The History Book Club discussion

Chapter Overviews and Summaries:

Chapter Twelve

In Chapter 12, Barry indicates that pneumonia kills either when there is so much fluid in the lung that not enough oxygen can be transferred into the bloodstream or when the pathogen that caused pneumonia enters the bloodstream.

He writes that when Cole became head of the Rockefeller Institute, he focused on finding a cure or vaccine for pneumonia.

He hired Oswald Avery to lead this work.

As Avery did more tests on the bacteria that caused pneumonia, he developed a better understanding of the bacteria. He created a serum he hoped could cure pneumonia.

Chapter Overviews and Summaries:

Chapter Thirteen

In Chapter 13, Avery’s serum cut the death rate from Type I pneumococci by half. A paper explaining how to make and use the serum was published. Meanwhile, a pneumonia vaccine was given to 12,000 soldiers at Camp Upton while 19,000 other soldiers served as control subjects. Over the course of the next three months, none of the vaccinated soldiers got sick. One hundred and one of the nonvaccinated soldiers contracted pneumonia.

Meanwhile, a board on pneumonia focused on how to best minimize the possibility of an epidemic among troops. They recognized the need to isolate sick troops, but knew it would be difficult to convince the army to take needed precautions. As expected, army leaders argued that they had the training and room needed to handle any epidemics.

And this catches up the Chapter Overviews and Summaries to where we are right now.

Part IV begins with next week's assignment (167) which we have not gotten to and next week's assignment starting Monday, August 10th with Chapter Fourteen.

Source: Book Rags

The Chapter Overviews and Summaries are now up through the end of Week Five - (pages 147 - 167) - August 3rd - August 9th
which is this week's assignment. Now I will continue to go through these previous and current chapters.

Bentley, if you’ll forgive me for jumping back to Chapter 6, I find it utterly incredible that they can pinpoint the Outbreak of the 1918 Pandemic to Haskell County, Kansas, early in that year ... it is amazing how quickly and how far the virus spread ... the evidence came from Dr. Loring Miner, something of an oddity in his profession and a product of the medical ferment in Ohio ...
Regards,
Andrea

We will be going back to anything that anyone wants to bring up including myself. There is no problem about bringing any idea, quote, event, person up again at any time. The only thing we ask is that spoiler html has to be used if anyone goes ahead on a single thread discussion.

And so it begins:


Bellevue Operating Theater - Sir William MacCormac

CHAPTER FIVE

THE MEN WHO CREATED the Rockefeller Institute always intended to have a small affiliated hospital built to investigate disease.

No patient would pay for treatment and only those suffering from diseases being studied would be admitted. No other research institute in the world had such a facility.

That much William Welch, Simon Flexner, Frederick Gates, and John D. Rockefeller Jr. did intend.

But they did not plan to have what Rufus Cole, the hospital’s first director, all but forced upon them. Tall, mustached, and elegant, with an ancestor who arrived at Plymouth, Massachusetts, in 1633, Cole did not appear to be a forceful man, did not seem someone capable of confronting Flexner.

But he always remained true to those things that he had thought out, and his thinking was powerful. Then he yielded only to evidence, not to personality, and advanced his own ideas calmly and with tenacity. His longtime colleague Thomas Rivers called him “a modest man, a rather timid man,” who “would go out of his way to dodge” a confrontation.

But, Rivers added, “He was considered the brightest man that ever graduated from Hopkins at the time he graduated. . . . If you get him mad, get him in a corner and kind of back him up, . . . [y]ou would find, generally to your sorrow, that the old boy wasn’t afraid to fight.”

Source: Barry, John M.. The Great Influenza (p. 80). Penguin Publishing Group. Kindle Edition.

Discussion Topics and Questions:

1. How did Cole and Flexner disagree? What were their differences?

2. How did the Rockefeller Institute apply science directly to patient care and thereby created the model of clinical research used today by the National Institute of Health?

3. How do you account that even by 1910 some of the hospitals and institutions in the US could compete with the best in the world; but that there were still unbridgeable gaps between the best medical practice and the worst?

4. What are your thoughts about this quote:
‘It is idle to talk of real laboratory work for students so ignorant and clumsy. Many of them, gotten through advertising, would make better farmers."

5. What were some of the flaws of the Flexner Report and what did you think of the A, B, and C classifications given some schools?

6. Was John D. Rockefeller smart to be seeing only a homeopathic physician?

Source: Barry, John M.. The Great Influenza (p. 84). Penguin Publishing Group. Kindle Edition.

Rufus Cole



Rufus Cole was the first director of Rockefeller Institute. Cole believed that the doctors at that institute should be doing active research on the patients there.

More:

Rufus Cole (April 30, 1872 – April 20, 1966) was an American medical doctor and the first director of the Rockefeller University Hospital. Under his leadership significant advances in treatment of bacterial pneumonia and later against tuberculosis were made.

In 1912 Cole and Alphonse Dochez developed a serum against Type 1 pneumococcus and also developed a method for testing whether an infection is caused by this or some other type of the bacterium.

The New York Times in its obituary for Cole called him "a pioneer in clinical medicine" and "an authority on lobar pneumonia".

The New York Times also wrote in the same obituary that Cole was President of Association of American Physicians in 1931, had honorary degrees from the University of Chicago and the National University of Ireland.

Cole received Kober prize in 1938 for advances against tuberculosis. He is also credited by Franklin C. McLean for creating a blueprint for clinical studies.

His ideas created the model of clinical research that is followed by modern research facilities. Cole additionally encouraged the doctors at the Rockefeller Institute to focus on finding a cure or vaccine for pneumonia.

Remainder of article:
https://en.wikipedia.org/wiki/Rufus_Cole

More:
http://www.nasonline.org/publications...
https://www.nytimes.com/1966/04/22/ar...
https://www.nytimes.com/1938/05/05/ar...
https://www.aai.org/About/History/Pas...
https://quod.lib.umich.edu/f/flu/1570...

Rufus Cole, the Guiding Philosophy of the Rockefeller Hospital, and the First Effective Therapy for Lobar Pneumonia
Link to article: http://centennial.rucares.org/index.p...

(no image) Acute lobar pneumonia; prevention and serum treatment by Rufus Cole (no photo)

Sources: Rockefeller University, Wikipedia, National Academy of Sciences, The New York Times, AAI

Simon Flexner



Simon Flexner was a scientist who was one of Welch’s protégés and his closest collaborator.

He was the first director of the Rockefeller Institute. He is most well-known for creating a serum to cure meningitis.

Flexner was also one of the scientists who was enlisted into the army to help find a cure or vaccine for the flu.

More:
https://www.encyclopedia.com/people/m...

The First Effective Therapy for Meningococcal Meningitis
Link: http://centennial.rucares.org/index.p...

Wikipedia Article:
Link: https://en.wikipedia.org/wiki/Simon_F...

Polio Place
Link: https://www.polioplace.org/people/sim...

Dr. Flexner's Experiment
Link: https://digitalcommons.rockefeller.ed...

The Rockefeller Foundation:
Link: https://rockfound.rockarch.org/biogra...

National Academy of Sciences
Link: http://www.nasonline.org/member-direc...

The History of Vaccines
Link: https://www.historyofvaccines.org/ind...

Medicine in American Art
Link: https://www.ajronline.org/doi/pdfplus...

(no image) A History of the Rockefeller Institute 1901-1953 by George W. Corner (no photo)

by James Thomas Flexner (no photo)

Sources: Wikipedia, Wikimedia, Polio Place, The Rockefeller Foundation, National Academy of Sciences, The History of Vaccines, Encyclopedia.com

Abraham Flexner



Abraham Flexner (November 13, 1866 – September 21, 1959) was an American educator, best known for his role in the 20th century reform of medical and higher education in the United States and Canada.

After founding and directing a college-preparatory school in his hometown of Louisville, Kentucky, Flexner published a critical assessment of the state of the American educational system in 1908 titled The American College: A Criticism. His work attracted the Carnegie Foundation to commission an in-depth evaluation into 155 medical schools in the US and Canada.

It was his resultant self-titled Flexner Report, published in 1910, that sparked the reform of medical education in the United States and Canada.

Flexner was also a founder of the Institute for Advanced Study in Princeton, which brought together some of the greatest minds in history to collaborate on intellectual discovery and research.

Remainder of article:
https://en.wikipedia.org/wiki/Abraham...

More:
https://www.ias.edu/scholars/flexner
https://www.ias.edu/ideas/usefulness-...
https://www.ias.edu/ideas/2007/flexne...
https://archive.org/stream/medicaledu...
https://globaleducationgroup.com/blog...
https://www.ias.edu/flexner-life

Comments on the Flexner Report
Link to Youtube video: https://youtu.be/HVsSo-dEnME

by Abraham Flexner

Sources: Wikipedia, Youtube, Institute for Advanced Study, Global UMA

And so we begin:


Dr. Loring Miner



CHAPTER SIX

HASKELL COUNTY, KANSAS, lies west of Dodge City, where cattle drives up from Texas reached a railhead, and belongs geographically to and, in 1918, not far in time from, the truly Wild West.

The landscape was and is flat and treeless, and the county was, literally, of the earth. Sod houses built of earth were still common then, and even one of the county’s few post offices was located in the dug-out sod home of the postmaster, who once a week collected the mail by riding his horse forty miles round trip to the county seat in Santa Fe, a smattering of a few wooden buildings that was already well on its way to becoming the ghost town it would be in another ten years—today only its cemetery remains as a sign of its existence.

But other towns nearby did have life. In Copeland, Stebbins Cash Store sold groceries, shoes, dry goods, dishes, hardware, implements, paints, and oils, while in Sublette, in the absence of a bank, S. E. Cave lent money on real estate for 7.5 percent.

Here land, crops, and livestock were everything, and the smell of manure meant civilization. Farmers lived in close proximity to hogs and fowl, with cattle, pigs, and poultry everywhere. There were plenty of dogs too, and owners made sure to teach their dogs not to chase someone else’s cattle; that could get them shot.

