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Posts Tagged ‘malaria

“Law; an ordinance of reason for the common good, made by him who has care of the community”*…

 

vaccination

 

In the fall of 1713, measles struck the city of Boston, where Cotton Mather, a Puritan theologian and pastor, lived with his pregnant wife and numerous children. Within a month, his wife, their twin newborn babies, another child, and their maidservant had all died. On November 12, Mather wrote in his journal, “The epidemical Malady began upon this Town, is like to pass thro’ the Countrey. . . . it [might] be a service unto the public, to insert in the News-paper, a brief Direction for the managing of the sick. I will advise with a Physician or two.” On November 21, he wrote, “Lord I am oppressed; undertake for me!” On November 23, he wrote, “My poor Family is now left without any Infant in it, or any under seven Years of Age.”

Eight years later, when an explosive smallpox epidemic threatened Boston’s population of eleven thousand, Mather became an outspoken advocate for a new prophylactic against the virus: inoculation. Dr. William Douglass, one of the few doctors in town with a medical degree, rallied others to oppose Mather, claiming that the method was untested (which was true, at least in the new colony) and that it jeopardized the lives of all those who received it. In young Boston, the fight over inoculation tore at epidemic-addled nerves. In November 1721, a bomb was thrown through Mather’s window. A letter attached to it read, “Cotton Mather, you dog, dam you! I’ll inoculate you with this; with a pox to you.”

Douglass won out, quashing Mather’s plans for a systematic inoculation of the town’s population. Eight hundred and forty-four people died of the virus, accounting for 75 percent of all deaths in Boston that year. The unexploded bomb on Mather’s floorboards disabuses those of us living in 2019 of the impression—generated over the past two years by endless news stories about the current global measles outbreak—that inoculation controversies are a novel feature of our present hyper-mediated, hyper-politicized time.

Measles was considered to be eliminated in the United States in 2000. Still, the virus has regained extraordinary ground—and claimed an increasing number of lives—in recent years. Seven hundred and four cases were reported in the United States in the first four months of 2019, according to the Centers for Disease Control and Prevention. The count reached 1,077 by mid-June, occurring in twenty-eight states. More than six hundred cases have occurred in New York City alone since September of 2018.

In June, the CDC issued a warning to travelers planning to leave the country, by which point outbreaks were occurring in all the places you’d expect, countries beset by depressed economies, poor public health management, war, or extreme poverty, including Ethiopia, Madagascar, Kyrgyzstan, the Democratic Republic of Congo, the Philippines, Sudan, and Georgia (not the U.S. state, although cases have been reported there as well). But also, cases were appearing in countries where entrenched vaccination systems existed and where measles had been thought largely a disease of the past: Belgium, France, Germany, and Italy.

The grand cause for these infections—and for the 300 percent growth of reported measles cases around the world in the first quarter of the year over the same quarter the previous year—is precisely the absence of what Cotton Mather proposed for 1721-era Boston: systematic vaccination of the population. The more interesting question, beyond simple international vaccination logistics, is: What ideological and historical shifts have allowed the reemergence of a disease once believed to be under controlled decline?…

A history of the debates over vaccination that asks, can the social contract be protected from a measles outbreak?: “Herd Immunity.”

* Thomas Aquinas

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As we pull up our sleeves, we might send healing birthday greetings to Giovanni Maria Lancisi; he was born on this date in 1654.  A doctor (he was personal physician to three popes), epidemiologist (he made the correlation between mosquitoes and malaria), and anatomist (his study of the heart resulted in the eponymous Lancisi’s sign), he is considered the first modern hygienist.

He carried out extensive anatomical and physiological studies, also epidemiology studies on malaria, influenza and cattle plague.  Contrary to the then-traditional conception of “mal’ aria ” – literally, “bad air” – Lancisi observed that the lethal fever, malaria, disappeared when the swamps near to the city were cleared.  He concluded that injurious substances transmitted from flies and mosquitoes were the origin of the disease.

250px-Giovanni_Maria_Lancisi source

 

 

Written by LW

October 26, 2019 at 1:01 am

“If you think you are too small to make a difference, try sleeping with a mosquito”*…

 

mosquito

 

A month after the opening salvos of the American Revolution at Lexington and Concord in April 1775, the newly appointed commander in chief of the Continental Army, George Wash­ington, had a request for his political masters in the Continental Con­gress. He urged them to buy up as much cinchona bark and quinine powder as possible. Given the dire financial pressures of the squabbling colonial government, and the dearth of pretty much everything needed to fight a war, his total allotment was a paltry 300 pounds. General Washington was a frequent visitor to the quinine chest as he suffered from recurrent bouts (and reinfection) of malaria since first contracting the disease in 1749 at the age of seventeen.

