Remembering and Honoring Anti-Miracles

During my recent sickness with COVID [1], I had some time to contemplate the amount of collective misery infectious diseases have inflicted on humans throughout history. My conclusion is, A LOT. An incomprehensible amount of suffering and misery. And that's not even counting the misery inflicted by infectious diseases of livestock or crops that result in hunger and economic loss. Amazingly, it has only been in the last 150 years or so that we have understood the causes of such diseases, and even more recently how to combat (some of) them effectively. Such knowledge and progress has been hard-won, and yet I am sometimes alarmed at how little value some people place on that knowledge. Clean water and sanitation, vaccines, and antibiotics have changed our world. I am especially disturbed when people think that faith in God can substitue for effective public health policies and medical care. It's like they are entirely ignorant of history--even recent history--and more to the point, Church history.

I've been reading through the Church's new Saints series on the history of the Church. The books describe a number of miraculous experiences in the history of the restoration, but I have been impressed that they also tell of what we might call anti-miracles. Many of these involve infectious diseases. Here are some examples I've collected.

Volume 1:

As the Camp of Israel disbanded, a devastating outbreak of cholera attacked its ranks. Saints who had been healthy only hours before collapsed, unable to move. They vomited again and again and suffered intense stomach pains. The cries of the sick filled the camp, and many men were too weak for guard duty... Joseph and the elders in camp gave blessings to the sick, but the disease soon struck many of them as well. Joseph fell ill after a few days and languished in his tent, unsure if he would survive. When people began to die, Heber Kimball, Brigham Young, and others wrapped the bodies in blankets and buried them along a nearby stream. The cholera ran its course after several days, clearing up in early July. By that time, more than sixty Saints had fallen sick. Joseph recovered, as did Nancy, Eunice, and most people in the camp. But more than a dozen Saints died during the outbreak, including Sidney Gilbert and Betsy Parrish, one of the few women in the camp. [p. 198-199]

Malaria was a problem in Illinois. After describing Joseph's miraculous healing of Elijah Fordham:

Joseph’s efforts to bless and heal the sick did not end the spread of disease in Commerce and Montrose, and some Saints perished. [p.376]

Volume 2:

Some of the challenges at Winter Quarters and other temporary settlements were impossible to avoid. By the time cold weather set in, over nine thousand Saints lived in the area, including thirty-five hundred who lived in Winter Quarters. Accidents, sickness, and death plagued every settlement. Malaria, tuberculosis, scurvy, and other illnesses claimed about one person in ten. About half of the deceased were infants and children. [p. 37]

During one of the westward migrations:

The elders in the camp fasted and gave blessings of healing and comfort to the sick, but cholera continued to claim more lives. Near the end of June, Jacob himself became too sick to keep up with the wagons. Other company leaders sent a carriage back for him, and when he rejoined the camp, the elders blessed him. His health continued to worsen, however, and he died on the afternoon of July 2. [p. 193]

In Hawaii:

One morning in February 1887, little Jay came down with a fever and a cough. At first, Susa and Jacob assumed it was a cold, but the symptoms got worse over the next week. They cared for Jay as best they could and called in Joseph F. Smith and others to bless him. Susa marveled at the faith exercised in behalf of her son. But Jay did not get any better... Jay did not improve, and that afternoon, he fell peacefully asleep and then passed away just before two o’clock. Susa’s grief was inexpressible, but she had barely begun mourning when Karl came down with the same sickness. As he grew worse, the Saints from around Laie fasted and prayed, but nothing helped. The family was placed under quarantine to prevent the spread of the disease, and Karl died soon after. [p. 493]

Volume 3:
This is a tragic but instructive story that I first encountered in Thomas Alexander's Mormonism in Transition. It's not about infectious disease, per se, but still involves microbes. I was pleasantly surprised to see it included in Saints. It involves Hyrum M. Smith, an Apostle and son of President Joseph F. Smith (and grandfather to M. Russell Ballard, current Acting President of the Quorum of the Twelve Apostles).