Discussion Topics and Questions:

1. What were your thoughts when you read the following quote:

"Epidemiological evidence suggests that a new influenza virus originated in Haskell County, Kansas, early in 1918. Evidence further suggests that this virus traveled east across the state to a huge army base, and from there to Europe. Later it began its sweep through North America, through Europe, through South America, through Asia and Africa, through isolated islands in the Pacific, through all the wide world."

2. What are your thoughts about this excerpt from an article in the Smithsonian written by the author?

From an article about the 1918 flu, by John M. Barry in
SMITHSONIAN MAGAZINE ,|NOVEMBER 2017:
..."We cannot say for certain that that happened in 1918 in Haskell County, but we do know that an influenza outbreak struck in January, an outbreak so severe that, although influenza was not then a “reportable” disease, a local physician named Loring Miner—a large and imposing man, gruff, a player in local politics, who became a doctor before the acceptance of the germ theory of disease but whose intellectual curiosity had kept him abreast of scientific developments—went to the trouble of alerting the U.S. Public Health Service. The report itself no longer exists, but it stands as the first recorded notice anywhere in the world of unusual influenza activity that year. The local newspaper, the Santa Fe Monitor, confirms that something odd was happening around that time: “Mrs. Eva Van Alstine is sick with pneumonia...Ralph Lindeman is still quite sick...Homer Moody has been reported quite sick...Pete Hesser’s three children have pneumonia ...Mrs J.S. Cox is very weak yet...Ralph Mc-Connell has been quite sick this week...Mertin, the young son of Ernest Elliot, is sick with pneumonia,...Most everybody over the country is having lagrippe or pneumonia.”...

More:
https://apnews.com/428151df24f841619b...
http://web.brrh.com/msl/GrandRounds/2...
https://www.athensnews.com/news/local...
https://en.wikipedia.org/wiki/Haskell...
https://www.npr.org/2020/04/03/826522...

Sources: Barry, John M.. The Great Influenza (p. 91-92). Penguin Publishing Group. Kindle Edition, Smithsonian Magazine, AP, The Athens News, NPR

The 1918 Spanish Flu-A Conspiracy of Silence | Mysteries of the Microscopic World (Part 1 of 3)

Link: https://youtu.be/7MHT5xTkL2g

Part II
https://youtu.be/TkgQQaVgqMw

Part III
https://youtu.be/kRU3RFZWY8I

What You Need to Know About Coronavirus
Link: https://youtu.be/seq0_n6xzik

How to Protect Yourself from Germs | How Viruses and Bacteria Spread
Link: https://youtu.be/o-eyYDNz7BQ

The Dynamic World of Infectious Diseases - 24 parts
Link: https://www.youtube.com/playlist?list...

Sources: The Great Courses, Science History/Distillations

More:
https://www.sciencehistory.org/distil...
https://www.smithsonianmag.com/histor...
http://muttermuseum.org/exhibitions/g...

by Alfred W. Crosby

by Katherine Anne Porter

by Laura Spinney (no photo)

And so we begin:


Sir (Frank) MacFarlane Burnet - National Portrait Gallery

CHAPTER SEVEN

NO ONE WILL EVER KNOW with absolute certainty whether the 1918–19 influenza pandemic actually did originate in Haskell County, Kansas.

There are other theories of origin, including France, Vietnam, and China.

But Frank Macfarlane Burnet, a Nobel laureate who lived through the pandemic and spent most of his scientific career studying influenza, influenza, later concluded that the evidence was “strongly suggestive” that the 1918 influenza pandemic began in the United States, and that its spread was “intimately related to war conditions and especially the arrival of American troops in France.”

Numerous other scientists agree with him. And the evidence does strongly suggest that Camp Funston experienced the first major outbreak of influenza in America; if so, the movement of men from an influenza-infested Haskell to Funston also strongly suggests Haskell as the site of origin.

Regardless of where it began, to understand what happened next, one must first understand viruses and the concept of the mutant swarm.

Discussion Topics and Questions:

1. What characteristics about viruses surprised you the most?

2. What is the only function of a virus?

3. How do genes resemble software?

4. What are your thoughts regarding this quote:

There are three different types of influenza viruses: A, B, and C. Type C rarely causes disease in humans. Type B does cause disease, but not epidemics. Only influenza A viruses cause epidemics or pandemics, an epidemic being a local or national outbreak, a pandemic a worldwide one.

5. How many of you were surprised by how smart the influenza virus is and how it hides from the immune system?

By entering the cell, as opposed to fusing with the cell on the cell membrane—which many other viruses do—the influenza virus hides from the immune system. The body’s defenses cannot find it and kill it. (104)

6. What were your thoughts about "mutant swarms"? How many of you were already familiar with this concept and how many of you were not? What amazes you about viruses and/or the influenza virus?

7. How shocking was this quote:

Influenza is an RNA virus. So are HIV and the coronavirus. And of all RNA viruses, influenza and HIV are among those that mutate the fastest. The influenza virus mutates so fast that 99 percent of the 100,000 to 1 million new viruses that burst out of a cell in the reproduction process are too defective to infect another cell and reproduce again. But that still leaves between 1,000 and 10,000 viruses that can infect another cell." (105-106)

More:

Sir Frank Macfarlane Burnet was born at Traralgon, Victoria, Australia, on September 3rd, 1899. He is the son of the Manager of the branch of the Colonial Bank in that town. He was educated at the Victoria State Schools and at Geelong College, completing his medical course at the University of Melbourne, where he graduated M.B., B.S., in 1922, and M.D., in 1923.

In 1923, Burnet went to the Walter and Eliza Hall Institute of the University of Melbourne to do research work on the agglutinin reactions in typhoid fever. He was from 1923-1924 Resident Pathologist at the Melbourne Hospital.

In 1926 he was awarded a Beit Fellowship for Medical Research and worked for a year at the Lister Institute, London.

In 1932 he spent a year at the National Institute for Medical Research, Hampstead, London. Otherwise, apart from many visits to various countries to give lectures or for other purposes, he has worked continuously at the Hall Institute in Melbourne.

In 1944 he became Director of this Institute and Professor of Experimental Medicine in the University of Melbourne.

It is impossible to give, in a brief space, an adequate idea of the range and fundamental importance of Burnet’s work. His work on the agglutinins of typhoid fever mentioned above was followed by the work on viruses for which he is nowadays justly famous. In 1935 he isolated a strain of influenza A virus in Australia, and subsequently did much work on serological variations of the influenza virus and on Australian strains of the swine influenza. He also published papers on variations in the virulence of influenza virus and on the mutation rates in it, which he calculated.

In 1946, in collaboration with W. I. B. Beveridge, Burnet devised a technique for cultivating viruses on the chorioallantoic membrane of chicken embryos and a method for determining the relative concentration of the material inoculated into these membranes by counting and statistically analysing the number of lesions that then appear on the membranes.

In 1947 he discovered, in collaboration with Stone, the receptor-destroying enzyme present in Vibrio cholerae, a discovery which led to the synthesis of neuraminic acid and to the demonstration, by Gottschalk and Cornforth, that purified influenza virus will quantitatively split the acetylgalactosamine neuraminic acid compound. Later it was shown that this enzyme derived from Vibrio cholerae can prevent infection by the influenza to a significant degree.

Burnet did much other important work on certain aspects of the prevention of virus infections and on important biological aspects of virus growth inside the cells in which they can live. He found that the filamentous forms of some viruses (e.g. those of myxoviruses such as those which cause influenza, mumps, fowl plague, and Newcastle disease) can be ruptured by suspending them in water, and suggested that their infectivity is limited to their tips, so that these filamentous forms can, as later work showed, be regarded as having an infective «warhead» composed of nucleic acid and a long tail composed of non-infective viral haemagglutinin.

Other aspects of Burnet’s work are his work on the surface properties of these filamentous forms, which are, he found, similar to those of cell surfaces, and his work with the haemagglutinin found in extracts of tissue infected with vaccinia, which can, he found, be precipitated by a saturated solution of ammonium sulphate and by cobra venom. He has also added much to our knowledge of the haemagglutination of red blood cells by various animal viruses, and has made contributions of fundamental importance to our knowledge of the genetic complexity of virus particles, and to the genetic interactions between related viruses which simultaneously infect the same cell and their relations to the transfer of neuropathogenicity. In addition, he has increased our knowledge of the inhibition of viruses by various substances, and of the complex details of immunological methods of studying viruses and of the immunology of viral infections.

Burnet has embodied his experience and experimental results, not only in numerous scientific papers, but in several books which show that he is a master, not only of a clear and attractive literary style, but also of lucid exposition of complex ideas and scientific facts.

Burnet received many honours and distinctions, among which the Fellowship of the Royal Society of London (1942), where he was awarded the Royal Medal in 1947 and the Copley Medal in 1959, and where he delivered the Croonian Lecture in 1950. He holds an honorary doctorate of the University of Cambridge, and was made a Fellow of the Royal College of Surgeons in 1953. He was knighted in 1951, and in 1958 he received the Order of Merit.

Burnet married Edith Linda Druce in 1928. They have one son, Ian, and two daughters, Elizabeth (Mrs. Paul M. Dexter) and Deborah (Mrs. John Giddy). Sir Frank Macfarlane Burnet died on August 31, 1985.

Work

Our immune system protects us against attacks by microorganisms and rejects foreign tissue. Part of our immunity has a hereditary basis, but part of it is acquired and is not present in the fetus. In 1949 Macfarlane Burnet theorized that the ability to distinguish between one's own and foreign tissue is not hereditary but is acquired during the fetus stage. The theory was substantiated when Peter Medawar succeeded in performing transplants of tissue between different mouse fetuses. The results had significance for organ transplants.

Nobel Lecture

https://www.nobelprize.org/uploads/20...

Other:
https://www.science.org.au/fellowship...

The Role of the Thymus in Immunity
https://www.mediatheque.lindau-nobel....

Sources: Barry, John M.. The Great Influenza (p. 98). Penguin Publishing Group. Kindle Edition, National Portrait Gallery, Noble Prize

PETER DOHERTY (1999)
How we Deal with Virus Infections



Link:
https://www.mediatheque.lindau-nobel....

