Tuesday, June 26, 2012

Edinburgh Interiors

How do you create a world?
Answer, if you are a member of the Pox and the City team:
Through hundreds of photos, reams of archives, and not nearly enough opportunities to sample the variety of Edinburgh restaurants.

And so in May 2012, Hannah Ueno, Laura Zucconi, and I went to Edinburgh on a Six-Day Mission: To boldly explore the streets, wynds, closes, interiors, and archives of the city, so we can create the virtual world of medical Edinburgh. We'll have more on the process in later blogs, but for now, I'll concentrate on Edinburgh interiors, as a small way to say "thank you" to all the hospitable folks who let us wander purposefully throughout their historic buildings, cameras at the ready.

What better way to begin our exploration of early 19th century Edinburgh intellectual life than with a trip to Old College (University of Edinburgh) and the Playfair Library. Even though we did not have an appointment, the helpful staff at reception allowed us upstairs to visit what is surely among the most ornate settings for final exams in the the world.

Yes, we know it had not yet been constructed in 1802 -- we are historians, after all -- and that young Dr. Robertson would never have taken an exam with hundreds of others, as students do today. But he might well have sat with that many in his Anatomy and Surgery class, or carved graffiti on one of the desks, as we saw in our minute examination of the desks pictured on the right.
We decided we couldn't get enough of ornate libraries, and we were very fortunate that Ben Bennett, of the Scottish Council on Archives, provided us with a wondrous tour of General Register House, built by Scottish Enlightenment architect Robert Adam. Not only is it a classic example of an Edinburgh dome, but also its search rooms revealed any number of Pox and the city gems: blueprints of the New Jail on Calton Hill and Parliament House, letters from Scots lairds to their physicians about precautions to take against smallpox, and treatment if the precautions proved ineffectual. One minister called together all his parishioners -- or as many as would agree to attend -- and, with doctors and vaccines at the ready, carried out a kind of mass vaccination then and there, praying that the Lord "look favourably on the endeavours used to soften the effects of a loathsome disease to the children  of this Parish and Neighbourhood."

No reconstruction of  Medical Edinburgh would be possible without a visit to the Royal College of Physicians of Edinburgh. Many thanks to Iain Milne, Sibbald Librarian, for inviting us to a reception and special viewing of some of the College of Physicians' treasures, including the library...
the archive room...

and the most beautifully preserved 18th century interior in Edinburgh.
Many thanks as well to Marianne Smith, Librarian at the Royal College of Surgeons of Edinburgh, for giving us a tour of the library and a glimpse of some of the most "special" of the collections, including an illuminated Book of Hours and a copy of the Nuremberg Chronicle.

And no trip to Medical Edinburgh could be complete without a visit to the Surgeons Hall museums! Photography isn't allowed inside the museum so I'll add one of my favorite images from their collection...
a preparation of the arteries of the foot. Gruesome, right? 
Stay tuned for more world-building as Pox and the City comes to a virtual environment near you...

Saturday, March 31, 2012

What’s in a Name? Or, Will Vaccination Turn Your Children into Cows?

When we think of vaccine, we think of injections. But when 18th century medical men thought of vaccine, they thought of cows. That’s because “vaccinae” is Latin for “of or pertaining to cows”, and the word entered the modern medical lexicon through the title of the famous 1798 work by Edward Jenner, “An Inquiry into the Causes and Effects of the Variolae Vaccinae, a Disease discovered in some of the Western Counties of England, particularly Gloucestershire, and known by the name of the Cow-Pox.”

Many generations of admiring doctors and historians have noted this title without observing that Jenner was engaged in a bit of sleight of hand. The disease he described was, indeed known as the Cow Pox by those who had bothered to give it a name: the dairymaids and farmers who were most susceptible to it. The disease, as he noted, appears on the nipples of cows, and then is communicated to the dairymaids, and then “through the farm, until most of the cattle and domestics feel its unpleasant consequences”(1). It was Jenner, perhaps after consultation with his medical mentors, like John Hunter, who gave it the Latin name, starting with Variolae – the Latin medical term for smallpox -- and adding to it the designation Vaccinae – of or from cows. Borrowing from other 18th century medical nomenclature, which listed first the genus, then the species of the disease, the term variolae vaccinae indicated that the genus, or general class of disease, was variolae, pox, while the species was vaccinae of, by, or pertaining to cows. Thus Jenner’s name did double duty: it both conferred a learned Latin pedigree on a disease of “cattle and domestics” and used conventions of scientific nomenclature to establish the relationship between smallpox and cowpox.

