人是能够采取行动的。

There's a sense that that human societies and human individuals can do things.

他们可以洗衣服。

They can wash their clothes.

他们可以避开那些空气污浊、密不透风的室内环境。

They can avoid, really closed indoor environments where the air is congested and dirty.

但他们并不知道，肺结核是通过微小的飞沫传播的，这些飞沫会把细菌从一个人传给另一个人。

They don't understand that tuberculosis is spread in tiny little droplets that carry the bacterium from one person to the next.

如果你说，只要保证通风良好、有干净的饮用水，再把沼泽排干，就能预防疾病——虽然他们对疟疾或所谓‘间歇热’的病因完全理解错了。

But if you say we can prevent disease by making sure that there's good ventilation and access to clean water and that we're draining swamps so that they they have the mechanism totally wrong of what calls of what causes, malaria or what they call the ague.

但如果说，把沼泽排干就能阻止疾病，那确实没错。

But if they say we can stop it by draining the swamp Yeah.

他们不知道，真正起作用的是消灭了传播疾病的蚊子，但效果就是立竿见影。

They don't know that it's killing the mosquitoes that are transmitting the disease, but it works.

说到昆虫和疾病传播，我觉得你关于奴隶贸易如何将西非这个疾病温床的病原体带到新大陆热带地区的那一章，简直堪称毁灭性地精准。

So so on the topic of of, of insects and and transmission, you have you have, I thought, a completely devastating chapter, basically, on the impact that the slave trade has on the spread of diseases from this kind of great sink of disease in West Africa to the the tropics in in the New World.

你提到埃及伊蚊是世界上最危险的动物，因为它把黄热病带到了牙买加和巴巴多斯这些原本被丛林覆盖、后来被砍伐种上甘蔗的岛屿。

And you you describe Eyleesi aegypti mosquito as the most dangerous animal in the world because it it takes yellow fever to the to Jamaica, to Barbados, islands that had been covered in jungle that have then been felled, sugarcane planted.

这种蚊子需要三样东西：糖、人体，还有静止的水。

And what this insect needs is sugar, human bodies, and stationary water.

而在奴隶种植园里，这三样东西全都有。

And on the slave plantations, have all three.

我们自然会把奴隶制看作一场瘟疫。

Obviously, we think of slavery as a plague.

但我之前没意识到，它实际上还像一个温床，让瘟疫得以滋生。

But I had not realized that it it it kind of literally serves to incubate plague as well Mhmm.

还有各种疾病。

And disease.

这种关联被广泛认识吗？

And is is this something that is widely appreciated?

因为我读你的章节之前，完全没意识到这一点。

Because I I had I I hadn't appreciated it at all till I read your chapter.

谢谢您。

Well, I thank you.

我觉得这非常重要，但不知为什么，大型疾病史中常常忽略了这一点。

I I think it's so important, and I think it has been too often missing from big histories of disease for whatever reason.

现在确实有一些非常出色的研究，特别是我深受约翰·麦克尼尔著作的启发，他的《蚊子帝国》对理解这些疾病做出了非凡贡献。

Now there's there's some very good work, and and in particular, I'm indebted to the work of John McNeil, whose book, Mosquito Empires, is is an amazing contribution to understanding these diseases.

但不知为何，以往的历史书写都过于欧洲中心化，只关注欧洲人带来的疾病，比如天花或斑疹伤寒，而我们其实并不清楚这些病的真正源头。

But for whatever reason, the the histories as they've been written have been, I think, very, Eurocentric and focused on what diseases Europeans are carrying, like smallpox or typhus, which we don't really know where that comes from.

然而，对于旧大陆的热带疾病传入新大陆的过程，却几乎没有得到同等的关注。

But, but there's been not nearly the same amount of interest or attention on the the introduction of tropical diseases from the old world to the new world.

这极大地影响了美洲社会的形成方式。

And this has a huge effect on the the kinds of societies that take shape in The Americas.

