Analgesia was not an option while giving birth until the mid 19th century as pain was believed to be a crucial part of the birthing experience. In 1591, Euphemia Maclean, a woman from Edinburgh, Scotland requested analgesia during the birth of her twins and was burned at the stake for this request. Analgesia started with Queen Victoria who used chloroform for the birth of her 8th child Leopold. It was Victoria’s experience that she told to others which made the practice catch on so quickly as Victoria felt that analgesia was an amazing invention which helped her immensely. In the 1950’s, the no medication approach swung back into fashion with Dr. Grantly Dick-Read, the first modern physician to suggest against analgesia as he believed the pain of childbirth to be psychological
Category: Immunology
The Discovery of Bacterium Causing Stomach Ulcers
For decades the medical community believed gastric ulcers were directly related to stress with the only options for relief being antacids and surgery. In the early 1980’s, Australian physicians Barry Marshall and Robin Warren discovered through biopsies of gastric ulcers, that nearly all were overrun by helicobacter pylori bacteria. Helicobacter pylori only seems to infect humans, as studies performed upon pigs and rats were unsuccessful as these animals were unable to contract the bacterium. Marshall decided to infect himself and within 5 days of doing so, he started running to the bathroom each morning to throw up. Tests demonstrated that Marshall had gastritis, a precursor to an ulcer. Marshall took antibiotics and was cured, proving once and for all that ulcers are caused by bacteria not stress. In 2005, Marshall and Warren won the Nobel Prize in Medicine for their findings
The First U.S. Presidential Vaccine Mandate
U.S. President George Washington issued the first presidential vaccine mandate, requiring all soldiers within the continental army to become vaccinated against smallpox on February 5, 1777. 90% of deaths during the American Revolution were due to disease, with smallpox being the most prevalent and difficult pathogen for the military to control. Immunization was viewed as an achievable solution to a virtually insurmountable problem as death from smallpox plunged from 30% to 2% after a becomming immunized. Vaccination, or “variolation” as it was referred to during the era, was achieved by taking a small piece of an active smallpox sore from an infected person, and then introducing it to the person being inoculated via inhalation or by scratching their arm and introducing the virus by touch. The mandate, although initially detested, became highly successful in its pursuit of lowering soldier mortality rate, with 40,000 soldiers vaccinated by the end of 1777
The Study of Bacteriophages in Antibiotic Research and Why They May be the Next Major Scientific Breakthrough
Bacteriophages, which are viral infections that reproduce to target and kill bacteria, were studied in Eastern Europe during the 1950’s by countries which did not have access to western medicine, including antibiotics. In 1 milliliter of sea water, billions of phages are present, with countless different varieties. Phages have tendril like appendages which are used to probe and identify hosts, clinging onto them, then forcing its own deoxyribonucleic acid down into the bacterial host. When this genetic code is introduced, it destroys the bacteria as a direct result. This leads to a chain reaction as hundreds more are produced each time this instance occurs, copies which then fledge out and find hosts of their own, building populations exponentially and wiping out bacterial infections completely. Bacteriophages were found prior to chemical antibiotics but when Penicillin was discovered, because it is so easy to develop and administer, chemical antibiotics became the clear path of choice in medicine with scientists not realizing the severity of this error until decades later. Antibiotics are often broad spectrum which is another reason antibiotic research overshadowed bacteriophagic research as different phages affect different bacteria and are therefore not broad spectrum. Because phages are self-replicating like bacteria, they have the ability to completely annihilate all bacteria presented before them in the same way that bacteria have the ability to totally annihilate their own host as well. Because of this, bacterial infections can be knocked out with 100% efficacy in all cases, regardless of the severity of the the infection, provided the correct phage is alotted enough time to do so. This is a task antibiotics often struggle to achieve and even if achieved, cannot be guaranteed in perpetuity as reinfection or resistance can occur at any time
Textile Pollution of the Citarum River in Indonesia
