Polio is back in Nigeria: only two cases that we know of; which isn’t particularly comforting, since most folks with polio have no symptoms.
The good news is that vaccines are available: and may get to most of those who need them before the disease does.
Zika, another viral disease, is still in the news, this time a case in Texas that affected a baby.
On a happier note, researchers are making progress on a brain-machine interface that could help folks walk again.
Saints: Sickly and Otherwise
Dominic Savio grew up in northern Italy when Tivoli Gardens was new. He enjoyed praying, was a good student, and when he was 14 — you guessed it, got sick.
A doctor agreed with his parents that Dominic was sick: and applied an old-fashioned medical procedure1 called bloodletting.
Dominic would likely have died anyway, the symptoms sound like pleurisy, but getting his arm cut 10 times over the next four days probably speeded things up.
The doctor assured Dominic’s parents that he’d recover. But when Dominic asked for the parish priest, so he could receive the sacrament of reconciliation and the Eucharist, his parents went along with his request.
After the priest had seen him, Dominic asked his father to read him prayers for the Exercise of a Happy Death from a book of devotions.
A little later, Dominic’s last words (translated) were:
“Goodbye, Dad, goodbye . . . what was it the parish priest suggested to me … I don’t seem to remember . . . Oh, what wonderful things I see …”
(From John Bosco’s “Three Lives: The Life of Dominic Savio,” chapter 24, via Wikipedia)
Dominic Savio isn’t the youngest Saint: there’s Paulus Lang Fu, for example, who was nine when he died.2
I suspect that some “lives of the Saints” books focus on folks like Dominic Savio, Damien of Molokai, and Maximilian Kolbe because we like sentiment and drama.
However, sainthood isn’t restricted to folks who experienced a messy martyrdom, or died of some horrible disease: smiling all the way.
Some fit that profile, but the Venerable Bede and Jane Frances de Chantal died peacefully, in their 60s.
They’re Saints because they “practiced heroic virtue and lived in fidelity to God’s grace” during their lives. (Catechism of the Catholic Church, 823)3
Getting and Staying Healthy: Within Reason
(From EPA, via BBC News, used w/o permission.)
I’ll be talking about polio, Zika fever, and brain-machine interface technology: but won’t claim that dealing with disease and disability offends God.
Given some traditional assumptions about faith, science, and dealing with reality; I’d better explain why I think using my brain is okay.
You saw the ardent Mr. Squibbs a couple weeks ago, although I didn’t introduce him at the time. He’s a mad scientist’s assistant whose brain had been replaced with that of a flying squirrel — and that’s another topic. (August 5, 2016)
Getting back to my brain and why using it doesn’t make me cringe with guilt and shame — I’m a Catholic, so I believe that God exists: the Father, Son, and Holy Spirit.4 (Catechism, 1)
I depend on God for salvation, and for my continued existence. (Catechism, 301, 1949)
But God made a world where the creatures in it, including me, play a role in making things happen. (Catechism, 41, 306–308)
Thinking, making decisions based on reason, is part of being human: but it’s option, not a requirement. I can use my brain, or decide to let whim and emotion guide me. (Catechism, 154–159, 311, 1730, 1778, 1804, 2339)
Let’s back up a little, and ask another question — “is being healthy okay?”
The short answer is yes; life and health are good things, “precious gifts entrusted to us by God:”
“Life and physical health are precious gifts entrusted to us by God. We must take reasonable care of them, taking into account the needs of others and the common good….”
Taking care of my body is okay, but it’s wrong “…to sacrifice everything for it’s sake, to idolize physical perfection and success at sports…..” (Catechism, 2289)
It’s okay to help sick people get better, too, and find new ways to cure disease. It’s even okay to transplant organs, providing we don’t kill or maim one person to help another. (Catechism, 2292–2296)
Even if a disease or injury would eventually kill me, medical treatments — including painkillers — are okay: within reason. (Catechism, 2276–2279)
That seems clear enough. Being healthy is okay, staying healthy is okay: within reason.
I’m forgetting something. No, don’t tell me, let me think: Saints. Mad scientists. Guilt, shame, and getting a grip. Right.