而美洲社会的形态，反过来也影响了疾病如何传播、如何在美洲境内发展。

And and the kinds of societies that take shape in the Americas influence the diseases, how they move and and how they fare the Americas.

正如您刚才所说，甘蔗种植园体系的建立，创造了这样的生态条件——

So exactly as you were describing, the creation of a of a sugar plantation regime creates the ecological context where

本质上就是死亡陷阱

They're death traps, basically,

对吧？

aren't they?

那就是死亡陷阱。

They're death traps.

简直难以置信。

They're unbelievable.

我的意思是，这种非人道的程度也让人震惊，实在难以想象。

I mean, it's it's the the inhumanity of it is is also mind boggling and and just extraordinary to to contemplate.

在加勒比地区、巴西这些地方，早期现代时期的死亡率，可能是人类历史上规模最大的持续性高死亡率之一。

But they're, the the mortality rates in, the places like The Caribbean, Brazil, in early modern times are, some of the probably the worst sustained, mortality rates in in any sort of large scale context in human history.

所以我们必须正视这其中的环境因素是什么？

And so I think we have to reckon with what are the environmental dimensions of that?

具体是哪些疾病？

What are the specific diseases?

你提到了黄热病和疟疾。

And you mentioned yellow fever and malaria.

这两种大概是最主要的。

Those are, probably the the two biggest ones.

但还有其他一些，比如钩虫病和雅司病，也是这个故事的一部分，却常常被忽略。

But there are others like hookworm, and yaws, that are also part of the story and and kinda get left out sometimes.

但整个哥伦布大交换的这一层面，关键在于不能只看欧洲带给美洲的东西，还要看到欧洲、非洲和新大陆之间的三角流动。

But but that dimension of the the whole Colombian exchange and making sure that that it's not just what Europe brings to the Americas, but also is this triangular movement between Europe Africa and the New World.

因为这也影响了当地社会的形成，你刚才想谈的是西非，对吧？

Because that also affects the kind of societies that grow up in so you meant to talk about West Africa, for example.

欧洲人当然不会去西非定居，那里众所周知太危险了。

Europeans don't, you know, settle in in West Africa, obviously, because it's notoriously dangerous.

我的意思是，去了就会死于疾病。

I mean, you you'll die of disease.

去西非的堡垒或者贸易站任职，往往等于被判了死刑。

You know, a posting to a West African kind of fort or something or a trading station can often be a death sentence.

对吧？

Right?

是的。

Yeah.

我认为这确实是欧洲没有直接殖民西非的重要原因之一。

I mean, I think it's certainly one of the one of the factors for why there's there's not direct European colonization of West Africa.

主要是因为疾病环境，尤其是恶性疟疾带来的极高死亡率，使得直到十九世纪医学和武器进步之前，这根本不可能实现。

It's simply that the the disease regime, first and foremost, the the effect of of malaria, falciparum malaria, the worst form of malaria, imposes such a heavy burden of mortality that it's not even really, a a possibility until the nineteenth century with with, advances in medicine and and weaponry at the same time.

我们能大致估算出的欧洲人在西非贸易中的死亡率，高得惊人。

So the, the European mortality rates that are involved in the West African trade that we can sort of piece together are so astonishingly high.

你不禁会想，他们到底是怎么说服人们去参与这种事的？

You just sort of wonder how did this even how did they convince people to to even be willing to to take part in it?

一定是欺骗、绝望和贪婪在驱动，但即便如此，面对他们所接触的疟疾环境，其致命程度依然令人难以置信。

It must it was deceit, desperation, greed, but but it's still just astonishing how how deadly it was to to encounter some of the environments of malaria that that they were exposed to.

我们之前聊了很多关于甘蔗的事。

We talked all about sugar.

那在美国南方的棉花种植园里，情况也一样吗？

Is it a different story on cotton plantations in the American South?

