Category Archives: Health and Fitness

How the bubonic plague changed drinking habits


Engraving of a man drinking plague water during the 1665 London outbreak.
Wellcome Collection, CC BY-NC-SA

James Brown, University of SheffieldAlcohol deaths in England and Wales in 2020 were the highest for 20 years. The Office for National Statistics recorded 7,423 deaths from alcohol misuse, a 19.6% increase compared with 2019. Although this is likely to have many complex causes, data from Public Health England suggests that the COVID-19 pandemic and its resulting lockdowns are at least partly responsible for the increase. Largely, the disruption of work and social routines have led to a surge of hazardous drinking within the home (with some fairly harrowing personal stories).

The Intoxicating Spaces project, of which I’m part, has been exploring how pandemics also influenced the use of intoxicants, including patterns of alcohol consumption, in the past. As part of this work, we’ve looked at how the successive bubonic plague outbreaks that gripped England, especially London, in the 17th century (1603, 1625, 1636 and 1665) wrought similar changes in people’s drinking habits.

Like today, these sudden and frightening outbreaks of disease restricted access to inns, taverns, alehouses and other public drinking places – the cornerstones of early-modern sociability. While never subject to wholesale closure, these environments were targeted by the equivalent of social distancing legislation. A 1665 London plague order, for example, identified “tippling in taverns, alehouses, coffee-houses, and cellars” as “the greatest occasion of dispersing the plague”, and imposed a 9pm curfew.

The extent to which these regulations altered 17th-century people’s relationship with alcohol is difficult to determine based on surviving information. However, anecdotal evidence suggests there might have been a comparable shift towards drinking at home.

In his classic 1722 meditation on the 1665 London outbreak Due Preparations for the Plague, Daniel Defoe told the story of a London grocer who voluntarily quarantined himself and his family in their home for the duration of the pandemic. Among the provisions he assembled were 12 hogsheads of beer; casks and rundlets containing four varieties of wine (canary, malmsey, sack and tent; 16 gallons of brandy; and “many sorts of distill’d waters” (spirits).

Painting of two men standing outside a tavern while a plague cart goes by.
A painting of a quarantined house during the 1665 London plague outbreak, with the signboards of public houses visible in the background.
Wellcome Collection, CC BY-SA

According to Defoe, this impressive stockpile was not gratuitous but “necessary supplies”. This is because, surprisingly from the perspective of today’s public health messaging, in this period alcohol was thought to have had medicinal value and its moderate consumption during plague outbreaks was actively encouraged.

Doctor’s orders

Contemporary doctors and medical writers believed alcohol worked as a plague preventatives, in two main ways.

First, the consumption of beers, wines and spirits was believed to strengthen the body’s key defensive organs of the brain, heart and liver. They were especially beneficial when taken first thing in the morning, with many commentators recommending fortifying liquid plague breakfasts.

In his 1665 plague treatise, Medela Pestilentiae, minister and medical writer Richard Kephale claimed that it’s good “to drink a pint of maligo [Malaga wine or port] in the morning against the infection”. (He was also effusive on “the inexpressible virtues of tobacco”.) Many recipes for the popular “preventative” and “cure” plague water invariably contain wine and spirits, as well as pharmaceutical herbs.

Second, and perhaps more significantly, moderate drinking was believed to ward off those fearful mental states that induced melancholy (early modern terminology for depression), which was thought to make people more vulnerable to contracting the plague.

As Defoe put it, the grocer’s liquor hoard was not for his and his family’s “mirth or plentiful drinking”, but rather “so as not to suffer their spirits to sink or be dejected, as on such melancholy occasions they might be supposed to do”. Likewise, in his 1665 plague treatise, Zenexton Ante-Pestilentiale, physician William Simpson advocated the “drinking of good wholesome well-spirited liquor” to “make the heart merry” and “cause cheerfulness”. This would banish “many enormous ideas of fear, hatred, anxiousness, sorrow, and other perplexing thoughts”, and thereby “fortify the balsam of life against all infectious breaths”.

Engaraving of plague ridden street.
Engraving of the 1665 London outbreak.
Wellcome Collection., CC BY-NC-SA

The key thing for all of these writers was alcohol “moderately taken”. Excessive drinking to the point of drunkenness was still cautioned against, and “living with temperance upon a good generous diet” (in the words of one author) remained the baseline for most plague medicine.

