Fair Conditioning
By R. D. Flavin

     Most (here only, read: more than a few) attempt to 'leave' this world a better place than they experienced it as.  The high-minded do so for reasons of posterity, the religious for ridiculous expectations of rewards or special considerations in an imaginary 'afterlife', but (one may hope) the vast majority of those who try to improve our precarious standing on Mom Terra do so for ...the kids, their kids' kids, and all those who will follow.  We must admit failure, in that future generations will likely never know a good cigarette, a great cheeseburger, or a traffic-cop who could be bought off with a folded ten or twenty dollar bill.  Oh, well...  Still, in matters of medical care for children, education, legal rights (and representation), and quality cartoons on Saturday mornings, we can and should do our best.  Ebb and flow, right and wrong, up and down, and ...almost and sort of, have been and will probably be cited again and again as we fail to or successfully ready the next generation for their time(s).  Adequate preparation and fair conditioning for our youth are essential for the continuation of this exquisite irony we call civil-ization.  Science-fiction acts as techno-spooky-ghost stories which should scare us into actively preventing as many bad things from happening as we can.  Just saying...

     The recent suggestion by The National Biodefense Science Board, which advises the Secretary of the U.S. Department of Health and Human Services, to test anthrax vaccinations on children ...seems paranoid and wrong.  Of course, way ouch, the competing story of the mailing of chickenpox contaminated lollipops for $50.00 a piece to parents who don't trust current U.S. immunization recommendations is also ...sad and embarrassing.  The ongoing debate concerning the mandatory vaccinations of little girls to stave off a sexually transmitted infection of Genital human papillomavirus (HPV) which can lead to, among other complications, warts and cancers, seems to be moved by pharmaceutical profits more than preventative concern.  And, gosh dagnabbit, some are rallying for little boys to get the HPV vaccine as well!  We've still not implemented adequate precautionary protections for kids who are homeschooled and thus avoid state public school immunization requirements, as demonstrated by the 2005 outbreak of measles in Indiana (though, cough, declared eliminated in 2000).  The skinny weasel: Anti-vaccinationists are often anti-scientific with pseudo-scientific claims and arguments, some are such because of non-scriptural religious beliefs and superstitions, while a few are simply cuckoo for Cocoa Puffs (var. crazy).   It's not and shouldn't be, as has been suggested, yet another example of science versus religion.  Good science versus bad science?  Sure!  For America, at least, religious “concern” played an instrumental role in our earliest usage of the inoculation procedures.

     With somber sobriety I advance that once upon a time (1692, late 17th century pre-Gregorian in approximate exactitude) the Province of Massachusetts Bay experienced an ethics version of The Perfect Storm with witchcraft hysteria, extreme local political factionalism, and opportunistic (read: greed-based) land acquisitions, which sorta'-maybe-kinda' contributed to the first small-pox inoculations in America (1721).  Yup, I connected magic and vaccinations.  Allow me to explain...

     Though I continue to regard American Colonial Puritans as synonymous with fundamentalist groupthink and the “Do as I say, not as I do” approach, I acknowledge their differentiation between 'good' magic and 'bad' occult practices as exceptionally hypocritical.   The construction of the Saugus Iron Works in 1646 marked the first grand business venture in America (as the financed Gloucester fish-drying station of 1623 didn't work out that well) and reflected the best of foundry advances and was equal to the finest of European examples.  Mine-work and metallurgy are respectable occupations, but locating the unrefined ore sometimes necessitated the employment of diviners (a century earlier Martin Luther was outspoken against the use of metal-dowsers, as his father was a miner).  Some cons are better than others and actual experience with stocks and stones would likely equal the success rate of the learned practitioners of alchemy and Hermeticism.  To supplement the soon-to-be depleted deposits of bog-iron, dowsers took their rods across the Massachusetts Bay Colony in search of ...anything useful.  The failed Topsfield Copper Mine of 1648 involved not only Hermeticism, but probably dowsers as well (the father of the founder of the Mormon cult, Joseph Smith, Jr., was a dowser from Topsfield).  Apparently, the Puritans could overlook the supernatural basis of dowsing for water and metals, essentials for survival and prosperity in the New World, yet while some fortune-telling and associated practices were tolerated, the later sundered the working dichotomy of 'good' and 'bad', and with Salem, shortly after the children (read: brats) started screaming for attention, a colonial's attempt to “know” what was true ...tossed too much fuel on the fire.  It's awkward to discuss.