那里的疾病死亡率是不是低一些？

Are they are they is the mortality rate from disease lower, though?

是的。

Yeah.

我的意思是，这本书里我只能浅浅涉及这一点，毕竟要跨越这么长的时间和广阔的空间，实在很难深入。

I mean, this is something I I can only kind of, superficially get into in the book because trying to move across so much time and space.

但说到疾病，你始终得考虑整个生态背景。

But it's clearly when you're thinking about disease, you're always talking about the the total ecological context.

你知道，种的是什么作物？

You know, what what's being grown?

土壤状况又如何？

What are the soils like?

即使在加勒比地区内部，差异也很大，而到了美国南方，尤其是密西西比河三角洲和最南端那些地方，环境显然最不适宜居住。

And there's a huge variety as you even within the Caribbean, but as you move into the, say, The US South, obviously, the unhealthiest regions of the South are like the the Mississippi Delta and the the really deep South.

新奥尔良可能是北美最不适宜居住的地方之一。

New Orleans, probably one of the the most unhealthy places in North America.

它是唯一一个黄热病几乎常年都能持续流行的地区。

It's really the only place where yellow fever can can basically be endemic, virtually all the time.

再往东到大西洋沿岸的潮汐地区，比如南卡罗来纳和中大西洋一带，种植园的环境、土壤、作物类型、农业模式、社会结构，还有蚊子——也就是疾病传播媒介——这些因素全都相互关联，疾病本身就是这段历史的重要组成部分。

And then there's a huge difference again as you move into, like, the Tidewater Atlantic, and differences even between, like, South Carolina, and the the Mid Atlantic, where the the plantation environments, the soils, crops, crop regimes, agricultural regimes, the social systems that those require, as well as the mosquitoes, you know, what what, disease vectors and what diseases can exist are all interconnected, and the the diseases are part of that story.

而且，再往北走，美国大西洋沿岸的梅森-迪克森线，作为南北分界，也是奴隶制从主导性社会制度逐渐边缘化的过渡地带，同时它还是疾病生态学上一个非常关键的分界线。

But, the the line and then even as you move further north, the, the Mason Dixon line in The US from really the South to the North along the Atlantic, which is sort of the the transitional zone also where slavery moves from becoming a really absolutely dominant social institution to a kind of increasingly marginal one, is also a really important disease gradient in the in the ecology of disease.

在美国，中大西洋以北地区几乎从未出现过恶性疟疾，但在南卡罗来纳却很常见。

And so you don't really have falciparum malaria, above the the Mid Atlantic ever in the in The United States, whereas you do have it in, say, South Carolina.

这一点非常关键。

And that's a huge huge, ingredient.

这是整个故事中极其重要的一环。

That's a really important part of the story.

如果你看看殖民史，尤其是英国殖民史，那些定居型殖民地——无论是17世纪的新英格兰、澳大利亚还是加拿大——这些地方能成为定居点，绝非偶然，因为它们基本不受黄热病和疟疾等疾病的威胁，而这些疾病原本会阻止殖民社区的建立。

And if you look at at the history of colonialism, European colonialism, and I guess specifically British colonialism, The the the settler colonies, whether it's New England in the seventeenth century or Australia or Canada, these are it's not a coincidence that these are areas that are are essentially kind of immune to yellow fever and malaria and all the kind of diseases that otherwise would would prevent settler communities from establishing themselves.

对。

Mhmm.

是的。

Yeah.

确实如此。

It is.

而且这也挺有意思的。

And it's it's interesting too.

殖民主义的思维方式根本不会从这些角度去考虑。

The the mentality, of of colonialism doesn't, doesn't really think in those terms.

比如在1760年代，很明显英国即将击败法国，准备进行和谈。

And, you know, one one example of this is in the seventeen sixties when it's obvious that the British are on the verge of defeating the French and preparing for treaty talks.

当时英国国内曾激烈讨论，是否应该要求获得加拿大。

There was a huge discussion in Britain about whether the Brits should demand Canada.