Hyrum’s sickness became more serious with each passing day. He felt severe pain in his abdomen, a sign he had appendicitis. His friends urged him to go to the hospital for an operation, but he refused. “I have kept the Word of Wisdom,” he said, “and the Lord will take care of me.” On January 19, the pain became almost unbearable. Hyrum’s wife, Ida, notified Joseph immediately, and he prayed earnestly for his son’s recovery. Apostles Orson F. Whitney and James E. Talmage, meanwhile, joined Hyrum at his bedside and watched over him during the night. A group of doctors and specialists, including Dr. Ralph T. Richards, Joseph’s nephew, also attended him...[Eventually he was pursuaded to go the hospital.] At the hospital, the doctors took two x-rays and decided to remove Hyrum’s appendix. During the procedure, Dr. Richards discovered that the appendix had ruptured, spreading toxic bacteria throughout Hyrum’s abdomen...

Hyrum survived the procedure, but Joseph remained weak with anxiety and spent the afternoon lying down, unable to eat. Hyrum seemed to gain strength that evening, which lifted Joseph’s spirits. Filled with gratitude and relief, he returned to his duties as Church president. Then, three days after Hyrum’s surgery, Joseph received a telephone call from the hospital. Despite many prayers and the careful work of the doctors, Hyrum had passed away... A cloud of sorrow hung over the Smith family in the days after Hyrum’s death. There were Saints questioning his decision not to go immediately to the hospital. “If he had gone when first spoken to,” some said, “he might have lived.” Presiding bishop Charles Nibley, a close friend of the family, agreed. Hyrum’s faith in the Word of Wisdom was well intentioned, he noted, but the Lord had also provided skilled men and women who were scientifically trained to care for the body. [p. 272-273]

The lesson of these anti-miracles, in my opinion, was once expressed by Elder Boyd K. Packer.

The very purpose for which the world was created, and man introduced to live upon it, requires that the laws of nature operate in cold disregard for human feelings. We must work out our salvation without expecting the laws of nature to be exempted for us. Natural law is, on rare occasions, suspended in a miracle.

We can choose to be wise and use our knowledge and technology to help protect us from negative effects of natural laws, or we can leave ourselves vulnerable to their operations. But what we cannot do is expect or believe that faith in God, alone, will save us from their consequences. The few examples above illustrate that much. Remembering such anti-miracles reminds us that health is naturally fragile, and we honor them when we choose wise practices and policies that weren't available to our forebearers.

Notes:
1. If you want gory details of my illness, continue reading. I was fully vaccinated and boosted previously, but the updated vaccines weren't yet available. I had a few days of feeling something going on in my nasopharynx, but figured it was just allergy or a light cold. That changed when I woke up in the middle of the night with a fever of 101 F. I did a rapid antigen test, which was positive for COVID. The next 36 hours were miserable. I had to take ibuprofin every 6 hours to keep the fever somewhat in check, otherwise I was cold and feverish. I fortunately did not have a headache or lose smell/taste, but I had various aches within my abdomen. I also pretty quickly developed a sore throat, which made it painful to swallow. That's bad enough for eating and drinking, but when you are coughing up phlegm and having to swallow it, it's insult to injury. My abdomen made all kinds of noises. The collected misery, pains, and noises made it difficult to sleep. Fortunately, the worst of the fever symptoms ended after about 36 hours. I thought about people earlier in the pandemic who suffered fever for days on end, and I recalled news articles about people who were cavalier about the disease and ended up in the hospital surprised at how very sick they were. I felt fortunate that wasn't me, but at times the warning in D&C 19 went through my mind, "how hard to bear you know not." I speculate that the acute fever was relatively short due to prior vaccination, but I wasn't out of the woods. All of that abdominal activity progressed to diarrhea that lasted several days. Meanwhile, my cough, sore throat, and general fatigue and sickness continued. Although I was out of the acute fever, it seemed like any place of pressure on my body would cause sweating and I had some impressive night sweats. I awoke one night astounded at how soaked my pajama bottoms were below the knee. It was almost as if I had been wading in a stream. Sleep was not entirely restful, as I would usually wake up in the night and have trouble going back to sleep. Sometime after the acute fever, I developed a decent cough that made sleep more difficult. Along the way I had variable appetite and tried to keep myself hydrated, but the persistent sore throat didn't help. Theoretically I was able to stop isolating after 5 days, but I was still strongly positive by rapid antigen test. I finally tested negative at 10 days, at which point my sore throat finally let up. By then I had lost 10 lbs. When I looked at how the CDC defined mild, moderate, and severe cases, I was surprised to find that I seemed to fit the mild definition. Mild is not the word I would use to describe my experience, especially the first couple of days, but I never needed to seek medical care so I guess from that perspective it's appropriate. Fortunately, I'm mostly recovered. I still have a bit of a lingering cough, but otherwise I feel fine and have returned to my exercise routine. I lived in isolation from the time I tested positive to testing negative, so was able to keep it to myself. While I guess all's well that ends well, it was not a fun journey and I recommend trying to avoid it.