     The events of the so-called Salem Witch Trials of 1692-1693 (other towns such as Andover, Boston, and Gloucester were also involved) initially radiated out from the Rev. Samuel Parris, Minister of Salem Village, and his household.  His daughter and a niece were diagnosed as stricken by witchcraft and a concerned parishioner, Mary Woodrow Sibley, instructed John Indian, a slave purchased in Barbados by Parris, how to bake a magical rye flour cake containing urine from the two afflicted girls and feed it to a dog to either rid the girls of their infirmity or, as is sometimes claimed, somehow compel the dog to reveal who had used witchcraft on the girls.  Something went wrong with the “experiment,” the magic was made public (Mary Sibley received excommunication until she apologized for the magic), and the girls' hysteria grew worse and they named three local women as witches, one of them being Tituba, the wife of John Indian, and also purchased as a slave by Parris in Barbados.  The rye cake with urine fed to a dog magic seems to derive from European folk superstition, though early commentators described it as derivative of “Indian powwows,” grouping Tituba and John Indian from Barbados with the Massachusetts' Wampanoag and other New England Native American tribes (var. Nations).  It's been suggested that some Wampanoag and others were captured at the end of King Phillip's War (1675-1676) and sold as slaves in Barbados and that Parris's “Indians,” Tituba and John Indian, were at 'home' in Massachusetts.  A current approach regards them as being Taíno/Arawakan aborigines from the Caribbean, though some still maintain an African connection with voodoo 'spells'.  History will likely remain silent, barring some future documentary discovery, concerning the true ethnicity of Tituba and John Indian, as well as their post-1693 fate.  John Indian disappears from the record after a series of claims and accusations, notably after naming Elizabeth Procter, the wife of a competing tavern owner (Parris allowed John Indian to do odd jobs for the Ingersoll Tavern and probably kept the wages) as a witch.   Tituba, likewise, vanishes after spending a short time in a Boston jail.  Perhaps they lived out their last years in one of the several local “praying villages” such as on Deer Island or at Natick.

     Partial blame for the resulting executions of the Salem Witch Trials hysteria has been leveled against the Rev. Cotton Mather, pastor of the (Congregationalist) North Church of Boston.  Mather was, among other things, an author and unrepentant egotist, with previous experience with claims of witchcraft and encouraging executions.  Several years earlier, he resided over the last public hanging of a witch on the Boston Common (a Gaelic and Latin speaking Irish Catholic woman, Goodwife Annie Glover) and invited one of the supposedly bewitched children of Glover's employer into his “Tremont” Cotton Hill home until she was ...healed.  In books, pamphlets, sermons, and public speeches, Mather continued to profess a profoundly personal disappointment that he couldn't do more for the children.  It may well be simple coincidence that Mather's firstborn child died in infancy mere months before Goody Glover's execution. [Note: Of Mather's fifteen children from three wives, only two survived him.]  Despite his religious intolerance of non-Congregationalists and his probable complicity in judicial atrocities, Mather may have had a genuine concern for the health of ...all “Christian” children.

     Returning from a failed attempt to conquer the French-ruled island of Martinique, English sailors and soldiers spread the Yellow fever virus throughout Boston in 1693 which caused a great many deaths and significantly damaged the confidence of the colonists to survive in the New World.  In 1706, as Mather recorded in his diary, he spoke to Onesimus, his African household slave (purchased for him by his North Church congregation), about disease and what means could be taken to prevent illness and death, and heard of an Arab/Muslim tradition of transferring a small portion of some scab/puss/blood from a “pox” infected person to an open wound of a healthy person.  It was said that the healthy person would then experience a mild bout of the sickness, recover, and would forever be immune to the disease.  It's believed the experimental procedure was first conducted by the ancient Chinese who eventually shared the knowledge with the Indian sub-continent.  With the rise and spread of Islam, the practice of inoculation (var. variolation) against the “pox” spread from India to Asia Minor, and subsequently into Africa (at the same time, sadly, as the disease was introduced).   As it may be assumed that Mather was much interested in the journal The Philosophical Transactions of the Royal Society (he had become a member in 1713 and extracts of several of his letters to Royal Society members were printed in Vol. 29; pp. 62-71 for the years 1714-1716), he was probably greatly intrigued by the reports of Drs. Emanuel Timoni(us) and Jacob Pylarini concerning Turkish inoculations as published in the journal in 1714 and 1717.  As Fate would have it, or kismet to some, in the spring of 1721 Cambridge and Boston were both besieged by smallpox outbreaks.  Mather, to his credit, fervently believed that the “new” inoculation technique could save the lives of the children (and adults) of Boston.  The task he set before himself was not an easy one.