没错。

Oh, that's right.

是的

Yeah.

整个加拿大

All of Canada

对

Yeah.

或者瓜德罗普

Or Guadalupe.

你知道，那是个小小的加勒比岛屿

You know, it's tiny Caribbean island.

关键是，当时居然还引发了如此激烈、备受关注的讨论

And it was the fact that it was even sort of a a major and and, you know, intensely felt debate.

你想要的，按我们现在纯粹从经济角度想，是这片拥有丰富自然资源和广阔土地的区域，还是一个产糖的岛屿？

Do you want what we would now you know, just thinking of it in crass economic terms, a region of vast natural resources and, hugely expansive land surface or a sugar island.

当时有很多人说，我们应该争取要糖岛

And, there are a lot of people who said we should we should demand Sugar.

这个法国的糖岛，在十八世纪的经济体系里价值极高。

This French sugar island, because it was so valuable, in in terms of the eighteenth century economy.

咱们先歇一会儿。

Let's take a quick break here.

几分钟后回来。

We'll see you in a few minutes.

大家好。

Hello, everybody.

我们有个超级棒、特别精彩、简直震撼的消息要宣布——即将举办一场《休息历史》的现场活动。

We have absolutely sensational, spectacular, stupendous news about a forthcoming Rest Is History live show.

没错，多米尼克。

We do, Dominic.

有时候有人抱怨，英国人对大英帝国了解得太少，学校里也没讲透。

Now sometimes there are complaints that people in Britain don't know enough about the British Empire that they don't study it in sufficient depth.

所以我们打算补上这一课，来讲讲维多利亚时代最宏大的帝国冒险故事。

So we are stepping in to make up for that, and we are we're going to be telling the story of the ultimate Victorian imperial adventure.

德米特里，这就是1868年的阿比西尼亚远征。

And that, Dominic, is the Abyssinian expedition of eighteen sixty eight.

这事儿吧，我倒不说是多高明，但真是疯得可以，对吧？

And it's well, I don't say it's brilliant, but it's mad, isn't it?

确实疯了。

It is mad.

为了让大家有个背景，这真是个了不起的故事。

To give people a bit of context, it's an amazing story.

阿比西尼亚的皇帝塔瓦德罗斯二世给维多利亚女王写过信，但女王一直没回。

The emperor of Abyssinia to Wadros the second, he was ignored by queen Victoria who didn't answer his letters.

于是他抓了几个英国人当人质，英国就派远征军去阿比西尼亚，直捣他的老巢马格达拉——那是个山上的堡垒。

So he took some British hostages, and then the British sent an expedition to Abyssinia to attack his capital at Magdala, his kind of mountain citadel.

这故事太精彩了，简直荒唐得离谱，正合《历史的休息》的口味。

It's an amazing, amazing story, a bonkers story, and precisely the kind of thing that we enjoy on The Rest Is History.

没错。

Yes.

我觉得整个国家都该听听这个故事。

And that I think the entire country could profit from hearing about.

所以我们接下来就要讲这个。

So that is what we're gonna be doing.

我觉得这简直就是一部《弗拉什曼》式的故事。

It is, I think, a very Flashman kind of a story.

完全没错。

Totally.

喜欢《弗拉什曼》的人，一定会喜欢这个。

So anyone who enjoys Flashman will enjoy this.

我们将在9月4日于伦敦南岸中心举办这场活动。

And we are going to be doing it at the South Bank Centre in London on the September 4.

这场活动还有少量余票。

We do have a few tickets for that.

我们9月5日还有一场，不过那场已经售罄了。

We're also doing it on the September 5, not to base, but that one is already sold out.

所以如果你打算来，赶紧订九月四号的票吧，官网是 restishistory.com。

So if you want to come, book your tickets for the September 4, and you can get them at the restishistory.com.

