Medicine – Historical Easter Eggs

March 27, 1915 Typhoid Mary

“In time of war, soldiers, however sensible, care a great deal more on some occasions about slaking their thirst than about the danger of enteric fever. Better known as typhoid, the disease is often spread by drinking contaminated water”. – Winston Churchill

In 1841, US President William Henry Harrison died only 32 days into his only term in office. The killer was a common culprit in Harrison’s day, one destined to end the life of Stephen A. Douglas of the famous Lincoln/Douglas debates, William “Willy” Lincoln (right), the 11-year-old son of President Abraham & First Lady Mary Todd Lincoln, and Martha Bulloch Roosevelt, mother of President Theodore Roosevelt.

Historians blame Typhoid fever for the plague that killed the great statesman Pericles and a third the population of Athens, in 430BC. “America’s first epidemic”, Typhoid killed some 85 percent of the settlers in the English colony at Jamestown between 1607 and 1624. Among native American populations, Typhoid fever was a “virgin soil disease” leading to widespread outbreaks among indigenous populations.

In 1880, German pathologist Karl Joseph Eberth first described the bacillus involved while, throughout the 19th century, Typhoid could be counted on to kill more combatants than any given war in which they had come to fight.

*Salmonella enterica enterica serovar Typhi*

There’s no polite way to say it. Typhoid is spread by fecal contamination between humans. Today, simple acts like flushing a toilet and washing one’s hands are parts of daily routine. In an age before modern plumbing and sewage, we’re talking about a plague sufficient to make the bogey man himself, quake with terror.

Even now, sciencemag.org reports some ten to thirty million cases per year and somewhere around 200,000 deaths worldwide each year. Today, scientists across the African continent and Asia contend with the multi-drug resistant strain H58, but now we’re ahead of the story. In a century beginning with the Napoleonic wars and ending with the gilded age, the “germ theory” of disease we now know so well rose only gradually to the fore, eclipsing the “miasma” theory so familiar to contemporaries of the Black Death.

Like the Chinese Coronavirus of another century, Typhoid symptoms range from excruciating death to nothing whatsoever. Mary Mallon was one of the latter. Born in 1869 in the north of Ireland, Mary was almost certainly infected in utero even as her mother was so tainted, at the time of birth.

Mary emigrated to the United States at age fifteen and lived for a time with an aunt and uncle. She worked as a maid at first but it didn’t take long to realize…Mary Mallon could cook. Soon she was hiring on with wealthy families as a personal chef.

In 1906, New York banker Charles Henry Warren arranged a treat for his family. A summer rental seemed just the thing. Warren rented the summer home of George Thompson and his wife in Oyster Bay, Long Island. Naturally, Warren went looking for a cook. Mary Mallon accepted the job.

That August, one of the Warren daughters fell ill with Typhoid fever. Mrs. Warren was soon to follow and then two maids. In total, six of eleven people in the household came down with the disease. Fearing they wouldn’t be able to rent the place, Thompson hired investigators to find the cause.

That first group found nothing and Thompson hired George Soper, a civil engineer known even then as, the “epidemic fighter”. It was Soper who first hypothesized that Mary herself, might be the cause. At this point, Mallon had left the family three weeks earlier. Soper examined Mallon’s employment history from 1900 to the present, and there it was. There were seven jobs during that time in which 22 people became ill, with Typhoid. One little girl died of the disease shortly after Mary came to work for the family.

The civil engineer turned “private eye“ went looking for Mary herself. He found her in March 1907, working for the family of one Walter Bowen.

Soper explained who he was and requested samples of Mary’s blood, urine and feces. Mallon responded in a fashion to be expected of a cornered wildcat. With a shriek and a carving fork she came at him, putting the man to flight.

Once again Soper tracked her down and showed up where she lived. This time, he brought help in the person of Dr. Bert Raymond Hoobler. And now there were two of them, fleeing for their lives.

Dr. Sara Josephine Baker was dispatched from the New York city health department but by now, Mallon wasn’t hearing a word of it. Next came Soper with five police officers, and an ambulance. Let the epidemic fighter describe what happened next.

“Now thoroughly convinced of her own persecution, “Mary was on the lookout and peered out, a long kitchen fork in her hand like a rapier. As she lunged at me with the fork, I stepped back, recoiled on the policeman and so confused matters that, by the time we got through the door, Mary had disappeared. ‘Disappear’ is too matter-of-fact a word; she had completely vanished”
George Soper

There followed a five-hour cat & mouse before they found her, hiding in a closet. It took several of them to wrestle Mary to the ground. Soper himself sat on her all the way to the hospital. He said it was like being in a cage with an angry lion.

Mary was taken to Willard Parker hospital where stool samples demonstrated the presence of Typhoid. Under questioning she admitted to “almost never” washing her hands, a practice not uncommon at that time. There followed a period of incarceration between 1907 and 1910 on North brother island on the East River, near the Bronx.

The press had a field day with the story. “Typhoid Mary” they called her.

“I never had typhoid in my life, and have always been healthy. Why should I be banished like a leper and compelled to live in solitary confinement with only a dog for a companion?”
Mary Mallon

During that time, 120 of 163 samples tested positive. Mary herself couldn’t understand why she was being treated this way. She had broken no laws. She’d been taken by force and against her will. She had a nervous breakdown. Her own samples smuggled out with the help of a friend, tested negative. She sued for her freedom. And lost. The courts didn’t want anything to do with it. Soper would visit from time to time and sometimes explained the importance of handwashing. She wasn’t buying any of it. Why…Would… They…DO THIS TO ME!? It was all she could think of.

In 1910, Mary was released to the mainland with an agreement t0 “take such hygienic precautions as will protect those with whom she comes in contact, from infection.” She promised not to accept work as a cook. Soon she was working as a laundress, earning $20 a month, without a home of her own, and teetering on the brink of destitution. She used to make $50 a month, as a cook.

It wasn’t long before she broke her word. Now it was “Marie Breshof” or “Mrs. Brown,” cooking for a restaurant on Broadway, or a hotel in Southampton. There was an inn in Huntington. A sanatorium in New Jersey. Her cooking gigs were always short-term and always followed by Typhoid outbreaks.

Then came the job at Sloan Hospital for Women. 20 people fell ill with Typhoid. Two died. Even the other other servants came to call the new cook, “Typhoid Mary”.

This time when they came for her, she didn’t resist. On March 27, 1915, Mary Mallon was returned to quarantine on North Brother Island. She had a stroke there in 1932 and spent the last six years of her life, partly paralyzed. She contracted pneumonia and died there on Armistice Day, November 11, 1938. Nine people attended her funeral.

Over her lifetime, Typhoid Mary is believed to have sickened no fewer than fifty, three of whom died. Some put her death toll as high as fifty. In a nation of laws the civil liberties side of her story stands to this day as an historic, unmitigated, disaster. Mary Mallon spent her last years alone in this small house on North Brother Island in the East River, near the Bronx

The history of Mary Mallon, declared “unclean” like a leper, may give us some moral lessons on how to protect the ill and how we can be protected from illness…By the time she died New York health officials had identified more than 400 other healthy carriers of Salmonella typhi, but no one else was forcibly confined or victimized as an “unwanted ill”.
The Annals of Gastroenterology, 2013

December 2, 1943 The Surprising Origins of Chemotherapy

In the 12th century, Bernard of Chartres described a process of finding truth, in building on the earlier discoveries of others. The concept is encapsulated in the words of Isaac Newton, in 1675: “If I have seen further it is by standing on the shoulders of Giants”.