However, then as now, it’s likely that the disruption of patterns of labour and leisure, along with the daily anxieties of living in a plague-stricken city, drove many to the psychological consolations of the bottle on a more dangerous and habitual basis. In A Journal of the Plague Year – Defoe’s other, more celebrated novel about the 1665 London outbreak – he tells the story of a physician who kept his “spirits always high and hot with cordials and wine”. But “could not leave them off when the infection was quite gone, and so became a sot for all his life after”.The Conversation

James Brown, Research Associate & Project Manager (UK), University of Sheffield

This article is republished from The Conversation under a Creative Commons license. Read the original article.


Brief History of Antidepressants



COVID-19 vaccination: What we can learn from the great polio vaccine heist of 1959



In a pandemic, vaccines are in very high demand, and this threatens their supply.
(Shutterstock)

Paula Larsson, University of Oxford

We find ourselves at a precarious time in global health. Many people are anxiously awaiting their turn to receive a vaccine for COVID-19, yet roll-out is slow and disorganized, with many countries facing supply shortages.

The conditions are ripe for opportunists to exploit the situation. Reports of unethical line-jumping by wealthy elites have started to surface, while others warn of the potential for a black-market trade in vaccines.

This isn’t the first time people have waited anxiously for a vaccine. The looking-glass of history reveals the uneasiness of emotion that accompanies moments like these, as well as the dark consequences that can arise when evil-doers take advantage of them.

One case in particular stands out as an important lesson for today: when thousands of vaccine doses were stolen by armed men during a supply shortage in 1959.

The polio epidemic

It was the summer of 1959, when the last great epidemic of poliomyelitis swept across Canada. Québec saw the most cases that year, with the newspapers reporting over a thousand cases and 88 deaths.

Although the health authorities in Montréal warned the public about the seriousness of the summer epidemic, they also begged the populace to remain calm. This was far from comforting for parents who feared for their children.

Polio infection could cause permanent paralysis and was deadly in five per cent of cases. Montréalers rushed to the vaccine clinics, sometimes waiting for hours in the rain.

Vaccine production in Canada was limited to only two laboratories, with the majority being provided by Connaught Labs at the University of Toronto. This put intense pressure on vaccine supplies and Québec, like the rest of North America, soon faced a vaccine shortage.

Three newspaper photos showing people lining up
Headline images showing the lone lines of people waiting to get a Salk vaccine. ‘The Montreal Gazette,’ Aug. 11, 1959.
The Montreal Gazette

A planned robbery

By August, Montréal was waiting desperately for more vaccines. It was a great relief when a huge shipment of the cherry-red vials arrived from Connaught Labs at the end of the month. The supply was enough to cover the city, and the surplus was planned for redistribution across the province.

Yet the redistribution never came to pass. One man by the name of Jean Paul Robinson, a temporary vaccine worker, had found the circumstances too enticing. Robinson had been tasked with running vials between the various clinics. He knew there was a shortage and that people were desperate. He also knew where the main supply of vaccine was stored: at the Microbiology Institute in the University of Montréal.

At 3 a.m. on Aug. 31, 1959, Robinson and two accomplices broke into the university armed with revolvers. They first locked the night guard in a cage with 500 lab monkeys. The thieves then broke the lock on the massive refrigerator, looted all the cases of the vaccine and stole the guard’s car as the getaway vehicle. In the end, they made away with 75,000 vials, valued at $50,000 (equivalent to almost $500,000 today). Robinson rented an empty apartment building and stashed his prize.

The crime shocked the country. The next day, the city announced it had completely run out of its vaccine supplies. Reporters seized on the situation, publishing reports of desperate mothers turned away from vaccine clinics in vain.

The provincial police were called in, and a special four-man team of investigators was assembled. They began by interviewing the hapless night guard. He couldn’t identify the culprits — who had been wearing nylon leggings over their faces — but he did overhear them speak about transporting the vaccines. The conversation provided the only lead: it seemed that at least one of the men had been “familiar with medical terms.”

The police soon brought in a medical student for questioning. By the next day, they had seized a supply of fresh vaccine from the shelves of a Pont-Viau drug store. The confiscated vials displayed the same serial number as the missing supply. Yet questioning both the medical student and the druggist led the police nowhere, and over the next few days, all leads ran dry. Worse yet, it seemed that the city was facing an upswing in infections, with another 36 patients admitted to hospital.

