Showing posts with label smallpox. Show all posts
Showing posts with label smallpox. Show all posts

Thursday, April 21, 2016

Having A Bad Day? How Johannes Kepler Found Harmony



Next time you have “one of those days” - when you forget your umbrella, catch all the red lights, or get served a latte instead of the cappuccino you ordered - contrast it with one of the days lived by someone in the 16th century. In the 1500s, people believed they were special. Our home was the center of the Universe. The Sun revolved around Earth in a perfect circle. And the Heavens were immutable. Then a handful of pesky astronomers came along and declared, "Everything you thought you knew is wrong!"

The trio of brave astronomers who deflated humanity’s ego by dethroning Earth from the center seat of the cosmos. From left to right: Copernicus, Kepler, Galileo.
Johannes Kepler and Galileo Galilei affirmed and refined ideas first put forth by Nicolaus Copernicus in the 1500s, essentially blowing people’s minds with the notion that the Earth rotates around the Sun. Kepler further showed that planets do not – gasp! – move in perfect circles, but rather follow elliptical orbits. Most people refused to entertain such nonsense and branded the ideas heretical.  
While we take this knowledge for granted today, the idea that planets - including Earth - move in imperfect circles (i.e. ellipses) with the Sun at one of the foci was deeply contrarian to what most people believed at the time.
We can better appreciate the magnitude of Kepler’s discovery, and put our trivial modern complaints in perspective, by reviewing what life was like back then. Born in Germany in 1571, Kepler never really got to know his father, Heinrich; like many men at the time, he constantly joined militias fighting numerous wars across Europe. During the few times Heinrich was home, his belligerent nature brought war into the house. Kepler’s mother, Katharina, was an amateur herbalist who made potions in an effort to help the sick.
Medicine in the Dark Ages was brutal, based on folktales and superstition. Treatments were usually senseless, cruel, and wildly ineffective. In addition to bloodletting (shown) and exorcism, people were guinea pigs for a wide array of herbal concoctions and potions. Kepler’s mother dabbled in the herbal arts, something she would later regret.


While Galileo made great strides in developing telescopes that revealed unprecedented detail of distal objects, no one suspected that our eyes were missing anything important here on Earth. People of Kepler’s time had no idea that the water they drank, the food they ate, or the air they breathed teemed with billions of microscopic creatures that could sicken them. Consequently, the people in Kepler’s time had no concept of germs, so illness was often attributed to the supernatural.

 

Due to this lack of medical knowledge, and seemingly endless warfare, the average life span for someone in Kepler’s day was typically just 40 years. One of the major ailments of his time was the dreaded “pox”, referring to the smallpox virus that we have now eradicated from the planet thanks to vaccination efforts. Kepler himself suffered from smallpox as a child, the infection leaving him with impaired vision and disfigured hands.

Smallpox disfigured or killed millions before Edward Jenner developed a vaccine in 1796.
Like many fathers during his time, Kepler had to endure heartbreaking losses involving his children. His first two children with his first wife, Barbara, died in infancy. His other three children all suffered from an outbreak of smallpox, and his 6 year old did not survive it. The pox was probably brought to Prague by invading soldiers, who also burned houses, raped the women, and slaughtered the men. Somehow the Keplers survived the war in Prague, but Barbara soon died of typhus. Kepler would marry again but suffer the loss of three more children from epilepsy, tuberculosis, and smallpox again.

 

It is difficult for us to imagine, but radio, television, and WiFi did not exist. There was no electricity, indoor plumbing, or sanitation services. No central heating, no air conditioning, no water treatment systems. People did not bathe regularly (usually just once a year!) nor did they brush their teeth. Most likely your job would be in agriculture and you would be poor and illiterate. Meat was a luxury item that was put on display to impress guests during conversation, giving rise to the sayings “bring home the bacon” and “chew the fat”.

 

Of course there were no planes, trains, or automobiles. Most people lived in small villages and their entire existence was usually confined to a 25-mile radius. Everyone knew everyone - stories and gossip were a major source of entertainment (some things never change). Being a mathematical wizard, Kepler’s talents gave him a license to travel and hobnob with royalty as an “Imperial Mathematician”. But even that couldn’t help him surmount the tide of hysteria about to consume his family.

 

While many may argue that doing math for a living is torture enough, Kepler had the misfortune of being drawn into the frenzy of witchcraft. Kepler fought tirelessly to free his beloved 70 year old mother, Katharina, who was imprisoned as a witch because one of the potions she administered to a neighborhood gossip tasted vile and made her sicker. Not helping matters, Katharina had an aunt who was burned for being a witch…and she did ask to have her father’s skull turned into a drinking cup for Johannes (it’s not like they had a Sharper Image store to find man-toy gifts).

 

If these charges seem a tad outrageous to you, you might be right. Some argue that the accusations against Kepler’s mother were fashioned to make Kepler suffer. His radical ideas about the cosmos were heretical to many, but it is not easy to bring an Imperial Mathematician to trial. So they went after an easier target.  