The Citarum River (pronounced “chit-ah-rum”) in Indonesia is considered to be the most heavily polluted river in the world with over 400 textile factories situated nearby which choose to dump their industrial waste directly into the river itself, treating the river as a sewer system which carries away waste. The problem is so intense that the Indonesian military has been implemented to help clean up the area but corporations have resorted to dumping their waste products at night and because the unseen chemicals are the real threat to those living near the river, these companies are permitted to continue dumping as no one can definitively prove their culpability without scientific measurements which are difficult to ascertain as Indonesia is a developing country. Corporations have even begun to strategically place their waste pipes under water so that they can pollute with impunity as no one can physically see the pollution being dumped. Water darker than its surroundings, steam, bubbles, and froth are all key signs which activists use to spot these illegal port systems. It’s difficult to pin point which factories produce textiles for western companies as western companies virtually always refuse to disclose which factories they work with. Some of the largest corporations in fashion (e.g. H&M, the Gap, Levi’s etc.) have revealed their sources but even with this disclosure, some of these companies have been linked to factories within this region. Indonesia isn’t a top 5 global producer of textiles, so to say that Indonesia is part of an even larger problem, is an accurate statement. Most people who live near the Citaum River use the river for bathing, drinking, and/or cooking, and noticeable dermatological effects have been noticed by those living within the area. The primary problem with the Citarum River is with heavy metals (e.g. mercury, cadmium, lead, arsenic etc.). Long term exposure to these substances can cause neurological problems as brain function becomes permanently damaged. These heavy metals are so dire that they can actually lower the intelligence quotient of children who are developing and attending their education. 28,000,000 (28 million) people rely upon the Citarum River daily and eat foods (e.g. rice) irrigated with its waters. Human rights activists have engaged these corporations by physically blocking piping and ducts which have caused the affected corporations to start hiring mercenary criminals to follow and attack those known to be a part of this resistance. Western consumers are the primary cause and possible solution for this problem because if there are no clients willing to purchase the garments, the industry as a whole will shift, not because of political pressure or governmental oversight, but rather because of sales. The problem is not centralized in Indonesia as other developing countries (e.g. India, Bangladesh, China etc.) are equally negatively impacted
The Rationale Why Pharmaceutical Organizations are Not Incentivized to Develop Antibiotics and Why This is Dangerous for the Worlds Next Pandemic
Within 5 short years of release, approximatly 20% of antibiotics become subject to resistance from bacterial pathogens which means that antibiotic proliferation is chronologically limited within its life expectancy. Coupled with this, if an antibiotic is highly effective, the scientific and medical community often rally against its usage so that such a tool can be saved in reserve for a global bacterial pandemic. In either scenario, return upon investment is less than what it would be with a different class of medication (e.g. selective serotonin re-uptake inhibitor, statin, hypnotic etc.) which is why pharmaceutical organizations are less interested in research and development dedicated to antibiotic medicine in favor of other, more profitable medication categories. This lack of investment however is myopic and will inevitably backfire upon the pharmaceutical industry as a whole if new antibiotics are not developed because medications used to treat cancer will become less in demand due to the fact that cancer patients are highly likely to acquire an infection during treatment when their immune system is comprised, with this infection often killing the patient if antibiotic solutions are not available. This would expectedly lead to a sharp decline in cancer medication treatment and subsequently pharmaceutical sales of related medications as patients would be likely to adopt living the rest of their life as fully as possible and forgoing treatment as they would be damned if they accept the cancer treatment and develop an infection which kills them but also damned if they don’t accept the treatment and let the cancer run its course which is almost always fatal. To provide comparison of the research, development, and manufacturing contrast between oncology medications and antibiotics, as of 2020, there are currently 800 medications in development for cancer and hypertension whilst only 28 antibiotic medications undergoing that same research phase and development process, with 2 of these antibiotics expected to become fully developed and able to reach the market and patients. The last new antibiotic class, lipopeptides, were introduced in 1984 with a gap referred to as an “antibiotic void” occurring during the 1990’s, 2000’s, 2010’s, and now moving into the 2020’s. The urgency of this threat is projected to become dire within the coming decades, with scientists predicting that by 2050, medicine could potentially come full circle to the pre-antibiotic era, with microbes which are completely and totally resistant to every antibiotic known to medicine
A Revolutionary Breakthrough in Oncology Treatment