Black and white photograph of children in a row of hospital beds with an attending nurse.
The widespread application of the polio vaccine in the 1950s and ‘60s helped bring polio under control in the early 1970s. Canada was certified ‘polio free’ in 1994. This image of polio patients was taken in September 1947 in Edmonton, Alta.
(Canadian Public Health Association)

Risk and capture

Meanwhile, Robinson was trying to figure out what to do with his ill-gotten supply of vaccine. Keeping the product cold was a difficult task — if left unrefrigerated for too long, the vaccine would be useless. He filled the refrigerator (saving one shelf for beer), while the rest of the cases were simply left on the floor at room temperature. Although he had been lucky to sell 299 vials for a tidy sum of $500 to the druggist at Pont-Viau, dispensing with the rest of the vaccine was too risky.

Taking a chance that the police were more interested in recovering the vials than catching the culprit, Robinson placed a call to the public police line. Posing as a concerned citizen, he declared that he had seen a large amount of suspicious cases labelled “Connaught Laboratories” being loaded out of a car on St. Hubert Street in the East End.

The police quickly discovered the missing cases of vaccine, but before they could be used, the vaccines would need to be tested thoroughly. This process could take up to two months, meaning the vials could not be used despite the epidemic. Fresh shipments of the vaccine were not planned to arrive for a few more weeks.

The public met the outcome of the investigation with outrage, with the Montréal Star going so far as to speculate that the police had made a deal with the guilty parties in order to recover the vaccine. Truly, it declared, “in the history of justice in Canada, this case must be unprecedented.” The stolen vaccines were eventually cleared for general use in October.

For their part, the police were far from done investigating. They soon turned their attention to identifying the culprit. They discovered that the man who had provided the police tip was also the man who had sold the Pont-Viau druggist his 299 vials. Evidence continued to mount against Robinson when the janitor of the apartment building identified him. After denying all charges, Robinson fled. He was discovered three weeks later hiding out in a small shed on an “isolated backroad farm.”

Newspaper front page BANDITS TAKE POLIO VACCINE IN BIZARRE LABORATORY RAID
The vaccine heist of 1959 shocked the Canadian public and made headlines across the country. ‘Victoria Daily Times,’ Aug. 31, 1959.
(Victoria Daily Times)

‘Beyond reasonable doubt’

Prosecuting Robinson turned out to be a much harder task, and the case eventually fell apart. Although one of his accomplices had originally identified Jean Paul Robinson as the mastermind of the heist, when the trial came around two years later, the witness recanted his original statement (he would later be charged with perjury).

Robinson himself proved imperturbable during courtroom interrogations. He painted himself a public-spirited citizen who had simply tried to “retrieve” the stolen vaccines from the true criminal mastermind: a mysterious man by the name of Bob. Robinson claimed that Bob had set the whole thing up before he had disappeared and escaped justice. The judge eventually ruled that although Robinson’s story was “strange and a little far-fetched,” in the end, “the Crown had not proven a case beyond a reasonable doubt” and he was acquitted.

As millions of people worldwide anxiously await the distribution of the COVID-19 vaccines, this case warns of the possible consequences of disorganized and poorly planned vaccine programs. Those looking to profit from mistakes, shortages and desperation are out there, and it is important that policy makers keep this in mind as vaccination programs are rolled out.The Conversation

Paula Larsson, Doctoral Student, Centre for the History of Science, Medicine, and Technology, University of Oxford

This article is republished from The Conversation under a Creative Commons license. Read the original article.


Worst Pandemics in History



The First Vaccine



Hippocrates and willow bark? What you know about the history of aspirin is probably wrong



Wellcome Images, CC BY-SA

Philippa Martyr, University of Western Australia

Aspirin is one of the most widely used drugs in the world. Its main ingredient comes from a natural product, salicin, found in plants such as willow and myrtle.

Aspirin is also a good example of how myths build up around ancient medicines.

Its origins have been closely linked with Hippocrates, the famous ancient Greek doctor and so-called father of medicine. He’s said to have used willow for pain relief, inspiring the development of aspirin centuries later.

But his writings barely mention willow. So why do we still believe the myth?

What’s all this about willow?

