Chapter 7

The strong, confident person who has strength to spare, reserves of energy, does his work easily and without friction. Half the timidities and indecisions of men are chargeable less to lack of ability than to lack of the physical vigor, the QUANTITY of energy, which is the driving power of character. In all the contests of life an important element in success is the ability to endure prolonged stress, to have the reserve energy that can be drawn upon and utilized as a driving force. This power is not alone necessary in the emergencies, the "short hauls" of life, but also in the long hauls that spread the strain through greater periods. Many of the failures of life are due as much to lack of ability to meet prolonged stress as to lack of experience or intelligence. Men of moderate ability but with great powers of endurance often succeed, while men of greater talent fail for lack of the ability to endure strain.

The man with a weak body and without the self-confidence that surplus energy gives is liable to be of uncertain judgment. Such a man in the presence of a problem requiring quick decision, doubts and hesitates and stands shivering on the brink of action while hastening opportunities pass him by.

Much of the loose thinking of our time is undoubtedly due to poor educational drill. In fact the failure of the schools to teach pupils how to apply the mind and how to think is one of their common reproaches. Inability to use the mind effectively is also frequently due to a lack of vigor and physical stamina. A person with poor digestion, or under-developed body, or weak circulation has of necessity a badly nourished brain. Such a brain, unless it belongs to a genius, will do poor thinking.

The mentally trained person who is also physically strong has the combination that puts his powers at easy command. He can be joyously busy doing the impossible because the doing of it has been made easy by training.

How much native power there is in all of us that for want of proper training or sympathetic encouragement never comes to maturity! How many of the finer qualities of character that, for want of a kindlier climate of cheerful companionship and wise direction, failed to mature and now lie dead in us! Very many people are only partly alive. A large part, and in some, the best part, is dead. The capacity they show is probably only a small share of a fine inheritance which, not knowing how to use, they allowed to die.

We have an instinctive liking for people who are strong and healthy. They appeal to us by their robustness and their confident display of energy. We do not now need the big muscles that were once necessary in wielding spear and battle-axe. We need, however, as much as the race ever needed well-developed bodies and habits of health.

It is not difficult for us to see that sports and games and play help to physical development, but it is not so plain that they may be made to develop the best qualities of character.

It is a fact, however, that all the important elements of character are tried out in games and sports. Enthusiasm, self-confidence, the adventurous spirit, alertness, promptness, unselfishness, cooperation, quick judgment--all these have their training and discipline on the game field. They comprise those fundamental native qualities that have gone to make humanity what it is. The young should have this training, and, if of the right kind, it may be made to contribute to the making of the best kind of character. The same quickness and accuracy of judgment that enable a boy to win a point in football may in later life be used to win a battle or save a business venture. Beyond this, there is of course gained the strong body that makes work easy and stress less difficult to bear.

Hall calls attention to the fact that two generations ago, Jahn, the great builder of German physique, roused the then despairing German nation by preaching the gospel of strong bodies. He created a new spirit in Germany, and the whole nation was aroused and seized with an enthusiasm for outdoor games and sports, and there arose a new cult for the body. His pupils sang of a united fatherland and of a stronger race. The Germans are in the habit of reminding us that it was about one generation after Jahn that the German Empire was founded and Germany became a world power.

Every argument for the physical training of boys applies with equal force to girls. Women need to be physically as strong as men. No race will remain virile and progressive unless both the fathers and mothers have the physical stamina that produces healthy, vigorous offspring. In this age, when women are going out into the world to compete with men it is highly important that they be physically strong if they are to stand the stress successfully. It was from rough barbarians, the rude war-loving Teutonic men and women described by Tacitus, that the Anglo-Saxon race inherited those splendid qualities of mind and body that have made their descendants masters of seas and continents.

It has been objected that gymnastics and field sports make girls coarse and mannish. The exact opposite has been found to be the case. It has been observed in colleges that when young women are properly led, their sports, in place of making them mannish, have a marked refining influence. They care more for correct posture because this is made one of their tests in athletic sports. They develop better manners and a new sense of pride in their appearance. They soon learn to avoid slang, loud talking and boisterous behavior. In the University of Chicago where they have excellent training, many of the girls have said that they came to have a new sense of dignity and to care more for their personal appearance.

They also develop the finer elements of character, a cooperative spirit, obedience to commands, patience, self-confidence, a spirit of comradeship, a democratic attitude and an appreciation of good qualities in others wherever found. All of these esthetic, social and moral qualities, woven into the texture of the growing character, and with the vigorous health that the physical training brings, are the best contribution to the making of the most effective type of the womanly woman. All games and sports and athletics for the young should therefore make for refinement and esthetic development.

The state needs now, and will always need, men and women who have sound bodies and abounding energy.

