play help to physical development, but it is not so plain that
they may be made to develop the best qualities of character.
It is a fact, however, that all the important elements of
character are tried out in games and sports. Enthusiasm,
self-confidence, the adventurous spirit, alertness, promptness,
unselfishness, cooperation, quick judgment--all these have
their training and discipline on the game field. They comprise
those fundamental native qualities that have gone to make
humanity what it is. The young should have this training, and,
if of the right kind, it may be made to contribute to the
making of the best kind of character. The same quickness and
accuracy of judgment that enable a boy to win a point in
football may in later life be used to win a battle or save a
business venture. Beyond this, there is of course gained the
strong body that makes work easy and stress less difficult to
bear.
Hall calls attention to the fact that two generations ago,
Jahn, the great builder of German physique, roused the then
despairing German nation by preaching the gospel of strong
bodies. He created a new spirit in Germany, and the whole
nation was aroused and seized with an enthusiasm for outdoor
games and sports, and there arose a new cult for the body. His
pupils sang of a united fatherland and of a stronger race. The
Germans are in the habit of reminding us that it was about one
generation after Jahn that the German Empire was founded and
Germany became a world power.
Every argument for the physical training of boys applies with
equal force to girls. Women need to be physically as strong as
men. No race will remain virile and progressive unless both the
fathers and mothers have the physical stamina that produces
healthy, vigorous offspring. In this age, when women are going
out into the world to compete with men it is highly important
that they be physically strong if they are to stand the stress
successfully. It was from rough barbarians, the rude war-loving
Teutonic men and women described by Tacitus, that the
Anglo-Saxon race inherited those splendid qualities of mind and
body that have made their descendants masters of seas and
continents.
It has been objected that gymnastics and field sports make
girls coarse and mannish. The exact opposite has been found to
be the case. It has been observed in colleges that when young
women are properly led, their sports, in place of making them
mannish, have a marked refining influence. They care more for
correct posture because this is made one of their tests in
athletic sports. They develop better manners and a new sense of
pride in their appearance. They soon learn to avoid slang, loud
talking and boisterous behavior. In the University of Chicago
where they have excellent training, many of the girls have said
that they came to have a new sense of dignity and to care more
for their personal appearance.
They also develop the finer elements of character, a
cooperative spirit, obedience to commands, patience,
self-confidence, a spirit of comradeship, a democratic attitude
and an appreciation of good qualities in others wherever found.
All of these esthetic, social and moral qualities, woven into
the texture of the growing character, and with the vigorous
health that the physical training brings, are the best
contribution to the making of the most effective type of the
womanly woman. All games and sports and athletics for the young
should therefore make for refinement and esthetic development.
The state needs now, and will always need, men and women who
have sound bodies and abounding energy.
The harsher phases of the human struggle may pass and wars may
cease, but the old contests of races, nations and individuals
will continue under other forms.
As the race grows older life will become more largely mental.
The increasing complexity of human relations and the more
delicate adjustments that these relations require will bring a
new and finer social order that will make higher demands upon
reason.
While there is no evidence that experience or time or training
will ever change the structure of the brain, it is probable
that we have as yet but imperfectly utilized our mental
possibilities. Stratton says:
Out of the depths of the mind new powers are always
emerging.[2]
[2] "Experimental Psychology and Culture," George M. Stratton.
Back of the mental life, and making it possible, are the
energies of the body, the functioning of the animal in man,
which in the brain are changed to the higher uses of the mind.
The ability to execute, to act effectively, to do and keep
doing, to do the work of the professional man, the banker, or
the scientist, all this is primarily physical, and from top to
bottom of man's activities the physical test is applied. With
the mental and emotional strain of civilized life goes the
physical strain which is the other half of the struggle, and
which now and always is both mental and physical. The Greeks
recognized this unity of mind and body twenty-five hundred
years ago and their results remain unmatched by any race.
They saw that the thought-out movements of physical training
resulted in mental training and this law of mental development
through physical training was a fundamental principle in their
educational plan.
The nation that will again make this an ideal will produce a
finer race of men, and other things equal, will excel in all
that makes a people great.