I accept the idea that my continuing existence depends on God, and that God made a world where the creatures in it — including me — help make things happen. (Catechism, 301, 306–308)
Thinking, making decisions based on reason, is part of being human. So is deciding whether or not I let whim and emotion guide me, or use my brain, and I said that before.
That’s why I think that I’m expected to keep myself healthy: within reason. (Catechism, 2288–2289)
Fear, Facts, and “a Precious Discovery”
(From James Gillray, H. Humphrey, Anti-Vaccine Society; via Wikimedia Commons; used w/o permission.)
“The Cow-Pock—or—the Wonderful Effects of the New Inoculation!”
About two centuries back now, James Gillray warned the British public against a controversial medical technology: inoculation.
Vaccination against disease goes back at least five centuries, when folks in China practiced a sort of variolation — I’m putting a resource list near the end of this post5 — which involved inhaling powdered material made from the scabs of someone with mild smallpox.
Disgusting, I know, which may help explain why Martin Lister didn’t follow up on reports he’d read about the procedure.
Finally, a 1714 letter published in the Philosophical Transactions got attention in Europe and America; leading to Lady Mary Wortley Montagu’s experiment with prisoners on Newgate Prison’s death row.
Edward Jenner survived a variolation procedure that included bloodletting and starvation, and made the connection between cowpox and smallpox a few decades later.
Experiments like Lady Montagu’s and Jenner’s triggered strong reactions, sensible and otherwise:
“for a man to infect a family in the morning with smallpox and to pray to God in the evening against the disease is blasphemy; that the smallpox is a judgment of God on the sins of people, and that to avert it is but to provoke him more; that inoculation is an encroachment on the prerogatives of Jehovah, whose right it is to wound and smite.”
(Contemporary reaction to inoculation experiments by American physician Dr. Zabdiel Boylston, circa 1720)
“Smallpox is a visitation from God; but the cowpox is produced by presumptuous man; the former was what Heaven ordained, the latter is, perhaps, a daring violation our of holy religion.”
(A physician’s reaction to Dr. Edward Jenner’s experiments in developing a vaccine for smallpox, (1796) via Psychological Sciences, Vanderbilt University)
Fear that God will smite anyone who uses the brains God gave us may account for what looks like a copy of Nicolas Poussin’s “Adoration of the Golden Calf” on the back wall in that “Cow-Pock” cartoon.
The golden calf incident happened while Moses was on Mount Sinai. It was a major violation of the Decalogue, and they really should have known better. (Exodus 20:4–6, 32:1–35)
Idolatry, putting anything ahead of God in my priorities, divinizing what is not God, is still a very bad idea. (Catechism, 2112–2114)
Inoculation wasn’t a ‘scientists against preachers’ thing, though. Cotton Mather, a Puritan minister, teamed up with Zabdiel Boylston5; having decided that preventing disease wasn’t evil.
Let’s see what other folks said about the newfangled sort of medicine:
“…In contrast, many village priests in Italy, Germany, Switzerland, and England not only urged parishioners to seek the preventative treatment, they became wholesale vaccinators themselves. Pastors in Bohemia charged parents with responsibility ‘before God for neglecting the vaccination of their children.’ In 1814, the Pope himself endorsed vaccination as ‘a precious discovery which ought to be a new motive for human gratitude to Omnipotence.’…”
(“Deliberate extinction: Whether to Destroy the Last Smallpox Virus,” pp. 19-20, David A. Koplow, Georgetown University Law Center (2004))
That would have been Pius VII who said vaccination was “a precious discovery which ought to be a new motive for human gratitude to Omnipotence.”
I’m inclined to think he was right.
1. Polio: It’s Back
(From AFP, via BBC News, used w/o permission.)
(“Polio can only be prevented through immunisation”
Nigeria to start emergency polio campaign”
BBC News (August 12, 2016)
“Nigeria has announced an emergency mass polio vaccination campaign in the north-east after two new cases emerged.
“They were the first incidences of the highly infectious disease in Africa for two years.
“The government said polio paralysed two children in Borno state, a part of Nigeria where Boko Haram militants have hindered health campaigns.