Luckily for the Americans, the British were also drastically short of Peruvian Spanish-supplied quinine throughout the war. In 1778, shortly before they entered the fray in support of the American cause, the Spanish cut off this supply completely. Any available stores were sent to British troops in India and the Caribbean. At the same time, the mosquito’s mer­ciless, unrelenting strikes on unseasoned British troops lacking quinine during the final British southern campaign — launched in 1780 with the capture of Charleston, the strategic port city and mosquito sanctuary­ — determined the fate of the United States of America.

As J. R. McNeill colorfully contours, ‘The argument here is straight­forward: In the American Revolution the British southern campaigns ultimately led to defeat at Yorktown in October 1781 in part because their forces were much more susceptible to malaria than were the American. . . . [T]he balance tipped because Britain’s grand strategy committed a larger proportion of the army to malarial (and yellow fever) zones.’ A full 70% of the British Army that marched into this southern mosquito maelstrom in 1780 was recruited from the poorer, famished regions of Scotland and the northern counties of England, outside the malaria belt of Pip’s Fenland marshes. Those who had already served some time in the colonies had done so in the northern zone of infection and had not yet been seasoned to American malaria.

General Washington and the Continental Congress, on the other hand, had the advantage of commanding acclimated, malaria-seasoned colonial troops. American militiamen had been hardened to their sur­roundings during the Seven Years’ War and the turbulent decades head­ing toward open hostilities against their king. Washington personally recognized, albeit short of scientific affirmation or medical endorsement, that with his recurrent malarial seasonings, ‘I have been protected be­yond all human probability or expectation.’ While they did not know it at the time, this might well have been the Americans’ only advantage over the British when, after twelve years of seething resentment and discontent since the passing of the Royal Proclamation [of 1763 that prohibited land sales to colonists], war suddenly and unexpectedly came.

The Americans’ secret weapon– an excerpt from Timothy C. Winegard’s Mosquito: A Human History of of our Deadliest Predator: “George Washington, Mosquitoes, and the American Revolution.”

[via the ever-illuminating Delanceyplace.com]

* Dalia Lama XIV

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As we douse ourselves in DEET, we might recall that it was on this date in 1781– before the fall of Yorktown, but after a decisive week of fighting– that General George Washington wrote to the President of the Continental Congress to give an account of the recent action.  Three days later the Siege of Yorktown (as it became known) ended with the surrender of British forces under General Cornwallis.  It was the final major land battle of the Revolutionary War; the capture of Cornwallis and his army prompted the British government to negotiate an end to the conflict.

300px-Surrender_of_Lord_Cornwallis

Surrender of Lord Cornwallis, by John Trumbull

source

 

“I never quite envisioned myself a proper doctor under that white coat”*…

 

The Agnew Clinic” by Thomas Eakin, 1889

Toward the end of the 19th century, Western medicine had an image problem. Joseph Lister’s ideas about antiseptics were spreading, and John Snow had made a breakthrough in mapping the spread of cholera. But to the public, most medical “cures” were little more than quackery and mysticism, and the appearance of a physician merely presaged a painful death.

At the same time, the reputation of science was in rapid ascendancy. The Industrial Revolution was transforming the towns and cities of Europe and America, and new breakthroughs were reported on a weekly basis in more than a thousand different scientific journals.

So the medical establishment did a costume change. Doctors dropped their traditional black coats, which were worn either as a mark of formality (like a tuxedo) or to symbolize the solemnity of their profession, and instead opted for white coats like the ones worn by scientists in their laboratories…

Sartorial history at its most clinical: “Why the White Lab Coat Changed Medical History.”

* Robert Jay Lifton

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As we battle “white coat hypertension,” we might spare a thought for Sir Ronald Ross; he died on this date in 1932.  A physician, bacteriologist, and mathematician, he located the malarial parasite in the gut of the Anopheles mosquito, identifying it as the disease vector– for which he became the first British Nobelist, awarded the 1902 Prize for Physiology or Medicine.

source

 

Written by LW

September 16, 2016 at 1:01 am

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