Source: Nobel Prize

And so we begin:


The Coronavirus versus the Immune System

CHAPTER EIGHT

AN INFECTION is an act of violence; it is an invasion, a rape, and the body reacts violently. John Hunter, the great physiologist of the eighteenth century, defined life as the ability to resist putrefaction, resist infection. Even if one disagrees with that definition, resisting putrefaction certainly does define the ability to live.

The body’s defender is its immune system, an extraordinarily complex, intricate, and interwoven combination of various kinds of white blood cells, antibodies, enzymes, toxins, and other proteins. The key to the immune system is its ability to distinguish what belongs in the body, “self,” from what does not belong, “nonself.” This ability depends, again, upon reading the language of shape and form.

Source: Barry, John M.. The Great Influenza (p. 107). Penguin Publishing Group. Kindle Edition.

Coronavirus vs the human immune system: the brutal microscopic war for survival

*Deadly ‘dance’ between Sars-CoV-2 and the body’s defences is playing out in thousands of cases the world over.

*Immunologists say - "The lung is the worst place to have that happen,’ as body’s reaction to infection can become so violent it damages tissue".

Link: https://www.scmp.com/news/china/socie...

More:

Coronavirus:
https://open.spotify.com/episode/6H3G...

Source: South China Morning Post

Chapter Eight


John Hunter. Painted by John Jackson in 1813, after an original by Sir Joshua Reynolds, who exhibited his painting at the Royal Academy in 1786.

Discussion Topics and Questions:

1. How does Barry describe the immune system of the body? What are its components?

2. Did you know the following and what surprised you about your immune system?

Anything carrying a “self” marking, the immune system leaves alone. (It does, that is, when the system works properly. “Autoimmune diseases” such as lupus or multiple sclerosis develop when the immune system attacks its own body.) But if the immune system feels a “nonself” marking—either foreign invaders or the body’s own cells that have become diseased—it responds. In fact, it attacks.

3. How do vaccines and vaccinations work?

4. What is "antigen drift"?

Bentley, what impresses me most about Barry’s book is the multitude of brief biological sketches of these unsung medical heroes ... will there be similar biographical thumbnails when the history of the 2020 Pandemic is written?
Regards,
Andrea

I cannot predict the future Andrea. Probably Doctor Fauci will be remembered. As far as a vaccine - we are only hearing about companies and not names of individuals. Corporations seem to have taken over. Maybe in the future - other generations will hear of the bravery of some of the doctors, nurses, medical profession.

Another thing that struck me as I read about the individuals who made a difference was that individuals were much more courageous and independent thinkers - more seemed to step up and take the initiative.

I am wondering whether the world has changed where folks are afraid to step out of the box.

And I am not talking about the protestors of today who in some ways are part of group and crowd think as well.

There were some powerful independent "individuals" then who got their joy out of learning.

Have you met men and women who are so charismatic because of their skill sets, their character that they stand apart and are admired for those intrinsic moral and ethical qualities - that was the norm then.

Now we have 24 x 7 cable news and leadership that is bereft of humanitarian goals - replaced by self interest I am afraid. Corporations and the economy appear to be more important than the safety and health of the populace. Bill Gates has stepped up and is shining a light on global initiatives and on the needs of people worldwide. Can you think of others?

Try your hand at some of the discussion questions which will make you think about the chapters and history we do know about. I am afraid that we do not know what future generations will think of us now. I just know that present generations are not too pleased with how things have unfolded regarding the pandemic - present company included.

This is the kind of thing which is unbelievable - the Philadelphia parade that created so many issues decades ago was for a good cause. I will leave others to decide about this one.

Biker rally expects 250,000 people but not requiring masks

https://www.cnn.com/videos/health/202...

Source: CNN

It is a good idea to focus on the following a bit to understand our present situation. This is sort of a public health announcement.

The following is important to know.

I have included this long quote because it explains what has happened today (Covid19 and how - antigen shift, etc.), it explains the seriousness of this situation which many are not believing for some unknown reason, and it explains what lies ahead and why the flu season might see a resurgence (second serious wave) of Covid 19 along with the influenza type of the season (its own Hemagglutinin and neuraminidase or a combination of subtypes).

One problem we have is that many of the current US population do not take this seriously and they should.

Whether it is this pandemic or the next one; or not wearing a mask, washing your hands, using hand sanitizer, social distancing and/or staying away from crowds - these are all critical.

Nobody wants to be among the 40% that gets the new strain before it has built up antibodies in some who are remaining and has sadly killed the rest.

Isn't it odd that with all of these pandemics that none of the 24 x 7 cable news channels, newspapers, politicians or even our parents or grandparents talked much about this or any of the others.

Everyone is like an ostrich sticking their head into the sand.

And, of course, the entire pandemic team was dismantled by the current administration not that the team had done that much; but at least it would have been in place.

Please discuss anything dealing with any of the above or the quote below. If you have varied and/or different ideas - we would like to hear those too. We all love a good discussion and debate.

Here is the quote:

"Pandemics generally develop only when a radical change in the hemagglutinin, or the neuraminidase, or both, occurs. When an entirely new gene coding for one or both replaces the old one, the shape of the new antigen bears little resemblance to the old one. This is called “antigen shift.”

To use the football-uniform analogy again, antigen shift is the equivalent of the virus changing from a green shirt and white pants to an orange shirt and black pants.

When antigen shift occurs, the immune system cannot recognize the antigen at all. Few people in the world will have antibodies that can protect them against this new virus, so the virus can spread through a population at an explosive rate.

Hemagglutinin occurs in eighteen known basic shapes, neuraminidase in nine, and they occur in different combinations with subtypes. Virologists use these antigens to identify what particular virus they are discussing or investigating. “H1N1,” for example, is the name given the 1918 virus, currently found in swine.

An “H3N2” virus is circulating among people today. Antigen shift occurs when a virus that normally infects birds attacks humans directly or indirectly. Since 1997, two different avian viruses, H5N1 and H7N9, have directly infected more than 2,300 people, killing more than 1,000 and threatening another 1918-like pandemic.

Birds and humans have different sialic-acid receptors, so a virus that binds to a bird’s sialic-acid receptor will not normally bind to—and thus infect—a human cell. In Hong Kong what most likely happened was that the eighteen people who got sick were subjected to massive exposure to the virus.

The swarm of these viruses, the quasi species, likely contained a mutation that could bind to human receptors, and the massive exposure allowed that mutation to gain a foothold in the victims. Yet the virus did not adapt itself to humans; all those who got sick were infected directly from chickens. But the virus can adapt to man. It can do so directly, with an entire animal virus jumping to humans and adapting with a simple mutation. It can also happen indirectly.

For one final and unusual attribute of the influenza virus makes it particularly adept at moving from species to species.

The influenza virus not only mutates rapidly but also has a “segmented” genome. This means that its genes do not lie along a continuous strand of its nucleic acid, as do genes in most organisms, including most other viruses. Instead, influenza genes are carried in unconnected strands of RNA.

Therefore, if two different influenza viruses infect the same cell, “reassortment” of their genes becomes very possible. Reassortment mixes some of the segments of the genes of one virus with some from the other. It is like shuffling two different decks of cards together, then making up a new deck with cards from each one. This creates an entirely new hybrid virus, which increases the chances of a virus jumping from one species to another.

If the Hong Kong chicken influenza had infected someone who was simultaneously infected with a human influenza virus, the two viruses might easily have reassorted their genes. They might have formed a new virus that could pass easily from person to person. And the lethal virus might have adapted to humans.

The virus may also adapt indirectly, through an intermediary. Some virologists theorize that pigs provide a perfect “mixing bowl,” because the sialic-acid receptors on their cells can bind to both bird and human viruses. Whenever an avian virus infects swine at the same time that a human virus does, reassortment of the two viruses can occur. And an entirely new virus can emerge that can infect man.

In 1918 veterinarians noted outbreaks of influenza in pigs and other mammals, and pigs today still get influenza from a direct descendant of the 1918 virus. But it is not clear whether pigs caught the disease from man or man caught it from pigs.

And Dr. Peter Palese at Mount Sinai Medical Center in New York, one of the world’s leading experts on influenza viruses, considers the mixing-bowl theory unnecessary to explain antigen shift: “It’s equally likely that co-infection of avian and human virus in a human in one cell in the lung [gives] rise to the virus. . . . There’s no reason why mixing couldn’t occur in the lung, whether in pig or man. It’s not absolute that there are no sialic acid receptors of those types in other species. It’s not absolute that the avian receptor is really thatdifferent from the human, and, with one single amino acid change, the virus can go much better in another host.”*

Antigen shift, this radical departure from existing antigens, led to major pandemics long before modern transportation allowed rapid movement of people. There is mixed opinion as to whether several pandemics in the fifteenth and sixteenth centuries were influenza, although most medical historians believe that they were, largely because of the speed of their movement and the number of people who fell ill.

In 1510 a pandemic of pulmonary disease came from Africa and “attacked at once and raged all over Europe not missing a family and scarce a person.” In 1580 another pandemic started in Asia, then spread to Africa, Europe, and America. It was so fierce “that in the space of six weeks it afflicted almost all the nations of Europe, of whom hardly the twentieth person was free of the disease,” and some Spanish cities were “nearly entirely depopulated by the disease.”

There is no dispute, though, that other pandemics in the past were influenza. In 1688, the year of the Glorious Revolution, influenza struck England, Ireland, and Virginia. In these places “the people dyed (spelling in original source). . . as in a plague.” Five years later, influenza spread again across Europe: “all conditions of persons were attacked. . . . [T]hose who were very strong and hardy were taken in the same manner as the weak and spoiled, . . . the youngest as well as the oldest.”

In January 1699 in Massachusetts, Cotton Mather wrote, “The sickness extended to allmost all families. Few or none escaped, and many dyed especially in Boston, and some dyed (Cotton Mather's spelling at the time) in a strange or unusual manner, in some families all weer (again Cotton Mather's spelling at the time) sick together, in some towns almost all were sick so that it was a time of disease.” At least three and possibly six pandemics struck Europe in the eighteenth century, and at least four struck in the nineteenth century.

In 1847 and 1848 in London, more people died from influenza than died of cholera during the great cholera epidemic of 1832.

And in 1889 and 1890, a great and violent worldwide pandemic—although nothing that even approached 1918 in violence—struck again. In the twentieth century, three pandemics struck.

