A Look Back at Vaccines

Mary Wortley Montague public domain

As various strains of the flu claim lives this week, I take a look back at a time before vaccines, when people tried to protect themselves from deadly epidemics with desperate measures.  The passage below is an excerpt from my book, Jonas Salk: The Battle Against Polio.  The passage refers not to polio, but to smallpox.  The idea of induced immunity took hold among some.  Variolation–deliberately infecting the healthy with smallpox–was one early practice.  A diplomat’s wife, Lady Mary Wortley, introduced the practice to Europe.

Lady Wortley’s practice was not that far removed from the development of the polio vaccine.  In the twentieth century, two varieties became available.  One, the Salk vaccine, introduced a killed virus into a healthy person.  The other, the Sabin vaccine, introduced a weakened, live virus.  Each of these vaccines carried risks, though the risks were not as great as they had been with variolation.

  What follows is a brief description of Lady Mary Wortley’s experience with variolation.

In 1716 Lady Mary Wortley Montagu accompanied her husband, Edward, to Istanbul, where he became Ambassador to the Ottoman Empire. In Istanbul Lady learned about variolation. Lady Mary’s brother had died from smallpox and she had survived the disease. Although little was understood about smallpox, one thing was certain: once people survived the disease, they would never catch it again. This was the wisdom behind variolation.

The Ottomans dealt with smallpox by taking a small bit of dried material from the scab of someone who was infected with a mild case of the disease. The dried material would be blown into the nostrils of a healthy person. The idea was to make the healthy person come down with a mild case of smallpox and gain immunity from the disease for life. This was the Ottoman version of variolation.

When Lady Mary brought the practice to Europe, it was a little different. In Europe, material would be scraped from a smallpox scab on someone who was actively suffering from the disease. This material would then be scraped into the skin of a healthy person. That person, it was hoped, would come down with a mild form of smallpox, survive, and then have immunity for life.

Variolation was widely used, especially among the powerful. Though many did not trust the procedure, it was the only way to induce immunity from smallpox until Edward Jenner discovered a vaccine. Variolation was largely abandoned after Jenner’s vaccine because it was possible to come down with severe cases of smallpox as a result of the procedure. There were deaths from variolation.

A. G. Moore

February 5, 2018

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The Han Agent, by Amy Rogers: Book Review

Han Agent review picture Unit_731_-_Complex
Unit 731: the Japanese compound in China where biological warfare experiments were carried out.

 

Amy Rogers’ new book, The Han Agent, is a fast-moving, suspense-filled thriller. This science fiction novel is, above all else, entertaining. I read through the book in one day–I  had to find out  “what happened”.  The story held my attention because it was well written, and because it honed so closely to reality.  In the tradition of the best science fiction, the book was grounded in facts and took those facts into the realm of imagination.  

Ms. Rogers knows her science, and her history.  She’s a scientist by training, so that wasn’t surprising.  However, her attention to historical detail was surprising, and gratifying.  The accuracy of events referenced in the story made the narrative all the more believable.

The plot is rooted in a biological weapons program carried out by the Japanese in WWII (and pre-WWII) China.  The protagonist is a young scientist, a woman who suffers from a flaw that has afflicted dramatic characters throughout history: hubris.  Suspense arises not only from concern about a deadly biological agent, but also from wondering if the young scientist, on whom so much depends, will resolve her moral dilemma.

The Han Agent is a credible exploration of scientific possibility.  Generally, people think about threats to security coming from a nuclear attack or a dirty bomb.  In The Han Agent, the author suggests a different, perhaps more devastating possibility.  Ms. Rogers creates a universe in which the unthinkable may be realized. 

The Han Agent is a great book.  Readers from various backgrounds and all ages will find it thought-provoking and enjoyable.

Bellevue Three Centuries of Medicine and Mayhem at America’s Most Storied Hospital: Book Review


By David Oshinsky

In 2016, a Johns Hopkins safety review panel reported that every year, 250,000 deaths in the United States are attributable to medical error. That’s a whopping 9.5% of all deaths in the country. As eye-opening as this statistic may be, it pales in comparison to deaths attributable to medical misadventure in previous centuries. According to David Oshinsky, author of Bellevue, eighteenth and nineteenth century medical treatment was as likely to be the cause of death as it was to save life. The evolution of medical care from that dark age occurred in fits and starts. Dr. Oshinsky offers a gripping description of the journey from darkness to the relative enlightenment of today.

This author skillfully blends medical and social history. He demonstrates the knack of a skilled teacher as he weaves anecdotes into a narrative of hard facts. Dr. Oshinsky has so much information at hand, that he doesn’t need to resort to conjecture to enliven his story. Truth, he proves, is indeed stronger than fiction.

Examples of Dr. Oshinsky’s dynamic writing are on display throughout the book, most memorably in his descriptions of surgery without anesthesia and treatment without antiseptics. In the first case, a boy’s leg is amputated. The father is present and aids in restraining his son. The sound of a saw fills the surgical theater as the child, without benefit of anesthesia, loses his leg. Shrieks fill the room. The father faints. We, the readers, are left with an indelible impression.

In another instance, President James Garfield suffers the consequences of medical obstinacy. The President is shot. An assassin’s bullet must be removed. The esteemed Dr. Frank Hamilton of Bellevue is called in. He, confident in his skills, declines to follow new guidelines in medicine that prescribe sterilization before contact with a patient. Garfield dies, month later, of massive infection. It is the medical consensus that this death was due not to an assassin’s bullet but to medical misadventure.

Dr. Oshinsky comes to the task of writing his book with excellent credentials. He is a professor of history at New York University and the director of Medical Humanities at NYU Langone Medical Center. In addition, he has won a Pulitzer Prize for an earlier book, Polio: An American Story.

The current book, Bellevue, is about the history of a public institution, and it is more. It traces the history of health care in New York City. It introduces readers to some giants of modern medicine, including Robert Koch, Joseph Lister and Florence Nightingale. The author’s broad perspective offers insight into the immigrant experience and its intersection with New York City politics. Dr. Oshinsky’s wide lens creates a richly textured tableau in which Bellevue Hospital is the focal point.

Bellevue is an easy read. I recommend it to anyone interested in history, and to those readers who would like to gain insight into the culture of the medical profession.

By A. G. Moore 2/10/17

The picture of Bellevue Hospital (above) is used under a Creative Commons
 4.0 International License