Honors 490 – International Epidemics
Class Notes – 9/11: Miller, Nightingale, Smith, and a Lecture by Penner
Critical Terms for Literary Study, Miller
On Narrative Theory
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We learn the nature of things as they are
We need fiction in order to experiment with possible selves and to learn to take our places in
the real world, and to play our part
Does fiction create or reveal order in the world when we read a narrative? (p. 69)
o We can test hypothetical versions of ourselves
 We learn lessons from characters
o Societal ideals are demystified (i.e. Shakespeare)
o Reinforcement of cultural norms by repetition and variation
Does a narrative challenge the essential self while revealing or proposing performative selves?
o How do we negotiate identity in different situations?
How do we create ideologies and how do we challenge them once we’re immersed in them?
o Ideologies: a set of accepted truths about the world
o “This is water” by David Foster Wallace (article about ideologies and being immersed in
a set of beliefs and he we challenge them)
Repetition with variation – the setup of an expected situation and then the breaking of the
pattern
Elements of a narrative (any version):
1. Beginning
2. Sequence
3. Reversal
4. Personification
5. Protagonist
6. Antagonist
7. Witness
8. Patterning or repetition of elements
Master narratives – repeatable observable actions that become widely accepted beliefs as
coined by Marxist theorist Frederic Jameson
o Can master narratives become limiting beliefs?
o Marianne Hirsch – talks about the novel of formation, or bildungsroman (the coming of
age novel); the Garman narrative reinforces societal values, while the French and
English forms challenge societal values
o With that in mind, what are the socioeconomic implications of how we talk about
epidemics in narrative?
o Can stop us from discovering new things
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 Remember the idea of the four humors staying in balance
Recounting historical events is a form of narrative too (p. 68)
o Stories about disease have their own rhythm
o The way they are told could shape how we see and understand the events
 By whom they’re told
 The context of the story
 The eyes through which we read them
 The audience (ex. Nightingale’s laboring populations, Iatrós reading (for
themselves, not meant to be shared))
Notes on Nursing, Nightingale
Key takeaways:
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Public health is taking a precedence
o Necessary because Industrial Revolution led people to flood to the cities
Changing the perception of nurses
o They used to have a poor reputation, as people who were just emptying chamber pots
(“hauling the slops”)
Trying to find compatible explanations for God and science
o (Defoe’s observations were still grounded by religion)
Therefore, a new disease theory is emerging: miasma
o Disease is present in and transmitted through the environment (i.e. dirty air, breath,
fecal matter, dust)
o It is not caused not caused by God
o It is not transferred from person to person
o Keeping the environment clean will prevent disease from infecting people
o *Remember, there is no knowledge of viruses and bacteria
Importance of sanitation
o Good ventilation
o Clean environment
o Not too crowded
o Well-lit
o Warmth
This is a simple task
o Equipped with a certain amount of knowledge (i.e. common sense), creating conditions
for the inhibition of disease is possible
o As a caretaker of your home, you are already equipped with this knowledge to keep
things clean (and thereby prevent disease)
Ideas of the world are progressing
o Aware that light is important: “stops growth and promotes scrofula, rickets, etc.” (p. 55)
o Questioning reasons for disease: “…several out of the same family all die, is it a reason
for supposing their poisoning ‘hereditary,’ ‘contagious,’ or the result of a ‘family
predisposition’?” (p.60)
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Other thoughts:
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Government is involved
Push/Pull – always struggling with cost/benefit
o A theory can explain some things not others
o Industrial Revolution is great but it creates some problems (flood of people, lack of
hygiene, increased need for health care)
Notes on nursing for the laboring populations
o Audience is working class
 What does that tell you about the social aspect of healthcare?
 Maybe it’s a process of bringing awareness to everyone, not the people
performing the function
 Preventative?
 Bringing a correlation between poverty and disease could encourage them to
play a more active role in their condition
 Shows a shift of responsibility from external (God) to internal
(maintainable environmental factors)
o Disease is not inevitable
 Maybe this will relieve social stigma surrounding diseases
o Empowering women and becoming informed
 By having certain knowledge (common sense)
 You can already take care of your house, so you are more equipped to help with
this than others
Their thought processes:
o Ionian Enlightenment era is driving these ideas
 Still pre-science
 Asking questions, but the scientific method is not what’s guiding their thoughts
o Empiricism – what is valid is what you get from observation
 Sight, smell, tangible things
 Causation – can infer from experience  recognizing the constant
conjunction
o If it happens over and over, this must be causing it
o This is the period in which microscopes are first being used
 Not trusted yet because optic theories aren’t completely developed (empiricist
challenge)
Using counter-arguments to question the concept of contagiousness
o Showing that the current, founded beliefs are wrong
o Contagion can’t be seen, so it doesn’t exist
Seeing this as a narrative –
o The disease theory can be read as the central personification
o Emphasis on patterns: multiple cases and reinforcement of ideas (OPEN THE WINDOW)
 Example after example after example…
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Westminster Review, Smith
Key takeaways:
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Looking at the effects on societies and on people in quarantine
o What happens to boats when you quarantine them?
o What happens to commerce when the boats are quarantined?
o Why is quarantine 40 days of isolation???
 This specific number is unfounded
 What can the public consider to be truth?
o Condillac: “the art of reasoning is nothing more than a language rearranged” (p. 521)
 We can liken this to “beating up the statistics” (Wisdom of Whores)
Example after example of how the current founded theories of diseases are incorrect
Proof why Typhus fever is not contagious (pp. 514-517):
1. It stays local (does not spread much outside the city it’s in, and is very prevalent in such
city)
2. It is “dependent upon the state of the weather”
3. Mortality increases in places of famine or poor quality food
4. It never spreads in healthcare institutions
5. It is never spread to other sick people in hospitals
6. Health care officials do not contract the disease
Are they beginning to understand the concept of an immune system, or maybe will these
thoughts lead them there?
o “Sometimes … during the prevalence of an epidemic, when the wards become unusually
crowded, and they [physicians] are exposed to unusual fatigues they are now and then
attacked” (p. 519)
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o Concept of being more susceptible to disease in times of stress or weakness (‘fatigues’)
Dr. Maclean – the disease is always at work; it never rests
Discerns between three ways of contracting a fever: through contagion, epidemic, or
contamination
Of note: much of the disease treatment is less than desirable, resulting in an aversion to
receiving such healthcare: “This system tends to…excite and perpetuate terror” (p. 526)
o This leads to people wanting to conceal their illness (p. 527)
o We can liken this fear to the current issue of cultural fear regarding the treatment for
Ebola in South Africa
Comparing to Smith and Nightingale
Similarities
Using counterarguments to make point
New importance of sanitation laws
-Touching on contamination
-Health standards are beginning to emerge
New disease theories
Repetition (citing example after example)
Citing correlations between poverty and disease
There is stigma attached to the disease and
therefore, the poor
Differences
Different audience:
Nightingale – laboring class
Smith – general public (?)
Origin of disease:
Nightingale – miasma
Smith – contagion | contamination | epidemic
Purposes:
Nightingale – offering solutions and guidelines to
dealing with diseases, empowering women to
take on the responsibility of healthcare (including
sanitation)
Smith – offering a new way to think of disease
and asking us to question the origin of current
disease theory; there are economic implications
to things like quarantine and how we treat the
sick – how are our narratives affecting the larger
social sphere?
Shifting the cause of contagion:
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