EDWARD JENNER AND VACCINATION
BY PROFESSOR D. FRASER HARRIS, M.D., D.Sc.
DALHOUSIE UNIVERSITY, HALIFAX, N. S.
WE are so exceedingly apt to take our blessings as a matter of
course that at the present time a large number of us have quite
forgotten, and some of us have never known, what a terrible
disease smallpox is and from how much suffering national
vaccination has saved us. But even many of us, who may not be
included amongst those who know nothing of smallpox, do come
within the group of those who know next to nothing of the life
and work of Dr. Edward Jenner. A number of persons think he was
Sir William Jenner, physician to Queen Victoria.
An infectious or communicable disease is one caused by the
admission of some form of living matter into the body of a
human being or of a lower animal. All diseases are clearly not
communicable in the sense that they are due to the presence of
living things. Indigestion, for instance, I can not communicate
to my neighbor, however serious my dietetic indiscretions.
Now, while the actual microorganisms causing many of the
infectious diseases have been discovered in these recent days
through the agency of the microscope--one of science's most
valuable gifts to suffering humanity--a few diseases
undoubtedly infectious have, even up to the present time, not
had their microorganic causes discovered. Smallpox or variola
is one of these. The term variola is from the Latin varus, a
pimple.
The name Small Pox, which first occurs in Holinshead's
"Chronicle" (1571), was given to this disease to distinguish it
from the Great Pox or syphilis, the French disease, or Morbus
Gallicus which attained the proportions of an epidemic in
Europe about 1494. The expression "The Pox" in the older
medical literature always refers to the Lues Venereal The word
"pox" is the plural form of pock; the spelling "pox" is
phonetic; "pocks" is the correct form.[1]
[1] Thus the following expression in Galt's "Annals of the
Parish" is justified--"My son Gilbert was seized with the
smallpox and was blinded by THEM for seventeen days."
Smallpox is unquestionably a highly infectious or communicable
disease, and in the language of a past day, there is a virus or
poison which can pass from the sick to the unaffected; when
this transference occurs on a large scale we speak of an
epidemic of smallpox. As Sir William Osler truly says, "It is
not a little remarkable that in a disease, which is rightly
regarded as the type of all infectious maladies, the specific
virus still remains unknown." The same, however, is true of the
common diseases of scarlatina, measles and chickenpox. Of some
diseases, the virus is a bacillus or coccus, excessively minute
fungi recognizable only under the microscope; but the
bacteriologists are now beginning to speak of viruses so
impalpable that they, unlike ordinary bacteria, can go through
the pores of a clay filter, are filter-passers, that is are of
ultra-microscopic dimensions. Some authorities conjecture that
the virus of variola belongs to the group of filter-passers.
The virus of smallpox, however, is very resistant and can be
carried through the air for considerable distances; it clings
for long periods to clothes, books, furniture, etc.
I shall not now digress to give the clinical details of a case
of smallpox; the eruption may be slight or it may be very
extensive. It occurs in three forms, discrete, confluent and
hemorrhagic. The most dangerous form of smallpox is the
confluent, in which the face and arms particularly are covered
with large pustular areas of a most disfiguring appearance.
The disease called chickenpox, or varicella, has no
relationship to smallpox and does not protect from it, nor does
smallpox protect from chickenpox.