Cancer kills 9,000,000 (9 million) people each year and despite having searched for centuries, a cure has yet to be discovered by scientists. At the center of the immune system is the T cell, a type of leukocyte which respond against bacterial and viral infections alike in an effort to keep their host healthy and alive. T cells determine between threatening and non-threatening foreign and non-foreign bodies within a host by leveraging a molecule upon the surface of all cells referred to as the “T cell receptor”. Jim Allison was the first person to successfully isolate and purify the molecule which recognizes this lock and key model for infectious disease, auto-immune disease, and other innocuous substances within the body be they foreign or internally created. In 1987, French scientist Pierre Golstein and his team discovered a new protein upon the surface of T cells which he named “CTLA-4”. To study CTLA-4 in laboratory rats, Allison had to build and design a rat antibody, a Y shaped protein which would trigger a reaction by CTLA-4. Cancers are mutations and should in theory be visible to the immune system, which is why the scientific community has struggled with the paradox of why tumors go undetected by the immune system for decades. There is no discernible reason as to why the immune system can recognize and resist influenza or any other foreign or domestic body but not cancer. Allison theorized that tumors have evolved an ability to fool the immune system, engaging CTLA-4 which turns on the T cells response to halt its search and destroy measures. Allison hypothesized that if he inserted a Y shaped antibody to block the gap in between the tumor and T cells, the tumor would no longer have its ability to hide, a trait which has been evolved by tumor cells over hundreds of millions of years. This would allow the T cell to infiltrate, attack from within the tumor, shrink, and ultimately kill the growth. Allison spent the next decade trying to turn this revolutionary breakthrough discovery into a medication which could be provided to cancer patients. Allison found Alan Korman, a scientist creating medications for auto-immune disease which provided him with the expert he required to turn this idea into a reality. Korman was tasked with taking the CTLA-4 antibody which Allison and partner Max Krummell developed for laboratory rats, and turn it into a medication which could safely work within human beings with this medication subsequently being named “Ipilimumab” (pronounced “ipi-lim-ooh-mab”). Korman ended up collaborating with a friend from graduate school, Nils Lonberg to accomplish this task. Ipilimumab consists of an intramuscular injection into the leg and a 90 minute intravenous medication drip in comparison to chemotherapy and radiation therapy which take months of treatment to complete and have devastating effects upon overall health as both bad and good tissue are destroyed in an effort to eradicate all tumor cells. Allison’s work with laboratory rats demonstrated that with the help of this newly developed antibody, T cells gained the ability enter into tumors and expand their size in an effort to destroy them from the inside out. This means that the fact that tumors grow initially upon administration is a positive marker and indicative of the medication working as it demonstrates successful infiltration of the tumor cells themselves. Patients often report feeling better after a few treatment sessions, sometimes even a single session, despite computer tomography scans demonstrating that their tumors are growing larger, which under normal circumstances would make a patient feel worse. Some patients even noted increased improvement after having stopped the Ipilimumab treatment, with no further therapy required. On March 25, 2011, the U.S. Food and Drug Administration released approval for Ipilimumab. Ipilimumab and its successors have treated nearly 1,000,000 (1 million) patients worldwide with many of these patients achieving permanent remission which is essentially the definition of having been cured of cancer. Although these medications do not work in every single case, they have definitively demonstrated to be a miracle medication for hundreds of thousands of people thus far. After completing this revolutionary discovery, Allison was awarded the Nobel Prize in Medicine in 2018 for his series of discoveries related to T cells and their ability to halt cancer in its progression in perpetuity
The Spanish Flu Pandemic of 1918 in London, England
At the end of World War I, soldiers coming back to London, England from the Western Front brought with them a particularly infectious version of influenza referred to as the “Spanish Flu”. Exact metrics are unknown because of poor data collection during the early 20th century but an estimated 50,000,000 (50 million) deaths occurred, 3x as many people than that which died during the entire span of World War I. Spanish Flu had its most devastating blitzkrieg upon London in the autumn of 1918, as thousands civilians and soldiers, weakened from 4.5 years of war, became ill within a few short days of Armistice Day. Spanish Flu works quickly to destroy the lungs of healthy victims, with those who contracted the pathogen feeling fine in the morning and often found dead, later that same evening. In 1918, 320 people died of Spanish Flu in London, but during 1919, Spanish Flu had a resurgence and exploded in severity with 16,000 – 23,000 people killed, a surge which caused a shortage of gravediggers and coffins, classifying Spanish Flu as the worst epidemic in living memory. The Spanish Flu outbreak came to an end in May of 1919 once enough of the British population had experienced the infection and either been killed or having survived, becoming immune to the point that the disease could no longer be passed through hosts efficiently enough to continue its spread
