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This concluding chapter looks at some of the big issues that remain in nutritional biology. Exploding protein into its constituent amino acids means having to deal with 19 extra dimensions, which is fine in theory but daunting in practice. However, such an expansion is what will be needed to understand the mechanisms of protein appetite, the role of protein in aging, obesity, and immune function, or the behavioral and metabolic consequences of replacing marine-based animal proteins with plant-derived alternatives in the diets of farmed fish. The next step will be to associate primary response variables such as life span, disease susceptibility, and fecundity with associated physiological, metabolic, and geometric responses. Other issues include nutritional epigenetics and early-life prevention of metabolic disease, human obesity, nutritional immunology, and modeling nutritional interactions.

Traditional Chinese medicine (TCM), which has had a reassuring effect on Western nations, came from China and some parts of Japan and Korea. The Chinese were needed as technicians in Western private clinics. There, they were skilful helpers. However, the fears of the citizens of industrialized Western nations were foreign to them. Tailoring so-called Chinese medicine to these fears is something they could not and perhaps still cannot manage. Modern immunology offered enough of war in the humans' bodies, not so much by the immunologists themselves, but by their interpreters: science journalists. For most people, the encounter with a potentially fatal illness is the most existential threat there is. No one wants to experience war in their own house, much less in their own body. At a time of existential fear, what is wanted is to feel warmth, empathy, and harmony. This is what TCM offers. It seems reassuring.

This chapter focuses on the epidemiology of infectious diseases. By the end of the 19th century, the significant role of microorganisms in many diseases of humans and other species was incontrovertible. The ground had been prepared for the enormous strides in the understanding of infectious diseases, especially with respect to agent and host, which followed in the 20th century. The unraveling of the nature of microorganisms and their role in disease, the mechanisms of immunity, recognition of the existence of viruses and their dependence on living matter for survival, led to the scientific development of the virtually new discipline of molecular immunology, to the rising potential for the control of microorganisms, and ultimately to paradigmatic shifts in the practice of public health. Having faced, understood, and at last found means to quell such great scourges as smallpox, the plague, syphilis, cholera, and typhoid, the major threats posed by infectious disease seemed to have subsided. Late in the 20th century, however, newly emerging diseases, and the human immunodeficiency virus (HIV) in particular, challenged medicine and the public health anew.

Advances in molecular biology over the last decade have enabled researchers to identify and characterize microbial partners that live in association with animals. These data have indicated that symbiosis is the rule rather than the exception among animals and that interactions with microbes are essential for animal health. This chapter focuses on what we have learned about how such associations influence animal developmental programs. The chapter first considers the‘fingerprin’ of evolutionary circumstances on development of particular animal features. Specifically, the selective forces that have shaped the development of form and function of the immune and digestive systems over evolutionary history are likely to have been strongly influenced by the radiation of animal phyla in the microbe-rich marine environment. The subsequent sections of the chapter consider what biologists have learned and are learning about how microbes influence each stage of development, from the egg through maturation to the adult animal. Particular emphasis is placed on recent findings on the impact of symbiosis on gut development, immunology, brain development, and normal behaviour of the animal host.

This chapter discusses microbiology in China's early twentieth century. In contrast to other narratives, the emergence of microbiology as a discipline in China during the early twentieth century did not rely on any single organization, charismatic leader, or colonial influence. Instead, multiple institutes and universities in Beijing, Nanjing, Shanghai, and other cities emerged as centers for research, and a small group of highly educated physicians and scientists participated in global research networks, even as they trained Chinese students and advised local health administrations. In the 1920s and 1930s, emerging fields such as immunology, virology, and bacteriology were identified with broader categories of inquiry, such as the medical sciences or microbiology. In addition to laboratory research, Chinese researchers translated new terms into Chinese and established professional organizations. Although research programs in microbiology were productive, their applications to public health were limited to specific projects in major cities. One important urban institution was the National Epidemic Prevention Bureau. After its 1919 establishment in Beijing, the bureau became a center for vaccine production and sponsored limited urban immunization campaigns. The outbreak of formal war with Japan in 1937 and the subsequent move of many researchers to the southwest disrupted the development of microbiology in China. Yet it also created opportunities for new cooperative relationships to form in the field of public health.

This chapter examines the immunological community that formed at Kunming, reconstructing a world that pulled its members from local health administrations, research laboratories, medical school clinics, and local factories. This diversity of perspectives and actors accords with recent trends toward understanding immunology in the context of medical practice and production as well as within the laboratory. It also helps articulate the involvement of researchers and medical workers in health initiatives that supported state-building processes. The sera and solutions they produced required distribution to populations often unfamiliar with the techniques of vaccination, and orders to immunize encompassed both coercive and persuasive methods. The increasing use of force to compel vaccination reflected the growing power of the Nationalist state—especially at provincial and national borders, where the examination and enforcement of immunization requirements contributed to the increasing control of political authorities. It also suggested the significance of biological characteristics such as one's immunization status in shaping individual rights and freedoms to travel.