     In June of 1721, Mather published an appeal to Boston-area physicians to begin inoculations immediately, but his urging was met with widespread scorn and ridicule.  The religious believed that inoculation challenged the will of God and most of the physicians held the procedure to be an unproven extension of folk medicine, that is to say, superstition.  One physician, indeed the only individual in Boston with an actual medical degree, Dr. William Douglass, criticized the inoculation and variolation experiments as “virtuoso amusements.”  Upon receipt of a follow-up letter from Mather, a physician from Brookline, Mass., Zabdiel Boylston, was moved enough to inoculate his own son (and also his 36-year-old slave and the slave's two and a half year old son).  Later, Mather would see his remaining children (and other family members, as well) inoculated.  For their courage, Boylston was threatened with hanging and Mather had a grenade tossed into his home.  The grenade malfunctioned and didn't explode, yet the attached note, “Cotton Mather, you dog; damn you. I'll inoculate you with this, with a pox to you.” apparently thrilled Mather, who imagined he could become a martyr for medicine.  In November of 1721, Dr. Douglas spoke before the Royal Society in London and gave a strongly biased (and factually misleading) report on Boston inoculations, informing the Society that 1000 people in and around Boston had been infected with smallpox, 60 had been treated with variolation, and that some had “severe attacks” and died.  A couple of years later, Boylston addressed the Royal Society and informed them that of Boston's 10,700 residents (1,500 are thought to have left the city when the disease broke out), 5,889 cases of smallpox were known with 849 resulting deaths.  Boylston (and others) had variolated 242 people with only 6 deaths.  For his efforts, Boylston was made a member of the Royal Society.

     Now, 'true' vaccination (from the Latin vaccinus or “pertaining to cows”) is credited to Dr. Edward Jenner of Britain who began using the cowpox virus to vaccinate against the smallpox virus in 1796.  Yeah, his initial paper to The Philosophical Transactions of the Royal Society was rejected and many of his peers and the media savaged him with insults, but his method was sound and within several years his vaccination technique had begun to be practiced around the world.  In July of 1800, Dr. Benjamin Waterhouse (Harvard Medical School; Chair of Theory and Practice of Physic) vaccinated his 5 year old son and later sent the positive results to President John Adams and Vice President Thomas Jefferson, both of whom became outspoken supporters of vaccination.  It's said that in honor of Jenner, Louis Pasteur began to apply the term 'vaccination' to all prophylactic inoculations.  Still, as science has moved forward, ...we ain't out of the magical woods yet!

     To be truthful, there have been anti-vaccinationists since Jenner's time.  Bad science and religion have often been to blame for the anti-vaccinationist movements, but increasingly the media has played a significant role.  One recent paper (Smith et al. 2008. “Media Coverage of the Measles-Mumps-Rubella Vaccine and Autism Controversy and Its Relationship to MMR Immunization Rates in the United States.” Pediatrics. 121, 4: 836-843) concludes with the advice “Keeping the doctor frequently updated with the most credible information and with strategies for discussing vaccine safety with parents may be the most efficient way to guarantee successful immunization practices in the face of increasing amounts of often unreliable and misleading information.”  And, of course, there are such media (or “attention”) whores as Jenny McCarthy who believes that because she looked good in a Playboy layout in 1994 that she's qualified to give medical advice to parents.  Well, I guess Lindsay Lohan, after her Playboy shoot, will soon be giving out free legal advice to any and all takers...  Caveat imbecilis!  Let the not-too-bright beware!

Here's to next year,
Rick

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