In ancient Greek mythology, Hercules poisoned arrows with the venom of the Hydra. Both sides in the battle for Troy used poisoned arrows, according to the Iliad and the Odyssey of Homer. Alexander the great encountered poison arrows and fire weapons in the Indus valley of India, in the fourth century, BC. Chinese chronicles describe an arsenic laden “soul-hunting fog” produced by the burning of toxic vegetation, used to disperse a peasant revolt in AD178.

“Soul-hunting fog”.

Yikes

The French were the first to use poison weapons in the modern era in August 1914, when tear gas grenades containing xylil bromide were used against German forces in the first month, of the Great War.

Imperial Germany was first to give serious study to chemical weapons of war, early experiments with irritants taking place at the battle of Neuve-Chapelle in October 1914, and with tear gas at Bolimów on January 31, 1915 and again at Nieuport, that March.

The first widespread use of poison gas, in this case chlorine, came on April 22, 1915, at the second battle of Ypres.

The story of gas warfare is inextricably linked with that of World War 1. 124,000 tons of the stuff was produced by all sides by the end of the war, accounting for 1,240,853 casualties, including the agonizing death of 91,198.

Had the war continued into 1919, technological advances promised new and fresh hell, unimaginable to the modern reader.

Today we think of chemical agents in WW2 as being limited to the death camps of the Nazis, but such weapons were far more widespread. The Imperial Japanese military frequently used vesicant (blister) agents such as lewisite and mustard gas against Chinese military and civilians, and in the hideous “medical experiments” conducted on live prisoners at Unit 731 and Unit 516. Emperor Hirohito personally authorized the use of toxic gas during the 1938 Battle of Wuhan, on no fewer than 375 occasions.

The Italian military destroyed every living creature in its path during the 1936 Colonial war with Ethiopia, in what Emperor Haile Selassie called “a fine, death-dealing rain”.

Nazi Germany possessed some 45,000 tons of blister and nerve agents, though such weapons were rarely used against western adversaries. The “Ostfront” – the battle on the eastern front – was a different story. Russian resistance fighters and Red Army soldiers were attacked, most notably during the assault on the catacombs of Odessa in 1941, the 1942 siege of Sebastopol, and the nearby caves and tunnels of the Adzhimuskai quarry, where “poison gas was released into the tunnels, killing all but a few score of the (3,000+) Soviet defenders”.

russian-soldier-in-a-rubber-gas-mask-on-the-eastern-front-russia-during-K07NJ9

None of the western allies resorted to chemical warfare in WW2, despite having accumulated over twice the chemical stockpile as that of Nazi Germany. The policy seems to have been one of “mutually assured destruction” where no one wanted to be first to go there, but all sides reserved the option. Great Britain possessed massive quantities of mustard, chlorine, Lewisite, Phosgene and Paris Green, awaiting retaliatory strike should Nazi Germany resort to such weapons on the beaches of Normandy.

General Alan Brooke, Commander-in-Chief of the Home Forces, said he “[H]ad every intention of using sprayed mustard gas on the beaches” in the event of a German landing on the British home islands.

The official American policy toward chemical weapons was enunciated in 1937, by President Franklin Roosevelt: “I am doing everything in my power to discourage the use of gases and other chemicals in any war between nations. While, unfortunately, the defensive necessities of the United States call for study of the use of chemicals in warfare, I do not want the Government of the United States to do anything to aggrandize or make permanent any special bureau of the Army or the Navy engaged in these studies. I hope the time will come when the Chemical Warfare Service can be entirely abolished”.

The Geneva Protocols of 1925 banned the use of chemical weapons, but not their manufacture, or transport. By 1942, the U.S. Chemical Corps employed some 60,000 soldiers and civilians and controlled a $1 Billion budget.

In August 1943, Roosevelt authorized the delivery of chemical munitions containing mustard gas, to the Mediterranean theater. Italy surrendered in early September, changing sides with the signing of the armistice of Cassibile.

The liberty ship SS John Harvey arrived at the southern Italian port of Bari in November, carrying 2000 M47A1 mustard gas bombs, each containing 60 to 70-pounds of sulfur mustard.

Bari was packed at the time, with ships waiting to be unloaded. It would be days before stevedores could get to her. Captain John Knowles wanted to inform port authorities of his deadly cargo and request that she be unloaded immediately, but secrecy prevented him from doing so. As it was, John Harvey was still waiting to be unloaded, on December 2.

For Luftwaffe Generalfeldmarschall Albert Kesselring, the traffic jam at Bari was an opportunity to slow the advance of the British 8th army on the Italian peninsula.

gettyimages-3276829-612x612 — Air raid on Bari, December 2, 1943

The “Little Pearl Harbor” began at 7:25PM when 105 Junkers JU-88 bombers came out of the East. The tactical surprise was complete, and German pilots were able to bomb the harbor with great accuracy. Two ammunition ships were first to explode, shattering windows some 7 miles away. A bulk gasoline pipeline was severed as a sheet of burning fuel spread across the harbor, igniting those ships left undamaged.

43 ships were sunk, damaged or destroyed including John Harvey, which erupted in a massive explosion. Liquid sulfur mustard spilled into the water, as a cloud of toxic vapor blew across the port and into the city.

Mustard gas is a cytotoxic agent, capable of entering the system via skin, eyes and respiratory tract and attacking every cell type with which it comes into contact. First comes a garlic odor as the yellow-brown, heavier-than-air cloud creeps along the ground. Contact results in redness and itching at first, resulting 12-24 hours later in excruciating, untreatable blisters on exposed areas of the skin. Sufferers are literally burned inside and out as mucous membranes are stripped away from the eyes, nose and respiratory tract.

Death comes in days or weeks. Survivors are likely to develop chronic respiratory disease and infections. DNA is permanently altered, often resulting in cancer and birth defects. To this day there is no antidote.

A thousand or more died outright in the bombing of December 2, 1943. 643 military service personnel were hospitalized for gas symptoms. 83 of them were dead, by the end of the month. The number of civilian casualties is unknown. The whole episode was shrouded in secrecy and remains to this day, one of the lesser-known chapters of World War 2.

At the time, the chemical disaster at Bari was of uncertain nature. Everyone with any knowledge of John Harvey’s secret cargo had been killed in the explosion. Lieutenant-Colonel Stewart Francis Alexander, an American physician from New Jersey, was sent by the Deputy Surgeon General of the US Army to find out what happened.

It was Dr. Alexander who figured out the responsible agent was mustard, and where the stuff had come from. In the process of testing, Dr. Alexander noticed the unknown agent went most heavily after rapidly dividing cells, such as white blood cells.

Alexander wondered if it might be useful in going after other types of rapidly dividing cells.

Like cancer.

Based on Dr. Alexander’s field work, Yale pharmacologists Louis Goodman and Alfred Gilman developed the first anti-cancer chemotherapy drug, in the treatment of lymphoma.

In the 12th century, Bernard of Chartres described a process of finding truth, based on previous discoveries. The concept is remembered in the words of Sir Isaac Newton, in 1675: “If I have seen further it is by standing on the shoulders of Giants”.