HISTORY OF SMALLPOX
There seems very little doubt that the home of smallpox was
somewhere on the continent of Africa, although it is true that
there are traditions pointing to its existence in Hindustan at
least 1000 B.C. One Hindu account alludes to an ointment for
removing the cicatrices of eruption. Africa has certainly for
long been a prolific source of it: every time a fresh batch of
slaves was brought over to the United States of America there
was a fresh outbreak of smallpox.[2] It seems that the first
outbreak in Europe in the Christian era was in the latter half
of the sixth century, when it traveled from Arabia, visiting
Egypt on the way. The earliest definite statements about it
come from Arabia and are contained in an Arabic manuscript now
in the University of Leyden, which refers to the years A.D. 570
and 571. There is a good deal of evidence that the Arabs
introduced smallpox into Egypt at the sacking of Alexandria in
A.D. 640. Pilgrims and merchants distributed it throughout
Syria and Palestine and along the north of Africa; then,
crossing the Mediterranean, they took it over to Italy. The
Moors introduced it into Spain whence, via Portugal, Navarre,
Languedoc and Guienne it was carried into western and northern
Europe. The earliest physician to describe smallpox is Ahrun, a
Christian Egyptian, who wrote in Greek. He lived in Alexandria
from A.D. 610 to 641. The first independent treatise on the
disease was by the famous Arabian physician, Rhazes, who wrote
in Syriac in 920 A.D., but his book has been translated into
both Greek and Latin. The first allusion to smallpox in English
is in an Anglo-Saxon manuscript of the early part of the tenth
century; the passage is interesting--"Against pockes: very much
shall one let blood and drink a bowl full of melted butter; if
they [pustules] strike out, one should dig each with a thorn
and then drop one-year alder drink in, then they will not be
seen," this was evidently to prevent the pitting dreaded even
at so early a date. Smallpox was first described in Germany in
1493, and appeared in Sweden first in 1578.
[2] Osler thinks the pesta magna of Galen was smallpox; Marcus
Aurelius died of it.
The contributions of Sydenham, the English Hippocrates, to the
knowledge of smallpox, are classical.
Throughout the Middle Ages, owing to the very crowded and
unsanitary state of the cities of Europe, smallpox was one of
the various plagues from which the inhabitants were never free
for any length of time.[3] Leprosy, influenza, smallpox,
cholera, typhus fever and bubonic plague constituted the
dreadful group. In most countries, including England, smallpox
was practically endemic; an attack of it was accepted as a
thing inevitable, in children even more inevitable than
whooping-cough, measles, mumps or chickenpox is regarded at the
present time. There was a common saying--"Few escape love or
smallpox." In the eighteenth century so many faces were pitted
from severe smallpox that it is said any woman who had no
smallpox marks was straightway accounted beautiful. Very few
persons escaped it in either the mild or the severe form in
childhood or in later life.
[3] England was by no means exempt, but it was not infection in
the modern sense that Shakespeare meant when he wrote--
"This England,
This fortress, built by Nature for herself
Against infection and the hand of war."
Now it is characteristic of a microorganic disease that a
person who has recovered from an attack of it is immune from
that disease for a longer or shorter time, in some cases for
the remainder of life. This is, luckily, as true of smallpox as
of any of the other acute infections. We do not now need to
enquire into the theory of how this comes about; it is a
well-recognized natural phenomenon. The modern explanation is
in terms of antigens and anti-bodies and is fast passing from
the stage of pure biochemical hypothesis into that of concrete
realization. Persons who have recovered from smallpox rarely
take it a second time; the few who do, have it in a mild form.
It follows, then, that if smallpox is purposely inoculated into
a human being he will for a long time be resistant to the
subsequent infection of smallpox. The fact of smallpox
protecting from smallpox is by no means without analogy in
other diseases. Thus in Switzerland, in Africa, in Senegambia,
it has been the custom for a long time, in order to protect the
cattle from pleuro-pneumonia, to inoculate them with the fluid
from the lung of an animal recently dead of pleuro-pneumonia.
Of course since the time of Pasteur we have been quite familiar
with the inoculation of attenuated virus to protect from the
natural diseases in their fully virulent form, for instance,
anthrax, rabies, plague and typhoid fever.
