Tag Archives: disease

A year of plague

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BY THE SUMMER, five hundred people were dying every week in London. The fatalities included both the rich and the poor. Parliament was moved from the capital to the city of Oxford. By July, the plague was destroying the city of London and every Londoner became regarded as a potential carrier of the disease. Towns such as Bristol would not admit Londoners unless they had proof that they were free of contamination. This proof was in the form of a document issued by the Mayor of London, in whose own household illness was rife. Towns near London shut their doors to Londoners and their citizens stayed at home.

In London, volunteer searchers inspected every house and whenever they came across one in which at least one resident had signs of the disease, they posted a notice above the door. This bore the words “God have mercy on us.” Then, two soldiers were posted by the entrance of each affected house to make sure that no one entered or left.  By August, the theatres, inns, and markets were closed in London. When business was conducted, coinage used to pay for goods was dropped into a tub of water by the customer and then retrieved by the vendor or supplier. Nobody touched the hands of another. Later that month, terrified Londoners began fleeing from the diseased city, but they were turned away from wherever they went. By September, 5000 Londoners were dying each week. Schools were closed. As a result, schoolteachers applied to the government for financial relief.

What I have been describing is nothing to do with the current covid19 pandemic, even if there are some remarkable similarities. Also, when considering the number of deaths, it is worth noting that London’s population in 1625 was about 300,000. It refers to a plague (possibly bubonic) that afflicted London in 1625. The information I have given has been extracted from a book that I am reading at the moment: a biography of Sir Harry Vane (1613-1662) by the historians JH Adamson and HF Folland, both professors at the University of Utah in the USA.

And, why, you might wonder, am I reading a book about a man whose existence was unknown to me less than a couple of months ago. The answer lies in Hampstead in north London. I was brought up in this part of the metropolis and recently have been revisiting old haunts and thus begun to become interested in Hampstead’s rich history. It was whilst rambling around Hampstead one cold February morning that I saw a gatepost (near the upper end of Rosslyn Hill) with a commemorative plaque. This memorial recorded the fact that the gate post was all that remained of the house in which Sir Harry Vane, politician and for some time a Governor of the Massachusetts Bay Colony, resided for some time before his arrest (ordered by King Charles II), trial, and execution.

What struck me when reading about the plague of 1625 and comparing it with what we are facing currently was how similar were some of the actions taken then with those taken now, almost 400 years later. By the way, in case you were wondering, the 1625 plague subsided almost completely by November that year and that was without any vaccines being available.

Cholera in Hampstead and spread of disease

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THIS IS NOT ABOUT our current plague, the covid19 pandemic, but an earlier one that occurred occasionally in the 19th century. In many countries today, millions of people live with plague and disease and might even accept it as a part of daily life. Fortunately, until recently this was not the case in the UK. However, in the 19th century when diseases and their transmission were less well understood than currently, living conditions in the UK were considerably less healthy than today, disease was rife, and life expectancy was not great. While walking amongst the picturesque steeply sloping back streets of Hampstead village in North London in late November 2020, we spotted a carved stone plaque high on a wall of a house, currently Heathside Preparatory School, on New End (at the point where the street makes a right angle and becomes north-south instead of east-west).

The plaque reads:

“This building was erected by voluntary contributions for a dispensary and soup kitchen. It was intended as a thank-offering to Almighty God for his special mercy in sparing this parish during the visitation of cholera in the year 1849. The site was purchased in 1850 and the building completed in 1853.

He shall deliver thee from the noisome pestilence. Thomas Ainger M.A. incumbent”

As you will discover soon, not everyone in Hampstead was spared from cholera in 1849. One of those, who was afflicted, not in 1849 but five years later, unwittingly made a great contribution to science.

Thomas Ainger (1799-1863), who was born in Whittlesea, Cambridgeshire and studied at Cambridge University, was awarded ‘perpetual curacy’ of St Mary’s Hampstead in 1841, a position he held until his death (http://hampsteadparishchurch.org.uk/data/magazines_2013.php?id=897). He was:

“An energetic parish priest and poor-law guardian; helped to found schools and a dispensary; enlarged his church and promoted the building of new churches in the district around Hampstead.” (https://venn.lib.cam.ac.uk/).