The harsher phases of the human struggle may pass and wars may cease, but the old contests of races, nations and individuals will continue under other forms.

As the race grows older life will become more largely mental. The increasing complexity of human relations and the more delicate adjustments that these relations require will bring a new and finer social order that will make higher demands upon reason.

While there is no evidence that experience or time or training will ever change the structure of the brain, it is probable that we have as yet but imperfectly utilized our mental possibilities. Stratton says:

Out of the depths of the mind new powers are always emerging.[2]

[2] "Experimental Psychology and Culture," George M. Stratton.

Back of the mental life, and making it possible, are the energies of the body, the functioning of the animal in man, which in the brain are changed to the higher uses of the mind. The ability to execute, to act effectively, to do and keep doing, to do the work of the professional man, the banker, or the scientist, all this is primarily physical, and from top to bottom of man's activities the physical test is applied. With the mental and emotional strain of civilized life goes the physical strain which is the other half of the struggle, and which now and always is both mental and physical. The Greeks recognized this unity of mind and body twenty-five hundred years ago and their results remain unmatched by any race.

They saw that the thought-out movements of physical training resulted in mental training and this law of mental development through physical training was a fundamental principle in their educational plan.

The nation that will again make this an ideal will produce a finer race of men, and other things equal, will excel in all that makes a people great.

EDWARD JENNER AND VACCINATION

BY PROFESSOR D. FRASER HARRIS, M.D., D.Sc.

DALHOUSIE UNIVERSITY, HALIFAX, N. S.

WE are so exceedingly apt to take our blessings as a matter of course that at the present time a large number of us have quite forgotten, and some of us have never known, what a terrible disease smallpox is and from how much suffering national vaccination has saved us. But even many of us, who may not be included amongst those who know nothing of smallpox, do come within the group of those who know next to nothing of the life and work of Dr. Edward Jenner. A number of persons think he was Sir William Jenner, physician to Queen Victoria.

An infectious or communicable disease is one caused by the admission of some form of living matter into the body of a human being or of a lower animal. All diseases are clearly not communicable in the sense that they are due to the presence of living things. Indigestion, for instance, I can not communicate to my neighbor, however serious my dietetic indiscretions.

Now, while the actual microorganisms causing many of the infectious diseases have been discovered in these recent days through the agency of the microscope--one of science's most valuable gifts to suffering humanity--a few diseases undoubtedly infectious have, even up to the present time, not had their microorganic causes discovered. Smallpox or variola is one of these. The term variola is from the Latin varus, a pimple.

The name Small Pox, which first occurs in Holinshead's "Chronicle" (1571), was given to this disease to distinguish it from the Great Pox or syphilis, the French disease, or Morbus Gallicus which attained the proportions of an epidemic in Europe about 1494. The expression "The Pox" in the older medical literature always refers to the Lues Venereal The word "pox" is the plural form of pock; the spelling "pox" is phonetic; "pocks" is the correct form.[1]

[1] Thus the following expression in Galt's "Annals of the Parish" is justified--"My son Gilbert was seized with the smallpox and was blinded by THEM for seventeen days."

Smallpox is unquestionably a highly infectious or communicable disease, and in the language of a past day, there is a virus or poison which can pass from the sick to the unaffected; when this transference occurs on a large scale we speak of an epidemic of smallpox. As Sir William Osler truly says, "It is not a little remarkable that in a disease, which is rightly regarded as the type of all infectious maladies, the specific virus still remains unknown." The same, however, is true of the common diseases of scarlatina, measles and chickenpox. Of some diseases, the virus is a bacillus or coccus, excessively minute fungi recognizable only under the microscope; but the bacteriologists are now beginning to speak of viruses so impalpable that they, unlike ordinary bacteria, can go through the pores of a clay filter, are filter-passers, that is are of ultra-microscopic dimensions. Some authorities conjecture that the virus of variola belongs to the group of filter-passers. The virus of smallpox, however, is very resistant and can be carried through the air for considerable distances; it clings for long periods to clothes, books, furniture, etc.

I shall not now digress to give the clinical details of a case of smallpox; the eruption may be slight or it may be very extensive. It occurs in three forms, discrete, confluent and hemorrhagic. The most dangerous form of smallpox is the confluent, in which the face and arms particularly are covered with large pustular areas of a most disfiguring appearance.

The disease called chickenpox, or varicella, has no relationship to smallpox and does not protect from it, nor does smallpox protect from chickenpox.