Practically every history of aspirin tells you Hippocrates prescribed willow to women in labour. Some say he prescribed willow leaf tea. Others say he told them to chew willow bark.

But when we look at what Hippocrates actually wrote, there is just one reference to burning willow leaves to make smoke for “fumigating” the uterus to get rid of a miscarried pregnancy.

This is pretty much the only reference to willow — ιτεα or itea — as a drug in these writings.




Read more:
Hippocrates didn’t write the oath, so why is he the father of medicine?


Could willow actually relieve pain?

Willow bark and leaves were used in some ancient medicines. However, these were often used externally, rather than swallowed. Because ancient weights and measures are confusing — and sometimes missing altogether in recipes — it’s hard to tell whether there was enough salicin in an ancient recipe to make a difference.

The bark of white willow (Salix alba), which Hippocrates may have been talking about, doesn’t contain much salicin, compared with other willows and salicin-rich plants like the myrtle tree.

Botanical drawing of white willow
The bark of white willow doesn’t contain much salicin.
Raw Pixel/Public Domain

A clinically effective dose of 60–120mg of salicin would be very hard to obtain from simply chewing white willow bark or drinking willow tea.

White willow also contains toxic, bitter-tasting tannins. These would make it hard to consume enough bark or tea to reach that dose, and would cause stomach pain long before you got there.

Natural salicin is more abundant in other ancient plants, such as the myrtle tree. But even then you would still probably give yourself a terrible stomach ache after ingesting enough of the plant to relieve pain.

Dioscorides was an ancient Roman who wrote a guidebook of medicines, still in print today. He described willow as a remedy for stomach ache, the respiratory disease tuberculosis, and as a contraceptive.

He said if you burned willow bark, soaked it in vinegar, then rubbed it on corns and calluses, it would remove them. He also recommended a hot pack containing willow leaves for gout (which we know now as a type of arthritis).

Celsus, another Roman medical writer, said warm willow packs or poultices would treat a prolapse of the womb or bowel (where the organ literally falls out of the body). Celsus advised to push it back in, and then bandage the warm dressing on the outside.




Read more:
Avicenna: the Persian polymath who shaped modern science, medicine and philosophy


Salicin is used today to treat corns and warts. But this doesn’t mean Dioscorides’ recipe worked because of the salicin. Vinegar is acidic and is said to soften corns on its own. Applying any kind of warm pack will also relieve pain.

If willow bark and leaves were handy and potent painkillers, we would have used them almost to extinction by now. Instead, by early modern times in Europe, willow was considered largely useless as a medicine.

This doesn’t mean willow was actually useless. It still contained salicin, but this hadn’t yet been isolated or refined into its modern form.




Read more:
Leaders as healers: Ancient Greek ideas on the health of the body politic


So, if it wasn’t Hippocrates, who was it?

It was English cleric Reverend Edward Stone who “rediscovered” willow.

In around 1757, Stone chewed on white willow bark out of curiosity and was struck by how bitter it was. He wondered whether it could be used medicinally, like the bitter cinchona bark (where the malaria drug quinine comes from).

Stone gathered and dried around half a kilogram of willow bark, then ground it to powder, before taking small doses every four hours to reduce his fever. Drying the bark would have concentrated the salicin, making its effect stronger.

When the powder seemed to relieve his fever, Stone tried it on his parishioners when they were sick. In 1763, he wrote to the Royal Society, reporting it worked.

How did a plant extract turn into aspirin?

Italian researchers Brugnatelli and Fontana managed to extract salicin from willow bark in 1826. Then German pharmacologist Johann Andreas Buchner created the name “salicin” in 1828 from the Latin word for willow, salix.

Felix Hoffmann, a researcher at the German company now known as Bayer, chemically modified the related molecule salicylic acid, which was eventually named aspirin. The company patented the name in 1899.

White aspirin pills in a grid on a blue background
Aspirin is one of the most widely used medicines today.
Daniel Foster/flickr, CC BY-NC-SA

Today aspirin is used for pain relief, reducing swelling, lowering body temperature and preventing blood clots.




Read more:
Weekly Dose: aspirin, the pain and fever reliever that prevents heart attacks, strokes and maybe cancer


Why do we keep repeating the willow myth?