“The development is seen as a major setback for Nigeria, which was on track to be declared polio free in 2017.
“The cases were confirmed exactly two years after Africa’s last previous case – in the Puntland region of Somalia, on 11 August 2014….”
Polio, poliomyelitis, infantile paralysis, hasn’t been a major problem in my country for decades. That hasn’t always been the case.
The disease goes back at least to the days when Egypt was a superpower. That’s a reasonable assumption, anyway, given the appearance of that chap, pictured on a stele made during Egypt’s 18th Dynasty, upwards of three millennia back.
Polio is caused by poliovirus, an RNA genome wrapped in a protein shell. It’s small, even for a virus, 30 nanometers across; and comes in three serotypes — a distinction that’s important to biologists and pharmaceutical researchers, but don’t bother trying to memorize the term. There will not be a test on this.
Michael Underwood identified polio as a particular disease, “a debility of the lower extremities,” in 1789.
By the 20th century, polio was probably the most-feared childhood disease in Europe and America. I’ll get back to that.
Iron Lungs and Statistics
(From CDC/GHO/Mary Hilpertshauser, CDC, and GHO; via Wikimedia Commons, used w/o permission.)
(Mr. Barton Hebert of Covington, Louisiana, lived in this iron lung from the late 1950s until his death in 2003.)
Polio epidemics didn’t happen before the 20th century, and there weren’t many times when more than one person got sick.
Between eight and 10 cases of infantile paralysis got recorded in the 1841 parish of West Feliciana parish, Louisiana, outbreak. In 1893, 26 folks in Boston got polio. Rutland and Proctor, Vermont had 132 cases in 1894.
The big trouble started in 1907:
- Oil City, Lehigh, Du Bois and Ridgeway, Pennsylvania
- New York
2,500 cases (5% fatality rate)
- State of Massachusetts
- Galesville, Wisconsin
- Oceana County, Michigan
- Du Bois, Pennsylvania
- Live Oak, Florida
(Source: “The Spatial Dynamics of Poliomyelitis in the United States: From Epidemic Emergence to Vaccine-Induced Retreat, 1910–1971” (2005))
Granted, 125 deaths in New York doesn’t seem like much: but that was just the first wave. Some 27,000 Americans got polio in 1916, more than 6,000 of us died — 2,000 in New York City.
That’s scary, particularly since folks didn’t know exactly how the disease spread.
Some of the folks who didn’t die spent part or all of the rest of their lives in an iron lung, like those folks in the Rancho Los Amigos Rehab Center’s polio ward. That photo is from the 1950s, and represents yet another reason I sincerely do not yearn for the ‘good old days.’
The iron lung’s basic design goes back to theoretical work done in 1670 by John Mayow.
Various folks built working prototypes in the 1800s, a “Drinker respirator” saved an eight-year-old polio victim’s life on October 12, 1928, and I’m running late — so check out the link list at the end of this section, or not. Your choice.
In the 1930s, each iron lung cost around $1,500 — roughly the same as an average home. The Both respirators cost a lot less, good news for folks who couldn’t breathe on their own.
Life in an iron lung is arguably better than suffocating, and surviving with a withered leg is fairly manageable. Not getting polio at all would be even better, which is why so many folks studied the disease.
Karl Landsteiner spotted the poliovirus in in 1908, and Jonas Salk announced successful tests of a vaccine in 1955.
The first few polio shots I got were Salk’s polio vaccine. Albert Sabin’s oral polio vaccine came out in 1961, and I didn’t mind switching from injections to taking a sugar cube with vaccine in it.
We’re still studying polio. Scientists developed a type of transgenic mouse back in 1990-91 that can catch the disease. I talked about transgenic mice and ethics earlier this month. (August 5, 2016)
Most folks who catch polio wouldn’t know it unless it showed up in a blood test. The disease has no symptoms in almost three quarters of all cases.
The other 28% of folks with polio get a sore throat and fever; nausea, vomiting, and other gastric troubles; or something that acts like influenza.