HISTORY OF SMALLPOX

There seems very little doubt that the home of smallpox was somewhere on the continent of Africa, although it is true that there are traditions pointing to its existence in Hindustan at least 1000 B.C. One Hindu account alludes to an ointment for removing the cicatrices of eruption. Africa has certainly for long been a prolific source of it: every time a fresh batch of slaves was brought over to the United States of America there was a fresh outbreak of smallpox.[2] It seems that the first outbreak in Europe in the Christian era was in the latter half of the sixth century, when it traveled from Arabia, visiting Egypt on the way. The earliest definite statements about it come from Arabia and are contained in an Arabic manuscript now in the University of Leyden, which refers to the years A.D. 570 and 571. There is a good deal of evidence that the Arabs introduced smallpox into Egypt at the sacking of Alexandria in A.D. 640. Pilgrims and merchants distributed it throughout Syria and Palestine and along the north of Africa; then, crossing the Mediterranean, they took it over to Italy. The Moors introduced it into Spain whence, via Portugal, Navarre, Languedoc and Guienne it was carried into western and northern Europe. The earliest physician to describe smallpox is Ahrun, a Christian Egyptian, who wrote in Greek. He lived in Alexandria from A.D. 610 to 641. The first independent treatise on the disease was by the famous Arabian physician, Rhazes, who wrote in Syriac in 920 A.D., but his book has been translated into both Greek and Latin. The first allusion to smallpox in English is in an Anglo-Saxon manuscript of the early part of the tenth century; the passage is interesting--"Against pockes: very much shall one let blood and drink a bowl full of melted butter; if they [pustules] strike out, one should dig each with a thorn and then drop one-year alder drink in, then they will not be seen," this was evidently to prevent the pitting dreaded even at so early a date. Smallpox was first described in Germany in 1493, and appeared in Sweden first in 1578.

[2] Osler thinks the pesta magna of Galen was smallpox; Marcus Aurelius died of it.

The contributions of Sydenham, the English Hippocrates, to the knowledge of smallpox, are classical.

Throughout the Middle Ages, owing to the very crowded and unsanitary state of the cities of Europe, smallpox was one of the various plagues from which the inhabitants were never free for any length of time.[3] Leprosy, influenza, smallpox, cholera, typhus fever and bubonic plague constituted the dreadful group. In most countries, including England, smallpox was practically endemic; an attack of it was accepted as a thing inevitable, in children even more inevitable than whooping-cough, measles, mumps or chickenpox is regarded at the present time. There was a common saying--"Few escape love or smallpox." In the eighteenth century so many faces were pitted from severe smallpox that it is said any woman who had no smallpox marks was straightway accounted beautiful. Very few persons escaped it in either the mild or the severe form in childhood or in later life.

[3] England was by no means exempt, but it was not infection in the modern sense that Shakespeare meant when he wrote-- "This England, This fortress, built by Nature for herself Against infection and the hand of war."

Now it is characteristic of a microorganic disease that a person who has recovered from an attack of it is immune from that disease for a longer or shorter time, in some cases for the remainder of life. This is, luckily, as true of smallpox as of any of the other acute infections. We do not now need to enquire into the theory of how this comes about; it is a well-recognized natural phenomenon. The modern explanation is in terms of antigens and anti-bodies and is fast passing from the stage of pure biochemical hypothesis into that of concrete realization. Persons who have recovered from smallpox rarely take it a second time; the few who do, have it in a mild form. It follows, then, that if smallpox is purposely inoculated into a human being he will for a long time be resistant to the subsequent infection of smallpox. The fact of smallpox protecting from smallpox is by no means without analogy in other diseases. Thus in Switzerland, in Africa, in Senegambia, it has been the custom for a long time, in order to protect the cattle from pleuro-pneumonia, to inoculate them with the fluid from the lung of an animal recently dead of pleuro-pneumonia. Of course since the time of Pasteur we have been quite familiar with the inoculation of attenuated virus to protect from the natural diseases in their fully virulent form, for instance, anthrax, rabies, plague and typhoid fever.