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Should Tea Be Allowed in Africa?

The history of Word of Wisdom observance in the Church is more interesting than you might expect. Many members are not aware that the uniformity of observance that is one of our most distinctive practices is a twentieth-century development that occurred primarily during the Joseph F. Smith and Heber J. Grant administrations. The story of this development is told in Thomas Alexander's classic treatment, "The Word of Wisdom: From Principle to Requirement [PDF]." However, the idea that the Word of Wisdom was not viewed as important before then goes too far in the other direction, according Paul Hoskisson's article last year in the Journal of Mormon History, "The Word of Wisdom in Its First Decade" [paywall]. Nevertheless, the strictness of observance did fluctuate within Joseph Smith's lifetime.

As part of his discussion, Hoskisson carves out two main exceptions to the Word of Wisdom: sacrament and medicine. When wine was used as part of the sacrament, it was obviously not viewed as a violation of Word of Wisdom observance. Similarly, medical exceptions were also tolerated, though not specifically recognized in D&C 89.

Even as late as the 1950s and early 1960s, I can remember faithful Latter-day Saints speaking of the medicinal use of tea and coffee. I have also heard anecdotal reports that some members continued to excuse their use of alcohol for medicinal purposes well into the second half of the twentieth century. Certainly statements about the medicinal value of prohibited substances reflect the generally held beliefs of members in Kirtland, Missouri, and Illinois.

Today in the Church the medical justification for breaking the Word of Wisdom has been severely restricted. I have not yet determined just when the medicinal loophole was tightened. Neither am I aware of any official Church prohibition today against legitimate medicines that contain the same active ingredients that are found in coffee, tea, and alcohol....

In short, from the date the Word of Wisdom was received in 1833, until at least the end of the nineteenth century, the Church seems to have implicitly or explicitly recognized two exceptions to strict abstinence—sacramental and medicinal—both of which were eventually eliminated or severely restricted.

(Fun Church history fact: A later example of the medical exception was when James E. Talmage temporarily took up cigar smoking, by order of the First Presidency.)

With this as background, I was interested to read an article on Slate.com a few days ago about wormwood tea as an anti-malarial. Medical authorities are worried that its widespread use could cause more harm than good by generating resistance to a class of anti-malarial drugs, but from a consumer point of view it's a no-brainer because it's cheap and easy.

The fact is that most traditional herbal remedies are probably useless, potentially dangerous, and will only delay a person’s efforts to seek proper medical treatment. But some herbs do have medically active compounds, albeit with varying levels of efficacy, and Africans are choosing to go that route because they know that drug supply won’t be cut off by war or corruption or bureaucratic incompetence. Herbs are not always going to be the right strategy, but the data about these unconventional interventions should be shared and discussed.

Let's put aside the question of what the best public health policy is. Would wormwood tea be prohibited by the Word of Wisdom? I'm not any kind of tea expert, but Wikipedia tells me that regular tea comes from Camellia sinensis, while wormwood is entirely different: Artemisia absinthium. So maybe on that basis it would not be considered prohibited. On the other hand, there's that T word. Maybe someone with more international Church experience than me would know.

Whatever the case, this seems like a worthy exception to the Word of Wisdom. The Word of Wisdom was made for man, not vice versa.