Dr. Sidney Farber of Boston built on this earlier work, producing remission in children with acute Leukemia using Aminopterin, an early precursor to Methotrexate, a chemotherapy drug still in use, today.

To some, the SS John Harvey a “savior of millions”, due to the vessel’s role in the pioneering era of modern chemotherapy drugs.

The claim may be a bit of an exaggeration, but not much. Once a virtual death sentence, the American Cancer Society today estimates that one in 30 alive today are currently undergoing treatment or have done so, in the past.

November 29, 1918 A Medical Mystery

Fully one-third of sufferers died in the acute phase, a higher mortality rate than the Spanish flu of 1918-’19. Many of those who survived never returned to pre-disease states of “aliveness” and lived out the rest of their lives institutionalized, literal prisoners of their own bodies. They had become living paperweights.

The Great War entered its third year in 1917, with another year yet to go. Before wars acquired numbers, it was the most cataclysmic war in living memory, destroying the lives of some thirty-six million on all sides and leaving untold millions more, maimed.

In March of the following year, a new batch of trainees cycled through Fort Riley in Kansas, fresh recruits destined for the “War to End All Wars”. On reporting for breakfast one morning, none could know that an enemy lurked among them, more lethal than the war itself.

Private Albert Gitchell was coming down with cold-like symptoms: sore throat, fever and headache. Never mind breakfast. Pvt. Gitchell was headed for the base hospital. By noon over a hundred reported sick, with similar symptoms.

Ordinary flu strains prey most heavily on children, elderly, and those with compromised immune systems. Not this one. This flu would kick off a positive feedback loop between small proteins called cytokines, and white blood cells. This “cytokine storm” resulted in a death rate for 15 to 34-year-olds twenty times higher in 1918, than in previous years.

The young and healthy immune system of the victims are precisely what killed them.

The armistice was a bare two weeks in the past on November 29, 1918. Formal peace negotiations would occupy the whole of 1919.

History has a way of swallowing some events, whole. Like they never even happened. The Spanish flu afflicted some five hundred million worldwide, killing an estimated fifty to one hundred million. Two to three times the number killed by the war itself and yet, the story was overshadowed by the end of the war.

Small wonder it is then, that such an event would itself eclipse a pandemic far smaller but in some ways more terrifying, than the worldwide calamity of Spanish flu. To this day, nobody knows where this enemy came from. Nor where it left to, when it went away.

In 1915, Austrian psychiatrist and neurologist Constantin von Economo described the signs and symptoms of a strange new condition which came to be called Von Economo’s Disease. The illness was labeled Encephalitis Lethargica, literally “Inflammation of the brain which makes you tired”.

“We are dealing with a kind of sleeping sickness, having an unusually prolonged course. The first symptoms are usually acute, with headaches and malaise. Then a state of somnolence appears, often associated with active delirium from which the patient can be awakened easily. He is able to give appropriate answers and to comprehend the situation. This delirious somnolence can lead to death, rapidly, or over the course of a few weeks. On the other hand, it can persist unchanged for weeks or even months with periods lasting bouts of days or even longer, of fluctuation of the depth of unconsciousness extending from simple sleepiness to deepest stupor or coma,” Die Encephalitis lethargica, Constantin von Economo, 1917

Encephalitis Lethargica is also known by the deceptively benign name of “Sleepy Sickness”. Von Economo distinguished three phases of the illness. Symptoms of the somnolent-ophthalmoplegic include paralysis of the cranial nerves leading to expressionless faces and involuntary eye movements, with overwhelming sleepiness leading to coma. Fully one-third of E.L. sufferers died during this phase, of respiratory failure. The hyperkinetic form manifested itself with restlessness and motor disturbances leading to facial contortion, anxious mental state and an inability to sleep, often leading to death by exhaustion.

Dr. Constantin von Economou top left, described the plight of E.L. sufferers, in 1917

The amyostatic-akinetic form frequently resulted in a chronic state resembling Parkinson’s disease, called Postencephalitic Parkinsonism.

Autopsies revealed this third phase to result from localized neurodegeneration of the Substantia Nigra, the basal ganglia structure of the mid-brain which plays a role in reward and associative learning as well as bodily movement. Unknown to the sufferer, this neurodegeneration takes place over an interval of a few days to thirty years, consigning the sufferer to a trance-like state in which the patient is rendered speechless and motionless, fully aware but, for all intents and purposes, a statue.

The 1973 non-fiction book Awakenings by Oliver Sacks, describes what that looks like:

“They would be conscious and aware – yet not fully awake; they would sit motionless and speechless all day in their chairs, totally lacking energy, impetus, initiative, motive, appetite, affect or desire; they registered what went on about them without active attention, and with profound indifference. They neither conveyed nor felt the feeling of life; they were as insubstantial as ghosts, and as passive as zombies”.

It is hard to imagine a more terrifying condition. Worldwide, Encephalitis Lethargica afflicted some five million between 1915 and 1924. The disease preyed mostly on young victims, between 15 and 35. Early symptoms include high fever, headache, fatigue and runny nose. Sufferers would take to bed believing it to be nothing more than a cold, or flu. Meanwhile, the unknown enemy within quietly spread to the brain.

Fully one-third of sufferers died in the acute phase, a higher mortality rate than the Spanish flu of 1918-’19.

For most who recovered, wellness would prove an illusion. Unknown to the sufferer, localized neurodegeneration was quietly taking place leading to a second phase of the disease. A state of Post-Encephalitic Parkinsonism (pep) would emerge sometimes, within a few days. Sometimes the process would take 30 years. Those who had entered this PEP state of the disease never returned to pre-disease states of “aliveness” and lived out the rest of their days institutionalized, literal prisoners of their own bodies. They had become living paperweights.

Barely 14 percent emerged from the condition with no lasting effect.

Professor John Sydney Oxford is an English virologist, a leading expert on influenza, the 1918 Spanish Influenza, and HIV/AIDS. Few have done more in the modern era to understand Encephalitis Lethargica: “I certainly do think that whatever caused it could strike again. And until we know what caused it we won’t be able to prevent it happening again.”

Doctors Russell Dale and Andrew Church discussed 20 new cases in 2004, published in the Oxford University medical journal Brain. The two hypothesize infection leading to a massive auto-immune response, possibly brought on by an unusual Streptococcus bacterium.

Further study is needed but, perversely, such study is only possible given more cases of the disease. For now, the lethal pandemic of 1915 – 1924 remains one of the great medical mysteries. An epidemiological conundrum, locked away in a nightmare closet of forgotten memory.

We can only hope it stays that way.

August 29, 1893 Nothing to See Here

To this day there remains no clear standard as to what’s in the public interest to know, and where lies the individual’s right, president or not, to a modicum of privacy.

“Rare photograph of Roosevelt in a wheelchair, with Ruthie Bie and Fala (1941)” – H/T Wikipedia

In the summer of 1921, a 39-year old Franklin Delano Roosevelt was enjoying some family vacation time at Campobello Island, off the coast of Maine. On August 10 he complained of fever and chills, and took to bed. The condition persisted for weeks. Four Physicians attended the future president of the United States, the diagnosis, poliomyelitis.