Each was caused by an antigen shift, by radical changes in either the hemagglutinin or the neuraminidase antigens, or both, or by changes in some other gene or genes. Influenza pandemics generally infect from 15 to 40 percent of a population; any influenza virus infecting that many people and killing a significant percentage would be beyond a nightmare. In recent years public health authorities have at least twice identified a new virus infecting humans but successfully prevented it from adapting to man.

To prevent the 1997 Hong Kong virus, which killed six of eighteen people infected, from adapting to people, public health authorities had every single chicken then in Hong Kong, 1.2 million of them, slaughtered. An even greater slaughter of animals occurred in the spring of 2003 when a new H7N7 virus appeared in poultry farms in the Netherlands, Belgium, and Germany.

This virus infected eighty-two people and killed one, and it also infected pigs. So public health authorities killed nearly thirty million poultry and some swine.

In 2004, H5N1, which had never fully disappeared, returned with a vengeance.

At this writing it has infected approximately four hundred people around the world in five years, and it has killed approximately 60 percent of them. It threatened, and it still threatens, to cause another pandemic.

In total, hundreds of millions of poultry were slaughtered in an attempt to contain it. Nonetheless it has become endemic worldwide.

This costly and dreadful slaughter was done to prevent what happened in 1918. It was done to stop either of these influenza viruses from adapting to, and killing, man.

Meanwhile, in 2009 an entirely unexpected virus, one combining genes from viruses which had previously infected birds, swine, and humans, has launched the next pandemic.

One more thing makes influenza unusual.

When a new influenza virus emerges, it is highly competitive, even cannibalistic. It usually drives older types into extinction. This happens because infection stimulates the body’s immune system to generate all its defenses against all influenza viruses to which the body has ever been exposed. When older viruses attempt to infect someone, they cannot gain a foothold. They cease replicating. They die out.

So, unlike practically every other known virus, only one type—one swarm or quasi species—of influenza virus dominates at any given time. This itself helps prepare the way for a new pandemic, since the more time passes, the fewer people’s immune systems will recognize other antigens. Not all pandemics are lethal.

Antigen shift guarantees that the new virus will infect huge numbers of people, but it does not guarantee that it will kill large numbers. The twentieth century saw three pandemics. The most recent new virus attacked in 1968, when the H3N2 “Hong Kong flu” spread worldwide with high morbidity but very low mortality—that is, it made many sick, but killed few.

The “Asian flu,” an H2N2 virus, came in 1957; while nothing like 1918, this was still a violent pandemic. Then of course there was the H1N1 virus of 1918, the virus that created its own killing fields."

Source: Barry, John M.. The Great Influenza (pp. 111-116). Penguin Publishing Group. Kindle Edition.

And so we begin: (with a very sad and reprehensible situation in World War I)

CHAPTER NINE

"IN THE SPRING OF 1918 death was no stranger to the world. Indeed, by then the bodies of more than five million soldiers had already been fed into what was called “the sausage factory” by generals whose stupidity was matched only by their brutality.

German generals, for example, had decided to bleed France into submission by matching it death for death at Verdun, believing that Germany’s greater population would leave it victorious.

The French later replied with their own massive offensive, believing that their élan vital would triumph. Only slaughter triumphed.

Finally one French regiment refused orders to make a suicidal charge. The mutiny spread to fifty-four divisions, stopped only by mass arrests, the conviction of twenty-three thousand men for mutiny, with four hundred sentenced to death and fifty-five actually executed. Yet nothing expressed the brutality of this war as did a sanitation report on the planned eradication of rats in the trenches to prevent the spread of disease.

A major noted, “Certain unexpected problems are involved in the rat problem. . . . The rat serves one useful function—he consumes the corpses on No Man’s Land, a job which the rat alone is willing to undertake. For this reason it has been found desirable to control rather than eliminate the rat population.”

Source: Barry, John M.. The Great Influenza (p. 119). Penguin Publishing Group. Kindle Edition.

Discussion Topics and Questions:

1. What were your thoughts while reading the above passage, about war, leaders, generals, situation at the time? How could men adopt such a philosophy about how expendable their own men were for the "ultimate win". How was that being victorious and at what cost? How did World War I spread the 1918 pandemic?

2. Did anybody else think that this was a very strange quote by the author?

"Anglophiles and Francophiles still regarded war as glorious. And they put intense pressure on President Woodrow Wilson to enter the war." (p. 120)

I am not sure that this is my impression of how we entered World War I and why. Any comments?

3. Another curious quote: (speaking about Woodrow Wilson)

"He was one of those rare men who believed almost to the point of mental illness in his own righteousness. (p. 121)"

Your comments about Wilson and about the author's quote?

4. Personally, I thought this was a very strange chapter. What are your thoughts? Obviously, Barry is not a fan of Woodrow Wilson. In part, he is blaming Wilson and this is his claim - "for turning the country into a tinderbox for the virus". Do you agree or disagree? Seems to me to be rather harsh. What do you think?

5. Did anyone of our readers realize that the American Red Cross was as politicized as the author claims or had a history of being so co-mingled with government policy? Comments?

6. Did anyone else wonder about the intensity of this chapter and the tone? How many of you would have liked to have lived during the period of history described in this chapter?

This was added to the CDC site in 2019 before the current pandemic:

How the Flu Virus Can Change: “Drift” and “Shift”

See link: https://www.cdc.gov/flu/about/viruses...

More
https://www.thequint.com/fit/all-viru...

Sources: The Quint, CDC

The Rockefeller University

How antibodies from llamas may lead to COVID-19 treatment
June 11, 2020

Link to article and video: https://www.rockefeller.edu/news/2823...

Source: The Rockefeller University

This shows antigenic shift which resulted in the H1N1 virus

Antigenic Shift and the H1N1 Influenza A Virus

Link: https://youtu.be/4H9PV65PUmQ

Source: Mechanisms in Medicine - Youtube

Bentley, I'm not aware of anyone in my close family getting the 1918 influenza (although I did have a grand uncle, my grandmother's younger brother, who was gassed in the trenches and never recovered; he died shortly after the war). i've heard about tuberculosis in my family but not influenza. David Brooks said at the beginning of our current pandemic that he thinks it's because everyone acted so badly during 1918 Influenza (acted so selfishly), the country got amnesia so it wouldn't have to face its bad behavior. I honestly don't know. From articles I'm reading, most of the country is acting badly so we probably will have amnesia again, once this is over. We are having the same arguments over individual rights versus taking care of your communities. The individual rights folks win the argument because they keep spreading the virus so it can never be gotten under control.

In terms of the quote on the actions of the generals, it's hard to interpret their actions any other way other than sheer stupidity. So many died due to their lack of care for their soldiers. You can see it in the results from Gallipoli and the trenches and all the songs that were written and sung (Dancing Matilda, etc.) and the books written about it (All Quiet on the Western Front, etc). One of my favorite is the Green Fields of France as sung by the Dropkick Murphys (believe it or not):

https://www.youtube.com/watch?v=zRmJw...

I come from a family of a lot of veterans. My sister was an officer in the Navy and she said that it seemed the higher ups were more concerned about the equipment than the safety of the crew. So maybe it hasn't changed that much.

I'm not that cynical but I'm not a vet.

Kathy

Woodrow Wilson



Woodrow Wilson, a leader of the Progressive Movement, was the 28th President of the United States (1913-1921). After a policy of neutrality at the outbreak of World War I, Wilson led America into war in order to “make the world safe for democracy.”

Like Roosevelt before him, Woodrow Wilson regarded himself as the personal representative of the people. “No one but the President,” he said, “seems to be expected … to look out for the general interests of the country.” He developed a program of progressive reform and asserted international leadership in building a new world order. In 1917 he proclaimed American entrance into World War I a crusade to make the world “safe for democracy.”

Wilson had seen the frightfulness of war. He was born in Virginia in 1856, the son of a Presbyterian minister who during the Civil War was a pastor in Augusta, Georgia, and during Reconstruction a professor in the charred city of Columbia, South Carolina.

After graduation from Princeton (then the College of New Jersey) and the University of Virginia Law School, Wilson earned his doctorate at Johns Hopkins University and entered upon an academic career. In 1885 he married Ellen Louise Axson.

Wilson advanced rapidly as a conservative young professor of political science and became president of Princeton in 1902.

His growing national reputation led some conservative Democrats to consider him Presidential timber. First they persuaded him to run for Governor of New Jersey in 1910. In the campaign he asserted his independence of the conservatives and of the machine that had nominated him, endorsing a progressive platform, which he pursued as governor.

He was nominated for President at the 1912 Democratic Convention and campaigned on a program called the New Freedom, which stressed individualism and states’ rights. In the three-way election he received only 42 percent of the popular vote but an overwhelming electoral vote.

Wilson maneuvered through Congress three major pieces of legislation. The first was a lower tariff, the Underwood Act; attached to the measure was a graduated Federal income tax. The passage of the Federal Reserve Act provided the Nation with the more elastic money supply it badly needed. In 1914 antitrust legislation established a Federal Trade Commission to prohibit unfair business practices.

Another burst of legislation followed in 1916. One new law prohibited child labor; another limited railroad workers to an eight-hour day. By virtue of this legislation and the slogan “he kept us out of war,” Wilson narrowly won re-election.

But after the election Wilson concluded that America could not remain neutral in the World War. On April 2,1917, he asked Congress for a declaration of war on Germany.

Massive American effort slowly tipped the balance in favor of the Allies. Wilson went before Congress in January 1918, to enunciate American war aims–the Fourteen Points, the last of which would establish “A general association of nations…affording mutual guarantees of political independence and territorial integrity to great and small states alike.”

After the Germans signed the Armistice in November 1918, Wilson went to Paris to try to build an enduring peace. He later presented to the Senate the Versailles Treaty, containing the Covenant of the League of Nations, and asked, “Dare we reject it and break the heart of the world?”

But the election of 1918 had shifted the balance in Congress to the Republicans. By seven votes the Versailles Treaty failed in the Senate.

The President, against the warnings of his doctors, had made a national tour to mobilize public sentiment for the treaty. Exhausted, he suffered a stroke and nearly died. Tenderly nursed by his second wife, Edith Bolling Galt, he lived until 1924.