Today, we can have injections that radically reduce the chances of suffering from cholera, but that was not the case back in 1849, when the mechanism by which the disease spreads was not yet understood. One case of the disease that significantly helped to further knowledge of its spread occurred in Hampstead in 1854.

Dr John Snow (1813-1858), who led the way in hygiene and anaesthesia, suspected that cholera was spread via drinking water. He demonstrated that cases of the disease were clustered around particular water sources. During an outbreak of cholera in 1854 in London’s Soho district, which was centred around a pump in Broad Street, now Broadwick Street, he found that by removing the handle from the pump so that the locals could no longer draw their drinking water from there, the local outbreak of cholera was brought to an end. The pump in Broad Street was only three feet away from a leaking cess pit and its water was contaminated by waste matter (www.ph.ucla.edu/epi/snow/broadstreetpump.html). Snow theorised that the cause of cholera was not as previously thought a ‘miasma’ in the air, but something in drinking water. Now, let Stephanie Snow continue the story (International Journal of Epidemiology, 2002; vol.31: pp 908–911):

“In 1849, the London Medical Gazette had suggested that in regard to Snow’s theory, the experimentum crucis [i.e. critical experiment] would be that the water conveyed to a distant locality where cholera had been hitherto unknown produced the disease in all who used it. One of the cholera victims Snow had traced through his Broad Street investigation was a widow who lived in Hampstead. She had a regular delivery of water from the Broad Street pump as she preferred its taste. Her last delivery was made on 31 August and by 2 September, having drunk the water, she had died from cholera. Snow regarded this as ‘the most conclusive’ of circumstances in proving the connection between the water pump and the cholera outbreak.”

The widow had lived at ‘West End’, which until the 19th century was that name of what is now West Hampstead.

The plaque in New End suggests that Hampstead Parish was ‘spared’ from the cholera in 1849. That was almost true. In that year, Hampstead had 8 deaths from cholera per 10,000, whereas many areas of London reported between 100 and 200 deaths from cholera per 10,000 (www.ph.ucla.edu/epi/snow/publichealth118_387_394_2004.pdf). The rate of cholera fatalities in its area was determined by the location of its drinking water supply.  The uppermost rates of deaths from cholera in 1849 were exceedingly high compared with even the highest rates of covid19 infection anywhere in the UK during the second half of 2020.  

John Snow had been alerted to the existence of the widow in Hampstead by Reverend Henry Whitehead (1825-1896), a vicar in London’s Soho district, who was at first sceptical of Snow’s theory of the water-borne transmission of cholera (http://www.ph.ucla.edu/epi/snow/whitehead.html) and favoured the idea that cholera existed as an airborne ‘miasma’. Although Snow and Whitehead differed on their ideas on the transmission of cholera, they decided to work together. Peter Daniell and David Markoff provide more detail (www.choleraandthethames.co.uk/cholera-in-london/cholera-in-soho/) about the widow in Hampstead:

“Whitehead was able to tell Snow about a widow living in Hampstead, who had died of cholera on the …  2nd September [i.e. 1854], and her niece, who lived in Islington, who had succumbed with the same symptoms the following day. Since neither of these women had been near Soho for a long time, it was impossible that they could have contracted the disease through breathing in the polluted air of the area. Intrigued, Dr Snow rode up to Hampstead to interview the widow’s son. He discovered from him that the widow had once lived in Broad Street, and that she had liked the taste of the well-water there so much that she had sent her servant down to Soho every day to bring back a large bottle of it for her by cart. The last bottle of water—which her niece had also drunk from—had been fetched on 31st August, at the very start of the Soho epidemic. This was just the sort of evidence he needed to prove the argument of the miasmatists wrong.”