As it was, then, known to mankind from a very early period that a person could be protected from smallpox by being inoculated with it, inoculation grew up as a practice in widely distant parts of the globe. The purpose of intentional inoculation was to go through a mild attack of the disease in order to acquire protection from the much more serious natural form of the disease--to have had it so as not to have it. A very high antiquity is claimed for this smallpox inoculation, some even asserting that the earliest known Hindu physician (Dhanwantari) supposed to have lived about 1500 B.C., was the first to practice it. Bruce in his "Voyages to the Sources of the Nile" (1790) tells us that he found Nubian and Arabian women inoculating their children against smallpox, and that the custom had been observed from time immemorial. Records of it indeed are found all over the world; in Ashantee, amongst the Arabs of North Africa, in Tripoli, Tunis and Algeria, in Senegal, in China, in Persia, in Thibet, in Bengal, in Siam, in Tartary and in Turkey. In Siam the method of inoculation is very curious; material from a dried pustule is blown up into the nostrils; but in most other parts of the world the inoculation is by the ordinary method of superficial incision or what is called scarification. By the latter part of the seventeenth century inoculation for smallpox was an established practise in several European countries into which it had traveled by the coasts of the Bosphorus, via Constantinople. In 1701 a medical man, Timoni, described the process as he saw it in Constantinople. Material was taken from the pustules of a case on the twelfth or thirteenth day of the illness. As early as 1673 the practice was a common one in Denmark, Bartholinus tells us. In France inoculation had been widely practiced; on June 18, 1774, the young king Louis XVI., was inoculated for smallpox, and the fashionable ladies of the day wore in their hair a miniature rising sun and olive tree entwined by a serpent supporting a club, the "pouf a l'inoculation" of Mademoiselle Rose Bertin, the court milliner to Marie Antoinette. In Germany inoculation was in vogue all through the seventeenth century, as also in Holland, Switzerland, Italy and Circassia. In England the well-known Dr. Mead, honored, by the way, with a grave in Westminster Abbey, was a firm believer in inoculation, as was also Dr. Dimsdale, who was sent for by the Empress Catherine II. to introduce it into Russia. Dr. Dimsdale inoculated a number of persons in Petrograd, and finally the Grand Duke and the Empress herself. The lymph he took from the arm of a child ill of natural smallpox. For his services to the Russian court Dr. Dimsdale was made a Baron of the Russian Empire, a councillor of state and physician to the Empress. He was presented with the sum of 1,000 pounds and voted an annuity of 500 pounds a year. At the request of Catherine, Dr. Dimsdale went to Moscow, where thousands were clamoring for inoculation. The mortality from smallpox in Russia seems to have been still higher than in the rest of Europe. The annual average death rate on the Continent at the end of the eighteenth century was 210 per 1,000 deaths from all causes, while in Russia in one year two million persons perished from smallpox alone. In England in 1796, the deaths from smallpox were 18.6 per cent. of deaths from all causes.

A great impetus was given to inoculation in England by the letters of Lady Mary Wortley Montague, the wife of our ambassador to Turkey, Edward Wortley Montague, and daughter of the Duke of Kingston. In 1717 Lady Mary wrote a letter to her friend Miss Chiswell, in which she explained the process and promised to introduce it to the notice of the English physicians. So convinced was Lady Mary of the safety of smallpox inoculation and its efficacy in preserving from subsequent smallpox, that in March, 1717, she had her little boy inoculated at the English embassy by an old Greek woman in the presence of Dr. Maitland, surgeon to the embassy. In 1722 some criminals under sentence of death in Newgate were offered a full pardon if they would undergo inoculation. Six men agreed to this, and none of them suffered at all severely from the inoculated smallpox. Towards the close of the same year two children of the Princess of Wales were successfully inoculated; and in 1746 an Inoculation Hospital was actually opened in London, but not without much opposition. As early as 1721 the Rev. Cotton Mather, of Boston (U. S. A.), introduced inoculation to the notice of the American physicians, and in 1722 Dr. Boylston, of Brooklyn, inoculated 247 persons, of whom about 2 per cent. died of the acquired smallpox as compared with 14 per cent. of deaths amongst 6,000 uninoculated persons who caught the natural smallpox. There was, however, great popular opposition to the practice of inoculation, and Dr. Boylston on one occasion was nearly lynched.

While successful inoculation undoubtedly protected the person from smallpox, sometimes the inoculated form of the disease was virulent, and certainly all cases of inoculated variola were as infectious as the natural variety. Inoculated persons were therefore a danger to the community; and there is no doubt that such persons had occasionally introduced smallpox into towns which had been free from the natural disease. At the end of the eighteenth century, just about the time of Jenner's discovery, public opinion was strongly against the continuance of the practice of inoculation, and as natural smallpox had not at all abated its epidemic character, the times were ripe for "some new thing."

Now there is a disease of cows know as cowpox or vaccinia (from the Latin vacca, a cow) which is communicable to human beings. It is thought to be due to the same virus which in pigs is called swinepox and in horses "grease." Jenner believed vaccinia to be the same pathological entity as human smallpox, modified, however, by its transmission through the cow. For a long time this view was stoutly resisted, but it has now been accepted as probably representing the truth. The identity of vaccinia and "grease" is certainly much more doubtful.

To many of Jenner's contemporaries the view that vaccinia had at one time been a disease of human beings seemed unlikely; but we are now in a far better position to admit its probability than were those of Jenner's time. We have since then learned that man shares many diseases with the lower animals, tuberculosis, plague, rabies, diphtheria and pleuro-pneumonia, to mention only a few. We have also learned that certain lower animals, insects for instance, are intermediary hosts in the life-cycle of many minute parasites which cause serious diseases in the human being, amongst which malaria, yellow fever and the sleeping sickness are the most familiar.