进入十九世纪，人们开始在英国，还有美国和西欧的城市里，真正重视起公共卫生问题。

So going into the nineteenth century, this is this is when people start to, certainly in in in Britain and I guess in The United States as well and in West European cities.

当时掀起了大规模的公共卫生改革工程。

There's massive projects to reform public health.

人们渐渐明白，住在自己的污秽里不好，把排泄物直接倒进河里更不行。

There's kind of understanding that basically living in your own shit isn't good and that dumping it in rivers isn't good.

但那时候大家还是普遍相信，像瘴气这类东西会在空气中飘荡。

But but that is still the assumption is still that there are kind of things like miasmas that that drift around.

你在书里提到，瘴气理论——也就是认为病菌随着空气传播——虽然完全错了，却意外推动了整治污染城市的运动。

And you say in your book that the the concept of the miasma, the idea that that germs kind of drift along on the air is it's it's it's but it's creatively wrong because it generates these campaigns to reform toxic cities.

对，就是这样。

Yeah, exactly.

我的意思是，瘴气理论认为，环境污浊、空气污染、腐烂物质散发的气味，这些能闻到的东西才是致病原因。

I mean, miasma miasma theory, the idea that sort of different kinds of, environmental corruption or or, pollution in the atmosphere, putrefying matter, so it's it's something you can smell, is a source of disease.

我们知道它是错的，因为它根本没有考虑到微生物会侵入人体这个事实。

You know, we may know to be wrong because it doesn't doesn't really posit the existence of of microbiological agents that infect the body.

但它可能引导我们去做一些实际上有效的事情。

But it may steer you towards doing some things that that nevertheless work.

再说，那时候的人根本不知道疫苗是怎么起作用的。

And again, mentioned, you know, gender doesn't even know how vaccination works.

没错。

There's Yeah.

你可以想到类似的例子，比如早期公共卫生运动对污水和清洁水源的重视。

Similar you can think of parallels in terms of some of the public health movements towards, sewage and clean water.

在十九世纪初，工业化和城市化迅猛发展，这些在某种程度上反而拖累了人类健康。

And in the context of the early nineteenth century, you have rapid industrialization, rapid urbanization, all of which is sort of, in some ways, setting back human health.

不过，骨骼确实开始变小了，对吧？

Well, again, skeletons start to shrink, don't they?

确实如此。

They do.

是的

Yeah.

对

Yeah.

你发现这其实是个悖论。

You you see that it's it's a paradox.

在西欧和美国，这一点都非常明显。

You see both very clearly in Western Europe and The United States.

在美国，这被称为内战前悖论：我们知道经济在增长，城市化、贸易、制造业和金融都在扩张，但人们的身高却在下降。

In The United States, it's called the antebellum paradox that we know there's economic growth and urbanization and trade and manufacturers and finance are expanding, but also people are getting shorter.

原因就在于城市生活环境带来的种种挑战。

And, the reason is because of the the challenges of living in urban settlements.

这推动了公共卫生运动的兴起。

And one thing this does is it spurs the the rise of the public health movement.

也就是卫生改革运动，催生了一股政治力量，开始积极倡导变革。

So it kind of the sanitarian movement, the the galvanization of a political force that starts to agitate.

这种现象在不同社会中表现形式各异，有多重层面。

And this has a multi it takes different shape in different societies, has multiple facets.

其中包含社会正义的维度，确实如此。

There's a social justice element to it that Yeah.

它指出，城市化让很多人变得极度贫困，沦为绝望的劳工。

Says, look, urbanization is making people very, very poor and desperate laborers.

这背后确实有政治因素，但主流观点认为，我们必须改善城市环境。

So there's there's there's really political dimensions to this, but they they they're on the track of saying, we have to clean up the cities.

这种趋势是不是因为霍乱这种新疾病的爆发而加剧了？我之前没太注意，你说霍乱是1817年8月在加尔各答以南50英里处首次出现的，这个起源点还挺具体的。

And is that turbocharged by the emergence of the new disease of cholera, which I hadn't real I mean, basically, it emerges, you say, August 1817, 50 miles from Calcutta, which seems very precise origination point.

