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Plague Time: The New Germ Theory of Disease

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"Plague Time (2000)" and Ewald's earlier "Evolution of Infectious Disease (1994)" advocate a new discipline called 'evolutionary epidemiology.'

One of the big shockers in both books is that: "Application of evolutionary principles does not lead to the conclusion that all parasites [including viruses and bacteria] evolve toward benignness."

Only under circumstances where new hosts are relatively hard to infect (due to a clean water supply or screened windows or condoms) are parasites forced to co-exist in a relatively benign state with their current victims. In both books, Ewald uses cholera as an example of a germ that has evolved to benignness in countries with clean water supplies, but is still a killer in countries with bad plumbing.

"Plague Time" takes this thesis a step further and concludes that many so-called chronic diseases such as atherosclerosis and certain cancers are also caused--or at least triggered by infection.

Peptic ulcers are a case in point. Even though some doctors back in the 1940s realized that antibiotics could heal ulcers, the technique never caught on in mainstream medicine. It was too easy to blame the patient's life-style and stress levels, and besides 'Helicobacter pylori' was hard to find. Four decades later, researchers in Perth, Australia discovered that patients with ulcers and gastritis improved after tetracycline. One of the researchers, Barry Marshall drank an infective dose of 'H. Pylori,' got gastritis, then cured himself with antibiotics. "Still, it was only in the mid-1990s that the medical establishment finally generally accepted the idea that peptic and duodenal ulcers are infectious diseases."

So what will the decisive medical technologies of the future be, if it is indeed accepted that many chronic illnesses are caused by infection? The author believes that, "Vaccines, antimicrobials, and hygienic improvements may control most heart disease, infertility, mental illnesses, and cancers, especially if these solutions are used not just to decimate pathogens but also to direct the evolution of the causative microbes."

"Plague Time" is a fascinating look at what may be the near-future of medicine if physicians can be trained to look at infectious diseases in terms of evolutionary epidemiology.

I can see some readers think this book is not easy for the layman, but the truth is if this is your first approximation to evolutionary medicine or evolutionary epidemiology, I think this is a good book for you to start. There are other excellent books out there like "Why do we get sick?" by Randolph M. Nesse and George C. Williams (which I personally recommend too) that may be simpler and broader, but they lack some of the originality Paul Ewald has in this book. The only thing I criticize about this book is that it could have made its point in fewer pages, that aside it was truly great.

Ewald's perspective is original and really logic, I only keep thinking it might be a little exaggerated to think it is going to revolutionize medicine. He surely states really important new axioms, and in this way he is revolutionizing medicine, but I believe the benefits derived by his hypothesis are not going to be that outstanding. The book is great and original, not hard reading but challenge common knowledge (not common sense, be careful).

The dramatic message of this book is that chronic diseases such as cancer, heart disease, and arthritis, are not necessarily caused by an inherent and inevitable breakdown of the human body, but by the action of infectious agents and by the immune response to those agents. Sooner or later, some bug finds its way through your defenses and settles in. Sometimes you know right away (small pox) BUT sometimes it takes years (AIDS, Lyme) sometimes it takes decades (shingles). This is not a new-agey wishful thinking assessment of risks, but a scientific analysis of disease and its causes, based on experimental data. The companion volume "The Evolution of Infectious Disease" covers much of the same ground but gives much detail to satisfy the sceptics.

I'm a scientist (but not a biologist) and I would bet this is one of the 20 century books that will still be a recommended book a century from now. Ewald's theory is still fighting for recognition, but there are so many factors that are "right" about it that it has to prevail (like evolution.) The big questions are about how effectively we can fight quietly acting micro-organisms whose effects don't show up for years or decades.

This book surveys the past, present, and future of infectious disease management, in many cases re-defining or re-classifying diseases accepted as genetic or risk-factor associated. This book would be very helpful to those trying to sort out the information and dis-information presented to them on the nightly news so that they can make informed decisions on the next trip to the doctor for the runny nose, as well as gaining some insight into the effects of current medical research on diseases that are much more serious (and how they get that way).

My first job out of graduate school was as a consultant in Nixon's War on Cancer. My background was in quantitative policy analysis not medicine. So I and the other consultants (also chosen for their mathematical skill not their medical knowledge)began to bone up on what was known about cancer. One thing was clear - it wasn't infectious.

We were wrong then. In the seventies the conventional wisdom was that maybe one percent of all cancers were caused by some infectious agent, usually suspected to be a virus. I was part of The National Cancer Control Survey. I interviewed State Public health Officers (every state has one). Nobody ever mentioned controlling viruses or any other pathogen.

Ewald traces the changing medical opinion about cancer in the decades since. Today at least 10% of cancers are considered to have been discovered to be caused by an infection. The trend is up. He thinks that someday soon medicine will consider cancer an infectious disease like TB or peptic ulcers.

At the time "The Lady of the Camellias" (La Traviata) was written no one knew that consumption was infectious. That's why Armand (Alfredo)kisses Marguerite(Camille-Violetta)without a second thought. TB was only discovered to be infectious in the late nineteenth century. Similarly for most of my life the medical establishment considered peptic ulcers to be caused by "stress". Only recently has the bacterium that actually causes it been found.

Ewald thinks that all chronic diseases like cancer, atherosclerosis, diabetes, arthitis, and schizophrenia are also caused by some as yet unknown virus or bacterium.

I think he's right.

The ideas in this book represent a possible future direction of medicine. Medicine isn't there yet, primarily because this book is written by a scientist, and medical doctors are not scientists, but practitioners - consumers of scientific knowledge, but usually not its producers. It will take a while for the medical community to realize that evolution matters to diagnosing and treating diseases; but there are already some hopeful signs, such as using methods based on ethnicity.

This book is good in outlining what was discovered over 50 years ago by Dr. Royal Raymond Rife. If you liked this book please read these as well as Politics In Healing by Daniel Haley, The Cancer Cure That Worked by Barry Lynes, The Hand Book Of Rife Frequency Healing by Nina Silver, PH.D.,

This book was amazingly helpful to me in making sense of chronic illness and seeing a bigger picture than what we typically learn in books about various illnesses. Some parts are a bit complex, but Ewald does a nice job of making the topic as understandable as possible. I was absolutely blown away by some of the historical points (such as findings in the 1800s about bacterial connections for major, common, chronic diseases). Ewald does say a few things that may prove to not be true (most significantly, that Lyme cannot be passed on from humans), but overall this book is incredibly enlightening. I would highly recommend this book for EVERYONE.

This book is a real mind opener. It intelligently braves to confront orthodoxy. Good for Paul! Medicine needs to constantly challenge the orthodox theories when they clearly don't work.

By faith and science, I am a creationist, but do not feel threatend by Ewald's genuine search for the truth. Microevolution is a testable fact and a great deal can be learned from this text and his theories on observation.

I also feel that this book should give us all more compassion on the victims of the disorders that plague humanity. Once their real causes are understood, then real substantitive actions can be taken to help them.

I found the theories to be very interesting, but found the author tended to repeat himself. I also felt the wording was a little too "scientific" for the average reader. With that said; I still may look read more of his books.