AIDS and Its Metaphors

Plague” is the principal metaphor by which the AIDS epidemic is understood. And because of AIDS, the popular misidentification of cancer as an epidemic, even a plague, seems to be receding: AIDS has helped to divest cancer of much of its aura of shame, of the unspeakable.

Plague, from the Latin plaga (stroke, wound), has long been used metaphorically as the highest standard of collective calamity, evil, scourge—Procopius, in his masterpiece of calumny, The Secret History, called the Emperor Justinian worse than the plague (“fewer escaped”)—as well as being a general name for many frightening diseases. Although the disease to which the word is permanently affixed produced the most lethal of recorded epidemics, being experienced as a pitiless slayer is not necessary for a disease to be regarded as plague-like. Leprosy, very rarely fatal now, was not much more so when at its epidemic height between about 1050 and 1350. And syphilis has been regarded as a plague—Blake speaks of “the youthful Harlot’s curse” that “blights with plagues the Marriage hearse”—not because it killed often but because it was disgracing, disempowering, disgusting.

It is usually epidemics that are thought of as plagues. And these mass incidences of illness are understood as inflicted, not just endured. Considering illness as a punishment is the oldest idea of what causes illness—an idea opposed by all attention to the ill that deserves the noble name of medicine. Hippocrates, who wrote several treatises on epidemics, specifically ruled out “the wrath of God” as a cause of bubonic plague. But the illnesses interpreted in antiquity as punishments, like the plague in Oedipus, were not thought to be shameful, as leprosy and subsequently syphilis were to be. Diseases, insofar as they acquired meaning, were collective calamities, and judgments on a community. Only injuries and disabilities, not diseases, were thought of as individually merited. For an analogy in the literature of antiquity to the modern sense of a shaming, isolating disease, one would have to turn to Philoctetes and his stinking wound.

The most feared diseases, those that are not simply fatal but transform the body into something alienating, like leprosy and syphilis and cholera and (in the imagination of many) cancer, are the ones that seem particularly susceptible to promotion to “plague.” Leprosy and syphilis were the first illnesses to be consistently described as repulsive. It was syphilis that, in the earliest descriptions by doctors at the end of the fifteenth century, generated a version of the metaphors that flourish around AIDS: of a disease that was not only repulsive and retributive but collectively invasive. Although Erasmus, the most influential European pedagogue of the early sixteenth century, described syphilis as “nothing but a kind of leprosy” (by 1529 he called it “something worse than leprosy”), it had already been understood as something different because it was sexually transmitted. Paracelsus speaks (in Donne’s paraphrase) of “that foule contagious disease which then had invaded mankind in a few places, and since overflowes …

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