As it was, then, known to mankind from a very early period that
a person could be protected from smallpox by being inoculated
with it, inoculation grew up as a practice in widely distant
parts of the globe. The purpose of intentional inoculation was
to go through a mild attack of the disease in order to acquire
protection from the much more serious natural form of the
disease--to have had it so as not to have it. A very high
antiquity is claimed for this smallpox inoculation, some even
asserting that the earliest known Hindu physician (Dhanwantari)
supposed to have lived about 1500 B.C., was the first to
practice it. Bruce in his "Voyages to the Sources of the Nile"
(1790) tells us that he found Nubian and Arabian women
inoculating their children against smallpox, and that the
custom had been observed from time immemorial. Records of it
indeed are found all over the world; in Ashantee, amongst the
Arabs of North Africa, in Tripoli, Tunis and Algeria, in
Senegal, in China, in Persia, in Thibet, in Bengal, in Siam, in
Tartary and in Turkey. In Siam the method of inoculation is
very curious; material from a dried pustule is blown up into
the nostrils; but in most other parts of the world the
inoculation is by the ordinary method of superficial incision
or what is called scarification. By the latter part of the
seventeenth century inoculation for smallpox was an established
practise in several European countries into which it had
traveled by the coasts of the Bosphorus, via Constantinople. In
1701 a medical man, Timoni, described the process as he saw it
in Constantinople. Material was taken from the pustules of a
case on the twelfth or thirteenth day of the illness. As early
as 1673 the practice was a common one in Denmark, Bartholinus
tells us. In France inoculation had been widely practiced; on
June 18, 1774, the young king Louis XVI., was inoculated for
smallpox, and the fashionable ladies of the day wore in their
hair a miniature rising sun and olive tree entwined by a
serpent supporting a club, the "pouf a l'inoculation" of
Mademoiselle Rose Bertin, the court milliner to Marie
Antoinette. In Germany inoculation was in vogue all through the
seventeenth century, as also in Holland, Switzerland, Italy and
Circassia. In England the well-known Dr. Mead, honored, by the
way, with a grave in Westminster Abbey, was a firm believer in
inoculation, as was also Dr. Dimsdale, who was sent for by the
Empress Catherine II. to introduce it into Russia. Dr. Dimsdale
inoculated a number of persons in Petrograd, and finally the
Grand Duke and the Empress herself. The lymph he took from the
arm of a child ill of natural smallpox. For his services to the
Russian court Dr. Dimsdale was made a Baron of the Russian
Empire, a councillor of state and physician to the Empress. He
was presented with the sum of 1,000 pounds and voted an annuity
of 500 pounds a year. At the request of Catherine, Dr. Dimsdale
went to Moscow, where thousands were clamoring for inoculation.
The mortality from smallpox in Russia seems to have been still
higher than in the rest of Europe. The annual average death
rate on the Continent at the end of the eighteenth century was
210 per 1,000 deaths from all causes, while in Russia in one
year two million persons perished from smallpox alone. In
England in 1796, the deaths from smallpox were 18.6 per cent.
of deaths from all causes.
A great impetus was given to inoculation in England by the
letters of Lady Mary Wortley Montague, the wife of our
ambassador to Turkey, Edward Wortley Montague, and daughter of
the Duke of Kingston. In 1717 Lady Mary wrote a letter to her
friend Miss Chiswell, in which she explained the process and
promised to introduce it to the notice of the English
physicians. So convinced was Lady Mary of the safety of
smallpox inoculation and its efficacy in preserving from
subsequent smallpox, that in March, 1717, she had her little
boy inoculated at the English embassy by an old Greek woman in
the presence of Dr. Maitland, surgeon to the embassy. In 1722
some criminals under sentence of death in Newgate were offered
a full pardon if they would undergo inoculation. Six men agreed
to this, and none of them suffered at all severely from the
inoculated smallpox. Towards the close of the same year two
children of the Princess of Wales were successfully inoculated;
and in 1746 an Inoculation Hospital was actually opened in
London, but not without much opposition. As early as 1721 the
Rev. Cotton Mather, of Boston (U. S. A.), introduced
inoculation to the notice of the American physicians, and in
1722 Dr. Boylston, of Brooklyn, inoculated 247 persons, of whom
about 2 per cent. died of the acquired smallpox as compared
with 14 per cent. of deaths amongst 6,000 uninoculated persons
who caught the natural smallpox. There was, however, great
popular opposition to the practice of inoculation, and Dr.
Boylston on one occasion was nearly lynched.
