August 28, 2015

Dr Jenner's Dead Cut

In the summer of 1808, the already famous Gloucestershire doctor, Edward Jenner, was in London, having a miserable time. The inventor of vaccine inoculation against smallpox was stuck in the City, waiting on the interminable bureaucracy of Parliament to finalise the details for the National Vaccine Establishment. He had many enemies: anti-vaccination pamphleteers who thought his ideas were eyewash; other vaccinators who coveted his glory; and personal nemeses who seemed to block his every move. Holed up in a place he abhorred, Jenner appealed to his friends for succour, but found them wanting. He perceived his opponents, ‘by the most abominable falsities’, endeavouring ‘to ruin my private character’. So much he could bear, ‘but when I find that no friend has step’d forth even to hold an Umbrella over my head it makes me feel miserable’. He went home at the end of the year, only to find out that events had unfolded to his distaste. The new Establishment was to nourish his enemies, and to dishonour Jenner himself. In desperation, he solicited advice: ‘I may most piteously exclaim, what shall I do?’ he asked Thomas Pruen. Pruen’s reply was dismissive: ‘I am sorry for your situation, but can afford you no kind of assistance’. Jenner felt this as a ‘dead Cut’ and told Pruen so:

Dr Jenner's Lancet, Science Museum London, Wellcome Images

What if a Man had met with an old Friend who had tumbled into a Cellar or any other kind of pit & had broke his bones & had pass’d by heedless of his moanings, saying I am sorry for you but cannot stay to help you out, because I have a pressing engagement, that I must attend to in another quarter? Would this have been balsam to his Wounds or a Caustic?

A month later, after some cooling off and some mollifying correspondence, Jenner announced that ‘the Cut is heald’.

Until recently, such talk would have been filed under metaphor and left at that. Jenner was miserable, but not in pain. The ‘cut’ wasn’t real. Recent studies on the ways in which pain experience is managed by the brain have begun to change our approach, casting new light on the affective pain utterances of historical actors. We’re now in a position to say, at least tentatively, that Jenner’s misery hurt.

How so? The turn towards affect in both historical studies and the neurosciences has foregrounded the importance of emotions in giving meaning to, or in defining, painful experiences. In fact, without stimulation of the affective centres of the brain, there is no experience, only pain. On the one hand, studies of people with the rare condition of pain asymbolia have found that without affective involvement, pain is meaningless. People with this condition are fully able to sense pain, but completely unable to interpret it. Bodily injury elicits no fear, no anxiety, no compulsion to flee or fight. A hand is put into the flame and it burns, but there is no reason to withdraw it. On the other hand, there are people who have no bodily injury whatsoever, but who feel the effects of, for example, social exclusion, as physical pain. Brain imaging has discovered that brain activity in affective centres under such conditions accords with what you would expect to see in a person suffering a physical injury. In sum, physical pain requires an emotional component in order to be experienced as pain, while certain ‘negative’ emotions are experienced physically as painful.

What’s the point? The science of pain is finally catching up with what sufferers have known all along: when they communicate that their body is in pain, they’re not making it up. But the specifics of the communication are contextually grounded, culturally formed. To take such utterances seriously is to entertain new potentialities in the history of experience. Much of the emotional suffering of the historical record – hysteria, melancholia, nostalgia, for example (to all of which Dr Jenner was prone) – has been under-treated by the history of medicine, in accord with twentieth-century medicine’s dualistic predilections, where pain is physical and suffering is only emotional or psychological. To enter into the historical experiences and meanings of suffering is to open up the possibility of understanding and interpreting the emotional and physical worlds of historical actors. Both the history of the body and the history of mentalités become united in a monistic history of experience that sets out to understand the dynamic relationship among emotions, their expression, bodily sensations and bodily practices.

This post first appeared on Emotions in Dialogue. You can pre-order Edward Jenner here and here

August 26, 2015

Bestiality in a Time of Smallpox

The news is rife with fear. Influenza is abroad. Worse still, measles is said to be making a big comeback. But disease is not the only problem. The flames of fear are being fanned by the opponents of vaccination. Measles, for example, is entirely preventable, but remains among us because of concerns that the vaccine prophylactic is worse than the disease. The thoroughly debunked notion that the MMR vaccine causes autism is still at large, and with it a cluster of nebulous fears of Big Pharma conspiracies and the risks of contaminating children with manufactured diseases. Yet such fears are not new. The fear of vaccination is as old as vaccination itself. Edward Jenner’s method for preventing smallpox summoned the spectre of sinful flesh. Vaccination was akin to bestiality; the vaccine itself was a beastly sexual disease.

The original ‘vaccine’, named after the cow from which it came, was a massive step forward in smallpox prevention. Until then, children were commonly inoculated with smallpox itself, which usually resulted in a light dose of the disease. Inoculation, however, killed many who underwent it, and left the rest fully contagious. Nevertheless, when Jenner’s Inquiry into the matter finally appeared in 1798, explaining how an animal disease would prevent a human one without resorting to dangerous inoculation, it attracted as much odium as it garnered support.
Wellcome Library, London

James Gillray’s popular 1802 print of the bestial effects of cowpox  strikes the modern viewer as ridiculous: cows emerging from heads, trunks and limbs. Jenner stands centrally, penetrating the arm of a terrified patient with ‘vaccine pock, hot from ye cow’. The patient has previously been ‘opened’ by a special brew. To the right, those already vaccinated undergo a series of horrors caused by contamination with animal disease. The image is shot through with innuendo about sexual transgression (communing with the beast) and venereal disease (syphilis).The pregnant hag on the extreme right seems at once to vomit and give birth to bovine progeny, while behind her another matron sprouts the satyr-like horns of the beast. The breeches of a bumpkin are breached. The faces of others are marked by monstrous eruptions of ‘the pox’.

The image reflects the intensity of the debates and fears around vaccination. Gillray’s caption directs us to the publications of the ‘Anti-Vaccine Society’: not a formal body, but a reference to Jenner’s principal opponents. The prominent physician Benjamin Moseley was the culprit in chief, responding to the ‘Cowmania’ in 1800 with a series of concerns. While Jenner had styled cowpox Variolae Vaccinae, smallpox of the cow, Moseley called it Lues Bovilla, bovine syphilis, with all the long-term mental and nervous consequences of the human ‘pox’. He asked:

Can any person say what may be the consequence of introducing the Lues Bovilla, a bestial humour – into the human frame, after a long lapse of years? Who knows, besides, what ideas may rise in the course of time, from a brutal fever having excited its incongruous impressions on the brain? Who knows, also, but that the human character may undergo strange mutations from quadrupedan sympathy and that some modern Pasiphaë may rival the fables of old?

His classical reference might pass us by, but the invocation of bestiality would have been obvious to the educated in 1800. Pasiphaë, cursed by Poseidon, had copulated with a bull. Having built a wooden cow and covered it with cowhide, she had hidden inside it in order to receive her desired mate. She later gave birth to the Minotaur. Moseley played not only on the taint of venereal disease, but also on the fragility and sanctity of the human, warning of a hybrid and brutal progeny. Vaccination was not only dangerous, it was immoral.

Wellcome Library, London
The search was on for proof of the bestial consequences of being inseminated with animal disease. In 1805 Dr Rowley, who derived his living from the impugned technique of inoculating with smallpox, claimed to have found it and to have showed it to Moseley. Moseley marked the animalistic transformation and Rowley published exaggerated portraits of Gillray-esque figures, supposedly drawn from life. The ‘Oxfaced boy’ was presented as tangible proof of the brutal result of bestial infection. Beware the ‘modern chimera’, went the cry.

Vaccination did not properly shake the fear of bestial venereal disease until the end of the nineteenth century, with some still adamantly claiming an identity between cowpox and syphilis. From 1853, responsibility for administering the vaccine in England was put in the hands of the Poor Law Guardians. The association of vaccination with the workhouse caused a resurgence of the syphilitic fear among the well-to-do. Jenner’s innovation helped fuel concerns. After an initial vaccination from the cow, he realised that it could then be carried on from arm to arm. The matter from one vaccination pustule could be collected and inserted into the arm of the next child. What respectable mother would take her child to be contaminated with matter drawn from the arm of a ne’er-do-well? Cowpox was one thing, but what about all the other diseases that riddled the poor? The class system relied on bodies being kept apart. The State’s insistence on bringing them together seemed to risk the fabric of civilisation, even if the risk of disease was actually minute. While most doctors believed that cowpox was not related to syphilis, how could they be sure that the vaccine wasn’t tainted with the diseases of the immoral when incubated in the arms of the poor? Better to risk smallpox than to invite syphilis into one’s children.

The fearful kept their children away and a preventable disease continued to rage, often to epidemic proportions. The form taken by fear reflects the preoccupations of the society that produces it. In our times it is a fear of corporate medicine and its reckless advocates, forcing unknown risks upon our children. For early nineteenth-century anti-vaccinists, cowpox vaccination was a sordid and unholy communion, the embodiment of an immoral trinity: animality, bestiality and sexually transmitted disease. 

This post first appeared on Notches. To order Edward Jenner click here or here.

August 24, 2015

Historical Heroes: Edward Jenner

Goodness, it’s been a while. For anybody wondering where I’ve been, I promise I’ve not been idle. On the contrary, expect to see three books from this author in the next year. Better still, expect them to not be too big a burden on your pocket books. Covering a range of subjects, they nevertheless speak to a number of the themes that have cropped up on this site over the years. I’ll keep you updated, okay? First up, a short biography of the father of the vaccine, Edward Jenner. Here’s a taste of what you can expect.

Edward Jenner, a country surgeon from Gloucestershire, England, was incurably curious. Mentored by the great surgeon, collector and experimenter, John Hunter, Jenner learned to see about him a natural world to be conquered, controlled, brought under the command of the human intellect. Such was the peculiar genius of Enlightenment science and medicine.

Activated by local talk of the powers of a minor disease contracted from the udders of cows, Jenner set about experimenting with cowpox to see if it really did protect a person from the deadly ravages of smallpox. Jenner’s innovation was, first, to infect a person with cowpox from the pustules of another person who already had the disease. This would prove that cowpox was transferable among humans. This he managed to do in 1796: the first vaccination, from vacca, the Latin for cow. His second innovation was to test the power of the vaccine by attempting to give the vaccinated person the smallpox. Lest that sound horrific, keep in mind that until Jenner pioneered a safe way to protect people from the smallpox, most children had been deliberately infected with the ‘speckled monster’ itself, in the hope that they would get away with a light dose of the dreadful disease. Often, those hopes had been dashed.

Jenner had essentially pioneered the clinical trial. While there was still a way to go before the vaccine was fully understood, Jenner’s experimental spirit and his indefatigable campaign to promote his discovery had a substantial impact. Despite fierce resistance in England that would outlast his own life, Jenner’s vaccine quickly made its way around the world, going viral courtesy of empires French, Spanish and British. Death rates from smallpox rapidly tumbled. Jenner is estimated to have saved some ten million lives. This medical victory came despite repeated attacks on the Jenner’s honour, his intellect, and his humanity from his own countrymen.

In 1980, after a concerted global campaign to spread the vaccine Jenner had devised to every corner of the world, the World Health Organisation declared smallpox extinct. It is, to this date, the only human disease to have been completely eliminated from the globe. Is that not the most heroic conclusion to a most heroic career?

Edward Jenner is published in the Pocket Giants series by The History Press this November. It is available for pre-order here and here.

April 09, 2013

Thatcher Is Gone: May We All Rest in Peace

I am a product of Margaret Thatcher’s United Kingdom. I served as guinea pig for every educational experiment she launched during her Premiership, and lived within sight of the pithead at Cadley Hill, which finally closed in 1988. I saw friends risk their liberty over the ill-fated Poll Tax and stood on the sidelines of a culture marked by the bleakness of strikes, the violence of football fans, race riots, class division, and the immanence of the IRA. My England of the 1980s was a grim, knee-capped, hopeless era in which Thatcher brandished a political crowbar. I have no fond affections for her, her ideology, or her political legacy.