The Ebola Contagion Epidemic of 2014
In late December of 2013, children of Meliandou, Guinea in West Africa found hundreds of bats nesting in a hollowed out tree. The children had no way of knowing that bats are the suspected carriers of the ebola virus. The children lit a fire and the bats scattered from the tree, allowing the children to catch and consume these bats as a source of protein. It is suspected that this is what triggered the ebola epidemic of 2014. Villagers originally thought that the illness spreading was due to witchcraft but authorities quickly identified the outbreak as ebola in an attempt to quarantine and curb the spread of the infection. Illness rapidly spread across the forest region of Guinea as those who were ill came into contact with healthcare workers whilst seeking medical attention which lead to surrounding areas becoming impacted. For 3 months, the symptoms of ebola were mistaken for cholera and malaria, which is why the contagion was unable to be controlled and halted. The problem quickly spiraled out of control with thousands becoming ill and a total of 11,315 deaths across 6 countries including Guinea, Liberia, Sierra Leone, Nigeria, Mali, and the U.S., however the U.S. faired best with only 49 of the total deaths. The government of Guinea had no idea how to respond as all previous ebola outbreaks had occurred over 1600 kilometers away, however the relief group Doctors Without Borders had decades of experience and were able to be flown in in and effort to curb the spread of the pathogen. Within 48 hours of arrival, Doctors Without Borders had setup a field hospital in the village of Guéckédou, Guinea, the epicenter of the ebola outbreak. Past outbreaks have taught physicians that the best counter attack is to isolate the ill, monitor those who have had contact with the sick, and safely bury the dead. Due to the scale of the problem and the fact that it was not isolated to a single group or village, Doctors Without Borders did not have the resources to contain this potential global threat which is why the World Health Organization became involved, a group which is part of the United Nations and has access to the best and most expensive resources in the world, with a mandate to help governments coordinate responses to outbreaks. The main problem facing the World Health Organization is that the organization itself does not take precedent nor command of any medical situation as it is the country which is dealing with a contagion that must take this lead. Due to the fact that Guinea is a poor nation with few resources, grabbing hold of the ebola outbreak was exceedingly difficult as physicians did not have proper oversight by those in power with ebola experience, the governments of affected nations were some of the poorest in the world, and the World Health Organization was in the process of downsizing, causing the entire process to become more complicated and convoluted as decision making was scattered and often conflicted. This created the perfect storm for ebola to quickly spread across the African continent and into the western world. The government of Guinea accused Doctors Without Borders of sowing panic among the public which further elevated tensions between the 3 organizations involved. Guinea’s Ministry of Health demanded that only laboratory confirmed cases be counted towards the total ebola death count which tied the hands of physicians and their governing organizations as this act downplayed the importance and severity of just how severe the ebola outbreak truly was which lead to further contamination as the public did not treat the disease with the full gravitas of what it demanded. It is believed that this single political act is what allowed ebola to jump across borders, starting with the neighboring country of Sierra Leone as residents of both states are permitted to freely cross the borderline of either nation as often as they wish, a political policy which should have been suspended during a period of mass outbreak. Rumors of foreign physicians killing impoverished residents with syringes helped inflame already growing tensions between healthcare professionals and the general public which made working with infected or potentially infected individuals exceedingly difficult for healthcare practitioners. The corpse of an ebola victim is highly infectious but in West Africa, it is customary for friends and family to spend hours with a person after death, washing and preparing them for their burial (e.g. cutting nails and braiding hair etc.). The sudden cessation of the ability to perform this ritualistic act deeply embedded within West African culture fueled even more resent from the public which caused mass rioting and chaos to ensue, endangering the lives of those who were there to help, made worse by the lack of education, language barriers, and cultural barriers already present. It is theorized that this cultural convention played a major and definitive role in the spread of the ebola virus, as mourners often touch the body during the funerary procession. It is believed by the inhabitants of West Africa that if a body is not laid to rest properly, the ghost of that person will return to haunt the people of the village which is why this ritualistic process is so deeply embedded and revered in this region of the world. The government of Guinea had no method of contact tracing, that is to say, there was