Researchers keep repeating the myth that ancient people understood the link between willow and salicin for pain relief, partly because everyone loves an epic tale. And the story of aspirin can be turned into one, with a bit of imagination. But it’s a good reminder to look at original texts if you can.

It’s also an example of how confirmation bias works. We know salicin is in willow, and salicin relieves pain. So when we find ancient references to willow, we think ancient people discovered salicin before us.

Modern medicine likes a respectable family tree. It helps give today’s manufactured products a good pedigree. It also helps us think of these products as safe, beneficial and part of a long healing tradition.

But the “ancient” history of aspirin has a lot of holes in it. So next time you pop an aspirin, thank Hoffmann rather than Hippocrates.The Conversation

Philippa Martyr, Lecturer, Pharmacology, Women’s Health, School of Biomedical Sciences, University of Western Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.


Surviving the Black Death



Scarabs, phalluses, evil eyes — how ancient amulets tried to ward off disease



An Egyptian winged scarab amulet (circa 1070 –945 BC).

Marguerite Johnson, University of Newcastle

Throughout antiquity, from the Mediterranean to Egypt and today’s Middle East, people believed that misfortune, including accidents, diseases, and sometimes even death, were caused by external forces.

Be they gods or other types of supernatural forces (such as a daimon), people — regardless of faith — sought magical means of protection against them.

While medicine and science were not absent in antiquity, they competed with entrenched systems of magic and the widespread recourse to it. People consulted professional magicians and also practised their own forms of folk magic.




Read more:
Spells, charms, erotic dolls: love magic in the ancient Mediterranean


Possibly derived from the Latin word “amoliri”, meaning “to drive away” or “to avert”, amulets were believed to possess inherent magical qualities. These qualities could be naturally intrinsic (such as the properties of a particular stone) or imbued artificially with the assistance of a spell.

Not surprisingly the use of amulets was an integral part of life. From jewellery and embellishments on buildings, to papyri inscribed with spells, and even garden ornaments, they were deemed effective forms of protection.

Amulets have been around for thousands of years. Amber pendants from Denmark’s Mesolithic age (10,000-8,000 BC) seem to have been worn as a form of generic protection.

Jewellery and ornaments referencing the figure of the scarab beetle were also popular all-purpose amulets in Egypt, dating from the beginning of the Middle Kingdom (2000 BC).

A solar scarab pendant from the tomb of Tutankhamen.
Wikimedia Commons



Read more:
Michelle Obama’s necklace and the power of political jewellery — from suffragettes to a secretary of state


Two of the most common symbols of protection are the eye and the phallus. One or both amulet designs appear in many contexts, providing protection of the body (in the form of jewellery), a building (as plaques on exterior walls), a tomb (as an inscribed motif), and even a baby’s crib (as a mobile or crib ornament).

In Greece and the Middle East, for example, the evil eye has a history stretching back thousands of years. Today the image adorns the streets, buildings and even trees of villages.

A tree adorned with the evil eye symbol in a Turkish village.
Marguerite Johnson

The magic behind the evil eye is based on the belief that malevolence can be directed towards an individual through a nasty glare. Accordingly, a “fake” eye, or evil eye, absorbs the malicious intention in place of the target’s eye.

Wind chimes

Greek ‘herm’ (circa sixth century BC).

The phallus was a form of magical protection in ancient Greece and Rome. The Greek sculpture known as a “herm” in English functioned as apotropaic magic (used to fend off evil). Such artefacts, featuring a head and torso atop a pediment — often in the shape of a phallus and, if not, definitely featuring a phallus — were used as boundary markers to keep trespassers out.

The implicit threat is that of rape; come near a space that is not your own, and you may suffer the consequences. This threat was intended to be interpreted metaphorically; namely, a violation of another’s property would entail some form of punishment from the supernatural realm.

The phallus amulet was also popular in ancient Italian magic. In Pompeii, archaeologists have uncovered wind chimes called tintinnabulum (meaning “little bell”). These were hung in gardens and took the form of a phallus adorned with bells.

This phallic shape, often morphing into bawdy forms, presented the same warning as the herm statues in Greece. However, the comic shapes in combination with the tinkling of bells also revealed a belief in the protective power of sound. Laughing was believed to ward off evil forces, as was the sound of chimes.

