Friday, 28 August 2015

Lady Mary Wortley Montagu and Smallpox Inoculation

The first "vaccine"-- before the word "vaccine" was invented was inoculation for smallpox, using actual pus from smallpox  pustules. The practice, by varying methods, seems to have been in use well before western medicine took notice of it. Knowledge of the procedure spread to western medical men from several sources during the early 18th century, including China and Africa.

The most influential source was reports of the practice in the Ottoman Empire. The most famous conveyor of the knowledge was Lady Mary Wortley Montagu, whose husband was British ambassador to the Sultan for several years in the 1710s. She had her children inoculated. (Shown here with her son and in "Turkish" dress.)

Lady Mary's reports and encouragement helped lead to a series of  experiments in London with the procedure in the 1720s. One of the most important involved the inoculation of the children of Princess Caroline of Anspach, wife of the future George II.

The princess was no doubt influenced by the death from smallpox of Queen Mary, wife of William III, in 1694 (William and Mary).

The success of these experiments, combined with news of similar successes in America promoted by Rev. Cotton Mather of Massachusetts and others, led to the practice becoming common in the British Empire by the mid-18th century. (Image: Cotton Mather)

The procedure was not without its dangers. About one percent of those inoculated died. In contrast, natural smallpox had fatality rates often exceeding 20 per cent. After 1800, inoculation with actual smallpox was gradually replaced by the less dangerous method of using "cowpox" matter to immunize against the disease. 

(This romanticized image shows Edward Jenner inoculating James Phipps with cowpox matter from pustules of Sarah Neames, milkmaid, on far right wrapping her hand)

This was the first method to be called "vaccination" a word derived from "vacca" -- Latin for "cow." The spread of vaccination in the 19th and 20th centuries led to the global eradication of smallpox by 1979, the first and only disease to be eliminated by human action.
(See my earlier post on vaccination for more information on that story.)

Monday, 24 August 2015

The First Vaccine Eliminated History's Greatest Killer, Smallpox

Perhaps the greatest weapon human beings possess against infectious disease is vaccines. They are also one of the most cost-effective, because they prevent disease and costly hospital and medical procedures. 

This lesson needs to be hammered home repeatedly, because humans have short memories and short attention spans. Vaccines have saved hundreds of millions of lives in our lifetimes alone. 

The vaccines for Covid-19 are now promising to release us from our lockdowns as well. They may be the only hope beyond herd immunity, whic wll cost many millions of lives. 

The terms "vaccine" and "vaccination" derive from the Latin "vacca" for cow. The reason is that the first effective vaccine used pus from a mild skin disease, the so-called cowpox, to immunize people against the deadly smallpox. 

"Cowpox" was in fact horse-pox, which sometimes infected cows. Most people who got it worked with cows or horses.

The cartoon below by James Gillray, c. 1800, shows Edward Jenner, usually given credit for the procedure, vaccinating people, who are turning into cows. Although satire, the cartoon shows the fears the procedure aroused in many people. 

The use of the vaccine derived from observations that people who worked with cows and got "cowpox" never got smallpox. Jenner was not the first to use the procedure. A farmer, Benjamin Jesty, pictured below, had employed it about twenty years before.

Jenner (below) was the first to publicize it and get credit, a knighthood, and a ton of money from Parliament.

Before the use of "vaccine" an immunization using actual smallpox pus from human cases had been in use, in some places for centuries. Inoculation, or variolation, as it was called, was intended to induce a mild case of the disease and lifelong immunity. It was not always mild. It had a mortality rate of about 1% inoculated and it sometimes left ugly scars. Image below compares inoculation and vaccination effects on arms.

The natural disease, however, often killed 20% or more of the infected, which explains the attraction of inoculation, especially during epidemics. Its use had become widespread by the time Jenner popularized vaccination. 

Vaccination was much safer than inoculation, but it was soon discovered that it did not provide lifelong immunity. Once that was understood, periodic re-vaccination became standard in the later 19th century. (Image below shows people being vaccinated in the US in 1870s.)

Public resistance to vaccination remained high in many countries for a long time. But access to it was a bigger problem, often because of cost or lack of health care infrastructure. 

By 1979, a global vaccination campaign headed by WHO had eradicated smallpox, the greatest killer disease known to mankind. Its success had also led to the development of many other "vaccines." The polio vaccine has nearly eliminated that disease. Vaccines have many other diseases on the run. 

The lesson: Get your jab!

Thursday, 6 August 2015

This Austin Ain't in Texas, Revised Version.

Austin, NV. Named for the other Austin in Texas, it was once a bustling metropolis of 10,000 people in its silver mining heyday. Like nearly every town in Nevada. Austin is now a village of 300 or so, about 100 miles from anywhere else.

Austin's great claim to fame in recent years is that Jeremy Clarkson and his Top Gear gang did part of a show here, driving through the nearby Reese River Valley at 700 mph. Really. A local bartender told us that after we had downed a few bottles of Icky. That's short for Ichthyosaurus IPA, brewed in Nevada and named for the state fossil. My, it is one tasty beer, "distinct, not extinct" and "highly evolved" as the label says.

Locals told us the Reese River spawned a local corporation. In the 1860's a group of enterprising fellows established the Reese River Navigation Company and sold stock to eastern rubes. The investors didn't know the river was only six feet wide. When it contained water, that is. Alas, the story seems to be a tall tale for the entertainment of today's rubes. It sure entertained us. Us being my son Alastair and I. We spent three nights in Austin as he made his way across Nevada's emptiness, the penultimate stage on his walk across America for a charity.

We were immensely fortunate to arrive in town on a day when Austin was having a Wine Walk and Dinner at Stokes' Castle as part of a sesquicentennial. The castle is actually a mock Italian tower. A railroad tycoon named Stokes built it on a hill above town, lived in it for a few months, then left. 

The castle was a bit of a disappointment but we enjoyed our meal and company. And the sunset from up there was one of the most gorgeous I've ever seen. Hat's off to Austin!

Sunday, 2 August 2015

The Loneliest Road in America

Nevada is a good place to stretch out your arms, catch some rays, and breathe clean air. I'm not talking about Las Vegas, of course, which is all about fear and loathing. Nearly everybody in the state lives there, but no one goes outside, except to get the next casino.

Most of Nevada is big, empty, and sunny. The people are friendly and helpful, on the rare occasions you actually encounter any people. Wild horses are more common. Jackasses, too. Calm down, politicians, I wasn't referring to you. Unless it was my Freudian side.

It's odd I know, but nearly every town along US Highway 50 ("The Loneliest Road in America") once had a population of about 10,000. I think the same 10,000 people kept moving about as gold and silver mines gave out in one place and lodes were found in another. They even moved hotels from one town to another. One built in Virginia City ended up in Austin, where it remains today.

A good example of all this is Eureka, between Ely and Austin. You know where that is, I'm sure. During the mining boom, Eureka had 10,00 people. Now it has around, 1900, the sign says.  I never saw more than about 25. That was at the Opera House, a Victorian era building now beautifully restored. It is a good venue and we were lucky to be there for a performance of western music by Ms. Belinda Gail. I honestly had never heard of Belinda, but she was damn good. Better than our hotel.