Here’s what happens when folks get polio:
- No symptoms
- Minor illness
- Nonparalytic aseptic meningitis
- Paralytic poliomyelitis
- — Spinal polio
79% of paralytic cases
- — Bulbospinal polio
19% of paralytic cases
- — Bulbar polio
2% of paralytic cases
- — Spinal polio
(Source: “Poliomyelitis” Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book); Atkinson W, Hamborsky J, McIntyre L, Wolfe S, eds. (2009); Public Health Foundation; via Wikipedia)
About 1% of all polio infections get into the central nervous system. This can be bad news, really bad news, or worse: headaches, pain in assorted places, and paralysis. The virus doesn’t make its way into the brain very often, happily.
Getting back to Nigeria, I hope they get enough kids immunized to head off a major outbreak there.
I also hope that more Americans don’t decide that vaccinations either aren’t necessary or are harmful. The good news is that as of 2013, a hefty percentage of American kids age 19-35 months get immunized:
- Diphtheria, Tetanus, Pertussis (4+ doses DTP, DT, or DTaP)
- Polio (3+ doses)
- Measles, Mumps, Rubella (MMR) (1+ doses)
- Haemophilus influenzae type b (Hib) (primary series + booster dose)
- Hepatitis B (Hep B) (3+ doses)
- Chickenpox (Varicella) (1+ doses)
- Pneumococcal conjugate vaccine (PCV) (4+ doses)
- Combined 7-vaccine series
Like I said earlier, being healthy is okay, and so is using our brains.
- Centers for Disease Control and Prevention
- National Institutes of Health
- “PVR poliovirus receptor [ Homo sapiens (human) ]”
NCBI, NIH (Updated August 13, 2016)
- “The Spatial Dynamics of Poliomyelitis in the United States: From Epidemic Emergence to Vaccine-Induced Retreat, 1910–1971”
Barry Trevelyan, Matthew Smallman-Raynor, Andrew D. Cliff; Annals of the Association of American Geographers; via NCBI (June 2005)
- “Transgenic mice expressing a human poliovirus receptor: a new model for poliomyelitis.”
Ren RB, Costantini F, Gorgacz EJ, Lee JJ, Racaniello VR; Cell; via PubMed (October 19, 1990)
- “PVR poliovirus receptor [ Homo sapiens (human) ]”
(From Getty Images, via BBC News, used w/o permission.)
(“The Zika virus can be transmitted via mosquitoes”
“Texas baby dies from Zika-linked defect”
BBC News (August 9, 2016)
“A baby born in Texas with the Zika-linked birth defect microcephaly has died, health officials say.
“The baby was infected in the womb while the mother was travelling in Latin America, though state officials have not identified where.
“The defect causes abnormally small heads and other developmental damage.
“Florida Governor Rick Scott also announced four more people had contracted the Zika virus, bringing the state’s total to 21 cases.
“Harris County, where the baby was born, now has two reported cases of babies born with microcephaly.
“The case is the first Zika-related death reported in Texas.
“The Zika virus, frequently transmitted by mosquitoes, often causes no symptoms, but is particularly dangerous for pregnant women….”
Zika fever is another disease that folks can have without knowing it.
I’m a bit more personally interested in this article, since I live on the same continent, live in Minnesota, and mosquitoes spread Zika. The mosquito isn’t the state bird, that’s the loon, but we get a mess of the little bloodsuckers each summer.
The CDC says that there’s “growing evidence of a link between Zika and microcephaly.” (Medscape.com)
I’ve got more to say about this, but that will wait for another post.
3. Learning to Use a Powered Exoskeleton
(From AASDAP/Lente Viva Filmes, via BBC News, used w/o permission.)
(“Patients first learned to control the legs of an avatar in virtual reality”
“Brain-robot training triggers improvement in paralysis”
Jonathan Webb, BBC News (August 11, 2016)
“In a surprise result, eight paraplegic people have regained some sensation and movement after a one-year training programme that was supposed to teach them to walk inside a robotic exoskeleton.
“The regime included controlling the legs of a virtual avatar via a skull cap, and learning to manipulate the exoskeleton in the same way.
“Researchers believe the treatment is reawakening the brain’s control over surviving nerves in the spine.
“The work appears in Scientific Reports.