The Presidential biographies on WhiteHouse.gov are from “The Presidents of the United States of America,” by Frank Freidel and Hugh Sidey. Copyright 2006 by the White House Historical Association.

Learn more about President Wilson’s first wife, Ellen Axson Wilson, who died during her term.

Link: https://www.whitehouse.gov/about-the-...

Learn more about President Wilson’s second wife, Edith Bolling Galt Wilson.

Link: https://www.whitehouse.gov/about-the-...

Source: The White House

===================================================

The following is what Barry was trying to say about Woodrow Wilson - I disagree with his assessment although we all believe in freedom of the press and gagging the press in not right except possibly in terms of national defense during a World War - but this is the gist:

According to Barry - Wilson was the President of the United States during the 1918 flu epidemic. Barry describes how Wilson, with his intentions of making the people of the country united in the war effort, made conditions ripe for an epidemic. Wilson insisted that workers flood to the cities to work in the munitions factories to make needed material for war. He also had new soldiers drafted into the county’s army. These new soldiers were crammed into overcrowded camps to train for the war. Wilson also controlled the newspapers and would not allow anyone to print anything about the epidemic because he worried that it would hurt the country’s morale regarding the war. Wilson was so focused on the war that he did not put any effort into preparing for the pandemic.

Barry also suggests that Wilson was personally impacted by mental instability as a result of the flu. He describes how Wilson suffered a bout of the flu during peace talks in Paris, France. Before he was sick, Wilson had adamantly refused to make concessions on his ideas about the peace treaty. He had even threatened to leave talks when it was suggested that he reconsider his ideas. After he was sick, Wilson conceded to the demands of Clemenceau, the things he had earlier refused to reconsider. Four months later, Wilson suffered a debilitating stroke, another medical condition that is said to be tied to the flu. (Sources for the above: Chapter Nine, Book Rags, John Barry)


The Big Four at the 1919 Paris Peace Conference on June 28, the day the Treaty of Versailles was signed. Left to right: Italian Prime Minister Vittorio Orlando, British Prime Minister David Lloyd George, French Prime Minister Georges Clemenceau, and United States President Woodrow Wilson. (Wikimedia/public domain

More:
https://lostcoastoutpost.com/2020/apr...

Woodrow Wilson: The great romantic (CBS Morning)
Link to video: https://youtu.be/js955GULZNY

by A. Scott Berg (no photo)

Biography
Link to video: https://www.potus.com/woodrow-wilson/

The Moralist: Woodrow Wilson and the World He Made
Link to video: https://youtu.be/rp_1gWny-JY

by Patricia O'Toole (no photo)

Khan Academy - The Fourteen Points
Link to video: https://www.khanacademy.org/humanitie...

Woodrow Wilson: His Presidency and His House
Link to video: https://www.c-span.org/video/?17461-1...#

Sources: C-Span, Khan Academy, Youtube, Biography, CBS Morning, BookRags, The Great Influenza, The White House

Bentley, this summary is a rather benign version of Woodrow Wilson's story and what I learned in school. I haven't read much further on Wilson other than these types of summaries in various books I've read. According to the summary in the book we are reading and other articles I've read recently, his legacy is a lot less benign (both what was done during WWI and his explicit racism). I know everyone is neither all good nor all bad but I think the Whitehouse.gov summary needs to be rewritten to reflect his legacy more fairly. Kathy

Kathy, once again - I am not an apologist for Wilson or any other person who lived during different times. I think we need to judge Wilson and the men and women who lived before us with the cultural lens of that period. He was influenced by the South; but he was not a bad man. He was wrong on civil rights; but he worked tirelessly on behalf of the United States and wanted a lasting peace. Was he flawed? We all are. I think the White House write-up is a fair one. I respect your right to express your viewpoint. And everybody's views are appreciated and welcomed.

I would recommend reading:

by John Milton Cooper Jr. (no photo)

Note: The above is a book which we discussed on the HBC.

Kathy wrote: "Bentley, I'm not aware of anyone in my close family getting the 1918 influenza (although I did have a grand uncle, my grandmother's younger brother, who was gassed in the trenches and never recover..."

Kathy, I just saw the post above and I want to read it carefully and then I will add to this post.

I am not sure that the country was "purposely" guilty of bad behavior - if we were fighting a war; but there are no perfect times. Those were not the easiest of days for the world.

But then again the behavior that we are seeing during the current pandemic does not reflect sensible and safe behavior. But many are doing the very best they can. The news is highlighting certain age groups which are not following social distancing - and that is dangerous and scary for all of us.

There are no winners in a pandemic - every nation is suffering from grief, loss of income or security, uncertainty and at the very least - a change in lifestyle, priorities and outlook. Almost overnight, our lives have changed. The loss that none of us want to suffer is the loss of life.

I wish I could say that taking care of our troops was the top priority by our leadership but there still is a long way to go. Every one who commands our troops should be willing to send their own sons and daughters into harm's way; because of their decisions and/or should have served themselves so that they understand intimately the perils and the horror of war.

The poetry of the WWI period is riveting, stark, shocking sometimes and poignant.

Dulce et Decorum Est
BY WILFRED OWEN

Bent double, like old beggars under sacks,
Knock-kneed, coughing like hags, we cursed through sludge,
Till on the haunting flares we turned our backs,
And towards our distant rest began to trudge.
Men marched asleep. Many had lost their boots,
But limped on, blood-shod. All went lame; all blind;
Drunk with fatigue; deaf even to the hoots
Of gas-shells dropping softly behind.

Gas! GAS! Quick, boys!—An ecstasy of fumbling
Fitting the clumsy helmets just in time,
But someone still was yelling out and stumbling
And flound’ring like a man in fire or lime.—
Dim through the misty panes and thick green light,
As under a green sea, I saw him drowning.

In all my dreams before my helpless sight,
He plunges at me, guttering, choking, drowning.

If in some smothering dreams, you too could pace
Behind the wagon that we flung him in,
And watch the white eyes writhing in his face,
His hanging face, like a devil’s sick of sin;
If you could hear, at every jolt, the blood
Come gargling from the froth-corrupted lungs,
Obscene as cancer, bitter as the cud
Of vile, incurable sores on innocent tongues,—
My friend, you would not tell with such high zest
To children ardent for some desperate glory,
The old Lie: Dulce et decorum est
Pro patria mori.

Bentley, my dad used to say the same thing to me when I was young. As long as attitudes like this don't give us an excuse for our current situation, I can live with it.

However, I'm not sure it as benign as that and it does permeate our current society and has impacted what is currently going on. Civil War history was purposively rewritten (in my textbooks both in grammar school and in college) to downplay how much slavery was the cause of the war and how profitable it really was. If you read enough of the original documents, you can see how much slavery was the cause of the war with the Southern states wanting to defend its continued existence and if you look at the development of US wealth in the 18th and 19th centuries, how much slavery was a significant contributor to our wealth with the North benefiting by taking the output of the South and using it in its factories. If you want to see how the South continued it under Jim Crow read (if you haven't already read it):

Slavery by Another Name: The Re-Enslavement of Black Americans from the Civil War to World War II by Douglas A. Blackmon

and the North looked the other way. I'm not sure how involved Wilson was in perpetuating these myths since I haven't read biographies about him so I will reserve final judgement.

I also learned that Northerners weren't really that serious about winning and didn't take it that seriously in my textbooks. That certainly is not the take in:

Team of Rivals: The Political Genius of Abraham Lincoln by Doris Kearns Goodwin

In addition, in the current book, I was shocked by how aggressive Wilson was in suppressing civil liberties in order to prosecute the war. I'm not sure even Lincoln was that aggressive based on what I've read and there certainly was a lot of complaints about Lincoln on that score. Again I will reserve final judgement until I read more about Wilson but since my reading list is quite long, it may be awhile before I get there.

Kathy

Kathy, I would have liked your Dad.

In life, you have to let go. You have to let go of the past, you have to let go of preconceived notions that you knew what it was like to live in any period of history because we don't. We do not know what it was like to be a slave, be a plantation owner, try to make a living in the South or the North, be an abolitionist, be a President from the South or the North, fight in the Civil War or just try to be a good community member during any of these times. We do not know what it was really like during our country's early days - the Revolutionary War, the Civil War, the French and Indian War or any of the World Wars. Of course, I can only speak for myself - but I was not there. I do not know first hand - I am relying on secondary sources. But none of us walked in their shoes.

Trying to rewrite history to suit your narrative is what the Taliban does. Always focus on the here and the now - the present. What can we do today which is different and better than what we did yesterday? What do we need to do today to ensure equality and justice for all? So that we can honestly say: "We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.

The citations (with a few tweaks)

by Douglas A. Blackmon

by Doris Kearns Goodwin

Bentley, I’m not trying to rewrite our past to fill a narrative. I’m trying to understand it to help our present. That’s why I read it. Otherwise it’s a pointless exercise and I could just read self help books. They are certainly easier to read. I’m a true believer that history informs people’s present actions. But you have the right to your own opinions. The books I cited are not fluff they are well researched and well regarded by more than me since both won the Pulitzer Prize. And lets leave the current topic here. Thanks, Kathy

Kathy, I get what you are saying. And I may not agree with all of what you posted; but what does that matter. I do agree and respect your right to say and feel whatever you believe That is up to you and you alone.

I do not find that self help books help anyone (lol) - once again someone is trying to shoe horn their formula into their narrative and one size does not fit all. The entire world needs self help - there is something to be said for the aphorism - "God helps those who help themselves". And that does not mean turn your back on the poor or those less fortunate than yourself. You help yourself by helping others. It takes the focus off of the "you" and by giving you help yourself and "focus on others". And I know that is your philosophy too because of the help you give to your community which is laudable.

I think we can learn a lot from history - in fact we should reflect on our history in order to make our today better. I love history for that reason. However, I think about what will folks a hundred years from now write about us? What will they think was so bad about us? And what can we do today to make sure that we are living our best lives and allowing others to live theirs?

I am not ruffled in the least by what you have said. All of it is fine. I enjoy the dialogue. And I respect you and all of your opinions, beliefs and I agree with you about history and the books you have cited.

