What’s in a Name

Last week, I called a sitting United States Senator a dumbass on Twitter.

I regret nothing.

The viral (pardon the pun) response to the tweet was an exhilarating ride. I learned there’s a lot of people out there that just don’t like China. Many people decided to share a National Geographic article about a new theory that the pandemic originated in China, apparently having missed the part where the point of my tweet was that the virus didn’t originate in Spain, and misinterpreting what I meant when I said it was first detected in Kansas.

(There are also two other prevailing theories about its origin, none of which can be definitively proven, nor are universally accepted).

Many people accused me of having an agenda to hide the origin of the coronavirus outbreak (which I never mentioned). Some lobbed completely false information at me (when I said first detected, I meant globally, not in the US, but thanks for playing, “America’s best CPA”! And no, it was not called the Spanish flu because more Spaniards died than anyone else, you’re citing an undergraduate research project posted online in 1997.)

And, predictably, a lot of people just resorted to insults. After a professional troll broke my demeanor at the end of the day, I muted the conversation and, when the number of likes had doubled by the following morning, I made my account private for a couple of days.

I recorded an episode of my old podcast yesterday about the “Spanish” influenza pandemic, if anyone is interested in learning more about the outbreak.

What’s in a name?

So, how do diseases get their names, and what’s the issue with calling COVID-19 the “Chinese virus” anyway?

Diseases were frequently named for their symptoms: “choleric,” for example, was used to describe someone who became so angry their face turned deep red (a symptom of the disease that took the name “cholera”).

“Bubonic plague” was named because it caused “buboes,” or masses of swollen tissues in the armpits or groins of its victims.

“Whooping cough” because of the sound patients made.

Others–pneumonia, bronchitis–were named for the parts of the body chiefly afflicted.

When Europeans began trading with and traveling to regions outside of Europe, the diseases they encountered became a concern; this became doubly so with the expansion of settler colonialism in the 18th century.

Check out, for example, the title of James Lind’s 1768 treatise, An Essay on Diseases Incidental to Europeans in Hot Climates, with the Method of Preventing their Fatal Consequences.[1] Lind’s essay suggested that the stresses that European bodies encountered in regions of ‘hot climate’–writing about the West Indies, he mentions the temperature, humidity, and local ecology–made them more vulnerable to disease.

James Johnson, writing in 1821, offered a similar analysis in The Influence of Tropical Climates on European Constitutions, which was about the experience of Europeans in India.[2]

Through this developed an entire field of medicine, commonly called “Tropical Medicine,” born of the idea that European bodies could not dwell in tropical environments without medical intervention.

In the beginning, the possibility that native medical practitioners might have effective treatments for local diseases was considered, mostly in India where Europeans—French, Portuguese, and English among them—frequently sought medical assistance from hakims and vaidyas, “encouraged by a belief that local doctors would be more familiar with the diseases of the climate and with the locally occurring medicines an obliging nature had provided for their treatment.”[3]

Such measures were relatively common as late as the 19th century, but were ultimately discouraged by colonial administrators who preferred European methods to native, buoyed by the notion of science-as-progress. Admitting that the colonies could compete with the metropole in scientific output ran counter to the notion of the mission civilizatrice.

New institutions were set up, first in Liverpool and then in London, to train doctors in the new field of Tropical Medicine.

The London School of Hygiene and Tropical Medicine. I have a very complicated relationship with this place. (author photo, 2016).

As new diseases in the “tropics” were identified, they were frequently named for the regions where they were found, almost as a warning. Go here, and you will contract this disease. Abandon all hope.

The unfairness of German measles

Several people in my mentions last week brought up that old childhood malady in the United States: the German measles. It’s one of the archetypes of a misnamed disease, because it was identified as a separate strain by three German physicians at the beginning of the 19th century, and was so named “German.”

Aha, my critics said. Can’t explain that, can you?

I remain unclear what this was supposed to prove, since even simple playground logic posits that two wrongs don’t make a right.

But, ask yourself … when was the last time you heard the term “German measles”? It’s now commonly called rubella, and has been for quite some time. Why?

Well, you see, the name “German measles” was discouraged among medical professionals in order to avoid giving the impression that the disease was endemic to Germany, that Germans were predisposed toward it, or that Germans carried the disease and could transmit it to others.

Funny, that.

In which it gets racial

Several other people brought up Zika, Ebola, Middle East Respiratory Syndrome, and Southeast Asian Respiratory Syndrome — all problematic names as well. (I do, candidly, wonder how many people realize Zika and Ebola are places in Africa). Several people pointedly asked if the West Nile River had its feelings hurt by the disease named after it. (For the record, it was named for the West Nile region in Uganda, in 1937.)

One critic–who’s not wrong, by the way–lamented that there’s been very little attention paid to the diseases that come out of Africa and the names they bear.

Unfortunately, that problem is bigger than myself. But, yes, the names of all of these diseases suggest that these places where white people don’t live are inherently dangerous.

