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Yesterday’s post concerned smallpox, one of the most dreadful scourges to ever afflict humankind. I shied away from writing about the physiological aspects of the disease–which is caused by two viruses, Variola major and Variola minor–because the symptoms are absolutely horrible (as I can fervently attest after some internet research involving photographs which were apparently taken in the cruelest depths of hell). Smallpox was badly named. It should have been called “deathrash” or “bloodskin” or “face-melt-fever”, but apparently Roman stoicism came to the fore and the Latin name merely means “spotted” or “pimple.” Not only did smallpox effectively kill off the native population of the new world (and later of Australia, which experienced a similar plague), but for thousands of years it regularly culled a sizable hunk of humanity from Africa, Asia, and Europe. Like influenza, the smallpox co-evolved in response to our immune reactions to it, so, even in parts of the world where people had inherited some resistance, the pestilence sometimes flared into a full scale pandemic.
But smallpox is gone (almost)! Humankind joined together and beat one of the most horrible things we have ever faced. Today the last remaining live smallpox viruses are imprisoned in laboratories in Atlanta and Koltsovo, Novosibirsk Oblast.
In grade school, we were taught that this stunning victory came about when an English physician named Edward Jenner realized that milkmaids who contracted a mild rash called cowpox became immune to smallpox. By deliberately giving people cowpox, Jenner found a way of protecting them from the fatal smallpox. Jenner thus invented immunology, one of the most useful and inexpensive forms of medicine. His great work was taken up by subsequent generations of immunologists and physicians in allied fields who improved upon his findings. Together they used national and international resources to immunize the world. Smallpox was officially proclaimed to be eradicated in 1979.
Yet Jenner had antecedents who were not well appreciated because of the preconceptions and prejudices of the day, (also, by necessity, he worked with human subjects whose bravery went unheralded). Jenner’s greatness is not diminished by looking back at the others who were involved in an epic struggle against history’s greatest killer. There are descriptions of smallpox avoidance techniques in ancient Sanskrit texts from India dating back to 1000 BC, however scholars do not agree on whether these texts describe inoculation or not. What is certain is that a medical text from Ming dynasty China does indeed describe an effective inoculation process. The Douzhen xinfa published in 1549 was written by Wan Quan, a pediatrician who believed that sunlight and fresh air were good for children (and that overfeeding and overmedicating were bad). Wan Quan described a method of variolation—by which means a healthy person was purposely infected with Variola minor, the less dangerous o the two forms o smallpox. By the time of the Lonquing Emperor who reigned from 1567–1572 (and was the son of the addled Jiajing emperor) variolation was widespread–powdered smallpox scabs were blown up the noses of healthy children so that they would contract Variola minor. This was effective in preventing smallpox, but it had a fatality rate of .05% to 2%–a dreadful margin (though nothing like the 30%+ mortality rate of smallpox pandemic).
Variolation gradually spread through the Chinese empire and through the Turkish and Islamic world, but it did not reach the attention of western medicine until the early 18th century. Lady Mary Wortley Montagu was the wife of the British ambassador to the Ottoman Empire from 1716 to 1717 (as well as a sort of feminist pioneer, poet, and adventurer). After losing a brother to smallpox (and being disfigured by the disease) Lady Mary was eager for a means to protect her children from the scourge. In 1718, the embassy surgeon inoculated her son and, based on the success of this procedure, she arranged for her daughter to be inoculated in 1721 (when the family was back in England). The procedure attracted the attention of the medical establishment and the royal family. Although many doctors were aghast at an “Oriental” procedure (which was being popularized by a woman, no less) the royal family intervened directly in the controversy when a smallpox epidemic swept England in the 1720s. In order to fully test the safety of the inoculation, the King offered a full pardon to six (or seven?) condemned prisoners in exchange for undergoing variolation. Not surprisingly the condemned prisoners chose an unknown medical procedure instead of the hangman’s rope, and when they survived they were duly freed. Variolation was also tested on six orphan children–who also survived. After these human tests, the royal children were inoculated against smallpox.
Inoculation spread quickly among the rich and powerful of Europe, but it was staunchly opposed by reactionaries and by churchmen (who believed it was contrary to God’s will). Against such a background, came Jenner’s discovery of a cowpox based vaccine which was vastly safer than using live smallpox. But even with the much safer vaccine, it was a long time before the immunologists started to win over many ignorant and superstitious people to the life-saving virtues of the vaccine (and nearly two hundred more years before they stomped out the loathsome blight of smallpox).
In Greek mythology, Apollo was the god of healing (as well as the god of light, poetry, music, and sundry other good things). Yet Apollo was surpassed as a healer by his son the demigod Asclepius. Asclepius should be one of the most exalted figures in classical mythology, yet his story is ambiguous and troubling (which is perhaps a more fitting tribute to the complexity and heartache of the healers’ arts). The mother of Asclepius was a mortal woman, Coronis, who cheated on Apollo with a mortal lover. When a crow reported to Apollo that Coronis was unfaithful, the sun god disbelieved the fowl and he turned all crows from white to black and gave them discordant voices. Yet the story rankled the god’s heart. When he investigated the rumor and found it to be true, Apollo killed Coronis with one of his terrible arrows. As she writhed in death agony, he slit her open to rescue the son she bore (hence Asclepius’ name means “to cut open”). Apollo then granted crows cleverness beyond other birds to make up for his anger.