“The eight subjects had been paralysed for three to 13 years before the rehabilitation programme began. Chronic cases of paralysis such as these are the most resistant to treatment. …”
I was going to wax eloquent on this brain-machine interface research, but household schedules and a string of technical issues have given me — wonderful opportunities for practicing patience.
Next week may, or may not, be less interesting: so I’ll just say that this research looks promising, and let it go at that. For now.
- “Bulldogs, Transgenics, and a Robot”
(August 5, 2016)
1 Bloodletting was a standard medical procedure for some two millennia. The idea is that draining controlled amounts of blood will balance the humors: what folks following Hippocrates called blood, yellow bile, black bile, and phlegm; or sanguis, kholé, melaina kholé, and phlégma.
The four humors reflected the four elements: blood, air; yellow bile, fire; black bile, earth; phlegm, fire. Folks like Theophrastus figured that having too much blood made us sanguine; folks with excess phlegm were phlegmatic; excess yellow bile, choleric; and too much black bile made us melancholic.
Medicine based on humorism, or humoralism, didn’t always result in bloodletting. Some physicians prescribed changes in diet, for example.
Bloodletting stayed popular, though, even after most researchers started looking for alternatives to humorism: maybe because doing something feels better than doing nothing. There’s the placebo effect, too.
We eventually found a connection between Leeuwenhoek’s “animalcules” and disease, developed antibiotics and fNIR, and that’s yet another topic.
- PubMed Central, National Institutes of Health
- “Clinical uses of the medicinal leech: a practical review.”
Porshinsky BS, Saha S, Grossman MD, Beery Ii PR, Stawicki SP; Abstract; Journal of Postgraduate Medicine (January-March 2011)
- “Exploring the use of the medicinal leech: a clinical risk-benefit analysis.”
de Chalain TM, Abstract, Journal of Reconstructive Microsurgery (April 1996)
- “Re-imagining Bleeders: The Medical Leech in the Nineteenth Century Bloodletting Encounter”
Robert G.W. Kirk, Neil Pemberton; Medical History (July 2011)
- “Clinical uses of the medicinal leech: a practical review.”
2Paulus Lang Fu was the youngest of at least 52 martyrs in one batch killed with Jesuit missionaries in the Militia United in Righteousness/Society for Justice and Harmony hit the Diocese of Xianxian.
“CANONIZATION: The solemn declaration by the Pope that a deceased member of the faithful may be proposed as a model and intercessor to the Christian faithful and venerated as a saint on the basis of the fact that the person lived a life of heroic virtue or remained faithful to God through martyrdom (828; cf. 957).”
“SAINT: The ‘holy one’ who leads a life in union with God through the grace of Christ and receives the reward of eternal life. The Church is called the communion of saints, of the holy ones (823, 946; cf. 828). See Canonization.”
(Glossary, Catechism of the Catholic Church)
4 The Trinity is not like Bruce Wayne or Kal-El/Clark Kent, one person with multiple identities.
God is one. (Exodus 3:13–14; Exodus 20:3; Isaiah 45:5)
God is also three Persons, and all three were at our Lord’s baptism. (Matthew 3:16–17)
Matthew 28:19 tells us to baptize “in the name of the Father, and of the Son, and of the holy Spirit.” That isn’t a grammatical error. It’s a straightforward declaration of the Trinity. (Catechism, 233)
God the Son reveals God the Father, God the Holy Spirit reveals God the Father and Son, and there’s a lot more to say about the Trinity. (Catechism, 232–260)
- “Edward Jenner and the history of smallpox and vaccination”
Stefan Riedel, MD, PhD; Proceedings (Baylor University. Medical Center) (January 2005)
- “History of Vaccine Safety”
Centers for Disease Control
Extra space between lines: “0.1–0.5%
— Spinal polio”
Odd shift in tense: “but we’ve got a mess of the”
Crunk thing word missing: “The Trinity not like Bruce Wayne or Kal-El/Clark Kent”
The Friendly Neighborhood Proofreader
Right! The extra space thing is an annoying (to me) oddity in this theme’s code for lists: but not annoying enough for me to take time, changing it. Thanks!
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