Roosevelt would spend the rest of his life in a wheelchair, able to stand only for brief and painful moments with the help of leg braces. During four elected terms the press went to great lengths to deemphasize if not hide altogether, the president’s disability.

On October 2, 1919, a near fatal stroke left President Woodrow Wilson incapacitated, unable to speak or move. First Lady Edith Wilson jealously guarded her husband’s condition from the press and the president’s opponents, blocking access and screening presidential paperwork. Sometimes she even signed her husband’s name, without his knowledge or consent. Edith denied usurping the presidency to herself but claimed instead to be acting only as “Steward”.

If you were around in 1978 you may remember the cringeworthy media coverage of Jimmy Carter’s hemorrhoids, raising the question of what’s in the legitimate public interest and what if any right does a president have to any sense of personal dignity, let alone privacy.

Fun fact: The only former executioner ever elected President of the United States, Stephen Grover Cleveland is best remembered for being the only President to ever serve two non-consecutive terms. The 22nd and 24th President of the United States was also, something of a medical miracle.

President Cleveland was inaugurated for the second time in the midst of the Panic of 1893, the worst economic downturn in American history, until the great depression. The nation suffered vast unemployment with hundreds of businesses closing down. The railroad industry was devastated. With a nation struggling, many looked to the new President to provide hope and a new direction.

Early in his second term, the President noticed a bumpy and rapidly growing patch on the roof of his mouth. White House physician Dr. Robert Maitland O’Reilly took one look and pronounced: “It’s a bad looking tenant, and I would have it evicted immediately”.

The health of the famously rotund, cigar chomping President was already a matter of public concern. Cleveland feared a cancer diagnosis would set off a panic. The tumor would have to be removed and the whole procedure, kept secret.

121015_HistoryofMedicine_PresidentCleveland

The only answer to the prying eyes of the press was to do it on the move, so there could be no scar. President Cleveland announced a four-day vacation aboard the private yacht Oneida, a cruise through Long Island Sound to Buzzard’s Bay and on to the President’s summer home called Gray Gables, on Cape Cod.

What followed is enough to amaze an oral surgeon and make the rest of us squirm. On July 1, 1893, the President was strapped to a chair and anesthetized with ether. The tumor extended through the president’s hard palate and upper jaw and nearly to his left eye. A surgical team of six removed nearly the entire left side of the upper jaw along with the tumor, and five teeth. The operation had taken ninety minutes and there was no external incision. It was all done through the President’s mouth. The trademark mustache remained undisturbed. Later on the president was fitted with a rubber prosthesis restoring Cleveland’s speech, and facial disfigurement.

The procedure was carried out in strict secrecy but didn’t remain that way, for long. On August 29, 1893, reporter Elisha Jay Edwards of the Philadelphia Press broke the story of a presidential surgery too bizarre to be true. White house staff denied the story, and launched a coordinated smear campaign against the journalist. Even the steward on board the Oneida stuck the story, declaring the president never missed a meal on that summer cruise. Other newspapers piled on denouncing Edwards as a “liar” and a “disgrace to journalism”.

A medical miracle for its time, what really transpired onboard the Oneida remained secret until 1917, nine years after Cleveland’s death.

One of the foremost newspapermen of the age Elisha Edwards was ruined and struggled even to find work, for the next fifteen years. The man wouldn’t see his reputation restored for 24 years.

To this day there remains no clear standard as to what’s in the public interest to know, and where lies the individual’s right, president or not, to a modicum of privacy.

August 12, 1865 The Shoulders of Giants

During the third century AD, the Greek physician Galen of Pergamon first described the “miasma” theory of illness, holding that infectious diseases such as cholera, chlamydia and the Black Death were caused by noxious clouds of “bad air”. The theory is discredited today, but such ideas die hard.

In the 12th century, French philosopher Bernard of Chartres described the concept of “discovering truth by building on previous discoveries”. The idea is familiar to the reader of English as articulated by the mathematician and astronomer Isaac Newton, who observed that “If I have seen further it is by standing on the shoulders of Giants.”

Nowhere is there more truth to the old adage, than in the world of medicine. In 1841, the child who survived to celebrate a fifth birthday could look forward to a life of some 55 years. Today, a healthy five-year-old may expect to live fully half again that of his ancestor.

Still, there are times when the giants who brought us here are unknown to us, as if they had never been. One such is Dr. Ignaz Semmelweis, one of the earliest pioneers in the field of anti-septic medicine.

Semmelweis studied law at the University of Vienna in the fall of 1837, but switched to medicine the following year. He received his MD in 1844 and, failing to gain a clinical appointment in internal medicine, decided to specialize in obstetrics.

The germ theory of disease was first proposed by Girolamo Fracastoro in 1546 and expanded by Marcus von Plenciz in 1762. Single-cell bacteria were known to exist in human dental plaque as early as 1683, yet their functions were imperfectly understood.

Today the idea that microorganisms such as fungi, viruses and other pathogens cause infectious disease is common knowledge, but such ideas were held in disdain among scientists and doctors, well into the 19th century.

In the mid-19th century, birthing centers were set up all over Europe, for the care of poor and underprivileged mothers and their illegitimate infants. Care was provided free of charge, in exchange for which young mothers agreed to become training subjects for doctors and midwives.

In 1846, Semmelweis was appointed assistant to Professor Johann Klein in the First Obstetrical Clinic of the Vienna General Hospital, a position similar to the “chief resident,” of today.

At the time, Vienna General Hospital ran two such clinics, the 1st a “teaching hospital” for undergraduate medical students, the 2nd for student midwives.

Semmelweis quickly noticed that one in ten women and sometimes one in five, were dying in the First Clinic of postpartum infection known as “childbed fever”, compared with less than 4% at the Second Clinic.

The difference was well known even outside of the hospital. Expectant mothers were admitted on alternate days into the First or Second Clinic. Desperate women begged on their knees not to be admitted into the First, some preferring even to give birth in the streets, over childbirth in that place. The disparity between the two clinics “made me so miserable”, Semmelweis said, “that life seemed worthless”. He had to know the reason why.

Childbed or “puerperal” fever was rare among these “street births”, and far more prevalent in the First Clinic, than the Second. Semmelweis carefully eliminated every difference between the two, even including religious practices. In the end, the only difference was the people who worked there.

The breakthrough came in 1847, following the death of Semmelweis’ friend and colleague, Dr. Jakob Kolletschka. Kolletschka was accidentally cut by a student’s scalpel, during a post-mortem examination. The doctor’s own autopsy showed a pathology very similar to those women, dying of childbed fever. Medical students were going from post-mortem examinations of the dead to obstetrical examinations of the living, without washing their hands.

Midwife students had no such contact with the dead. This was it. Some unknown “cadaverous material” had to be responsible for the difference.

Semmelweis instituted a mandatory handwashing policy, using a chlorinated lime solution between autopsies and live patient examinations.

Mortality rates in the First Clinic dropped by 90%, to rates comparable with the Second. In April 1847, First Clinic mortality rates were 18.3% – nearly one in five. Hand washing was instituted in mid-May, and June rates dropped to 2.2%. July was 1.2%. For two months, the rate was zero.

The European medical establishment celebrated the doctor’s findings, and Semmelweis was feted as a giant of modern medicine. No, just kidding. He wasn’t.

