The Great Influenza Read Online Free Page B

achievement of medicine and certainly the greatest achievement until the late 1800s. And Europe was in intellectual ferment. Half a century later Newton revolutionized physics and mathematics. Newton's contemporary John Locke, trained as a physician, emphasized the pursuit of knowledge through experience. In 1753 James Lind conducted a pioneering controlled experiment among British sailors and demonstrated that scurvy could be prevented by eating limes (ever since, the British have been called 'limeys.') David Hume, after this demonstration and following Locke, led a movement of 'empiricism.' His contemporary John Hunter made a brilliant scientific study of surgery, elevating it from a barber's craft. Hunter also performed model scientific experiments, including some on himself (as when he infected himself with pus from a gonorrheal case to prove a hypothesis.)
    Then in 1798 Edward Jenner, a student of Hunter's (Hunter had told him 'Don't think. Try.') published his work. As a young medical student Jenner had heard a milkmaid say, 'I cannot take the smallpox because I have had cowpox.' The cowpox virus resembles smallpox so closely that exposure to cowpox gives immunity to smallpox. But cowpox itself only rarely develops into a serious disease. (The virus that causes cowpox is called 'vaccinia,' taking its name from vaccination.)
    Jenner's work with cowpox was a landmark, but not because he was the first to immunize people against smallpox. In China, India, and Persia, different techniques had long since been developed to expose children to smallpox and make them immune, and in Europe at least as early as the 1500s laypeople (not physicians) took material from a pustule of those with a mild case of smallpox and scratched it into the skin of those who had not yet caught the disease. Most people infected this way developed mild cases and became immune. In 1721 in Massachusetts, Cotton Mather took the advice of an African slave, tried this technique, and staved off a lethal epidemic. But 'variolation' could kill. Vaccinating with cowpox was far safer than variolation.
    From a scientific standpoint, however, Jenner's most important contribution was his rigorous methodology. Of his finding he said, 'I placed it upon a rock where I knew it would be immoveable before I invited the public to take a look at it.'
    But ideas die hard. Even as Jenner was conducting his experiments, despite the vast increase in knowledge of the body derived from Harvey and Hunter, medical practice had barely changed. And many, if not most, physicians who thought deeply about medicine still saw it in terms of logic and observation alone.
    In Philadelphia, twenty-two hundred years after Hippocrates and sixteen hundred years after Galen, Benjamin Rush, a pioneer in his views on mental illness, a signer of the Declaration of Independence, and America's most prominent physician, still applied logic and observation alone to build 'a more simple and consistent system of medicine than the world had yet seen.'
    In 1796 he advanced a hypothesis as logical and elegant, he believed, as Newtonian physics. Observing that all fevers were associated with flushed skin, he concluded that this was caused by distended capillaries and reasoned that the proximate cause of fever must be abnormal 'convulsive action' in these vessels. He took this a step further and concluded that all fevers resulted from disturbance of capillaries, and, since the capillaries were part of the circulatory system, he concluded that a hypertension of the entire circulatory system was involved. Rush proposed to reduce this convulsive action by 'depletion,' i.e., venesection - bleeding. It made perfect sense.
    He was one of the most aggressive of the advocates of 'heroic medicine.' The heroism, of course, was found in the patient. In the early 1800s praise for his theories was heard throughout Europe, and one London physician said Rush united 'in an almost unprecedented degree, sagacity and