My focus as far as action is on today. Why waste your energies arguing about what happened years ago. It would be best to change what you can change and to do it now. And let the rest of it go.

Discussion and debate are engaging and should be fun. I love hearing what you have to say. So do not be deterred.

And so we begin:

CHAPTER TEN

"WHILE AMERICA still remained neutral, William Welch, then president of the National Academy of Sciences, and his colleagues watched as their European counterparts tried to perfect killing devices.

Technology has always mattered in war, but this was the first truly scientific war, the first war that matched engineers and their abilities to build not just artillery but submarines and airplanes and tanks, the first war that matched laboratories of chemists and physiologists devising or trying to counteract the most lethal poison gas.

Technology, like nature, always exhibits the ice of neutrality however heated its effect. Some even saw the war itself as a magnificent laboratory in which to test and improve not just the hard sciences but theories of crowd behavior, of scientific management of the means of production, of what was thought of as the new science of public relations.

Source: Barry, John M.. The Great Influenza (p. 133). Penguin Publishing Group. Kindle Edition.

Discussion Topics and Questions:

1. What did the author mean when he stated that this was the first scientific war?

2. How did Welch at Johns Hopkins assist President Wilson?

3. Why was the Surgeon General of the Army William Crawford Gorgas so effective?

4. How did the Rockefeller Institute became Army Auxiliary Laboratory Number One? Were you surprised that so many older scientists were joining the army in droves?

5. Can you imagine the following quote being a reality? Comments?

"Sometimes physicians, threatened by intelligent and educated nurses, waged a virtual guerrilla war; in some hospitals physicians replaced labels on drug bottles with numbers so nurses could not question a prescription." (p. 141)

6. How did the war syphon off all of the best doctors and nurses leaving medical care for civilians non existent? What could have Gorgas have done differently?

William Gorgas



William Gorgas was the surgeon general for the U.S. Army. Despite his title, he had little influence in the operations of the military.

Military leaders would not listen to him on topics of overcrowding, quarantine for new troops, or disease control. After an outbreak of the measles should have been a wake-up call for the military, Gorgas hoped he would get more cooperation, but he did not.

Hoping to prepare for the sickness Gorgas believed would come with the war, Gorgas tried to encourage the training of practical nurses. Current nurses who were trained in scientific nursing refused to help with this training.

Even though he tried his best to prevent an epidemic outbreak in the army and keep this epidemic from spreading to civilians, Gorgas was unable to prevent the flu pandemic.

More:
https://www.lindahall.org/william-gor...
http://www.encyclopediaofalabama.org/...
https://iris.paho.org/bitstream/handl....
https://curiosity.lib.harvard.edu/con...
https://curiosity.lib.harvard.edu/con...
https://www.britannica.com/biography/....

The Panama Canal Zone in the early 1900s was described as “one of the must unhealthful places in the world.”

Ridden with mosquitoes, the Isthmus of Panama was a hotbed of yellow fever, malaria, and pneumonia. Previous efforts to render the Isthmus healthy and habitable to outsiders had been unsuccessful. But Dr. William C. Gorgas, armed with knowledge and passion acquired throughout his life, was ready to take on the task.

Born in Alabama on October 3, 1854, Gorgas was the son of a military man. His father, Josiah Gorgas, had served in the Confederate army and later with the United States. This was young William’s first exposure to the world of war and it instantly fascinated him. He decided then that he would follow in his father’s footsteps, and contribute to military efforts through whatever means necessary.

When he grew older and was unable to attend West Point, the premier military school, Gorgas did not waver in his course. Instead of becoming a soldier, he chose to pursue medicine with the intention of becoming a military doctor.

Gorgas attended Bellevue Medical College in New York and graduated in 1879. He briefly interned at Bellevue Hospital and took on a few temporary positions before he could finally volunteer for the Army as a doctor in 1880.

Much of Gorgas’ earliest medical career was spent in rural military outposts in Texas, North Dakota, and Florida, where he tended both civilian and military patients. When some patients began to present symptoms of yellow fever, Gorgas was ordered not to treat them, as he was not immune.

He ignored this order though, and contracted yellow fever himself. Despite the odds Gorgas survived the disease, and during his treatment and recovery met the woman who would become his wife, Marie Doughty.

Now immune, Gorgas was able to tend to patients suffering from yellow fever without fear. The memory of his infection never left, and it served as a focal point that guided his career. If possible, he would not allow others to suffer as he had.

Treating and eliminating the disease became his mission, his campaign, the enemy he fought. Inspired by his goal, Gorgas accepted new challenges, the most significant of which were his terms in Cuba and Panama.

Gorgas’ first target was the yellow fever epidemic in Havana, Cuba. It was reported that “yellow fever [had] been continuously present in this city [Havana] since 1762,” and so it was difficult to believe it could ever be eliminated there.

When Gorgas began his service, the theory of mosquitoes as transmission vector for yellow fever was still controversial. Experiments to prove transmission performed under Walter Reed seemed convincing, but Gorgas remained unconvinced it was the only transmission method.

As such, he performed experiments of his own, including one that involved the now famous nurse Clara Maass, to confirm the vector and explore the best way to induce immunity. These experiments helped verify the truth, and possibly helped convince many of those in authority who remained unconvinced about the mosquito vector theory.

Once Gorgas was confident mosquitoes were a – if not the only – vector of infection, he began a massive cleanup of the city.

Gorgas’ plan contained a three-part approach, the first centered on cleaning general waste, trash, and debris from the city’s streets. This reduced the infection rate of many diseases, but had only a small effect on yellow fever.

To counter this, Gorgas established a team of responders who would visit the house of anyone infected. Once there they would line all openings with screens to keep infected mosquitoes in and uninfected mosquitoes out.

The team would then use sulfur to kill off any mosquitoes inside the house. This drastically lowered infections, but in order to decrease the number of adult mosquitoes, the third portion of the plan was larvae destruction.

As yellow fever mosquitoes breed in water, Gorgas eliminated sources of standing water, and lined those he could not eliminate with oil to suffocate mosquito larvae.

Despite the complexity of his work, Gorgas remained humble, writing in his report that “the same thing could be accomplished by any community anywhere else,” so long as the community put in the effort and resources. “No elaborate machinery of any kind is necessary; merely men and brooms.”

Gorgas’ cleanup and vector control efforts proved wildly successful, reducing deaths from both malaria and yellow fever. Between 1890 and 1900, just at the start of Gorgas’ work, 462 people on average died of yellow fever in Havana each year.

By 1901 the number of deaths from yellow fever had dropped to 12.11 Sources reported 5,643 deaths from malaria between 1890 and 1900, and only 444 deaths between 1900 and 1910.

A portion of this success can be attributed to Gorgas’ personality. He was excellent at calmly and clearly communicating the goal of his work to the people of Havana, and worked hard to listen to their complaints without malice.

This helped him convince the people to work with an occupying power. Consequently, Gorgas, his team, and the people of Havana were able to control yellow fever and malaria for many years to come.

With the success in Havana under his belt, Gorgas was sent to Panama in 1904 where he was “intrusted [sic.] the organization of the sanitary department,” for the US Panama Canal project.

Creating a passage across the Isthmus of Panama had been attempted and abandoned before, mostly due to disease and health issues.

During the French Panama railroad efforts, one hospital in Panama City recorded 1,041 deaths over nine years from yellow fever alone.

But within two years, Gorgas had effectively eliminated yellow fever and controlled malaria using the same methods he had developed in Havana, thus allowing the United States to complete the canal.

As part of his mission to eradicate yellow fever, Gorgas shifted the focus of his career from treating disease to preventing it. In doing so he spread concepts of proper sanitation and hygiene further, continuing the Sanitary Revolution that was sweeping society in the late nineteenth and early twentieth century. Sanitation had become increasingly important within the surgeon’s suite and the treatment room, but public sanitation and hygiene had often been disregarded.

This was especially true for disease prevention, where immunization tended to take the forefront. Gorgas, however, was one of the pioneers who pushed for keeping cities clean, helping to establish disease prevention as a significant part of medicine.

Gorgas was elected president of the American Medical Association in 1908, six years before the Panama Canal opened in 1914. He was one of the few important figures in the canal project to remain part of the team until the end of construction.

After the canal’s completion, Gorgas continued to work in public health as a consultant, advising on pneumonia for a project in South Africa. While there, he was informed that he had been appointed Surgeon General, putting him in charge of policy and organization for the Army’s medical systems.

At the start of World War I, Gorgas, still serving as Surgeon General, lent his expertise in sanitation to the military. In this role he issued “detailed instructions designed to end the lax sanitary practices that had allowed disease to run rampant in previous wars.”

In addition, Gorgas used his position with the American Medical Association and his celebrity status in the medical community, to increase volunteers for the American Medical Corps. By November of 1918, Gorgas had gathered a force of 30,591 physicians and 21,849 nurses.

Gorgas survived the war, and by the end of his career he had acquired numerous promotions, honorary degrees, and awards. He had even been granted a knighthood, which King George V conferred on him just before Gorgas’ death following a stroke.

In spite of it all Gorgas only referred to himself as “Doctor,” remaining firmly aligned with the medical profession which had allowed him to see the world and given his life purpose.


Standing water and unpaved roads in Colon, Panama,1905 (Linda Hall Library)

More:

Dr. William Gorgas - Library of Congress
Summary
Film has ca. 2 ft. of views of Dr. William Crawford Gorgas, chief sanitation officer of the Panama Canal (1904-1913) and member of the Isthmian Canal Commission, standing in front of a building; location of this sequence is undetermined. Remainder of film shows Dr. Gorgas and an unidentified man riding on a Panama Canal Company train. The two men are silhouetted against passing scenery of the Canal Zone as Dr. Gorgas shows the other man points of interest. The train passes a body of water which is probably a part of the canal, countryside, buildings probably on Front Street, Colon, including a YMCA club; final scene of people walking across tracks after the train passes.
Link to Video: https://youtu.be/WsxzJGlPhZk

The Man who saved the Panama Canal
Summary: This Alabama native, is known throughout the world as the conqueror of the mosquito, and the malaria and yellow fever it transmits. His pioneer efforts in halting an epidemic of yellow fever enabled the United States to complete the Panama Canal.
Link to podcast: https://youtu.be/MUUacPA0ykw

And so we begin:

CHAPTER ELEVEN

"WILSON HAD DEMANDED that “the spirit of ruthless brutality . . . enter into the very fibre of national life.”