 

Despite eloquent counter-arguments delivered by her son, Katharina’s trial dragged on and she was sentenced to territio verbalis, a psychological terrorism in which she was shown the horrific instruments of torture and subjected to gruesomely detailed descriptions of how they would be used. She did not cave and defiantly announced, “They may do whatever they wish to me. Even if they wanted to pull one vein after the other out of my body, I would have nothing to confess.” So after 425 days in a dank prison with little more than bread and broth, she was finally released. While there is an undeniable element of victory here, the abuse wrecked her aging body and she died nearly six months later. 

Just hearing about the medieval torture devices was enough to force a confession out of many a prisoner.
During this time when Kepler was fighting a silly superstition to save his mother and watching helplessly as his children succumb to disease, he also lost a good friend in The Thirty Years’ War raging between the Catholics and Protestants. In the midst of the pointless bloodshed driven by the irrational behavior of men, Kepler cocooned himself in his study to find solace in the beauty of mathematics and geometry, resulting in another masterpiece, The Harmony of the World. Like his mother, he seemed to draw strength from adversity, and discovered logic in the Universe when none could be found among the humans on Earth.

Written during a period of his life that was distinctly unharmonious, Kepler’s Harmonices Mundi (Harmony of the World) contained his famous third law of planetary motion.
So the next time you feel like your planets must be out of alignment, pause for a moment to reflect on the wonderful marvels that surround us today and make  life longer, healthier, and more entertaining. With war, plagues, poverty, and witch-hunts raging all around him, Kepler was able to transform our world with his mathematical prowess. Kepler weathered a hurricane of human folly and managed to illuminate fundamental truths in a time of darkness that shine to this day, over 400 years later.

Kepler also recorded the appearance of this “new star” in the sky in 1604, which is now known to have been a supernova. He also has a space telescope named after him; launched in 2009, the Kepler space observatory has found thousands of new candidate planets.  


 

Contributed by:  Bill Sullivan


 

Reference:

Connor, James A. (2004). Kepler’s Witch. New York, NY. HarperCollins Publishers, Inc.

 

Thursday, April 16, 2015

Outbreak! Time To Review The Origins Of Vaccination

The US is currently experiencing an alarming spike in the number of measles cases. Yes, measles! Don’t we have a vaccine for that virus? Yes, we do. It first became available in 1963 and was so effective that by 2000 the US declared it had eliminated measles. But in 2014, a record 644 cases suddenly appeared in 23 distinct outbreaks.

Measles is caused by a very contagious virus that infects the respiratory system, causing high fevers, coughing, and a nasty rash. Complications are common and can lead to life-threatening situations, especially in undeveloped nations. Measles has rarely been seen in the US in recent decades, but has made an alarming resurgence in 2014-15.
Unfortunately, 2015 is shaping up to be a bad year for measles, too, largely due to a multi-state outbreak propagated by so-called anti-vaxxers attending Disneyland in California. A study published last month showed that this single incident has spread measles to seven states and two additional countries and was due to parents who declined to vaccinate their children. Sadly, many of those who were infected were innocent bystanders of this misguided decision - they could not be vaccinated due to age or a legitimate medical condition.

We’ve recently discussed some of the fears the anti-vaccine movement cites to justify their opposition to vaccination, much of which stems from the completely fraudulent studies of the disgraced doctor, Andrew Wakefield. But perhaps it is worthwhile to take a trip back in time to review the origins of vaccination, which begin with the horrifying disease called smallpox.

Referred to as “the Speckled Monster”, smallpox is caused by an extremely contagious virus with a signature “dumb-bell” appearance.
Once infected with the smallpox virus, the victim becomes covered head to toe with burning pustules. The virus can also infect internal organs, which usually meant death in less than a month. Those lucky enough to survive the infection were left badly scarred and disfigured. Humanity has been struggling with this dreadful affliction since at least 1100 BC. We know this because the mummy of Egyptian pharaoh Ramses V contains the signature pockmarks caused by smallpox. Recent genetic studies suggest that the smallpox virus emerged 3000 to 4000 years ago in east Africa.

Smallpox is one of a number of infectious agents that has been a major factor in steering the course of history. Smallpox was instrumental in the conquering of the Aztecs in 1521 by Hernan Cortes and the Incas by Pizarro in 1533. Disturbingly, the early Puritan settlers in North America considered smallpox a “miracle” that purged their “New World” of the Native Americans.
The first advance in treating smallpox, which hinted at a new era of medicine, was made around 950 AD in China. Someone took note that smallpox survivors never got the disease twice and got the idea that maybe by giving someone a tiny bit of the disease on purpose would protect them from the real thing. To do this, they took the scabs from someone who looked like they were beating the infection, ground them into a powder, and blew them up the nose of someone who hadn’t caught smallpox yet. It sounds disgusting, but it worked! The scab-sniffers got very mild cases of smallpox but recovered.