The imbecility of the response to Semmelweis’ findings is hard to get your head around, and the doctor didn’t help himself. The medical establishment took offense to the idea that they themselves were the cause of the mortality problem, and that the answer lay in simple cleanliness.

Semmelweis himself was anything but tactful, publicly berating those who disagreed with his hypothesis and gaining powerful enemies. For many, the doctor’s ideas were extreme and offensive, ignored or rejected and even ridiculed. Are we not Gentlemen!? Semmelweis was fired from his hospital position and harassed by the Vienna medical establishment, finally forced to move to Budapest.

Yearly_mortality_rates_1841-1846_two_clinics

Dr. Semmelweis was outraged by the indifference of the medical community, and began to write open and increasingly angry letters to prominent European obstetricians. He went so far as to denounce such people as “irresponsible murderers”, leading contemporaries and even his wife, to doubt his mental stability.

Dr. Ignaz Philipp Semmelweis was committed to an insane asylum on July 31, 1865, twenty-three years before Dr. Louis Pasteur opened the institute for the study of microbiology.

On August 12, 1865, British surgeon and scientist Dr. Joseph Lister performed the first anti-septic surgery, in medical history. Dr. Semmelweis died the following day at the age of 47, the victim of a blood infection sustained following a severe beating by asylum guards.

June 28, 1981 Marathon of Hope

“The running I can do, even if I have to crawl every last mile. We need your help. The people in cancer clinics all over the world need people who believe in miracles. I am not a dreamer, and I am not saying that this will initiate any kind of definitive answer or cure to cancer. But I believe in miracles. I have to”. Terry Fox, letter to the Canadian Cancer Society, October 1979

We’ve all known a “natural”. Be it academics, sports or what-have-you, we’re talking about that person who is naturally wired for a task. Who just…”gets it”. Then there is a second type. One born without that natural talent whose success depends on guts, drive and determination to succeed.

When it came to sports, Terrance Stanley Fox was one of those.

The second child of four born to Betty and Rolland Fox, Terry arrived on July 28, 1958 in Winnipeg, Manitoba, the family later moving to British Columbia, the westernmost province in Canada.

Terry’s best buddy Doug Alward was a basketball natural, starting for the Mary Hill Jr. High School Cobras. Fox loved the sport but basketball is difficult for a guy who stood barely five feet high in Jr. high. Coach Bob McGill suggested he go out for cross country which he did, but he never lost the desire to play hoops.

Fox would practice every morning before school and during the summers. He finally made the team in grade 8, dead last, and only played a single minute for the whole season. By grade 10 Fox and Alward were first string guards for the Port Coquitlam High School Ravens. Later that year the two shared the school’s Athlete of the Year award. Fox continued with cross-country running and also soccer and rugby. By grade 12 Fox was actually the better basketball player while Alward went on to distinguish himself, in long distance running.

The year was 1976. The year when Terry first noticed that pain, in his right leg.

Terry began college that year at Simon Fraser University where he tried out and won, a place on the schools Junior Varsity basketball squad. A car wreck later that year did little to help that sore knee. Terry worked through it but, a training run the following spring left him in so much pain he could barely move. Suspecting something more serious Rolly took his son to the family doctor.

Dr. Michael Piper suspected osteogenic sarcoma, an aggressive bone cancer which often begins in the knee. The diagnosis was confirmed on March 4. The only choice was amputation.

The night before his surgery, high school basketball coach Terri Fleming brought him an article. It was about an amputee named Dick Traum who went on to run the marathon, in New York city. “Someday” he told nurse Judith Ray the following morning, “I’m going to do something like that”. Doctors amputated the leg above the knee on March 9, 1977.

Terry was walking again in a few weeks, with the help of an artificial leg. There were chemotherapy sessions and physiotherapy. Golf dates with his father and through it all, a growing sense of…something. Yes his hair was falling out but Terry saw other cancer patients during this time and somehow, he felt like one of the lucky ones. Many of these people were destroyed by this disease, some were dying, but…Terry…he had a Future.

There were sixteen months of chemotherapy and, despite the nausea, Terry took up wheelchair basketball. His hands would blister and bleed as he struggled to master this new approach to an old game. Within two years he had made the national team.

But he never forgot that article, or his own sense of responsibility to those who, like himself, suffered from this terrible disease.

Fox began to train at night, first a half-mile, and then more. Prosthetist Ben Spencer helped with modifications to his artificial leg, making it easier to withstand the impact of running.

There was a half-marathon in 1979 in which he finished dead last but only ten minutes behind, the last two-legged runner. Around this time Terry had an idea that turned into an obsession. A fund raiser for cancer research. He would run across Canada in a “Marathon of Hope” and he would do it, the following spring. The goal to raise $24 million, representing a dollar from every person in Canada.

The marathon of hope got off to a wet, cold start on April 12, 1980, when Terry dipped his artificial leg in Atlantic waters, off of Newfoundland. He filled two bottles, one for a souvenir and the other, he would dump into the Pacific.

Terry Fox, Doug Alward and Darrell Fox near White river, Ontario. H/T the Canadian Encyclopedia

The response was disappointing throughout much of the maritime provinces. Little had been done to publicize the run. Very few even knew it was happening. Terry pushed on running about 42km a day, supported by Doug Alward in the van and later joined by Terry’s brother, Darrell.

Nothing whatever had been done to publicize the run throughout all of Quebec but that all changed in Ontario, with the help of businessman Isadore Sharp and Bill Vigars, of the Canadian Cancer Society. Journalist Leslie Scrivener of the Toronto Star began to write a weekly column on Fox’s run.

He became a national star in Ontario, gaining personal meetings with Prime Minister Pierre Trudeau, British actress Maggie Smith and NHL Greats Darryl Sittler and Bobby Orr.

For 143 days Fox ran ever westward covering a total of 5,373 kilometers, equivalent to over 128 full-length marathons. It all came to an end on September 1 in a place called Thunder bay.

The pain he could live with. Terry Fox had demonstrated that but the cough was relentless, and debilitating. The cancer had returned and now, it was in his lungs. He was airlifted on September 2.

STOCK Terry Fox. Published 19800903 with caption: Terry Fox’s mother and father are embraced by his companion Bill Vigars as ambulance attendants wheel Terry to jet for flight to British Columbia. Photo taken by David Cooper Sept. 2, 1980.

The CTV telethon airing later that week raised $6.5 million, for cancer research. Fox received the Companion to the Order of Canada two weeks later, becoming the youngest person ever to win Canada’s highest civilian honor. That December he won the Lou Marsh trophy as Canada’s Athlete of the Year.

Port Coquitlam High School was later renamed, in his honor.

Donations topped $24.17 million on February 1, 1981, achieving Terry’s goal of raising a dollar from every person in Canada. Terry Fox’s Marathon of Hope was a success. His struggle against that hideous disease which had taken his leg, was not.

There were long months of cancer treatments but this thing was relentless. In June 1981 Terry contracted pneumonia. He went into a coma on June 27. Terry Fox died at 4:35 am on June 28 at Royal Columbian Hospital. He would have been 23 in about a month.

Flags across all of Canada were lowered that day, to half-staff. Let Prime Minister Pierre Trudeau have the last word in this story as he himself spoke, before the House of Commons:

“It occurs very rarely in the life of a nation that the courageous spirit of one person unites all people in the celebration of his life and in the mourning of his death. Our profound gratitude for the gift which Terry gave to all of us, the gift of his own boundless courage and hope.”