To carry out that charge Creel had wanted to create “one white-hot mass,” a mass driven by “deathless determination.” He was doing so.

This was truly total war, and that totality truly included the medical profession.

Creel’s spirit even injected itself into Military Surgeon, a journal published by the army for its physicians, which said, “Every single activity of this country is directed towards one single object, the winning of the war; nothing else counts now, and nothing will count ever if we don’t win it.

No organization of any kind should be countenanced that has not this object in immediate view and is likely to help in the most efficient way. . . . Thus the medical sciences are applied to war, the arts are applied in perfecting camouflage, in reviving the spirits of our soldiers by entertainment, etc.”

Source: Barry, John M.. The Great Influenza (p. 144). Penguin Publishing Group. Kindle Edition.

Discussion Topics and Questions:

1. How did Gorgas stem the tide and help improve the lot of the American soldiers. Why was Gorgas' forward thinking so critical in 1917?

2. Why were Flexner, Vaughn and Avery warnings ignored and how would the 1917-18 pandemic alleviated? Why was overcrowding so dangerous? How do the remedies recommended and ignored in 1917-18 (which caused countless unnecessary deaths) - the same ones "that should not be ignored now" with Covid 19?

3. Why is measles causing one million deaths worldwide? How did bacteria invade the lungs after the virus had weakened its defenses? Is that happening with Covid 19 - are other complications contributing to the already weakened state caused by the initial virus? What have we learned from the current situation that we should have learned from the 1917-1918 epidemic?

Oswald Avery



"Oswald Avery was among the scientists at the Rockefeller Institute who was focused on finding a cure or vaccine for pneumonia. He became the world’s leading investigator in pneumonia. He also made discoveries in molecular biology, including proof that DNA carried the genetic code.

Oswald Avery led the team that discovered DNA passes heredity instructions through successive generations of organisms – it carries the chemical code of life.

Avery and his colleagues published their discovery in a classic paper describing what came to be known as the Avery–MacLeod–McCarty experiment. The experiment actually represented more than a decade’s worth of scientific investigations.

Beginnings

Oswald Theodore Avery was born in Halifax, Nova Scotia, Canada on October 21, 1877. His British parents, Joseph Francis Avery and Elizabeth Crowdy, had arrived in Canada four years earlier.

They had emigrated because Joseph, a Baptist minister, felt a spiritual calling to do God’s work in North America. The couple’s three sons were all born in Canada; Oswald was the second son.

The family moved to New York City, USA when Oswald was 10 years old. His father had been invited to take over as pastor of Mariner’s Temple Baptist mission. The mission was on New York’s lower East Side, an overcrowded part of the city with a multitude of social problems – a tough place for children to grow up.

In their spare time Oswald and his older brother Ernest taught themselves to play the cornet. From the age of 12 onwards, Oswald and Ernest performed music on Sundays outside the mission. The idea was to entice passers-by inside. The neighborhood’s population included many Catholics and Jews, and Oswald’s father was eager to convert them to the Baptist creed.

Oswald was a highly talented musician. Later he was awarded a scholarship to the National Conservatory of Music, a scholarship he did not use.

At the age of 15, Oswald suffered two shocks: first the death of his brother Ernest most likely from tuberculosis; then the death of his father from kidney disease.

No Science at College

In 1893, just before reaching the age of 16, Oswald Avery got his diploma from New York Male Grammar School and enrolled at Colgate Academy.

He became a freshman at New York’s Colgate University in 1896, where again his musical talent shone through and he became leader of the college band.

He majored in humanities, averaging higher than 9 out of 10 in his final years. He graduated with a bachelor’s degree in humanities in June 1900, age 22. He had taken science courses only when they were compulsory.

The courses he chose in his final year included Philosophy, English Literature, Political Economy, Public Speaking, and History of Art.

Medical School

By the fall of 1900, Avery’s ideas about his future had changed dramatically: he entered medical school – Columbia University’s College of Physicians and Surgeons in New York.

He continued to score good grades at Columbia, with one ironic exception. The man who would eventually become a world-renowned bacteriologist scored his worst grades in the bacteriology course.

In 1904, age 26, Avery graduated and moved into general medical practice.

An Introduction to Bacteriology

After two years working as a family doctor, Avery was fed up. Too many of his patients were suffering from incurable conditions, leaving him feeling thoroughly helpless.

He reached the conclusion that the best way he could help society would be to find ways of stopping microorganisms killing people. He decided to become a microbiologist.

He made the transition gradually, working part-time in milk bacteriology – his job was to make measurements of bacteria in milk before and after pasteurization.

Pneumonia Research

In 1907, age 30, Avery became assistant director of the Hoagland Laboratory in Brooklyn, New York. There, in addition to teaching students, he trained in modern chemical and bacteriological methods. He also learned to carry out experiments with unusually meticulous care – this would be one of the characteristics of his future research work.

He began his research career with a study of fermented milk products such as yogurt. He investigated their role in controlling harmful gut bacteria in humans, a theme that would became fashionable again about 100 years later.

Avery published nine papers in academic journals. In 1913, a paper he wrote about tuberculosis caught the eye of Rufus Cole, director of the Rockefeller Institute in Manhattan. On a visit to Hoagland, Cole made a point of having a chat with Avery, sizing him up.

The upshot was that Avery became a bacteriologist at the Rockefeller Institute in September 1913, a month before his thirty-sixth birthday.

For the rest of his career, Avery focused his research on pneumonia bacteria. Penicillin antibiotics were still decades away, and over 50 thousand people in America were dying of pneumonia every year.

A Strange Way to Become an American

America entered World War 1 in 1917. Avery attempted to join the U.S. Army Medical Corps as an officer. He was refused, because, although he had lived all his adult life in America – over 30 years in fact – he was not a citizen.

Avery, 40 years old and an eminent bacteriologist, enlisted as a private – the lowest rank. Then, because he was on active duty in wartime, he was naturalized as an American citizen. In 1918 he was promoted to Medical Corps Captain.

Mendel, Miescher, and DNA

In 1866, Gregor Mendel, working in Moravia (now the Czech Republic), showed offspring inherit their parents’ physical characteristics according to clear mathematical rules. His work was ignored until 1900.

In 1871, Friedrich Miescher in Germany discovered a new substance, naming it nuclein, because it came from the cell nucleus. Today we call this substance deoxyribonucleic acid or, more simply, DNA.

Scientists did not actually suspect that DNA played a role in heredity. They knew something must carry instructions from parents to offspring, and they knew the instructions followed Mendel’s laws. These instructions – the units of heredity – were given the name genes.

Nobody knew what genes were made of, but for a long time they were thought to be based on proteins.

The Griffith Experiment – Life Gets Weird

In 1928, Frederick Griffith in the UK found something amazing – he turned one strain of bacteria into another.

His work involved Streptococcus pneumoniae, a species that has two strains – Rough (R) and Smooth (S) – so named because of their appearance under the microscope.

Rough is not especially harmful. Smooth is a killer.

Griffith experimented by infecting mice with R and S bacteria. He found:

* Mice infected with R survived – as expected.
* Mice infected with S died – as expected.
* Mice infected with heat-killed S survived – as expected.
* Mice infected with a mixture of R and heat-killed S died – NOT expected.
*Moreover, living S were found in the bodies of mice infected with a mixture of R and heat-killed S – NOT expected.
* Something from the dead S had prompted the living R to produce living S. And, very significantly, the change was heritable: When R was transformed to S, the following generations of bacteria were S.

After Avery

From Skepticism to Belief

Griffith’s work interested Avery. It related to his own specialty – pneumonia bacteria. Avery admired Griffith, but greeted his extraordinary results with disbelief, suspecting the bacteria were contaminated.

A young research fellow in Avery’s lab, Martin Dawson, repeated Griffith’s work. When Dawson confirmed Griffith’s results, Avery was forced to admit that R to S transformation was a fact. Other laboratories came to the same conclusion.

No Need for Mice

Dawson continued researching the strange phenomenon. In 1930, he made significant progress, proving that mice were innocent bystanders. He mixed R and heat-killed S bacteria in glassware and saw R reproducing to produce S.

First Isolation of DNA

Dawson moved to a new job and Avery enthused another young Rockefeller researcher, James Alloway, to begin working on what he called the transforming principle.

Alloway dissolved heat-killed S cells and filtered out fragments to leave a fibrous substance. We now know this was DNA, but Alloway did not. He found this substance was all that was required to transform R to S. In 1932, Alloway moved to a new job.

Dawson and Alloway offered theories about the transforming principle, neither of which would prove to be correct.

Slow, Difficult Work

Avery began carrying out experiments himself, but his time was severely limited by work on other major studies. He also spent about six months away from the lab seriously ill.

The experiments were difficult, often producing results that could not be repeated. Progress was very slow.

By 1935, Avery’s evidence suggested to him that neither proteins nor carbohydrates caused the transformation. Perhaps, he speculated in 1936, a nucleic acid was the key factor? Of course, there are only two nuclei acids, DNA and RNA, so Avery was getting close to the answer. However, many more years would pass before he felt he had proof of his speculation.

Getting Faster – Proteins and Lipids Positively Ruled Out

In 1935, Avery was joined by a new young researcher, Colin MacLeod, a prodigy who had been admitted to Montreal’s McGill University at the age of 15.

MacLeod and Avery had unusually similar backgrounds: they were each natives of Nova Scotia and each had moved to New York. They were both qualified medical doctors who had shifted careers into bacteriology. Their fathers had both been protestant church ministers, and both had moved to Canada from the UK.

MacLeod gave the research a new impetus, developing more reliable laboratory techniques. However, both Avery and MacLeod were involved in other projects too.

In 1940, they dropped all other work to concentrate on the transforming principle, toiling together for long hours in the laboratory.