By the late 1600s, the Chinese practice of delivering smallpox scabs into healthy people to prevent the disease had been refined and spread to the Turkish Empire. As shown above, a drop of pus from a person beating smallpox was scratched into the skin to “inoculate” another person and prevent him or her from getting the full-blown disease. The technique spread to England thanks to Lady Mary Wortley Montagu, wife of the ambassador to Turkey in the early 1700s.
These primitive vaccination efforts carried a great deal of risk compared to today’s methods. Since the individual was being inoculated with live smallpox virus, there was always a chance of developing full-blown smallpox and dying, along with the risk of transmitting smallpox to others. To offset the latter, England instituted “inoculation stables”, woeful low-cost sheds where peasant children were sent to stay until they either died or recovered from the smallpox inoculation.

Enter Dr. Edward Jenner. Born in 1749, he did time in an “inoculation stable” as a young lad. Smallpox may not have scarred his skin, but his experience in the stable scarred him psychologically. He decided to dedicate his life to finding a better way to beat the “Speckled Monster”. Just like the Chinese in 950 AD, keen observation is what led Jenner to an amazing breakthrough. But Jenner’s eureka moment didn’t occur in the lab or in the hospital. It came to him while observing…milkmaids.


Milkmaids had a reputation for always being pretty, with clear and smooth skin, largely because they never seemed to suffer smallpox and the extensive scarring it left in its wake. There was even a saying at the time, “If you want to marry a woman who will never be scarred by the pox, marry a milkmaid.”
In talking to milkmaids, Jenner learned that they frequently caught cowpox, a very mild disease carried by the cattle they handled every day. The milkmaids who caught cowpox would develop a few pustules on their hands that resolved on their own fairly quickly. But when Jenner proposed that cowpox was protecting the milkmaids from smallpox, most people wrote the idea off as superstitious nonsense.     

Jenner knew he had to conduct an experiment to prove the naysayers wrong. Jenner somehow convinced the parents of a young boy named James Phipps to be the guinea pig in his experiment. Jenner took cowpox pus from a milkmaid’s hand and scratched it into James’s arm. As expected, the boy developed a mild case of cowpox and recovered from it, unscathed. He called the process "vaccination" based on the Latin word for cow, "vacca". 

The next step was to see if the cowpox vaccination protected the boy from real live smallpox. So Jenner, probably with shaking hands, inoculated James with smallpox pus taken fresh from a victim at the height of the illness. Each day they waited for what must have seemed like an eternity, but James never came down with smallpox. Jenner was not only right, but his success also inspired others that we do not have to take infectious disease lying down. We can fight it.


Jenner tried 20 more times to inoculate James Phipps with smallpox, but the boy never showed a single pustule. What did James get for being used as a lab rat? Jenner built him a cottage, which is today the Jenner Museum.
So what is actually happening here? How does vaccination protect someone against an infectious disease? Unbeknownst to Jenner, we now know that microbes cause infectious disease – viruses, bacteria, fungi, and parasites. We also know that we are equipped with an immune system that battles these foreign invaders. A vaccine trains the immune system to recognize an invader before it conquers too much territory. Microbial invaders consist of foreign proteins (called antigens) that are recognized by immune cells as “non-self”. These immune cells take up to two weeks to fully kick into gear and destroy the invaders. In some cases, the invaders grow too fast or produce toxins and the immune system just can’t outpace the infection.

But when the immune system wins, it remembers the invader. If the pathogen dare challenge you again, your immune system reacts much more quickly, usually destroying the invader before you even experience symptoms. Vaccination allows your immune system to preview antigens from a weakened form of the virus (like smallpox from a pustule of a recovering patient) or a related virus that causes little or no disease (like cowpox), so it will be “primed and ready” for the real invader if it should come along.
 
With the first vaccination came the first anti-vaxxers. James Gillray, who drew this infamous cartoon in 1802, misled people into believing that Jenner’s cowpox inoculation would “bovinize” people, causing them to give birth to calves or have them spring out of the body. 

The word “virus” comes from a Latin word meaning “poisonous force”. Humanity has been battling these forces for thousands of years and through persistence and hard work, we finally hit upon a remarkably safe and effective antidote. To refuse the antidote may seem like a personal choice, but as evidenced by the recent measles outbreak, it puts all of us in danger.



Contributed by:  Bill Sullivan
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Majumder, M., Cohn, E., Mekaru, S., Huston, J., & Brownstein, J. (2015). Substandard Vaccination Compliance and the 2015 Measles Outbreak JAMA Pediatrics DOI: 10.1001/jamapediatrics.2015.0384

Babkin, I., & Babkina, I. (2015). The Origin of the Variola Virus Viruses, 7 (3), 1100-1112 DOI: 10.3390/v7031100

Marrin, Albert. “Dr. Jenner and the Speckled Monster”, Dutton Children’s Books, New York, 2002.