霍乱在某种程度上是十九世纪最具代表性的疾病之一，尤其从全球视角来看。

It's cholera is cholera is, in some ways, one of the the most revealing diseases of the nineteenth century, particularly from a global perspective.

我认为，首先得从全球的角度来理解它。

And I think, first of you have to look at it from a global perspective.

这是一种重大的传染病。

It's a major disease.

它至今仍是一种严重的疾病。

It's still a major disease.

这种病非常可怕，因为它是通过粪口传播的——粪便污染了下一个人的消化系统，人就感染了。

It's a terrifying disease when when you it's fecal oral transmission, so you get it from from poop getting into the the digestive tract of the next victim.

它会导致严重且迅速的脱水，感染后一天内就可能致命，这简直非同寻常。

It causes very severe and rapid dehydration, so it can kill you within a a day of infection, which is which is pretty extraordinary.

它确实是全球化的产物。

And it it really is a product of globalization.

我们现在知道，霍乱并不是一种古老的疾病。

We now know that cholera isn't an ancient disease.

它可能在1817年之前就存在过，但时间并不长。

It may have existed before 1817, but not for for all that long.

真正让它成为全球性疾病的，正是从那个时刻开始的。

And and that really is the moment when it becomes a a global disease.

它传到了加尔各答。

It reaches Calcutta.

它通过航运网络传播出去了

It reaches the the shipping networks of

确实如此

Yeah.

因为加尔各答就在旁边，那是英属印度的首府，没错。

Because because it's next to Calcutta, which is the capital of British India and British Exactly.

于是它就开始向世界各地扩散。

So then it goes out into the world.

而且

And it

它向世界各地扩散了。

It goes out into

世界其他地方也出现了疫情。

the world.

这一点我们很清楚。

We see that.

第一波疫情没怎么波及西欧，但已经让人吓坏了。

And the first wave doesn't quite make it to Western Europe, but it's terrifying.

到了1832年，它终于传到了那里。

But then in 1832, it does.

它传到了欧洲和美国。

It reaches it reaches Europe and The United States.

这是一种传染病。

And it's it's a disease.

有意思的是，它实际造成的死亡人数远不如黑死病或后来的流感在西欧那么惨重。

It's interesting in that it doesn't actually kill anything like the number of people that plague or soon influenza will in Western Europe.

但它让整个社会吓得不轻，因为当时人们已经取得了控制传染病的重大进展。

But it really it scares the heck out of society because it it's at a time when, there'd already been really important progress against in controlling epidemic disease.

像鼠疫杆菌引发的那种大规模致命瘟疫，已经在西欧基本得到了控制。

So the the really violent plagues, mortality shocks mostly caused by Yersinia pestis, had sort of been brought under control in Western Europe.

虽然大多数人还是死于传染病，但主要是肺结核、伤寒这类长期存在的地方病。

Most people still died of infectious disease, but they died of tuberculosis and typhoid and sort of constant endemic diseases.

霍乱之所以令人恐惧，一方面是因为它发作迅猛、症状惨烈，另一方面是因为它在欧洲刚刚开始控制住传染病的时候大规模爆发，威胁到好不容易取得的成果。

And cholera was partly terrifying because it killed you so quickly and was so ghastly violent, in its course, but it was also terrifying because it was clearly causing these major epidemics at a time when Europe had just sort of started to to get those under control, and it threatened to undo that.

顺便问一下，霍乱的影响也体现在它是穷人的病吧？

Just to ask on on the impact that cholera has, it's also, a disease of the poor.

没错。

Right?

因为穷人更容易接触到肮脏的水源。

Because the poor are likely to have in filthy water.

是的。

Yeah.

某种程度上，这种状况反而推动了社会公平运动的发展。

In a sense, that that kind of amplifies social justice movements.