March 26, 1953 Polio

” Every stomach ache or stiffness caused a panic. Was it polio? I remember the awful photos of children on crutches, in wheelchairs and iron lungs. And coming back to school in September to see the empty desks where the children hadn’t returned.” – David Oshinsky

When I was little a boy I once asked my mother. What is polio? At the time I didn’t understand the look that crossed her face but I’ve thought about it, often. What I saw that day was the realization that the nightmare which had terrorized her generation, was something her children would never have to fear.

Recall the terrors of the AIDS virus. Now, instead of the well understood vectors by which that virus is transmitted, imagine all the terrifying finality of that disease combined with the randomness, of the common cold. Like the Covid-19 nightmare of the last two years polio too was ever-present, but with far more lasting results.

The first major polio epidemic in the United States appeared in Vermont, when 132 cases were diagnosed in 1894. A larger outbreak killed 6,000 New York City residents in 1916, with over 27,000 cases diagnosed.

Wheelchair — Franklin Delano Roosevelt suffered polio at the age of 39

Poliomyelitis tended to come out in the summer, disproportionately effecting children and young adults. 58,000 cases were reported in the 1952 epidemic alone, 3,145 of them died and another 21,269 left with mild to disabling paralysis.

A President of the United States suffered from polio, as a younger man. The press did their best to treat the matter with delicacy, but the disease left him able to stand only with great pain and difficulty, dependent on a wheelchair for the rest of his life.

Others were doomed to 800-pound monstrosities called “iron lungs”, seven-foot long, “negative pressure ventilators” which reproduced the movements of breathing. The Smithsonian Institution estimated that in 1959 some 1,200 Americans were dependent on iron lungs.

Today, modern “biphasic” ventilators (alternating negative/positive pressure) are worn like the cuirass of the conquistadors, all but replacing the iron lung. As of 2014, there were only ten individuals left, living their lives in one of the things.

A story of inspiration: Martha was 13 that day in 1948 when the family buried her brother, Gaston. The boy had died of poliomyelitis, a plague which had terrorized, a generation. She didn’t tell her parents that night when she went to bed, that her body ached. Mom and Dad already had enough to worry about. Martha was a year in the hospital before coming home, in an iron lung. She would spend the next 61 years of her life paralyzed from the neck down, dependent on the 7-foott metal tube in which she lived, to breathe. I can personally think of nothing worse and yet Martha made the best of it, going on to earn high honors in high school and college, entertaining guests at her home and even writing a book once voice to text, became a reality.

“I’m happy with who I am, where I am,” Mason told The Charlotte Observer in 2003. “I wouldn’t have chosen this life, certainly. But given this life, I’ve probably had the best situation anyone could ask for.” You may be interested in the following radio segment about the life, of Martha Mason.

NPR All Things Considered segment describing the life, of Martha Mason

Early efforts to develop a vaccine, proved fruitless. One New York University study produced no immunity whatever, at the cost of nine dead children. Other vaccine trials used “volunteers” from state mental institutions.

Jonas Edward Salk was born on October 28, 1914, the son of Jewish immigrants of Irish descent. Daniel and Dora (Press) Salk were not themselves formally educated, but the couple kept their kids focused on school.

Salk attended City College of New York and New York University School of Medicine, taking the road less traveled on graduation from Med School. Instead of becoming a practicing physician, Salk went into medical research.

Salk accepted an appointment to the University of Pittsburgh School of Medicine in 1947, the following year beginning a project funded by the National Foundation for Infantile Paralysis, which later became the March of Dimes. The grant was funded to determine the number of polio types, but Salk took it several steps further. He saw it as an opportunity to develop a vaccine.

It’s not widely known that the American Revolution took place during a smallpox pandemic. George Washington himself was a proponent of vaccinating, which, as with rabies, was always done with live virus.

Live virus vaccination carries obvious risks. Dr. Salk was interested in the way the body developed antibodies to killed virus. On March 26, 1953, Dr. Salk announced the successful test of a vaccination, to prevent polio. He and his team completed lab trials in 1954, injected themselves and volunteers alike, with inert virus. Having experienced no ill effects, field trials began a short time later.

Field trials of Dr. Salk’s vaccine were some of the most extensive in history. 20,000 physicians and public health officials were involved in the trial, along with 64,000 school personnel, 220,000 volunteers, and over 1,800,000 school children.

News of the vaccine’s success was announced on April 12, 1955. Jonas Salk was hailed as a miracle worker. David Oshinsky, history professor at New York University and author of Polio: An American Story, tells a story about that day.

“The public was horribly and understandably frightened by polio. There was no prevention and no cure. Everyone was at risk, especially children. There was nothing a parent could do to protect the family. I grew up in this era. Each summer, polio would come like The Plague. Beaches and pools would close — because of the fear that the poliovirus was waterborne. Children had to stay away from crowds, so they often were banned from movie theaters, bowling alleys, and the like. My mother gave us all a ‘polio test’ each day: Could we touch our toes and put our chins to our chest? Every stomach ache or stiffness caused a panic. Was it polio? I remember the awful photos of children on crutches, in wheelchairs and iron lungs. And coming back to school in September to see the empty desks where the children hadn’t returned.”
David Oshinsky

Jonas Salk consumed over seven years of his life on his goal. When broadcast journalist Edward R. Murrow asked him “who owns the patent on this vaccine”, Dr. Salk replied: “There is no patent. Could you patent the sun?”

All those years, all that time, work and effort, and even in the end the man took no personal financial interest in the result. A mortal virus afflicted the children of his generation. One man was going to lift heaven and earth if he had to, to stop it.

In the late 1950s, Salk became interested in building his own research institute. He searched for a site for over a year, until meeting San Diego Mayor Charles Dail, himself a polio survivor. Dail showed Salk 27 acres on a mesa in La Jolla, just west of the proposed site for the new UC campus then planned for San Diego. In June of 1960, the citizens of San Diego overwhelmingly voted “yes”, to donate the land for Salk’s dream. Construction began with initial funding from the National Foundation/March of Dimes, and completed in 1967.

Jonas Salk died on June 23, 1995, at the age of 80. A memorial at the Institute bearing his name reads: “Hope lies in dreams, in imagination and in the courage of those who dare to make dreams into reality.”

By 1979, the disease was eradicated from the United States. The worldwide effort to wipe out polio began in 1988, with the Global Polio Eradication Initiative. 20 million volunteers from virtually every country in the world have vaccinated over 2.5 billion children, at a cost of $11 billion. Worldwide, the incidence of new polio cases decreased by 99%. Today, polio remains endemic in northern Nigeria and the border regions between Afghanistan and Pakistan.

So it is that those of us born after 1955 can live out our lives in blissful ignorance, having no idea of the terrors our parents endured before us.

March 16, 2006 RPG

Channing Moss, standing with his upper body out of the Humvee, felt something and smelled smoke. He looked down to see it was himself. His body was smoking.

Paktika Province is a wild and lawless region in the east of Afghanistan, a border crossroads with the west of Pakistan and home to a number of Taliban and Al Qaeda units.

