Maxime Schwartz, How the cows turned mad, transl. Edward Schneider, Berkeley and London, University of California Press, 2003, pp. viii, 238, £17.95 (hardback 0-520-23531-2).

Abstract

Billed as a “detective story” that “illuminates the remarkable progression of science”, How the cows turned mad is the English translation of a French text by Maxime Schwartz, molecular biologist and former head of the Institut Pasteur, Paris. Schwartz goes beyond existing histories of Bovine Spongiform Encephalopathy (BSE or “mad cow disease”) to consider the growth of knowledge about related diseases, which since the 1960s have been grouped together under the heading Transmissible Spongiform Encephalopathies (TSEs). These include scrapie in sheep, Creutzfeld Jacob Disease (CJD) in man, and kuru, a disease of cannibalistic Papua New Guinea tribesmen. To Schwartz, TSEs are “the disease”, and BSE, CJD, kuru and scrapie are the different “guises” that it has adopted in a bid to escape scientific detection. Starting in the eighteenth century, he moves effortlessly over time and space, tracing its diverse clinical and pathological manifestations. He describes how late nineteenth- and twentieth-century advances in bacteriology, genetics, biochemistry and molecular biology enabled European and American scientists to make important discoveries that contributed to the understanding of disease aetiology, pathology and epidemiology. He also recounts how, in recent years, the consumption of BSE-infected meat and the use of contaminated human growth hormone preparations has given rise to CJD in young adults, and asks whether, in the light of concurrent scientific knowledge, such tragedies could have been avoided. The English translation of this text is brought up to date with a new chapter, which describes the events and discoveries of the year 2001. In conclusion, the author identifies several impediments to the growth of knowledge about “the disease”: its elusive behaviour; the existence of disciplinary and professional barriers which meant that scientists were often unaware of relevant work undertaken in another field; and the fact that scientists' findings, in suggesting that an infectious protein (prion) caused “the disease”, ran counter to accepted scientific thought. Written for a lay audience in the year 2000, when BSE and CJD were subject to widespread media attention, Schwartz's aims were two-fold: to educate readers, so enabling them “rationally [to] assess the often alarmist information” that came their way, and to celebrate the successes of modern science. It is impossible to assess whether he has managed to dispel fears about BSE and CJD, but in his second goal he has largely succeeded. This is a concise and extremely readable account, which provides a good overview of the growth of knowledge about TSEs and renders accessible some extremely complex scientific information. As such, it is a good starting point for anyone wishing to learn more about the nature of these unusual diseases, although the bibliography is limited, and the reader may find irritating Schwartz's portrayal of “the disease” as a sentient being that has repeatedly tried to evade capture. Historians, however, will find this work rather less useful. The author's retrospective narrative runs counter to mainstream academic history of medicine, as does his celebration of scientific heroes and their discoveries, and his imposition of a present-day disease category upon the past. In confining his attention to the science of “the disease”, Schwartz mentions but does not address the controversies that surrounded it and so neglects its immense political, economic and cultural significance. There is also much scope for deepening his analysis of how scientific dogma and disciplinary boundaries have influenced not only the growth of scientific knowledge but wider perceptions of and responses to the TSEs. That said, Schwartz's book is a good departure point for future studies, and it is to be hoped that historians will succeed as well as he in popularizing this extremely important subject.