它确实跨越了各种政治立场和议题，毫不留情地影响所有人。

It cuts across it cuts across all kinds of politic political divides and issues exactly.

咱们来聊聊另一种全球化疾病，或者说是另一场大流行病吧。

Let's talk about another globalized globalized disease, if you like, or or another pandemic.

我想，大多数听众对这一种应该都很熟悉，因为自从新冠疫情爆发以来，我们听到的最多就是它，也就是所谓的西班牙流感。

So this is the one with which most listeners will, I guess, automatically be familiar because it's the one we've heard most about since the arrival of COVID nineteen, which is the so called Spanish flu.

我们知道，西班牙流感曾在第一次世界大战期间协约国的军营里流行，比如埃塔普勒那里。

So we know that the Spanish flu was around in the great allied kind of troop camps at Etap.

有说法认为它可能源自美国中西部，然后被带过去的。不过据我所知，目前对此还没有定论，也许你更了解情况。

There is some suggestion that it might have come from the American Midwest and been brought by I mean, I I as far as I know, the jury is kind of out on that, but but maybe you know better.

那么，你觉得从西班牙流感中，我们还能吸取哪些其他教训呢？

But do you think there are well, what are the what are the other lessons we can learn from the Spanish flu?

1918年和1919年的情况，跟2020年和2021年相比，有没有特别能引起共鸣的相似之处？还是说你觉得它们完全不一样？

Are there are there particularly resonant parallels between, you know, the nineteen eighteen, nineteen situation and twenty twenty, twenty one, or or or are they completely different, do you think?

嗯，就像学者们常说的，既有相似之处，也有不同之处。

Well, like a good academic will say yes and no.

这个

The

当然。

Of course.

这一点还无法确定。

And the jury is out.

我觉得我们其实并不清楚它是否真的源自美国中西部。

I think it we we don't really know that it came from the American Midwest.

更近期的研究表明，等我们真正注意到它的时候，它已经同时在各地出现了，目前我们仍不清楚它的真正源头。

The the better, more recent work suggests it was everywhere at once by the time we really see it, and we don't actually at this time know where it came from.

这是甲型流感。

It's influenza a.

它起源于禽类，是一种病毒。

It's it's of avian origins, so it's a it's a virus.

这是一种病毒性疾病，其病毒通常在鸟类种群中长期存在。

It's a viral disease, whose virus is normally endemic in bird populations.

这种病属于比较罕见的类型——大多数传染病都是哺乳动物的疾病。

It's one of the kind of unusual the most rare diseases are mammal diseases.

这是一种禽类疾病，虽然不是完全独一无二，但确实有点特别。

This is a this is a bird disease, which is kind of not totally unique, but it's it's a little bit weird.

流感的演化方式和新冠完全不同，它的基因组是分节段的。

And, influenza evolves in very different ways from COVID nineteen, so it has a segmented genome.

有点像由八个部分组成的基因组，可以自由组合。

It's kind of like a genome that exists in these eight mix and match parts.

H1、N1这些名称，指的就是这些片段编码的蛋白质。

And this is like the h one, n one, are describing the the proteins for that are coded for by by these different parts.

病毒进入宿主细胞后，如果同一个细胞里同时存在两种不同的病毒株，这些片段就会重新组合，形成新的搭配。

And so the the viral genome gets inside a host cell, and when it reassembles, if there's two different viruses, two different strains in the same cell, the parts, the mix and match parts can get put together in a different fashion.

这种机制让流感变得特别难以捉摸。

So it evolves in this way that it can make it very elusive.

所以我们现在还是得不断预测，尽量跟上每年会冒出哪种流感毒株。

So we still, obviously, are always trying to kinda predict and keep up with which which strain of the the flu is gonna emerge this year.

流感的历史很有意思，因为1918年的流感并不是历史上第一次大流行。

The history of flu is very interesting because the nineteen eighteen flu is not the first big flu pandemic, in history.

