Technology and Culture

124 Book Reviews TECHNOLOGY AND CULTURE is not so, since not all pests are amenable to one or the other method, and many factors enter into the selection of a particular pest manage­ ment strategy. Regardless of the flaws, which are relatively minor in the context of the overall value ofthe work as a resource document, I recommend the book very highly. It will be of special interest to entomologists but should also appeal to environmentalists, state and federal agricultural administrators, and many others. J. E. Gilmore* Cholera: The American Scientific Experience, 1947—1980. By W. E. van Heyningen and John R. Seal. Boulder, Colo.: Westview Press, 1983. Pp. xvi + 343; illustrations, tables, notes, references, index. $27.50. 'Phis history is told by two participants in the century-and-a-halflong effort to understand and treat cholera. John Seal held a number of administrative posts at the National Institute of Allergy and Infec­ tious Diseases and is currently employed at the Preventive Research Institute of the National Institutes of Health, and W. E. van Heynin­ gen, noted biochemist specializing in bacterial toxins, is professor emeritus of bacterial chemistry at Oxford University. Late-19th-century success in identifying the disease-causing prod­ ucts (toxins) of the microbes that produce diphtheria, tetanus, and botulism encouraged biological scientists to hypothesize and probe for the cholera toxin. It was discovered seventy-five years later. The details ofthis long search are presented in chapter 2, which is a fine synopsis of the scientific and technological aspects ofcholera bacteriology up to the modern period. The cholera bacillus and toxin never became significient in treating people who contracted the disease, especially during the seven major cholera epidemics that occurred after 1832. Rather, simple techniques applied on a large scale—a technology of treatment in the sense that these techniques grew out of a scientific understanding of the effect but not the cause of the disease—saved the lives of millions of cholera victims. While the search for the toxin continued, specialists in the study of cholera evolved treatments that proved effective, even though they *Mr. Gilmore is director of the Tropical Fruit and Vegetable Research Laboratory of the USDA’s Agricultural Research Service, heading a team of fourteen scientists in research to develop pest management strategies for suppression/control/eradication of four species of tropical fruit Hies in Hawaii. His publications deal primarily with fun­ damental biology, control, and management strategies of citrus and deciduous fruit insect pests, and fruit flies. TECHNOLOGY AND CULTURE Book Reviews 125 could not explain the toxicological mechanism. The immediate prob­ lem created by a cholera attack is the loss ofvast amounts ofbody fluids from the digestive tract. Those caring for cholera patients replaced the fluid intravenously with an appropriately mixed solution containing salts. When fluids were injected into the bloodstream during the attack, the patient was sustained until the disease subsided. Earlier experience extending back to the 19th century had indicated that fluids given by mouth would be expelled or promote more diarrhea. However, if fluids continued to be given long enough to rehydrate the body, the cholera would eventually decrease and the patient recover. Until the biochemical basis of this method of rehydration was reinterpreted in 1963, cholera patients treated in hospitals were administered fluids only through a vein, in spite ofthe extreme thirst they suffered (caused in part by the salts they were given). In 1963 it was discovered that water could also be given to quench the thirst, thus sparing patients many uncomfortable hours. The discovery of the rehydration method of treating cholera not only provided a simple, effective, and relatively inexpensive technol­ ogy to cope with this disease; it also led to research and treatment programs designed to control a variety ofother diarrheal diseases that affect and kill millions of infants each year in Asia, Africa, and Latin America, and are the sixth most common cause ofdeath in Europe and North America. Controlling a disease as quickly devastating as cholera has depended on the fortitude and determination ofmany American, British, Indian, and Japanese scientists supported largely by government grants, many of them sponsored by the United States. The fear that cholera would spread to Western nations or...