Advancements in the medical sciences follow a well-trod path: observation of a problem, reasoned hypothesis and experimentation, and implementation of a solution. This course is governed by logic and, occasionally, reinforced by unorthodox thinking with the ultimate goal of improving the viability of man. An exception to this rule is the invention of the rubber glove. One of the most important breakthroughs in the practice of medicine was born not of careful problem-solving and the scientific process, but of a romantic gesture, a clinical schoolboy’s crush, an event which one observer described as “Venus [coming] to the aid of Aesculapius.”
Smallpox has haunted man for almost as long as we have been walking this earth. The variola virus that causes the deadly pox had been known to liquidate entire communities, towns, and cities since antiquity, stalking along trade routes and capitalizing upon human behavior and patterns of movement. Egyptian mummies unearthed from their tombs bear the pocked faces of fortunate survivors; Chinese emperors, Indian peasants, Russian Tzars, and Australian Aborigines – around the world, millions succumbed to virus in the centuries before the discovery of an effective vaccine.
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.
It was the work of the lunar god, a “disease of the moon,” thought the Mesopotamians. The Romans attributed it to demonic possession. Priests and peasants in the Middle Ages considered the “falling sickness” a contagious evil.
Today our understanding of seizures and epilepsy rests not with lunar cycles or the supernatural, but with scientific insights into the developing brain and the pathologies of various diseases. We now know that there are over forty different disease processes that can cause the syndrome known as epilepsy, ranging from metabolic disorders to tumors, from trauma to congenital diseases.
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.
Forensic biology has made tremendous strides in the past few decades thanks largely to advances in DNA techniques and analysis. Genomic sequencing has generated new methods of human identification reaching far beyond fingerprints and dental records, providing crucial information in the course of investigations, valuable evidence in historical fieldwork, and personal closure in the wake of tragedy.
Ringworm is one of the most common and widespread childhood maladies. Deceptive in its naming, ringworm is no parasite but rather a fairly mild, though atrociously itchy, fungal skin infection that affects 300 million people worldwide. An infection with the contagious Tinea capitis fungus is usually summarily dismissed by means of antifungal medications, but for decades prior to the discovery of such cures in the 1950s, infections with ringworm and other species of fungus were as intractable and as challenging as their bacterial counterparts. The mid-twentieth century, as modern an era as it seems, marked the early days of effective antimicrobial treatments, and though practical pharmaceuticals for bacterial, viral, and fungal afflictions were on the horizon, they were still far from universally available.
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.