Disease and the Digital Humanities

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A couple of months ago I gave a paper at The Charleston Conference, an annual meeting geared towards librarians, archivists, and publishers, that once in a while includes a token historian or two. I was on a panel organized by Wiley Blackwell titled “Transforming Research, and your Library,” which focused on problems of selecting archival content for digitization, and on the myriad uses of digital archives by students and scholars. See a write-up here.

In addition to being called an “end-user” (which I first took as a slur) for the first time, what surprised me most about the questions I received was how unaware the librarians, archivists, and publishers in the audience were about what I was doing with digital archives in the classroom and in my own research.

I am a historian of public health and epidemic disease, focusing on the nineteenth century and through the lens of Britain and the British Empire. As thematic approaches to interrogating the past, questions of health, disease, and medicine are particularly well-suited to new tools in digital humanities. Disease, of course, is not only a patient-experienced, subjective and narrative event, it is also a spatial, historical, and population level phenomenon, making the use of big data and visual data particularly appealing. There has been something of a groundswell in the history of medicine for integrating digital humanities, given steam most recently by a workshop I attended in 2016 at the National Library of Medicine, titled “Images and Texts in Medical History,” and seen in recent projects by medical historians-cum- digital humanists like Tom Ewing, who has been using visual data and mapping to analyze the Russian flu epidemic of the late nineteenth century.

My own use of digital tools in analyzing historical and archival texts has revealed two increasingly common axioms of our times; (1) that digital methodologies are best practiced alongside traditional methods of source analysis, and (2) that rather than provide new answers, digital tools are often most helpful to historians in asking new types of questions. Finishing a book on typhoid fever in Victorian Britain, for example, I’ve long known from archival research that the terms “typhoid” and “enteric” were used interchangeably, but unevenly in the nineteenth century, but I wasn’t exactly sure about the broader trends. Designing a Python script using 100 years of “data” from the British Medical Journal and the Lancet, I coded all uses of both terms, and in a minute or so I saw with some clarity the differing uses of the nosological terms in a much more nuanced way than a google Ngram. The finding didn’t exactly answer a historical question—in fact it was confirmatory— that had stumped me using traditional methods, but rather, led to a fascinating new query; why had the term ‘enteric’ been so popular in the British medical press from the 1870s to the 1890s?  

My latest use of digital tools is perhaps less esoteric, and hints at the kind of transformative ways that the intersection of digital humanities and the history of medicine can have real, tangible effects on public health and the study of disease.

I’m currently collaborating with an archivist and an epidemiologist to analyze a rare manuscript at the Waring Historical Library. “MSS 292: Report of Cases of Influenza” is a casebook compiled by Dr. J. Mercier Green, Charleston’s Health Officer, in 1918-19. What makes Green’s casebook so remarkable is that it contains ledgers and scraps of paper written by Charleston’s physicians, who sent to Green the names, dates, addresses, and the race of Charlestonians sick with influenza. Historical research on the most significant pandemic in modern global history has tended to focus on mortality (deaths) rather than morbidity (sickness), and on the public representation of the disease in the media—see, for instance, the University of Michigan’s Influenza Encyclopedia.

For the Charleston Flu Project, we’re admittedly tackling the spread of the epidemic in one U.S. city, but given the remarkably in-depth nature of Green’s manuscript and the ‘data’ therein, our goal is to both digitize the content, which will be useful for historical and genealogical research, and also to build a GIS map to visualize and model flu sickness in Charleston. For practicing epidemiologists such a morbidity model, when combined with existing mortality models as well as genomic sequencing of influenza viruses, has the potential to be at the cutting edge of epidemic preparedness in public health.

Decades ago historians William McNeill and Alfred Crosby made the cogent argument that disease has been a central actor in historical change, a view so commonplace today that its premise is rarely even debated. Yet new tools in digital humanities are changing the way that we think about disease in the longue durée of human history.