Tintinnabulum from Pompeii (circa first century AD).
Author provided

One scholarly view of magic is that it functions as the last recourse for the desperate or dispossessed. In this sense, it presents as a hopeful action, interpreted by some modern commentators as a form of psychological release from stress or a sense of powerlessness.

Contemporary ‘magical thinking’

In the context of “magical thinking”, amulets may be dismissed by critical thinkers of all persuasions, but they remain in use throughout the world.

Often combined with science and common sense, but not always, amulets have made a resurgence during the COVID-19 pandemic. The amulets are equally as diverse, coming in all shapes and sizes, and promoted by politicians, religious leaders and social influencers.

A traditional form of adornment and protection in Javanese culture, now popular with tourists, “burnt root” bracelets, known as “akar bahar”, have been sold by community shamans. Indonesia’s Agriculture Minister Syahrul Yasin Limpo, meanwhile, has promoted an aromatherapy necklace containing a eucalyptus potion touted as a preventative against COVID (useless in terms of science but perhaps less dangerous than hydroxychloroquine).

This necklace prompts the question: where does alternative medicine end and magic begin? It is not a new question, since there has been an intersection between magical lore and medical knowledge for thousands of years.




Read more:
A murky cauldron – modern witchcraft and the spell on Trump


In Babylon, circa 2000-1600 BC, a condition known as “kuràrum disease” (identified as a ringworm, symptoms of which include facial pustules), was responded to by both magicians and doctors. And in one text there is a “healer” who appears to perform the role of magician and doctor simultaneously.

Other ancient cultures also practised medical magic through amulets. In Greece, magicians prescribed amulets to heal the wandering womb, a condition whereby the womb was believed to dislodge and travel throughout a woman’s body, thus causing hysteria.

These amulets could take the form of jewellery on which a spell was inscribed. Amulets were also used to prevent pregnancy, as evidenced in a recipe written in Greek from around the second century BC, which instructed women to: “take a bean with a bug inside it and fasten it to yourself as an amulet.”

In a contemporary religious context, written amulets replace spells with prayers. In Thailand, for example, Phisutthi Rattanaphon, an Abbot at Wat Theraplai Temple in Suphan Buri, has issued people with orange paper inscribed with protective words and pictures.

Designed to ward off COVID-19, the papers represent the crossover between magic and religion; a paradigm as entrenched as the blurring of magic and medicine in numerous historical and cultural contexts. Thankfully, face masks and hand sanitiser are also available at the temple.The Conversation

Marguerite Johnson, Professor of Classics, University of Newcastle

This article is republished from The Conversation under a Creative Commons license. Read the original article.


Coronavirus vaccine: lessons from the 19th-century smallpox anti-vaxxer movement



English physician and scientist, who was the pioneer of smallpox vaccine, Edward Jenner sees off the anti-vaccinators.
Wikimedia/Wellcome Collection

Steven King, Nottingham Trent University

There is hope a coronavirus vaccine might be ready by the end of the year. But for it to eliminate COVID-19 a critical mass of people must be vaccinated. And if the protective benefits of a COVID-19 vaccine fall off rapidly (as seems to happen with naturally acquired antibodies) maintaining immunity will require multiple vaccinations. So unless people keep renewing their jabs, the critical mass will decline quickly.

How will politicians ensure critical mass and renewal? For UK prime minister Boris Johnson (who labels those who oppose vaccination as “nuts”) and others, vaccination is a matter of duty. There is a logical case (we know people who have died or suffered badly from COVID-19) and a moral case (to protect others if not yourself).

Yet anti-vaccination sentiment focused on the rights of citizens not to act is clear. A recent poll of 2,000 people across the UK found that 14% would refuse to take a vaccine.

The rights of citizens not to act mean that compulsory vaccination cannot be (and has not been) ruled out. The history of other vaccination programmes, particularly the first truly national campaign against smallpox, shows how difficult the balancing of rights and duties will be.

A disappearing act

The 19th-century invention of vaccination created a new national imperative for the UK to combat endemic smallpox. The risk of dying from smallpox for those who contracted it was substantially higher than that for COVID-19 today. Survivors gained immunity but often at the cost of physical scarring and long-term health problems.

Vaccination and subsequent elimination should have been a no-brainer. Yet local and regional outbreaks persisted across the 19th century.

Governments of this period assumed (sometimes incorrectly) that the middle-classes would realise the value of vaccination. The poor and marginal were different. For them, mass compulsory vaccination awaited.