This learned convention was incorporated into medical journals like the Edinburgh-based Annals of Medicine, which put in the 1800 index next to Cow-Pox, See Vaccine. And now that Jenner had brought it to their attention, practitioners began to “see vaccine” everywhere. It turned out that this disease of Cow Pox, and its attendant immunity from smallpox, had been part of rural folklore throughout southern England. Doctors located a similar set of beliefs in the West Country. The “country people of Ireland,” it turned out, were also “well acquainted with the disease”, and gave it the name of Shinah (2). The eminent medical professors at Edinburgh University were hard-pressed to explain why their benighted countrymen should have so unaccountably failed to develop so useful a folk-belief, and concluded that the cows of Scotland’s dairy districts, like Fife, simply did not get “the genuine vaccine disease”(3). Eventually, though, they were able to find a gentleman, “a most ingenious artist,” who could remember that his parents had owned a farm near the Scots town of Jedburgh, and that his mother, “who occasionally assisted the maids in the concerns of the dairy, never had smallpox, though frequently exposed to the disease” (4).

But as all these medical practitioners bustled around, making earnest inquiries as to vernacular names of what soon became known as the Vaccina disease, opposition was mounting. Matter from a cow used to treat humans! Introducing a “bestial humour into the human frame”! (5) Benjamin Moseley, one of the most vitriolic controversialists of his day, raged against the new practice, renaming it the Lues Bovilla (the bovine plague) a clear reference to Lues Venerea (the plague of venery) or syphilis. Moseley compared “Cow-Pock” to “Cow-Dung”, and gave graphic descriptions of supposed “nasty, filthy eruptions” he had seen in children who had been vaccinated(6); he claimed to have seen a whole series of new diseases, including Facies Bovilla, or Cow Pox Face, Scabies Bovilla, Cow Pox Itch or Mange, Tinea Bovilla, or Cow Pox Scaldhead. Most terrifying of all were his case histories, like the stories of poor Sarah Burley, “whose face was distorted, and began to resemble that of an Ox; and Edward Gee who was covered with sores, and afterwards with patches of Cow’s Hair,” as a result of inoculation by one of the “cow poxers”, as Moseley derisively termed them. Even more disgusting was the story of little William Ince, “vaccinated when four months old”, who broke out in all manner of sores and eruptions all over his body. They eventually dried up, but then there “appeared on his back and loins, patches of hair; not resembling his own hair, for that was of light colour, but brown; and of the same length, and quality, as that of a Cow.” The message was clear: vaccinate your child, and he will turn into a cow. And not even a healthy cow: as Moseley concluded, the child “remained in a miserable state, under various changes, until he was three years and a half old, when he languished and died.”(7)

Moseley’s rhetoric pushed pro-vaccine advocates on the defensive, so that they wound up writing panegyrics to the cleanliness and hygiene of Great Britain’s cows – “the most healthy of all animals” -- not unlike modern proponents of hormone-based drugs who, when criticized, point out that their chemicals come from yams (8)

And yet there was one area that both Jenner’s supporters and critics agreed on: the linguistic shift from “vaccinae” as an adjective referring to a cow, to “vaccinate” as a verb, meaning the inoculation with the disease entity known as a virus. Much later Louis Pasteur took up the verb and generalized it to apply to the medical procedure we know today. Now millions of people worldwide get their “vaccinations,” giving no thought to cows whatsoever.

(1)Annals of Medicine, 1799,77.
(2)John Ring, A Treatise on the Cow Pox, London, 1801, I:28-30.
(3)Annals of Medicine, 1802, 446.
(4)Annals of Medicine, 1802, 321-4.
(5)Benjamin Moseley, Treatise on the Lues Bovilla, London, 1806, vi.
(6)Moseley, Treatise, 127.