If we had not noticed the plaque in Hampstead, I doubt that I would have become aware of the West End widow’s role in the unravelling of the method of transmission of cholera. Below the plaque and on the same wall, there is a pink granite object, which looks like a broken drinking fountain. This bears the date ‘1859’, five years after the large outbreak in Soho, and I hope that people did not contract cholera by drinking from it. It was in that year, that Joseph Bazalgette (1819-1891) began his programme of improving London’s sewerage system. This helped to reduce the out breaks of cholera, but there was at least one more in the East End of London in 1866.

Seated above a cow

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I HAVE WALKED PAST IT OFTEN, noticed it, but had never examined it carefully until a few days ago. I am referring to the statue of Edward Jenner (1749-1823) that surveys the formally arranged pools and fountains in the Italian Gardens at the north end of the Serpentine Lake. This body of water was created in 1730 at the request of Queen Caroline (1683-1737), wife of King George II.  Originally it was fed by water from the now largely hidden River Westbourne and Tyburn Brook. Now its water is pumped from three bore-wells within the confines of Hyde Park.

 

BLOG JENNER LATE 286 

Jenner is depicted seated in what looks like an uncomfortable chair, resting his chin on his left hand, his left arm being supported on an armrest.  The bronze statue was created by the Scottish sculptor William Calder Marshall (1813-1894). He also created the sculptural group representing ‘Agriculture’ on the nearby Albert Memorial. The Jenner sculpture was originally located in Trafalgar Square, where it was inaugurated in 1858 by Prince Albert, the Queen’s Consort three years before his demise. In 1862, the sculpture was moved to its present location in the Italian Gardens. Incidentally, the design of the gardens was based on those at Osborne House on the Isle of Wight and were created in 1860 to the design of the architect and planner James Pennethorne (1801-1871).

Jenner, a qualified medical doctor, is best known for his pioneering work in developing protection against smallpox. This derived from his experimentation based on his (and other people’s) observation that the pus from blisters that milkmaids received from cowpox protected them against the far more serious disease smallpox. Justifiably, Jenner has been dubbed the ‘father of immunology’. So great was his achievement that Napoleon, who was at war with Britain at the time, awarded Jenner a medal in 1803, the year Napoleon was planning to invade Britain with his recently formed Armée d’Angleterre. The French leader said:

“The Sciences are never at war… Jenner! Ah, we can refuse nothing to this man.” (see: https://www.nature.com/articles/144278a0).

Maybe, these words of the great Napoleon can still teach us something about international cooperation generosity of spirit.

His fame in the field of vaccination overshadows Jenner’s other achievements in science and medicine. He was a first-rate zoologist. For example, his observations, dissections, and experiment established for the first time that the baby cuckoo is born with a depression in its back that allows it to displace the eggs of the  bird whose nest the cuckoo has colonised. The baby cuckoo ejects his or her host’s eggs without the help of the adult cuckoo, which has deposited her eggs in the nest of another species. Jenner published his findings in 1788. This was a few years before he established the effectiveness of vaccination in the late 1890s. He self-published his results in 1898 after his most important paper was turned down by The Royal Society.

Getting back to his statue in the Italian Gardens, there are two features that I had not noticed before examining it carefully recently. One of these is a depiction of the Rod of Asclepius on the backrest of Jenner’s seat.  The serpent entwined helically about a rod is traditionally associated with medicine and healing. Beneath the seat, there is a depiction of a cow’s head. This is appropriate symbolism given the importance of cows in the discovery of smallpox vaccination. The word vaccine is derived from the Latin word ‘vaccinus’, which in turn is derived from ‘vacca’, the Latin for ‘cow’. There is an object depicted below the cow’s head, which I fancy, using a little imagination, might be a stylised depiction milk maid’s cloth hat.

Jenner was not the only person experimenting with inoculation against smallpox, but he is the person best remembered for it because his results and reasoning convinced the world of the concept’s validity and applicability.

Although I do not find the monument to Jenner to be particularly attractive, it is one of London’s statues least likely to arouse anger as its subject had nothing to do with slavery. In contrast to many other well-known figures of his era, Jenner should be remembered for his important involvement in a development that has benefitted mankind for well over two centuries. I hope that his scientific descendants currently working around the world in laboratories will be able to create a vaccine to counter the Covid-19 virus as soon as possible.