An article from Time magazine describes the U.S. base: “The U.S. firebase looks like a Wild West cavalry fort, ringed with coils of razor wire. A U.S. flag ripples above the 3-ft.-thick mud walls, and in the watchtower a guard scans the expanse of forested ridges, rising to 9,000 ft., that mark the border. When there’s trouble, it usually comes from that direction.”

article-1392699-0C581BE600000578-294_634x435 — Channing Moss, second from right

The morning of Thursday, March 16, 2006 dawned bright and clear as a force rode out from the 10th Mountain Division. Their mission was to seek out a remote mountain village, and meet with village elders. They were twenty-four American soldiers in five Humvees and a handful of Afghan National troops, riding a pickup truck.

Paktika is a trackless wilderness of ragged hillsides and wadis, seasonal riverbeds flowing southwest from the mountains of Sar Hawza, to the north. The land appears custom made for an ambush, with dangerous high spots in nearly every direction.

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Some four hours into the mission, gunfire broke out from above. First small arms, then came the rocket-propelled grenades. Twenty-three-year-old Private Channing Moss remembered, it sounded like rattling spoons.

RPGs were soon raining down. The pickup exploded, killing two Afghan soldiers. The rest scrambled to get out of the “kill zone” as three rocket propelled grenades struck Private Moss’ Humvee. Staff Sergeant Eric Wynn, 33, felt one slice through his face. Channing Moss, standing with his upper body out of the Humvee, felt something and smelled smoke. He looked down to see it was himself. His body was smoking.

article-1392699-0065C3F100000258-490_634x321 — RPG ammunition, found on the outskirts of Basra

A rocket propelled grenade is exactly what it sounds like, a weapon roughly the size of a baseball bat, propelled at nearly the speed of a bullet. Standing as he was, Channing Moss had taken one of these things in the hip, leaving nothing but the fins, sticking out of his body. The weapon now inside of him was capable of turning everyone in the vehicle to a “pink mist”.

What happened next, is beyond belief. When every human instinct says “get the hell away from that thing” Moss had a whole team by his side, throughout the ordeal. Company medic Spc. Jared Angell, 23, working to stabilize that thing for transportation. Lieutenant Billy Mariani came over once the fighting had died down: “I grabbed his hand and I just said, ‘Hey, buddy, we’re gonna get you out of here.’” Badly wounded himself, Wynn literally held his own face together while reporting casualties over the radio, and holding Moss’ hand.

article-1392699-0C584A4E00000578-13_306x360 — Private Channing Moss

The MEDEVAC crew arrived escorted by an Apache attack helicopter, they knew what they were dealing with. Army regulations say it’s too dangerous to carry such a human bomb. It could take out every man on the chopper and blow the bird out of the sky: four MEDEVAC crew members, and three wounded soldiers.

Pilot CW2 Jorge Correa spoke with his team: “I asked my crew, you know, ‘Are you guys comfortable with this? Because I wasn’t gonna put my crew in jeopardy if they weren’t comfortable with it.” Co-pilot Jeremy Smith recalled the moment: “We all said, ‘Yeah, let’s get him on board and let’s get outta here.’”

It was the same thing, back at the aid station. Explosives expert Staff Sgt. Dan Brown. Two surgeons, Major John Oh and Major Kevin Kirk and the whole team at the aid station. Three surgical staff. All did their jobs knowing that, at any instant, the whole team could be vaporized.

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Channing Moss was well beyond the “golden hour” with expectations of survival, growing dim. The man’s heart actually stopped and the surgeons administered epinephrine, knowing that physical heart massage could detonate the ordnance still inside the man’s body.

Despite massive injury to his torso Private Moss, survived. There would be four more surgeries back at Walter Reed and an endless hell of physical therapy as the man progressed from bed to wheel chair to crutches, to a cane. Moss had a Purple Heart coming and then some but refused to receive it, until he could stand on his own two legs and walk to receive his medal.

article-1392699-0C581BEF00000578-877_634x446 — Channing Moss and his wife Lorena, reunited with Majors Oh and Kirk

Explosives expert Dan Brown spoke for the whole team, I think, in explaining what they had done: “He was American, he was a solider, he was a brother and he was one of us. And there was nothing gonna stop us from doing what we knew what we had to do … We knew we did right. In that screwed up world we did something right.”

A Trivial Matter:

While rare, unexploded ordnance has been lodged inside of living human bodies on no fewer than thirty six occasions between WW2 and the modern era, requiring surgical removal. All but four, survived.

November 3, 1752 Quacks

As for the man who blinded Händel and all but murdered Bach, he worked most of his 72 years blinding hundreds of unfortunates before he himself, lost his sight. The English writer Samuel Johnson later described the man’s life as “an instance of how far impudence may carry ignorance.”

From Brahms to Beethoven, Mendelssohn to Mozart, German composers have formed the core and the nucleus, of western music. And not just the classical stuff. Frankfurt-born Hans Zimmer has composed scores for over 150 different films including The Lion King, the Pirates of the Caribbean series, Gladiator, and the Dark Knight trilogy. The German-born Persian composer Ramin Djawadi may not be a household name but we know his scores for the 2008 Marvel film Iron Man and season 7 of Game of Thrones, both nominated, for Grammy Awards. The German-American singer/songwriter Henry John Deutschendorf Jr. may not be a household name but his stage name certainly is. We remember him, as John Denver.

1685 was a good year for German composers, George Frideric Händel born on February 23 in Halle and Johann Sebastian Bach barely a month later, in Eisenbach. Bach’s father Johann Ambrosius was a 7th generation musician and encouraged the boy, to learn the violin. Not so Händel ‘s father. A respected barber-surgeon aged 63 at the time of Händel’s birth to his second wife Dorothea, Georg expected his son to study civil law.

Little George found means to smuggle a clavichord into an attic room where he would steal away to practice, while his parents slept.

The boy was yet to turn ten when he accompanied his father to the court of the Duke of Johann, Adolf I. Somehow, George found himself on the organ stool and, when he began to play, Georg could only wonder where THAT came from. The Duke was so impressed he persuaded his father to allow him to study music and the rest, is history.

J.S. Bach was only ten when he lost both of his parents, only eight months apart. It was an uncle, Johann Christoph, who introduced the boy to the organ. Like Händel , Bach went on to become one of the most prolific composers of the Baroque era.

From 1727 to this day the anthem Zadok the Priest is performed at coronation ceremonies, of British royalty. The magnificent strains of George Frideric Händel’s “Messiah” and Johann Sebastian Bach’s “Christmas Oratorio” are favorites, of the Christmas season. And yet there is another, darker connection between the two men. While the two never met both composers were blinded, by the same quack physician.

In the Dutch language a kwakzalver is a seller of cures, nostrums and potions of dubious origin, and little efficacy. In 1665 an outbreak of Bubonic Plague ravaged London causing doctors to flee by the score leaving quacksalvers and charlatans to pray on the vulnerable, and the fearful.

So bad was it Daniel Defoe, author of Robinson Crusoe, penned the following:

“Infallible preventive pills against the plague.” “Neverfailing preservatives against the infection.” “Sovereign cordials against the corruption of the air.” “Exact regulations for the conduct of the body in case of an infection.” “Anti-pestilential pills.” “Incomparable drink against the plague, never found out before.” “An universal remedy for the plague.” “The only true plague water.” “The royal antidote against all kinds of infection”;—and such a number more that I cannot reckon up; and if I could, would fill a book of themselves to set them down.
Daniel Defoe

British surgeon Dale Ingram remarked: “Every one [of the quacks in London] was at liberty to prescribe what nostrum he pleased, and there was scarce a street in which some antidote was not sold, under some pompous title.”