The result was an explosive atmosphere. Rumours of deaths after vaccination and of the rounding up of the poor like animals generated a sustained popular backlash, with some organising under the umbrella of the National Anti-Vaccination League.

19th century cartoon of people marching in protest
An attack on smallpox vaccination and the Royal College of Physicians’ advocation of it, 1812.
Wikimedia/Wellcome Collection

Yet even after vaccination became compulsory in 1853, there were many ways in which, by accident or design, ordinary people citizens avoided the jab. Some people simply disappeared from the records or failed to appear when asked. Those most prone to doing so (those in crowded households or immigrants, for example) were also the groups most susceptible to disease.

Census data consistently undercounts the national population. Undercounting in the 1800s may have missed around 10% of some communities. Even for the 2011 census, around 6.1% of the population is believed to have been missed. Achieving vaccination critical mass is difficult where you do not know the true size of the mass and the most vulnerable are the least detectable.

The poor also “clogged up” the vaccination system. Sometimes they agreed to participate and then did not turn up, a common feature for systems of compulsion where there is no ultimate sanction. On other occasions, as for instance at Keighley in 1882, people would supplement this activity with the sending of anonymous hate mail in an attempt to disrupt the work of local vaccinators.

Fight for their rights

Taking advantage of local tensions was also a useful avoidance technique. “Smallpox riots” in the face of attempts at crude compulsion were frequent and sustained.

Sometimes organised by local agitators, and sometimes spurred on by instances of children dying after vaccination, such unrest varied on a spectrum from small and localised to community-wide and sustained. Riots at Ipswich, Henley, Leicester and Newcastle were particularly notable.

Nor should we forget that vaccination opponents spread rumours about and caricatured vaccines and vaccinators, undermining the credibility of the system in the public imagination. These included one cartoon from the 1880s in which helpless children are shovelled into the mouth of a diseased cow while, at the other end, a doctor portrayed as the devil incarnate shovels dead children excreted by the cow into a cart bound for mass graves.

In July 2020 public figures stand accused of using Twitter to the same effect for COVID-19 vaccination.

Cartoon of children being fed to a disease-ridden cow creature, representing vaccination.
Children are fed to a disease-ridden cow creature, representing vaccination.
Wikimedia/Wellcome Collection

Most forcefully, while politicians used the law in order to force vaccination, the law could also be turned against them. Penalties against parents for failing to vaccinate children, introduced in 1853 and strengthened in 1867, were routinely ignored by courts. Compulsory child vaccination was removed in 1898 and the freedom to refuse introduced.

Long-standing opposition to vaccination by some scientists as well as ordinary people crystallised in 1885 with a huge demonstration at Leicester (ironically the recent focus of a British local lockdown). This and ongoing smaller protests across the country forced the government to introduce a Royal Commission to reflect on the whole question of compulsion. The verdict ultimately fell on the side of the rights of the individual.

It is not hard to imagine the 2021 human rights case in which a court must decide on the balance of the legal and collective duty of citizens to get vaccinated against COVID-19 nd the individual right to choose.

Our political and medical elites believe that people will accept moral responsibility: “get vaccinated”. Yet little thought has gone into how a mass vaccination programme works.

We will see some of the lessons of 20th-century vaccination schemes repeated, with public information campaigns and elements of coercion via vaccination programmes in schools and care homes. Nonetheless, the lack of serious credence given to anti-vaccination “nuts” and the resistance that a vaccination programme may generate feels oh so 19th-century.The Conversation

Steven King, Professor of Economic and Social History, Nottingham Trent University

This article is republished from The Conversation under a Creative Commons license. Read the original article.


Border closures, identity and political tensions: how Australia’s past pandemics shape our COVID-19 response


Susan Moloney, Griffith University and Kim Moloney, Murdoch University

Tensions over border closures are in the news again, now states are gradually lifting travel restrictions to all except Victorians.

Prime Minister Scott Morrison says singling out Victorians is an overreaction to Melbourne’s coronavirus spike, urging the states “to get some perspective”.

Federal-state tensions over border closures and other pandemic quarantine measures are not new, and not limited to the COVID-19 pandemic.