But, before I move on, let me touch one last time on the name “Spanish” influenza. The virus may have come from Kansas, France, China, or somewhere else, but we can be pretty certain it didn’t originate in Spain. And one commenter suggested that people are trying to clear Spain’s reputation because Spain is “white.”

Not so fast. This is also an oversimplification. Spain–and the Spanish–may be considered white now, but at the beginning of the 20th century this wasn’t necessarily the case, especially in the United States.

The US had fought a war with Spain, and they were our bogeyman. Other European powers weren’t huge fans either–Spain, along with the Ottoman Empire, was a Mediterranean imperial remnant, one that peaked around 1600 and was limping along in decadence (from the verb “to decay”), refusing to join the modern world.

At the time, the US was also engaged in an internal debate about whether to admit southern Europeans–non-Protestants, mostly poorer–as immigrants.

The Spanish, Italians, and Greeks may not have been considered “of color” but they weren’t considered equal to the “superior European races” like Britons, French, Germans, or Scandinavians.

Did this play into the popularity of the name “Spanish flu?” Almost certainly.

Coronavirus and COVID-19

Which brings us to coronavirus.

How many times have you seen someone reference “bat soup” in relation to the origin of the outbreak?

We don’t know who patient zero was, or how they contracted the virus. Yes, they probably lived in Wuhan (or in Hubei province).

And, yes, the coronavirus was detected a few years ago in bats. Most humans who contract illnesses from bats are bitten or handle diseased animals.

Have you once seen it suggested that, say, a sanitation worker who found a near-dead animal might have been patient zero?

Have you seen it suggested that someone out camping or hiking for the weekend was bitten by an infected animal?

No. Of course you haven’t.

You’ve seen references to people eating bat soup, because a media outlet went to Wuhan, and, without any actual evidence, found a local market serving bat meat and identified it as the place where the disease came from.

Let’s set aside the fact that properly cooked meat doesn’t transmit disease.

The reference to “bat soup” is intended to reinforce the foreign-ness and other-ness of China. The virus came from there. It is theirs. It comes from their weirdness.

We have a long history of doing this in the West: presenting China, specifically, as the antithesis of all that is Western–disease ridden humans at their most primal (well, except for Africa, whose humanity we’re barely likely to even acknowledge).

The question of blame

Did the Chinese government bungle its response to the coronavirus outbreak? You betcha.

So did the UK government, the American government, and a host of others.

In 2015, the World Health Organization issued guidelines on the naming of diseases that recommended against the inclusion of geographic names in order to prevent the stigma of association for residents of the area.

So, when politicians insist on calling the virus “Chinese,” what are they hoping to accomplish?

When the American president crosses out “coronavirus” on his prepared remarks and writes “Chinese virus” in magic marker in letters so large they can be seen off-podium, what is he hoping to accomplish?

When the Secretary of State sinks a joint G-7 statement on the virus over the insistence that it be called “Wuhan virus,” what is he hoping to accomplish?

Whenever I pose this question, I keep seeing “China needs to take responsibility” as an answer.

If China needs to be held accountable, sue the Chinese government for reparations and damages.

Everyone knows the virus came from China. I, myself, have never denied this.

But my question stands: what is us calling it “Chinese” to each other supposed to accomplish?


[1] James Lind, An Essay on Diseases Incidental to Europeans in Hot Climates. With the Method of Preventing Their Fatal Consequences. (London: Printed for T. Becket and P. A. de Hondt, in the Strand, 1768).

[2] James Johnson, The Influence of Tropical Climates on European Constitutions : Being a Treatise on the Principal Diseases Incidental to Europeans in the East and West Indies, Mediterranean, and Coast of Africa (United States, 1824), http://catalog.hathitrust.org/Record/008886165.

[3] Arnold, Colonizing the Body, 11; M. N. Pearson, “First Contacts Between Indian and European Medical Systems: Goa in the Sixteenth Century,” in Warm Climates and Western Medicine: The Emergence of Tropical Medicine, 1500-1900, ed. David Arnold, The Wellcome Institute Series in the History of Medicine, Clio Medica 35 (Amsterdam and Atlanta: Rodopi, 1996).

The Curious Case of the Thomas Cook Hospital in Luxor

Over the weekend, the Thomas Cook company went bankrupt and shuttered operations, leaving hundreds of thousands of people stranded worldwide and searching for flights home.

A number of us Twitterstorians became particularly concerned about the impending demise of the company a few days ago when Ziad Morsy, a martime archaeologist and Ph.D. candidate at the University of Southampton tweeted that Thomas Cook’s historical archivist had lost his job.

The Thomas Cook company was 178 years old when it collapsed (just over a month before Britain may or may not exit the European Union–coincidences which have been commented upon elsewhere). Some of its history in relation to British imperial history was covered by another colleague in a Twitter thread yesterday:

Inasmuch as it’s easy to point to the Thomas Cook Company’s early days as those of a commercial company essentially making money off of the expansion of the British Empire, there are occasional glimpses at a richer and more complicated role for the company in various contexts (@afzaque covers several of them in his thread, which is worth a read).