no method in place to monitor those who had come in contact with ebola victims which allowed for hundreds of cases to go undetected. The World Health Organization debated whether or not to declare an international health emergency which would have acted as a global distress signal, enacting the aid and preparation for a counter attack from many of the worlds most industrialized nations (e.g. the U.S., Canada, Japan etc.). Officials worried that declaring a global emergency would create panic which would only help exacerbate the issue as many countries, particularly in Europe and the Middle East, could potentially close their borders in an effort to ensure the ebola virus remained exclusively in Africa, the worlds most impoverished continent. To exacerbate the already fevered tensions between government officials, healthcare workers, and the public at large, an event transpired which threw much of the West African population into a panic. In Kenema, Sierra Leone, a woman purporting herself as a nurse, began shouting in the center of the cities most populated marketplace, “there is no ebola! I say to everyone it’s not real. Ebola is not real. It’s cannibalism”. The crowd started to cry for others to come over, to hear the supposed confessions of a nurse stating that physicians are killing innocent people for the consumption of their bodies as meat. The tide quickly changed and the crowd began turning upon the healthcare staff present, throwing stones, giving chase, and threatening their lives, forcing the evacuation of virtually all physicians, nurses, and other interdisciplinary healthcare personnel. This woman was not a nurse, rather she was a person afflicted with mental illness, but her impact greatly exacerbated an already uneasy hoard of people, so much in fact that law enforcement were forced to attend and disperse tear gas to control the ire of the group. By this point, the ebola outbreak had claimed more than 800 people across 3 countries. Physicians urged the World Health Organization to declare an international emergency however organization officials refused to do so because it was believed that this act would only add fuel to an already raging and seemingly out of control inferno of illness and chaotic unrest. It was at this point that the ebola outbreak rose to a new level when an infected Liberian traveled to Nigeria, Africa’s most populous nation, and the U.S., forcing the World Health Organization to declare an international emergency, by holding a press conference given by Dr. Margaret Chan, the Director-General of the organization itself. A high ranking team was assembled and deployed to Geneva, Switzerland in response, devising and enacting a plan to employ thousands of western medical professionals in an attempt to curb an infectious outbreak which was growing by this point at an exponential rate. The outbreak was so beyond the reach of control by this time that it had spread across a broad geographical area, unlike anything ever witnessed in modern memory. The main caveat to the curated plan was that the World Health Organization did not have a standing force of physicians, nurses, laboratory technicians, and other various healthcare practitioners, ready and willing to help serve in the fight to combat such a prevalent contagion, nor did they have the budget to build one. The only option available was to appeal to the worlds wealthiest nations, persuading and to an extent pleading with trained and qualified healthcare workers who were willing and able to travel abroad and join the collective effort. This endeavor would take time as acquiring a team en mass is an extraordinarily ambitious goal to accomplish. Rioting continued to occur with some hospitals being overrun by disillusioned citizens who were angry, frightened, and frustrated enough to allow every patient under quarantine to run back into the village, allowing for the proliferation of the disease to spread even further. Governments attempted to respond by sending in military squadrons to guard sanctioned quarantined buildings in an effort to help contain an outbreak which for all intents and purposes was completely out of control and continuing to spiral into calamity. Citizens were killed both by soldiers with firearms as well as infection as those who were infected were in the streets, amongst the general populous. Doctors Without Borders began constructing ELWA 3 (pronounced “ell-wah-three”), the largest Ebola treatment center ever built, but despite their best efforts, the facility was not large enough to contain the sheer volume of people who needed medical aide. It was at this point that Doctors Without Borders made an urgent plea directed solely towards the U.S to provide thousands of soldiers immediately in order to help isolate and treat patients. Dr. Tom Frieden, Director of the Center of Disease Control, traveled to the ELWA 3 clinic in Monrovia, Liberia to see first hand, just how bad the epidemic was. Frieden recounted his experience by stating that he witnessed a “level of devastation that I have never seen” and that he was “seeing a country essentially in free fall and knowing, knowing with certainty that no matter what we did, it was going to get a lot worse before it got better”. Frieden called then President Barack Obama stating that the outbreak was expanding at an exponential pace, doubling every 3 weeks, resulting in a tripling of results with every month of delay