Clark Stanley claimed to have studied with native Hopi shaman and learned the medicinal benefits, of snake oil. The original snake oil salesman made a tidy sum until the US Congress passed the Pure Food and Drug Act, in 1906. In 1917, investigators discovered that Stanley’s elixir was nothing but ordinary mineral oil and beef fat flavored with red pepper, and turpentine. William Bailey’s RadiThor, a nostrum for the cure of erectile dysfunction was basically radium, dissolved in water. Ebenezer Byers, the wealthy Pittsburgh industrialist who won the 1906 US Amateur golf tournament was so enamored of the stuff he drank two to three bottles, every day. The federal government shut RadiThor down in 1932 but not before Byers met a horrible end, his skeleton destroyed and much of his skull eaten away, his jawless body buried, in a lead lined coffin. In 1822, British businessman James Morrison cured his own “inexpressible suffering” with a home made vegetable pill said to cure, whatever ails you. Morrison’s “vegetable universal medicines” were roundly criticized by the medical establishment of the time, but that didn’t seem to hurt business. In 1836 one of Morrison’s resellers was convicted of manslaughter when the post-mortem of one unfortunate revealed a belly full of Morrison’s pills, to be the cause of death.

Which brings us to John Taylor and no, I’m not talking about the founding member, of Duran Duran. The self-styled “Chevalier” (knight) John Taylor was an oculist, Royal Eye Surgeon to none other than Britain’s King George, II.

Flamboyant, egotistical and utterly without principle, Taylor would ride into town in a horse drawn carriage painted with images of eyes and the words qui dat videre dat vivere (giving sight is giving life), painted on the side. Victims err, I mean patients of this Baroque era ShamWow pitchman were instructed to leave the bandage on for seven days, plenty long enough for the good doctor to get paid, and leave town. When he wasn’t busy writing his two-volume autobiography “The Life and Extraordinary History of the Chevalier John Taylor”, Taylor would ride into town and deliver a speech on a street corner before performing surgery. On the street corner. In an age before anesthesia with little conception of bacteria the idea was to get in and out, as quickly as possible.

Bach was losing his sight when he underwent the first of two unsuccessful surgeries. After the second, the composer developed a painful post-operative eye infection. Unsurprisingly, a ‘cure’ of laxatives and bleeding did little to relieve the symptoms. Johann Sebastian Bach died of his infection, just a few months later.

Händel was suffering with cataracts when he met the good doctor. Taylor performed a “couching” of the lens on this day in 1752, the insertion of a sharp hook to dislodge the lens and push it down, to emit light. On those few occasions where the procedure succeeded the patient would wear enormous, thick glasses to compensate, for the rest of his life. The other 70 percent including Mr. Händel …went blind.

The man who blinded Händel and all but murdered Bach worked most of his 72 years blinding hundreds of unfortunates before he himself, lost his sight. The English writer Samuel Johnson described the man’s life as “an instance of how far impudence may carry ignorance.” Today the name of John Taylor is all but forgotten, while the works of Bach and Händel live on, after all these centuries.

There’s a reason they call this stuff…Classical.

August 12, 1865 The Shoulders of Giants

Today, the idea that microorganisms such as fungi, viruses and other pathogens cause infectious disease is common knowledge, but such ideas were held in disdain among scientists and doctors, well into the 19th century.

In the 12th century, French philosopher Bernard of Chartres talked about the concept of “discovering truth by building on previous discoveries”. The idea is familiar to the reader of English as expressed by the mathematician and astronomer Isaac Newton, who observed that “If I have seen further it is by standing on the shoulders of Giants.”

Nowhere is there more truth to the old adage, than in the world of medicine. In 1841, the child who survived to celebrate a fifth birthday could look forward to a life of some 55 years. Today, a five-year-old can expect to live to eighty-two, fully half again that of the earlier date.

Yet, there are times when the giants who brought us here are unknown to us, as if they had never been. One such is Dr. Ignaz Semmelweis, one of the earliest pioneers in anti-septic medicine.

In the third century AD, the Greek physician Galen of Pergamon first described the “miasma” theory of illness, holding that infectious diseases such as cholera, chlamydia and the Black Death were caused by noxious clouds of “bad air”. The theory is discredited today, but such ideas die hard.

The germ theory of disease was first proposed by Girolamo Fracastoro in 1546 and expanded by Marcus von Plenciz in 1762. Single-cell organisms – bacteria – were known to exist in human dental plaque as early as 1683, yet their functions were imperfectly understood. Today, the idea that microorganisms such as fungi, viruses and other pathogens cause infectious disease is common knowledge, but such ideas were held in disdain among scientists and doctors, well into the 19th century.

In 1846, Semmelweis was appointed assistant to Professor Johann Klein in the First Obstetrical Clinic of the Vienna General Hospital, a position similar to a “chief resident,” of today.

At the time, Vienna General Hospital ran two such clinics, the 1st a “teaching hospital” for undergraduate medical students, the 2nd for student midwives.

The difference was well known, even outside of the hospital. Expectant mothers were admitted on alternate days into the First or Second Clinic. Desperate women begged on their knees not to be admitted into the First, some preferring even to give birth in the streets, over delivery in that place. The disparity between the two clinics “made me so miserable”, Semmelweis said, “that life seemed worthless”.

He had to know why this was happening.

Midwife students had no such contact with the dead. This had to be it. Some unknown “cadaverous material” had to be responsible for the difference.

Semmelweis instituted a mandatory handwashing policy, using a chlorinated lime solution between autopsies and live patient examinations.

Mortality rates in the First Clinic dropped by 90 percent, to rates comparable with the Second. In April 1847, First Clinic mortality rates were 18.3% – nearly one in five. Hand washing was instituted in mid-May, and June rates dropped to 2.2%. July was 1.2%. For two months, the rate actually stood at zero.

The European medical establishment celebrated the doctor’s findings. Semmelweis was feted as the Savior of Mothers, a giant of modern medicine.

No, just kidding. He wasn’t.

The imbecility of the response to Semmelweis’ findings is hard to get your head around and the doctor’s own personality, didn’t help. The medical establishment took offense at the idea that they themselves were the cause of the mortality problem, and that the answer lay in personal hygiene.

Semmelweis himself was anything but tactful, publicly berating those who disagreed with his hypothesis and gaining powerful enemies. For many, the doctor’s ideas were extreme and offensive, ignored or rejected and even ridiculed. Are we not Gentlemen!? Semmelweis was fired from his hospital position and harassed by the Vienna medical establishment, finally forced to move to Budapest.

Dr. Ignaz Philipp Semmelweis was committed to an insane asylum on July 31, 1865, twenty-three years before Dr. Louis Pasteur opened his institute for the study of microbiology.

Barely two weeks later, August 12, 1865, British surgeon and scientist Dr. Joseph Lister performed the first anti-septic surgery, in medical history. Dr. Semmelweis died the following day at the age of 47, the victim of a blood infection resulting from a gangrenous wound sustained in a severe beating, by asylum guards.

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