这种病一定多次从鸟类传播到人类身上，引发过一波又一波的呼吸道疾病。

So this is a disease that must repeatedly have moved out of bird populations into humans and caused waves of respiratory disease.

但其实有一场发生在

But the So there's one in

十九世纪九十年代，对吧？

the eighteen nineties, isn't there?

俄罗斯流感。

The Russian flu.

1890到1892年那场大流行，有人叫它俄罗斯流感。

Big one in 1890 to '92, sometimes called the Russian flu.

所以人们常拿它跟新冠作比较。

And so people have compared that to to COVID.

不仅如此，有些人还稍微回溯了一下，

Well, even more than that, some people have, wondered set back a little bit here.

包括新冠在内，人类冠状病毒共有七种，来自同一个家族。

There are including COVID nineteen, there are seven coronaviruses that infect humans from this family, seven different species.

在新冠出现之前，其中四种就已经广泛存在了。

Four of them before COVID nineteen are already everywhere.

我们每个人都可能得过几次。

We've all probably had a couple of them.

它们只会引起普通的感冒。

They cause little common colds.

我们可以估算这些病毒的年代，十五年前有一篇论文通过分析病毒基因组指出，导致人类普通感冒的一种冠状病毒，大约在1890年出现。

We we can estimate how old these viruses are, and an older paper about fifteen years ago using the the viral genome said that one of the main causes of the common cold in human, this species of coronavirus, emerged around 1890.

因此，有人会想，俄罗斯流感会不会就是这种现在常见的冠状病毒首次出现的时候？因为我们没有俄罗斯流感的DNA或RNA——我该说，是RNA。

And so this sometimes has caused people to wonder, could the Russian flu because we don't have the the DNA or RNA, I should say, of the, the Russian flu.

所以我们其实并不知道它到底是什么引起的。

So we don't actually know what caused it.

于是有人推测，这会不会就是这种如今常见的冠状病毒首次出现的时刻？

And so people have said, could this have been actually the emergence event of this now common cold coronavirus?

我觉得这是个非常有趣的问题，我们需要确凿的数据，比如从受害者肺组织中提取的病毒RNA，这种样本肯定存在于某个博物馆的收藏里。

I think it's a really interesting question, and and we would like hard data in the form of the RNA of the virus from lung tissue of a victim, which surely exists in a museum collection somewhere.

他们当年就是从1911年用甲醛保存的肺组织里分离出麻疹病毒的。

They got measles from from, like, 1911 from a a lung preserved in formaldehyde.

所以应该有人能解决这个问题，但我认为俄罗斯流感很可能就是普通的流感。

So somebody somewhere should be able to to just solve this question, but I think the Russian flu is probably flu.

不过到了1918年，这场流感大流行突然爆发了，这是真的。

In 1918, though, this influenza pandemic explodes, and it's a it's true.

这真是一场非同寻常的事件。

It's a really extraordinary event.

某种程度上，这是全球化世界在没有喷气式飞机时代的终极体现。

In some ways, it's the it's the ultimate expression of a globalized world without yet jet travel.

当时靠的还是蒸汽船和铁路，才把病毒传到遥远的地方。

So it's still steamship and railroads that are that are spreading it over long distances.

但这是化石燃料运输时代最严重的全球大流行，造成的死亡人数高达五千万到一亿。

But it is this it's the ultimate pandemic in in the age of fossil fuel transportation, and its global impact is enormous, fifty to a hundred million dead.

那时候没有我们现在这样的治疗手段和医疗护理。

They didn't have the same therapeutics or clinical care that we have today.

但有个很矛盾的现象，我觉得怎么强调都不为过——1918年的流感，偏偏最致命的是那些正值青少年到成年初期的健康人。

And paradoxically, one of the really big differences, I I think this we can't emphasize this enough, is that the 1918 flu disproportionately affects healthy people in their late childhood to to early adult.