While successful inoculation undoubtedly protected the person
from smallpox, sometimes the inoculated form of the disease was
virulent, and certainly all cases of inoculated variola were as
infectious as the natural variety. Inoculated persons were
therefore a danger to the community; and there is no doubt that
such persons had occasionally introduced smallpox into towns
which had been free from the natural disease. At the end of the
eighteenth century, just about the time of Jenner's discovery,
public opinion was strongly against the continuance of the
practice of inoculation, and as natural smallpox had not at all
abated its epidemic character, the times were ripe for "some
new thing."
Now there is a disease of cows know as cowpox or vaccinia (from
the Latin vacca, a cow) which is communicable to human beings.
It is thought to be due to the same virus which in pigs is
called swinepox and in horses "grease." Jenner believed
vaccinia to be the same pathological entity as human smallpox,
modified, however, by its transmission through the cow. For a
long time this view was stoutly resisted, but it has now been
accepted as probably representing the truth. The identity of
vaccinia and "grease" is certainly much more doubtful.
To many of Jenner's contemporaries the view that vaccinia had
at one time been a disease of human beings seemed unlikely; but
we are now in a far better position to admit its probability
than were those of Jenner's time. We have since then learned
that man shares many diseases with the lower animals,
tuberculosis, plague, rabies, diphtheria and pleuro-pneumonia,
to mention only a few. We have also learned that certain lower
animals, insects for instance, are intermediary hosts in the
life-cycle of many minute parasites which cause serious
diseases in the human being, amongst which malaria, yellow
fever and the sleeping sickness are the most familiar.
It appears to have been understood before Jenner's time that
persons who had acquired cowpox by handling cattle, but
especially by milking cows, were immune from smallpox. In the
reign of Charles II. it is well known that the court beauties
envied the dairy-maids because having had cowpox, they could
not take smallpox which all women so dreaded. Dr. Corlett tells
us that the Duchess of Cleveland, one of the King's mistresses,
on being told that she might lose her place in the royal favor
if she were disfigured by smallpox, replied that she had
nothing to fear as she had had cowpox. In 1769 a German, Bose,
wrote on the subject of cowpox protecting from smallpox. In the
year 1774 a cattle dealer, Benjamin Jesty, at Yetminster, in
Dorset, inoculated his wife and three children with cowpox.
None of them ever took smallpox during the rest of their lives
although frequently exposed to its infection. Jesty died in
1816, and it is recorded on his tombstone that he was the first
person who inoculated cowpox to protect from smallpox. Cowpox,
or vaccinia, though infectious for cows, is not transmissible
among human beings, in other words, as a disease of man it is
not infectious. Edward Jenner, the Englishman of Berkeley in
Gloucestershire, was the first person to think scientifically
on the fact that cowpox protected from smallpox. John Hunter
had said to him, "Jenner, don't think, try." Luckily, however,
he did both. Thinking alone avails little, experimentation
alone avails not much, but the one along with the other has
removed mountains. Just as Newton thought scientifically about
that falling apple and reduced our conceptions of the universe
to order, just as Watt thought scientifically about that
kettle-lid lifted by the steam and so introduced the modern era
of mechanical power brought under man's control, so Jenner
thought about and experimented with cowpox until he had
satisfied himself that he had discovered something which would
rid the human race forever of the incubus of an intolerable
pestilence.
It was in 1780 that Jenner set himself to study cowpox in a way
that had never before been attempted, for he was convinced that
in the having had an attack of the disease lay the secret of
the conquest of that world-scourge. He confided in his fried
Edward Gardner about "a most important matter . . . which I
firmly believe will prove of essential benefit to the human
race . . . should anything untoward turn up in my experiments,
I should be made, particularly by my medical brethren, the
subject of ridicule." Luckily he was quite prepared for both
ridicule and opposition; for has not everything new been
ridiculed and opposed? Galileo was opposed, Bruno was opposed,
Copernicus was opposed, Harvey was opposed, George Stevenson
was opposed, Pasteur was ridiculed and opposed, and so were
Darwin, Simpson and even Lister. The physiological inertia even
of the educated has too often blocked the path of advancement:
but Jenner is in illustrious company, a prince amongst the
hierarchy of the misunderstood.