By 1941, Avery and MacLeod were certain the transforming principle was protein-free and lipid-free. They knew this because they could reliably remove these substances from heat-killed S bacteria, and see that whatever was left caused the R to S transition.

At this stage MacLeod officially left the project; he had been appointed Professor of Bacteriology at New York University’s School of Medicine. In practice, however, he came back frequently as the project neared its exciting conclusion.

Rough is Transformed to Smooth by Smooth’s DNA

With MacLeod’s official departure, Maclyn McCarty, a 30-year-old postdoctoral fellow from Indiana, joined the project in September 1941. McCarty had been carrying out research at Johns Hopkins Hospital. When his boss there, Professor Edwards Park, heard McCarty was going to join Avery’s lab, he told McCarty that Avery was at the top of the stratosphere for research.

Progress was now rapid. The scientists removed all other parts of the cell to leave just the transforming substance. McCarty established by chemical testing that the substance could only be deoxyribonucleic acid, i.e. DNA. Avery noted that DNA had not even been found in these bacteria before.

Avery–MacLeod–McCarty

Near the end of 1943, Avery, MacLeod, and McCarty submitted their work for publication in the Journal of Experimental Medicine. It was published the following year."

Source: Famous Scientists

More:

Genes are DNA

"They had discovered that DNA is genetic material. It induces heritable changes in bacteria. It has very high molecular weight, and is therefore a huge molecule. Their work came to be known as the Avery–MacLeod–McCarty experiment.

Ironically, Avery’s work was completed while World War 2 was raging. He and his colleagues discovered one of the secrets of life in a time when more scientists than ever were seeking efficient ways of delivering death.

Avery was 66 years old when his DNA work was finally published.

The idea that genes are DNA was strongly resisted. A number of influential scientists would not let go of the idea that genes were proteins. They explained away Avery’s results by saying his DNA was contaminated by proteins. However, in time, nobody could contradict DNA’s new status.

One of the few scientists to quickly embrace Avery’s work was Edwin Chargaff, and it was he who took the next great steps toward understanding DNA’s role in genetics.

By 1953, James Watson and Francis Crick had discovered DNA’s structure and how it replicates. Avery lived long enough to see this.

Scientists now know with certainty that DNA carries the instructions needed to assemble lifeless molecules into living organisms.

No Nobel Prize

Avery was never awarded a Nobel Prize. He was nominated frequently for work on antigens he did in the 1930s. He was also nominated for his DNA work. The nominations were not successful.

In 1945, the British Royal Society awarded Avery its prestigious Copley Medal, and in 1947 he received America’s major prize in medicine – the Lasker Award.

Some Personal Details and the End

Avery lived mainly for his work. He never married and had no children. He never lost his fondness for music, and in his vacations he enjoyed spending time sailing.

He had been a notable public speaker and debater at college, but in his professional life he was usually reluctant to speak in public. In fact, he was really only at ease in his laboratory, in the company of his researchers. Everyone called him ‘Fess’ – short for Professor.

In 1948, age 71, Avery moved to Nashville, Tennessee to enjoy some family life. He rented a large house close to the home of his younger brother Roy, who was teaching bacteriology at Vanderbilt University. Avery spent a lot of time with Roy’s family. His cousin Minnie Wandell became his housekeeper.

Oswald Theodore Avery died age 78 on February 20, 1955 in Nashville of liver cancer. He was buried in Nashville’s Mount Olivet Cemetery."

Source: Famous Scientists

Image of Lactobacillus plantarum bacteria, common in fermented foods. The presence of such bacteria in the human gut is believed to improve our health.

The white substance is DNA extracted from cell nuclei.

Viral Pneumonia at 40x Magnification

Discussion Topics and Questions:

1. How unbelievable was the following quote: 30%!

He told Gorgas that the mortality rate for troops developing pneumonia after measles “is stated to be 30% but more now in hospital will die.

2. Discuss the importance of what was learned in 1917-1918 - and what we are learning now with Covid-19:

"Osler called pneumonia “the captain of the men of death.” Pneumonia was the leading cause of death around the world, greater than tuberculosis, greater than cancer, greater than heart disease, greater than plague. And, like measles, when influenza kills, it usually kills through pneumonia." (p. 151)

And so we begin:

CHAPTER TWELVE

"MEDICAL DICTIONARIES define pneumonia as “an inflammation of the lungs with consolidation.”

This definition omits mention of an infection, but in practice pneumonia is almost always caused by some kind of microorganism invading the lung, followed by an infusion of the body’s infection-fighting weapons.

The resulting inflamed mix of cells, enzymes, cell debris, fluid, and the equivalent of scar tissue thickens and leads to the consolidation; then the lung, normally soft and spongy, becomes firm, solid, inelastic.

The disease kills usually when either the consolidation becomes so widespread that the lungs cannot transfer enough oxygen into the bloodstream, or the pathogen enters the blood-stream and carries the infection throughout the body.

Pneumonia maintained its position as the leading cause of death in the United States until 1936. It and influenza are so closely linked that modern international health statistics, including those compiled compiled by the United States Centers for Disease Control, routinely classify them as a single cause of death.

Even now, early in the twenty-first century, with antibiotics, antiviral drugs, oxygen, and intensive-care units, influenza and pneumonia combined routinely rank as the fifth or sixth—it varies year to year, usually depending on the severity of the influenza season—leading cause of death in the United States and the leading cause of death from infectious disease."

Source: Barry, John M.. The Great Influenza (p. 152). Penguin Publishing Group. Kindle Edition.

Discussion Topics and Questions:

1. What is the single most cause of pneumonia? Have we seen many differences in how pneumonia as a secondary infection was treated in 1917-1918 compared to how it is treated today with Covid-19? Why or why not?

2. What is the difference between "passive immunity" and "active immunity"?

3. Isn't it amazing how we are faced with the same dilemma all over again. Why are some strains, mutations, or antigens of Covid 19 more deadly than others? Here the quote was talking about the pneumonia virus - yet we could very likely be talking about the Covid 19 virus today.

"Different types had different antigens. Sometimes also the same type was virulent, sometimes not, but why one killed and another caused mild or no disease was not yet a question anyone was designing experiments to answer. That lay out there for the future, a sort of undertow pulling at the data. The focus was far more immediate: finding a curative serum, a preventative vaccine, or both." (p. 155)

4. How were Avery and Welch so unlike each other? What were the strengths and weaknesses of both men and what were your impressions of how the author described them?

5. How many were familiar with this fact?

"Male mice were and are generally not used in experiments because they sometimes attack each other; the death or injury of a single mouse for any reason can distort experimental results and ruin weeks of work." (p. 159)

Bentley, what fascinating photographs! It amazes me what powerful electron-microscopes and other scientific marvels enable us to see of this originally hidden world of viruses and bacteria ... not to mention the elements of the individual cell!
Regards,
Andrea

Very true Andrea. It helps to see the image of the virus and to know that it is real even though we cannot see it with the naked eye.

I am glad that you liked them.

This is a write up on one of the major themes of the book. I will post these periodically. Please feel free to debate for or against what Barry argues with your posts:

Here is the first one.

Impact of the War on the Pandemic

Barry argues through his book that World War I had a negative impact on the pandemic. He points out that if the country had not been at war, it is possible that the flu would not even have become a pandemic. Barry additionally blames the rapid spread of the flu on the overcrowding at military camps. He also faults the government for putting so much emphasis on the war effort that they neglected to consider an epidemic.

Barry suggests that if America had not been at war, the flu would not have spread beyond Haskell County. He writes: “As sparsely populated and isolated as Haskell was, the virus infecting the county might well have died there … except this was wartime” (95). It is surmised that a soldier visiting Haskell County probably brought the flu from home to Camp Funston, where there was a mild outbreak. Soldiers from that camp spread the virus worldwide as they were deployed.

Barry also argues the premise that it was because the soldiers were crammed into military camps intended for far fewer people that the flu spread so rapidly among them. When a measles outbreak occurred in one of the camps, Gorgas criticized military leaders “for rushing troops to cantonments under living conditions that failed to meet minimum public health standards, for overcrowding …” (150). Even though Gorgas pointed out that overcrowding led to disease, the army did nothing to relieve conditions in the camps.

Finally, Barry argues that the government was so focused on the war effort that they refused to acknowledge the seriousness of the flu.

In the army, Gorgas warned his superiors that he feared a disease might break out in the military training camps and tried to be prepared, but his superiors would not listen to him or follow his recommendations.

When the citizens of the United States began to get sick, Wilson would not allow the papers to print information about the flu because he feared it would take attention away from the war effort. He allowed the people to live in fear of the disease rather than try to take any action against it.

Source: Book Rags

The Immune System - Ira Mellman (Genentech)

Dr. Mellman explains that the immune system is made up of specialized cells that protect us from the huge number of pathogens we continually encounter. The immune system has two "arms"; innate immunity which detects components shared by all pathogens and adaptive immunity which detects components specific to individual pathogens. Mellman explains how these two "arms" work and the important role of dendritic cells in linking the two "arms" together.

Link to Video: https://youtu.be/gMs8huslkqo

Sources: Youtube and iBiology.com

And so we begin:

CHAPTER THIRTEEN

"EVEN WHEN COLE first tried the new serum on patients it showed promise.

He and Avery immediately devoted themselves to refining their procedures in the laboratory, in the methods of infecting horses and producing serum, in the way they administered it.

Finally they began a careful series of trials with a finished product.

They found that giving large dosages of serum—half a liter—intravenously cut the death rate of Type I pneumonias by more than half, from 23 percent to 10 percent. It was not a cure.

Pneumonias caused by other types of pneumococci did not yield so easily.

And, as Avery and Cole stated, “Protection in man is inferior to protection in mice.”
mice.”

Source: Barry, John M.. The Great Influenza (p. 162). Penguin Publishing Group. Kindle Edition.

Discussion Topics and Questions:

1. Could you believe that they tested the vaccine on themselves? Comments?

"After proving it worked in animals, they and six other Rockefeller researchers turned themselves into guinea pigs, testing its safety in humans by giving each other massive doses." (p. 163)

2. How are some of the beginning stages of testing a vaccine for pneumonia back in the 1917-1918 timeframe the same as what we are hearing about for Covid-19? What should we be more aware of ?
.