Like many other demigods, Asclepius was raised and tutored by the centaur Chiron, a matchless teacher. Soon the pupil surpassed the student and it was rumored that snakes licked Asclepius’ ears and taught him secret knowledge (to the Greeks snakes were sacred beings of wisdom, healing, and resurrection). Asclepius bore a rod wreathed with a snake, which became associated with healing. To this day a species of pan-Mediterranean serpent, the Aesculapian Snake (Zamenis longissimus) are named for the demigod.
Being the greatest healer in the world brought wealth and fame to Asclepius, who had many successful children, each of whom was named after some aspect of the medical craft (Hygiene, Panacea, Recuperation, etc…), but his success became his undoing. When he left Chiron, the centaur had given him two vials of blood—one from the left side and one from the right side of a gorgon. The blood from the left side was a fatal poison which caused ultimate agony (as Chiron himself experienced firsthand at his anguished destruction). The blood from the gorgon’s left side was a miraculous elixir which could bring the dead back to life. Asclepius began to accept gold to revive the dead and he drew the baleful attention of Hades. Afraid that the decisions of the gods would cease to hold terror for mortal kind, Hades begged his brother to make a final end of Asclepius. Zeus was in full agreement and he burned Asclepius to a cinder by casting a lightning bolt at him.
Apollo was furious at the death of his son (and the extinction of the apex of medical art). Not daring to strike Zeus, Apollo killed the Cyclops who has fashioned the lightning bolt, an act which led Zeus to banish Apollo to the mortal realm for a year (during which time the god designed the walls of Troy). When his term was served, Apollo joyously rejoined the other Olympians. Different traditions interpret the story’s end differently. In happier versions, Zeus and Hades bring Asclepius’ spirit to Olympus to act as god of healing forever. In other versions Apollo and Zeus hang the image of Asclepius in the heavens as the constellation Opiuchus, “the Snake Bearer” both to remind humankind of the physician’s greatness and to warn them to eschew seeking immortality.
The quince (Cydonia oblonga) is a flowering tree of the rose family which bears an edible golden fruit. Quinces are rare in America due to their susceptibility to fireblight disease (a bacterial infection caused by Erwinia amylovora). Because the fruit are unusual here and because, without cooking or other treatment, they are very sour and bitter, quinces are regarded as a sort of poor relation to apples and pears (both of which are indeed very close relations within the rose family), but probably it should be the other way around. Not only does the quince occupy an exalted place in literature and the arts, but the tree is believed to hold a treasure trove of medically useful compounds in its leaves, bark, and fruit.
Quince trees are small trees which, in spring, bear many large single blossoms of bright pink. The flowers are hermaphrodites, able to fertilize themselves. When fertilized the blossoms develop into chartreuse-colored pubescent fruit which then further ripen into a bright golden yellow in autumn (when also the tiny fuzzy hairs fall off). The knobbly pear-like fruit are exceptionally tart but become sweet if treated with salt, bletted (left on the tree to decompose slightly), or cooked. The quince is exceptional for baking, for making sweet wines and liquors, and for jams and sauces. Additionally quinces have long been a feature of traditional medicine and a host of recent studiessuggest that different parts of the plant might have a number of therapeutic properties including lipid lowering effects, antidiabetic activity, and antiallergic properties among others (in addition to being a healthy nutrition and fiber source).
The quince originated in the Caucasus region between the Caspian and the Black Sea (a region where wild quince trees can still be found). Cultivation of the little tree began in Mesopotamia, between the Tigris and Euphrates Rivers. If that sounds like a familiar location, it should, for it was there that human hands created the first cities. From the cradle of civilization, the quince spread to the Levant and the Mediterranean long before the apple or the pear. For this reason the fruit is a favorite candidate (along with the fig) as the forbidden fruit of Genesis. Additionally, anytime an apple appears in ancient Greek literature or myth, it can reasonably be assumed to be a quince–which means the infamous golden apple of Eriswhich caused the Trojan War was actually a golden quince. Indeed quinces are gold colored and have been a traditional feature of classical Greek nuptial ceremonies since records exist. The quince lingered on as a symbol of Aphrodite and is one of the trees sacred to the love goddess. A number of fertility myths and superstitions remain attached to the quince in the Balkans and in Turkey.
Beyond the Mediterranean world, the quince has an active artistic life as well. The knobby glowing fruits have been a source of inspiration to artists for a long time, but perhaps they are even more celebrated in literature. Peter Quince is the rustic craftsman and playwright from William Shakespeare’s A Midsummer Night’s Dream and Wallace Stevens later borrowed the character to narrate Peter Quince at the Clavier, an examination of desire, music, and thought. Tennyson, Browning, and Keats all alluded to the fruit or flowers of the quince which feature frequently in Victorian poesy. In fact The golden fruits are the second fruit mentioned in the poem The Goblin Market (which must surely rank as the greatest fruit-themed poem ever written). Finally, the fruit features prominently in The Owl and the Pussycat by Edward Lear, a work of literature familiar to everyone which surely deserves mention here, involving as it does farm animals, mammals, a turkey, and the moon which was (and remains) in outer space.
‘Dear pig, are you willing to sell for one shilling
Your ring?’ Said the Piggy, ‘I will.’
So they took it away, and were married next day
By the Turkey who lives on the hill.
They dined on mince, and slices of quince,
Which they ate with a runcible spoon;
And hand in hand, on the edge of the sand,
They danced by the light of the moon,
They danced by the light of the moon.