Foot and mouth

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Wales 1 SMALL

Before she died in 2012, we used to make annual visits to a dear friend, whom I had known since my childhood, in South Wales. She used to live in London, but when she retired, she moved to a village in the Brecon Beacons, near the River Usk. We stayed in her cottage but were encouraged to leave her in peace from after breakfast until about four in the afternoon. We did not mind this because there is plenty to explore in the area and often the weather was good at the times of the year that we visited her.

In 2001, disaster hit Wales in the form of a vicious outbreak of foot and mouth disease. In order to prevent its spread, all footpaths and many open spaces were closed to visitors. This and the appalling rain that fell relentlessly during our visit, restricted what we could do while we were allowing our guest a few hours relief from her guests. We drove around the countryside not particularly having much fun.

One day, we arrived at a small town with a name I am unable to pronounce correctly:  Llanwrtyd Wells. It was lunch time. We parked outside a hotel near the town centre. The floor of the lobby was covered with a grubby, well-worn carpet. We were shown into an unattractive dining room. Our hopes for having a decent meal fell as we surveyed the room’s dingy uninviting décor. The sight of incessant rain falling outside did little to enhance the dreary mood that this unappealing room was inducing.

The hotel’s owner brought us menus. We asked what he recommended. He said “steaks” and showed us the large range of meats listed in the menu. We asked his advice about which steak to choose. Then, he did something that transformed the dingy place for us.

He gave us a ‘tutorial’ about the relative merits of different kinds of beefsteak and their tastes. The least tasty, in his opinion, was the costliest cut, fillet steak. Sirloin steak was, he advised us, tastier and cheaper than fillet. However, he considered that the tastiest cut was rib-eye. He explained that the latter was marbled with fine streaks of fat, and it was this that gives it its superior taste. We ordered it and discovered he was right. He regretted that he was unable to serve the local, and in his view far superior, Black Mountain beef. This was because of the problems connected with the foot and mouth outbreak.

Whenever I buy steak, I look for rib-eye first, and if this is not available, I go for sirloin. Whenever I think of beefsteak, I always remember that dreary eatery in Llanwrtyd Wells and its helpful landlord. For a long time, I could not remember in which town in Wales, we were given our tutorial about steaks. Recently, I discovered some photographs I had taken there almost twenty years ago. In one of them, there was a pub sign that read “Neuadd Arms Hotel”. Seeing this helped me discover where we had been.

Mustard

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My father’s grandfather lived in Cape Town (South Africa) during the Spanish influenza pandemic at the end of the first world war.

He was terrified that he would be afflicted with the deadly illness. He had heard that applying a mustard plaster would help him avoid the disease. So, he smeared his stomach with mustard and covered it with an adhesive plaster. Then, he retired to bed.

After about three days, my great grandfather developed a high temperature. Fearing the worst, he summoned a doctor. The medic tore of the plaster to reveal the damage that the mustard was causing. It had ‘eaten’ through the skin, which was then becoming infected. The infection caused by the mustard was causing the fever, not the dreaded ‘flu.

My great grandfather survived the Spanish ‘flu. What killed him several years later was something that was supposed to protect him from illness. He died following an adverse reaction to an anti-tetanus injection.

Flying rats

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pigeons

 

My late mother was awfully concerned about avoiding germs. For example, every can of food had to be washed before opening it just in case rats or mice had scampered across it in a warehouse.  Also, when we visited toilets in public places in the 1960s, we were told to put toilet paper on the seats so that we would not pick up germs that other users had left behind. Interestingly, in many public toilets nowadays, notably on aeroplanes, disposable toilet seat covers are provided. Mum would have approved of this development.