It’s these sorts of things that make the potential loss of the company’s archive particularly painful, as it is one of those out-of-the-box sources for material that can shed startling new light on historical periods.

And hence, I present …

The curious case of the Thomas Cook Hospital

I ran across the hospital while writing the first two chapters of my dissertation, which wound up comprising a comprehensive history of public health in Egypt between 1805 and 1914 as one did not already exist. (Wanna publish it? It’s not going to be in the monograph.)

4472016022_01761fe8b9_z.jpg
The West Bank of the Nile, opposite Luxor, in 2010.

It was located in Luxor, a settlement that is notable mostly for what people were doing there thousands of years ago, as it is built on top of the ruins of what was almost certainly not known to its inhabitants as Thebes, but was one of the New Kingdom capitals of ancient Egypt. Across the Nile River, wide and lazily flowing at this point, is the pyramid-shaped hill that marks the location of the Valley of the Kings.

Given the numerous pharaonic sites that dot the landscape up and down the river from Luxor, Cook had the bright idea to utilize boat travel for wealthy tourists to visit them without the hassle of having to move constantly to new hotels every night. Luxor, at the epicenter, was the site of the train station from which Wagon-Lits and other operators operated sleeper trains to Cairo.

In 1890, Luxor was a small town — perhaps five thousand permanent inhabitants, which could swell as high as twenty thousand during tourist season when there was work to be had.

John Mason Cook–the son referred to in the company’s official name “Thomas Cook & Son” after 1865 — had the idea to open a hospital as early as 1887:

In 1887, he decided, driven by the reactions of rich foreigners–British, American, German–in the face of the unfortunate hygienic conditions of the local population, to construct a hospital. “Accomplished in 1891, inaugurated by the Khedive Tewfik Pacha, it comprised 26 beds (of which 8 were for women, 10 for men)*, the buildings well constructed, each isolated from the other, in a healthy and fortuitous position.”

*(no, this doesn’t equal 26).

Jagailloux, Serge. La Médicalisation de l’Égypte Au XIXe Siècle. Synthèse 25. Paris: Éditions Recherche sur les civilsations, 1986. (translation mine).

The hospital was co-directed by a Syrian doctor and an Englishman (only the latter–a Dr. Saimders–is named). Given that neither were in residence in Luxor in the off season (April to November), a third doctor–an Egyptian–was appointed to see patients in the off-season.

It was estimated that over 120,000 patients were seen, with over 2,000 operational procedures performed, in its first twenty years of operation. The hospital was presumably built primarily for the treatment of visiting foreigners, with Egyptians working in the tourist industry as a secondary priority.

_One_of_the_dahabeahs_of_Thomas_Cook_&_Son,_(Egypt)_Ltd._.jpg
“One of the Dahabeahs (sic) of Thos. Cook & Son Company (Egypt)”
Berlin: Cosmos art publishing Co., 1893.
Collection of the Brooklyn Museum

What is interesting is that, with Cook’s blessing, the hospital was opened to the public as well. In 1898, The Lancet enthusiastically reported that people were coming from over two hundred miles away to seek treatment at the facility. (“Egypt.” The Lancet 152, no. 3905 (July 2, 1898): 59.)

After the British occupation in 1882, funding for public health flatlined. Under Lord Cromer, the public health budget never exceeded 100,000 Egyptian pounds (at the time LE 1 = £0.95).

Hospitals in the provinces, which were already run down and developing a bad reputation among patients (most of them had been built in the 1840s), were frequently closed or moved to other, newer buildings that were not purpose-built to serve as hospitals.

The construction of private facilities was encouraged by the Anglo-Egyptian government; the government would not open new hospitals or dispensaries (a combination pharmacy/clinic used to supplement hospitals in smaller settlements) in towns that had “good” private facilities. Many of the hospitals were funded by local European communities to serve their own–Austro-Hungarians, French, Greeks, Italians, and Anglo-Americans all had their own facilities in Cairo and/or Alexandria, most of which referred their Egyptian patients to government facilities.

Hence, it is a point of curiosity for me as to what inspired John Mason Cook to open his hospital to the general public, especially given that his company did not lack for wealthy clientele to fill its beds.

It suggests that, even at the height of imperialism, with a company that can (and has) be considered an agent of an imperial power, things are never quite as simple as they might seem.

As I was writing this, Ziad tweeted me this tantalizing entry from the archival catalog:

Hence, the answer to my questions may lie in this box, whose future is now in doubt.

What you can do to help

If you’re one of us history types who has benefitted, or could benefit, from consulting the Thomas Cook archives, this thread has specific action items you can take to let people know that there is interest in saving the archive and not letting its contents be dispersed or destroyed.