This epilogue discusses that by the end of the socialist period in 1978, a new generation of immunologists and bacteriologists was beginning to rise to prominence, although the Cultural Revolution had broadly impeded and delayed education in this field. Many founding figures in modern Chinese immunology were by this time retired or dead. Despite the erosion of many programs that had delivered vaccines and other health services to large rural populations, mass immunization has continued after the economic reforms of the 1980s as a mandatory, regular practice of childhood health in China. A baby born in the People's Republic of China, much like their counterparts in the United States and Europe, is given a battery of mandatory shots by the age of two that provides protection against diphtheria, tetanus, pertussis, measles, mumps, rubella, and other illnesses—and including the BCG and oral polio vaccines. These vaccinations are administered against a backdrop of growing environmental crisis and rising pharmaceutical safety concerns. By 2010, however, cancer, respiratory disease, cardiovascular disease, and other chronic illnesses replaced infectious diseases as the primary causes of death. China's twentieth century thus saw a remarkable transformation in causes and scales of mortality. The establishment of a universal, mandatory immunization system in the mid-twentieth century helped make that transformation, and its surveillance, possible.

This chapter talks about certain observations and conclusions arrived at through the study of ecological immunology. The rate of parasitism and the level of immune response, for example, are often varied among individuals and populations. This variation, however, can be explained by ecological or demographic factors. The chapter also looks at the various costs that immune defences incur, including the cost of evolving and maintaining a defence, and the cost of using defence. It looks at the limiting resources for immune defences – energy, food, and nutrients – and how the capacity to immune-defend affects host fitness, where organisms face the problem of how to allocate their limited resources to defend, versus other demands, in order to achieve a maximum possible fitness. Finally, the chapter looks at the various elements of defence, namely resistance and tolerance. Resistance is where hosts reduce parasite numbers, while tolerance is where the damage caused by the infection is limited.

This chapter focuses on Niels Jerne's visit to California. Adda was accompanying him, but the children, now aged twelve and eighteen, would remain in Denmark, and the apartment on Amaliegade would be rented out. His many books and Tjek's paintings made the apartment Jerne's umbilical cord to Denmark and a reflection of his life history:“Don't let it catch fire,” he allegedly said when leaving, “because if it catches fire I don't come back—this is my life.” He had looked forward to discussing his selection theory with Max Delbruck during the transatlantic crossing, but nothing came of it. Delbruck is supposed to have defended himself by saying that he could not discuss immunology because he didn't know anything about the subject, at which point Jerne began to ask himself why Delbruck wanted him in California at all.

This chapter shows how Niels Jerne viewed the Paul Ehrlich Institute. To him, it was an “ancient institute” where most people went home at four in the afternoon and almost nobody carried on any research alongside the work of standardization and testing: “They didn't want to do science at all.” He therefore set to work on a major housecleaning—to throw aside the traditional German academic hierarchies and rituals that stood in the way of his mission to modernize European immunology. He wanted to establish an institute where, as a younger assistant expressed it, you “could ask any question” and where “nothing was considered stupid.” The memorial hall, devoted to the memory of Paul Ehrlich, was converted to a seminar room where Jerne held an “antibody workshop” with his new colleagues under the heading “Continuation of the Discussion, Opened by Professor Ehrlich, on Antibodies and Their Formation.” .

This chapter describes the enormous efforts Niels Jerne had invested in setting up the Basel Institute for Immunology. Some questioned whether Jerne would be able to continue without establishing a more hierarchical organization. John Humphrey thought his friend was running the institute as “a scientific commune,” with the Taborites and the Levellers as models, and imagined, as an inevitable outcome, that “sooner or later a pyramidal structure will evolve.” However, Jerne was to remain in Basel almost ten years and would hold firmly to his vision of the communicative network in which everyone was to participate in the intellectual life. For many years, even the laboratory technicians took part in the research seminars and were generally given significantly greater responsibility for their work assignments than was customary, especially in comparison with their Roche counterparts.

This chapter focuses on the time of Niels Jerne's retirement, after more than a decade as director of the Basel Institute. Roche asked Fritz Melchers, who had been at the institute almost since its start, to take over the post. Jerne was sixty-eight years old, and despite two or three packs of cigarettes a day and ever increasing alcohol consumption, he was still in full vigor. For about a year, he functioned as conseiller general of the Pasteur Institute's new Department of Immunology, but he was not comfortable there. Instead he moved permanently to his summer residence in Languedoc with his young wife, Alexandra, who for many years had lived alone for long periods in Chateau de Bellevue. In France, he had more time to read, as usual on the most diverse subjects—everything from Marshall Berman's Marxist critique of modernity, All That Is Solid Melts into Air, to Nicolas Schoffer's La theorie des miroirs, a book that reinforced his vision of the immune system as an endless hall of mirrors.