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Science and the Word of Wisdom

When it comes to scripture being ahead of science, the Word of Wisdom (WofW) (D&C 89) is one of the first examples that comes to mind, in part, because of its iconic status. The ill effects of alcohol and tobacco are well established, and the prescription of grains, fruits, vegetables, and limited meat are in line with modern recommended dietary guidelines. It seems like a slam dunk example of scripture leading science, and it is often touted as such. However, it's a little more complicated than that.

As a historical matter, the Word of Wisdom was not really revolutionary for its time. It came amidst a temperance movement that made similar recommendations. Further, Lester Bush [1] has shown that it also matched the leading medical opinion of the time quite well. This is not because the physicians of the time suspected that, say, tobacco could cause cancer (a claim not made by the WofW either), but because the cause of disease was understood differently and the proscribed substances were thought to be contributing factors.

It might be argued that the endorsement of fruits and vegetables, with moderation in meat, was ahead of its time, but I don't think this is necessarily the case for two reasons. First, this counsel also matched medical opinion of the time (particularly the emphasis on seasons), but for reasons different than one would think today. Second, well, what else were the Saints going to eat? The dietary guidance of the WofW was basically what most of humanity had been doing since its beginning (or at least since the invention of agriculture).

There are also a couple of places where the WofW does not match current science, or does so tenuously. Tobacco is an interesting case. Long used in Native American folk medicine, it became a prominent medicinal treatment in European and colonial American medicine. In fact, it came to be viewed by some as a panacea and the list of ailments that it was alleged to cure--including bruises--was long. Although its use had been controversial for some time, the tide of enthusiasm for it began to turn in earnest in the nineteenth century. Nicotine was chemically isolated by chemists Posselt and Riemann in 1828 (five years before the WofW) and thereafter it's medicinal use came under sustained attack [2].

As for its endorsed uses, a search of Pubmed for references to tobacco and bruises did not turn up any relevant articles. Apparently BYU professor Rulon Francis found that bruises in rats treated with tobacco juice healed 20% faster. This finding was highlighted in the New York Times (Apr 28, 1981), but the story appears to end there. Although Francis published his method for bruising the rats, he does not appear to have published his tobacco findings. Thus the evidence for bruise-healing properties of tobacco is preliminary at best. The WofW also directs the use of tobacco for "all sick cattle," which is quite an inclusive category and recalls the reputation of tobacco as a panacea. Bush found that, historically, the use of tobacco in cattle was much less common than its use in horses. At any rate, whether or not tobacco would effectively treat any cattle ailments, a literal interpretation holding that tobacco is good for all sick cattle just isn't tenable.

Finally, the WofW prescribes various grains for livestock, including "rye for the fowls and for swine." However, as Steve Peck brought to my attention in his post, No death before the rye, chickens do not do well on diets heavy in rye. A little Internet searching turns up the reason: rye contains substances that interfere with digestion. Additionally, both swine and poultry find rye to be less palatable than other grains.

Before ending I should clarify that the question of whether the WofW was scientifically novel is largely a separate question from whether it was inspired. At the time it was given there were already socially and medically-based reasons to think that the proscribed substances were "not for the body, neither for the belly," and that grain and fruit were good. In most of these cases our modern knowledge has added to or replaced the old reasons, magnifying the inspiration in our eyes. Further, the WofW does not spell out any reasons for its recommendations other than that it is given "in consequence of evils and designs which do and will exist in the hearts of conspiring men in the last days."

So to summarize, although portions of the WofW have been borne out by modern science in a dramatic way, the WofW was not scientifically novel for its time and cannot be said to have--to paraphrase John Walton--offered a novel scientific perspective at the time. In coming to this conclusion, it's important to recognize that we are addressing a narrow question that has little to do with its revelatory basis and relevance today.


Notes:

1. Lester Bush (1981), The Word of Wisdom in Early Nineteenth-Century Perspective [PDF].

2. Grace G. Stewart (1967), A history of the medicinal use of tobacco 1492-1860.

See also:

Anne Charlton (2004), Medicinal uses of tobacco in history.

Word of Wisdom in the Encyclopedia of Mormonism

Michael Ash (2000), Up in Smoke: A Response to the Tanners' Criticism of the Word of Wisdom

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