Our new research shows such measures are entwined in our history and tied to Australia’s identity as a nation. We also show how our experiences during past pandemics guide the plans we now use, and alter, to control the coronavirus.




Read more:
National and state leaders may not always agree, but this hasn’t hindered our coronavirus response


Bubonic plague, federation and national identity

In early 1900, bubonic plague broke out just months before federation, introduced by infected rats on ships.

When a new vaccine was available, the New South Wales government planned to inoculate just front-line workers.

Journalists called for a broader inoculation campaign and the government soon faced a “melee” in which:

…men fought, women fainted and the offices [of the Board of Health] were damaged.

Patients and contacts were quarantined at the North Head Quarantine Station. Affected suburbs were quarantined and sanitation commenced.

The health board openly criticised the government for its handling of the quarantine measures, laying the groundwork for quarantine policy in the newly independent Australia.

Quarantine then became essential to a vision of Australia as an island nation where “island” stood for immunity and where non-Australians were viewed as “diseased”.

Public health is mentioned twice in the Australian constitution. Section 51(ix) gives parliament the power to quarantine, and section 69 requires states and territories to transfer quarantine services to the Commonwealth.

The Quarantine Act was later merged to form the Immigration Restriction Act, with quarantine influencing immigration policy.

Ports then became centres of immigration, trade, biopolitics and biosecurity.

Spanish flu sparked border disputes too

In 1918, at the onset of the Spanish flu, quarantine policy included border closures, quarantine camps (for people stuck at borders) and school closures. These measures initially controlled widespread outbreaks in Australia.

However, Victoria quibbled over whether NSW had accurately diagnosed this as an influenza pandemic. Queensland closed its borders, despite only the Commonwealth having the legal powers to do so.




Read more:
This isn’t the first global pandemic, and it won’t be the last. Here’s what we’ve learned from 4 others throughout history


When World War I ended, many returning soldiers broke quarantine. Quarantine measures were not coordinated at the Commonwealth level; states and territories each went their own way.

Quarantine camps, like this one at Wallangarra in Queensland, were set up during the Spanish flu pandemic.
Aussie~mobs/Public Domain/Flickr

There were different policies about state border closures, quarantine camps, mask wearing, school closures and public gatherings. Infection spread and hospitals were overwhelmed.

The legacy? The states and territories ceded quarantine control to the Commonwealth. And in 1921, the Commonwealth created its own health department.

The 1990s brought new threats

Over the next seven decades, Australia linked quarantine surveillance to national survival. It shifted from prioritising human health to biosecurity and protection of Australia’s flora, fauna and agriculture.

In the 1990s, new human threats emerged. Avian influenza in 1997 led the federal government to recognise Australia may be ill-prepared to face a pandemic. By 1999 Australia had its first influenza pandemic plan.




Read more:
Today’s disease names are less catchy, but also less likely to cause stigma


In 2003, severe acute respiratory syndrome (or SARS) emerged in China and Hong Kong. Australia responded by discouraging nonessential travel and started health screening incoming passengers.

The next threat, 2004 H5N1 Avian influenza, was a dry run for future responses. This resulted in the 2008 Australian Health Management Plan for Pandemic Influenza, which included border control and social isolation measures.

Which brings us to today

While lessons learned from past pandemics are with us today, we’ve seen changes to policy mid-pandemic. March saw the formation of the National Cabinet to endorse and coordinate actions across the nation.

Uncertainty over border control continues, especially surrounding the potential for cruise and live-export ships to import coronavirus infections.




Read more:
Coronavirus has seriously tested our border security. Have we learned from our mistakes?


Then there are border closures between states and territories, creating tensions and a potential high court challenge.

Border quibbles between states and territories will likely continue in this and future pandemics due to geographical, epidemiological and political differences.

Australia’s success during COVID-19 as a nation, is in part due to Australian quarantine policy being so closely tied to its island nature and learnings from previous pandemics.

Lessons learnt from handling COVID-19 will also strengthen future pandemic responses and hopefully will make them more coordinated.




Read more:
4 ways Australia’s coronavirus response was a triumph, and 4 ways it fell short


The Conversation


Susan Moloney, Associate Professor, Paediatrics, Griffith University and Kim Moloney, Senior Lecturer in Global Public Administration and Public Policy, Murdoch University

This article is republished from The Conversation under a Creative Commons license. Read the original article.


%d bloggers like this: