Infectious diseases have long been the companions of war and natural disaster. For those that barely escaped death in the calamities of antiquity, walking away with what appeared to be a light injury, the agony of a gangrenous wound or convulsive, back-breaking muscle spasms would deal an impending final blow. For centuries, a dreaded complication from an innocent blister or a bullet wound was the untreatable and catastrophic tetanus, caused by Clostridium tetani.
It is common knowledge that the discovery of penicillin in the laboratory of Alexander Fleming radically changed the world of medicine and public health, allowing us to treat and cure once intractable and deadly bacterial infections. Less well-known is the winding road from discovery, past numerous roadblocks including production limitations and the second World War, to widespread use. A decade and a half of limited access to the world’s first antibiotic came to an end in 1943, when a prolifically moldy cantaloupe was purchased from a grocery store in Peoria, Illinois. We would double down in our battle against infectious diseases less than a decade later, when two female scientists inspired by the humble discovery of penicillin would identify the first known antifungal agent in the mucky soil of a Virginia dairy farm.
The mother gazes at her naked, lethargic infant, wan with a pustular red rash dotting his chest. She’s dressed in the fashion of the day: a high-necked black blouse with leg-of-mutton sleeves, a heavy full-length skirt, a formless red feather jutting from her hat. She holds a white handkerchief to her distorted scarlet face, one arm hanging limply at her side, seemingly in despair over the lamentable circumstances that have brought her to this bare waiting room.
The Nuremberg Code was drafted in 1947 following the appalling revelations of human experimentation committed in Nazi concentration camps. The overarching goal of the Code was to establish a set of rules for the ethical conduct of research using human subjects, guaranteeing that the rights and welfare of such participants would be protected. Two important principles guide and define this Code: the concept of voluntary, informed consent and that no experiment shall be conducted in which “there is an a priori reason to believe that death or disabling injury will occur.”
It seems to have started, as many things medicinal do, with Hippocrates. We may not understand precisely why, some 2000 years ago, the great Greek physician chose to insert the bladder of a pig into a patient’s chest and then inflate this porcine balloon. But it may have had something to do with tuberculosis and with the phenomenon of “pulmonary collapse,” which has had a surprisingly long and fruitful run in the annals of medical history.
The plague is back, and this time it’s not thanks to far-voyaging ships or caravans traversing some distant trade routes, but to corn. This disease, caused by one of man’s oldest bacterial foes, Yersinia pestis, and spread by flea-infested rodents, is often overlooked in modern times in favor of more headline-grabbing epidemics like Ebola, HIV, and antibiotic-resistant STDs. But the plague has always kept close quarters with mankind and continues to surprise us with its adaptability.
Laissez les bons temps rouler! Tomorrow is the final and momentous hurrah of the Carnival season, which culminates with Mardi Gras, otherwise known as Fat Tuesday. In New Orleans, the city I call home, Carnival is a season of festivities, decadence, and tradition, one that is celebrated amongst neighbours and visitors alike. Our revelry is an egalitarian one – everyone is welcome to come witness and participate in Carnival. But, for over a century, just a couple of hours away from the Crescent City, there lived a community of exiles, quarantined and barred from society, who were forced to forge their own Mardi Gras traditions. In honor of the biggest party of the year, I’m republishing my article on the celebration of Mardi Gras at one of America’s last leper colonies, just a few hours up the Mississippi river in Carville, Louisiana.
Abracadabra! Many of us are familiar with this mystical incantation. Its arcane staccato and euphonious intonation has become deeply ingrained in our language through the word’s use as a magical catchphrase. The hex was, in my childhood experience, rather useless when it came to opening locked cabinets and provoking instantaneous transformations; nothing was conjured and very little materialized except for my own disappointment. But millennia past, this word was held in reverence, and it was used for a whole other purpose altogether. Abracadabra was not a silly-sounding piece of magician’s gibberish, but the “most famous of the ancient charms or talismans employed in medicine” and a powerful invocation against a very specific and very dangerous curse: malaria.
In March of 1942, a young woman was dying of sepsis in a New Haven hospital. In just one day, she would be miraculously revived by a newly discovered experimental drug, seemingly by “black magic” as one consulting physician would mutter. The woman’s full recovery with the new antibiotic known as penicillin was the very first occasion of its usage in the United States and would jump-start the pharmaceutical industry’s interest in and manufacture of the drug (1).
The Hajj, the pilgrimage to Mecca by millions of Muslims from around the world, is one of the largest gatherings of man on the face of the earth. This annual event took place just last month with relatively little fanfare from the news media, which is, from an epidemiological standpoint, a very good thing. Every year, public health officials wring their hands at the thought of possible outbreaks caused by the global pathogen du jour capitalizing upon the convergence of millions of worshipers in the Saudi Arabian desert. SARS stole the headlines in 2009, Middle Eastern Respiratory Virus or MERS had it last year, and Ebola seemed a likely contender for this calendar year.