instituted. Obama responded by implementing emergency U.S. aide, sending thousands of soldiers and medics, 10 months after the outbreak had initially begun, in an attempt to quell and eradicate the spread of this viral disease. Other industrialized nations soon followed suit and the United Nations created a new emergency mission for the World Health Organization and other related agencies to coordinate the response. Work began on the ground with the building of new treatment centers and training to teach those deployed how to properly bury affected victims. Despite these monumentous efforts, the ebola virus was still ahead of the response and threatened to spread beyond African borders. Shortly after this humanitarian response, cases in Monrovia began to sharply decline, but experts believed that the downward trajectory would bounce back in an even more dramatic resurgence as people were now staying home due to the events which had recently transpired across the African continent, allowing them to infect more people than if they had been under isolation. Fortunately, the drop in reported cases remained steadfast in its declination as Liberians stopped trying to nurse their sick and started burying the dead in an appropriate and safe manner. Liberians began to understand that the ebola virus was so drastically deadly that previous cultural customs had to be shelved for the time being so that the disease could be expunged and life could return to normal for those who had survived. Thousands more continued to die across West Africa, but the changed behavior of West Africans and the massive international response gradually turned the tide of the war
The Eurasian Yamnaya People and Their Cultural and Physical Dominance of the European and Asian Continents
The Yamnaya people were bands of nomads who roamed territory north of the Black Sea and Caspian Sea during the Bronze Age. By 3000 B.C., the Yamnaya became the greatest horse culture of the ancient world, as they were the first culture to adopt both riding upon horseback as well as the pulling of horse wagons. This breakthrough in technology allowed the Yamnaya to transport food and supplies more easily and readily so that the best pasture lands could be acquired. This allowed the Yamnaya to quickly become the most dominant culture within the Central Step region. Horses allowed for larger herds of cattle and sheep, which permitted wealth to be quickly generated and redistributed into local economies. The Yamnaya alongside other cultures which they combined with traversed across the Central Step, moving as far east as Mongolia and as far west as central Europe. The Yamnaya nomads dominated virtually every culture encountered which is understood due to the fact that many regions began speaking the Proto-Indo-European language in the Yamnaya dialect. The rationale for this is that language is connected to power and/or wealth which is a large incentive for a person or group of people to adopt because it provides unique advantages in all aspects of life including everything from economic trade to finding a romantic life partner. The Yamnaya left no written record of a written language but linguists are able to piece together fragments of the Yamnaya dialect due to the fact that many languages in Europe and Asia, including ancient languages like Greek and Latin, modern romantic languages like Italian, French, and Spanish, Germanic languages like various Scandinavian languages and English, and Russian and Sanskrit, all derive from the common Proto-Indo-European language spoken by the Yamnaya (e.g. the English term ”brother” is “frater” in Latin, “bratar” in Sanskrit, and “pratar” (pronounced “pray-tarr” with a rolled “R”) in Greek). The term “wheel” and “wagon” are Yamnaya terms, and only appeared after the Yamnaya people became dominant within the Central Step region where these two technologies were developed. This is important because Proto-Indo-European languages like that of the Yamnaya must have been spoken after the invention of the wheel around 3500 B.C., as the terms invented would have no use prior to the advent of the practical application (e.g. only using the term “hard drive” in English after the advent of computers, as there is no intended use prior). Many linguists believe that all languages stem from a single source language and that this single source may be the Yamnaya dialect. This dialect and Yamnaya culture as a whole spread across Europe and Asia with millions of modern day people in both continents with generic markets tracing their lineage back to the Yamnaya people. Archeologists and anthropologists believe the Yamnaya were so successful because of learned, acquired immunity towards the Bubonic Plague. Evidence of yersinia pestis bacteria exists within the burial sites of Yamnaya people, which means that the Bubonic Plague was already affecting humans as far back as 3000 years before any written record. This evidence further demonstrates that the Bubonic Plague began within Eurasia, possibly in Yamnaya communities and that those who survived, were most likely able to dominate other European and Asian cultures which did not have acquired immunity as they brought the plague with them when invading foreign territory. It is believed by experts that this immunity and transference of the Bubonic Plague allowed the Yamnaya to expand across the known world, conquering and acquiring the people and regions they came across