Recently while rummaging through some old photographs, I came across one of me, aged about 10, in Siena, Italy. I was kneeling on the floor feeding pigeons that had flown on to my hand. As a child, I loved doing this. My parents would buy me a paper cone filled with corn seeds. I would fill my palm with some of these, and then pigeons used to perch on my finger tips and pick up bits of corn with their beaks. I remember that the pigeon’s ‘feet’ felt quite soft. Feeding these creatures was a real treat.

Well, I was not unusual. Many people enjoy feeding birds from their hands. Today, in London’s Kensington Gardens there are flocks of green parakeets that happily feed from visitors’ hands.

The surprising thing was that my germ conscious mother permitted my sister and me to feed pigeons as described already. In New York, pigeons are known as ‘flying rats’. Pigeons are are actually less hygienic than rats and they carry mites, which irritate human skin. I cannot believe that pigeons in Italian cities in the 1960s were any cleaner than those flying about today. Had my mother been aware of the pigeons’ unsavoury lack of hygiene, feeding these creatures would have been totally forbidden to my sister and I. I am pleased that she did not realise that the dear flying rats are so filthy!

Mad cow

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we don’t see ev’rything

that we consume:

might be germs with any bite

 

Bovine_500

From time to time, the United Kingdom is subject to agricultural diseases that need to be accompanied by nation-wide restrictions to limit spreading. A frequently occurring example of this is so-called foot-and-mouth disease. During such epidemics, those not involved in agricultural activities, such as hikers and tourists, are confined to roads, told to keep out of fields where traces of the disease may be lying.

During one outbreak of foot-and-mouth, we were spending a holiday in Wales. Wherever we went, we saw signs and barriers that prevented free movement across the countryside. What with the incessant rain, it made our trip rather dreary. We stopped for lunch in an ugly little town in central Wales. The most attractive looking eatery was a dowdy pub, devoid of any architectural merit. We sat down in its ageing dining room, trying to avert our eyes from the peeling wallpaper and a horrible worn carpet that badly needed to be replaced. Things looked up when the inn-keeper arrived to take our food order. We were attracted to beef steaks. There was a bewildering range of options for this on the menu.  Our host patiently explained the differences between the different types of beefsteak, explaining how the tastiness of the meat itself was related to its fat content and distribution within the cut. Fillet steak, for example, has little fat, not much taste without sauces, but wonderful texture. He recommended rib-eye as being the cut with just the right amount and distribution of fat to be tasty on its own. He was quite right, we discovered in that unattractive dining room in rainy Wales.

bovine

Some years later, Mad Cow disease (Bovine spongiform encephalopathy) became a concern in the UK. One evening, when we were going to a theatre near St Martins Lane in London, there were large headlines about the disease on the front page of the latest issue of the Evening Standard newspaper. Before the performance, we entered a branch of McDonalds for a quick snack. Almost everyone in the café was eating beef burgers, despite the headlines on the newspapers that some of the customers were reading!

Shortly after this, we went on a driving trip through France. In one small town, we walked passed a small restaurant with a sign hanging in its glass-fronted door. It read (in French): “We might be mad, but our beef is not.”

While the Mad Cow scare was at its height, we were invited to stay with some friends in Belgium. We had stayed with them often before. We asked them what they would like us to bring from London. They said they would love a home-made curry, enough for about twelve people. Although I am married to an Indian, it is I who makes the meat curries in our family. I prepared and cooked a huge lamb curry. As it is only a few hours’ drive between London and Belgium and the curry would have to be re-heated before being served, we thought it safe to transport the casserole containing it without refrigeration.

There were more security checks than usual at the English end of the Channel Tunnel. After our car had been examined, and the engine checked for hidden items including explosives, we were asked if we were carrying any meat products across the English Channel. We mentioned that we were transporting a casserole of cooked lamb curry. The security officials looked puzzled, told us not to move, and then walked away towards an office. One of them returned, and asked:

“It’s lamb, not beef is it?”

We confirmed that it was not beef.

“And thoroughly cooked?”

“Yes.”

“Well, what with all those spices, we’ll let you take it through the tunnel.”

Nobody asked us about meat when we arrived in France. We drove through a bath containing disinfected, and then headed for our destination.