 Cadley Hill, 1984

That being said, and with Glenn Greenwald’s important intervention in mind, I see no humanity in dancing on Thatcher’s grave, or on anyone else’s for that matter. I do not understand how so many characteristically reasonable people – people who spend their lives looking for intellectual angles on everything with an ever-refining insistence on nuance – can take pleasure, and I am discerning an abundance of genuine heartfelt glee, from the death of a person. This kind of people bemoaned the crass triumphalism of Joe Public in America on the death of Osama Bin Laden, but happily celebrate the enfeeblement and subsequent miserable demise of a compatriot. If Thatcher was criticised for commodifying the individual, de-humanising society in the process, then the vacuous danse macabre instigated by her death seems to testify to the depths to which that de-humanisation went.

Schadenfreude is, quite obviously, not typically a particularly English quality. At the moment, however, one wouldn’t know it. By all means speak ill of the dead, but in the name of humanity stop raising a glass to death. It is unbecoming of the dignity that so many people who detested Thatcher claimed to wish to uphold.

March 10, 2013

Taxi-Driver Wisdom

It took me 49 hours to get from Ottawa to Berlin, largely thanks to one airline’s inability to be an airline. A conversation with said airline might proceed thus:

Own planes?
Rented space at airports?
Got customers?
Got any idea how put those pieces together in a workable system?
Er, well…
Trained your staff?
They don’t go by train…

(Yes, Air Canada, it’s you).

But the vagaries of travel do give one time to think, as well as ample opportunity to hear the wisdom of taxi drivers, whose lives tend to operate only between airport and city, even if once or twice they have made terrible and unforgiving journeys of their own. In fact it is the likelihood that your taxi driver is an immigrant of some kind that gives him – it is usually a him – his wisdom, for in many cases it means he has suffered. All the tedious miles ferrying us from pillar to post have given him sufficient time to reflect on the causes of that suffering, and the inordinate number of bigots he has met in the back of his cab have given him cause to reflect on the length of the roots of the evil that has been done to him. You may not always agree with your taxi driver, but should he wish to talk I suggest you listen. It is rarely dull.

One of my many couriers during the chronic pain of my latest Odyssey is a Moroccan Arab. He used to work for the East German embassy in Rabat. He liked Germans. Organised minds. Efficient workers. But everyone had a problem with flags back then and, come to think of it, the biggest problem with the world now is people with flags. Whether it’s Russians putting a flag on the ocean floor at the North Pole, Canadians waving flags on the ridiculously partisan Canadian coverage of the Olympics (who would want to miss another valiant third place finish?), or the Americans sticking flags everywhere and especially where they’re not wanted, the world’s problems basically boil down to flags. From the DRC and Rwanda to China and Taiwan, to Argentina and the UK, the flag – and the nationalism it stands for – is the fundamental barrier to us all getting along. For our problems are common, and we are all enslaved to the interests of a few who esteem themselves superior.

At the eye of the storm are the greetings-card manufacturers who have managed to sell Father’s Day to an all too compliant Western culture. Humanity should begin with family, not be in thrall to corporations who tell it when to love. He doesn’t need a day picked out at random for his son to say ‘Happy Father’s Day’, any more than he needs a government to tell him to love, protect and nurture his son. These relations existed before governments, before capital, and before flags. He put his son through college. It’s what dads do. His son bought him his taxi last week. It’s what sons do.

The ties that bind are such that no adversity of circumstance ought to bring them down. A stupid woman once told him how she left her husband for a younger man. He asked if she loved her husband. She said she used to. This concept did not fly with our man, who could not grasp the notion of a love that passes. I’m sure the woman had an unpleasant ride, but our taxi driver’s grip on the truth, full of innocence and naiveté and yet, paradoxically, tainted by experience, has a compelling quality of frankness, simplicity, purity.

I’m sorry to leave my chauffeur when we arrive at the airport. I know I’m not going to have any company for another day. But I am reassured that the shortness of the average taxi ride, and the high volume of stranded frequent flyers, means that the wisdom of the taxi driver, such as it is, will be dispensed hundreds of times in a week. Some passengers might emerge from the back of the cab feeling that the number of tips they have received en route surely merit the large one they are about to give in return.
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