disease and culture.
ILS4120 Disease and CultureBurdens of Disease Chapter 6, The EnlightenmentWorksheet For parts 1 & 2, please provide bulleted answers 1. Describe the experiment(s) conducted by Charles Maitland in 1721 in detail. Be sure to: · Name the disease agent and type of inoculation material used. · State the hypothesis being tested · Give the sample size · Describe the test subjects. Who were they (gender, age, socioeconomic status, etc.) and how were they chosen? Did they agree to the experiment? Were they informed of the dangers? Did they volunteer, if so why? Were they coerced by an authority figure? · Describe the potential risks and benefits to the experimental subjects. · Explain the experimental results and conclusions 2. Describe the experiment(s) conducted by Edward Jenner in 1796 in detail. Be sure to: · Name the disease agent and type of inoculation material used. · State the hypothesis being tested · Give the sample size · Describe the test subjects. Who were they (gender, age, socioeconomic status, etc.) and how were they chosen? Did they agree to the experiment? Were they informed of the dangers? Did they volunteer, if so why? Were they coerced by an authority figure? · Describe the potential risks and benefits to the experimental subjects. · Explain the experimental results and conclusions _____________________________________________________________________________________ 3. ESSAY Assignment to be submitted via ulearn; 5 points Please provide a well-written short (500 - 600 word) but complete personal opinion essay evaluating the experiments conducted by Charles Maitland and Edward Jenner in the 18th century in terms of ethical considerations. Compare the two experiments and decide if they were EQUAL in terms of ethical violations. Justify your answer and be sure to include the pertinent details (noted in parts 1 & 2 of the worksheet). State your opinion on whether the ends justify the means in each experiment. Justify your answer. Be sure to consider the state of scientific understanding and the social/economic and political environment that prevailed in the 18th century and the impact this work has had on humanity over the centuries. Burdens Ch 5 Disease and the Enlightenment 18th Century Learning Objectives/Outcomes. Students should be able to … Describe the early modern (18th century) disease environment in terms of diet and the incidences of nutritional deficiency diseases, including pellagra. Discuss the problems and diseases that came with the crowed conditions in early modern cities. Explain the characteristics of European warfare that created optimum conditions for the spread of disease. Describe the early modern social changes that had a great long-term impact on the disease environment. Explain how Enlightenment thinkers viewed the relationship between the environmental conditions and the mind. Describe the “new” diseases that afflicted 18th century Europeans: scurvy, syphilis, rickets, influenza. Explain the miasma theory of disease and name the “fevers” that prevailed in the 18th century Learning Objectives/Outcomes (continued) Compare the medieval and 17th century thinkers beliefs about causes of disease to the beliefs of the 18th century Enlightenment thinkers. Explain how acceptance of the “Germ Theory of Disease” in the 19th century changed how disease was viewed. Describe Enlightenment view of mental illness and treatment of the mentally ill. Describe the environmental efforts advocated by the European Enlightenment thinkers to fight disease. Describe the Enlightenment view of science. Describe the three forms of smallpox, their impact on 17th & 18th century Europe and the efforts undertaken in the 18th century to prevent this disease. Describe in detail the variolation experiments conducted by Maitland and the inoculation experiments conducted by Edward Jenner and name the individual credited with developing the smallpox vaccine. Describe the cause, symptoms, virulence of yellow fever, how the government responded to the epidemic in Philadelphia in 1793 and the political effects that John Adams claimed the Philadelphia yellow fever epidemic may have had. The Scientific Revolution and the Enlightenment The scientific revolution of the 17th & 18th centuries produced the science-based European view of life and way of thinking called the Enlightenment The Enlightenment relied on science to explain things and as a tool for solving problems Healers adopted new approaches to specific diseases The Enlightenment was a period of rapid change, lack of consensus, and confusion regarding disease: what is disease? how should it be handled? 4 Health Challenges in the Rural West In isolated rural communities there was heavy reliance on a few foods so their diets were affected by local famines Protein and iron deficiency were common Dietary deficiency diseases: scurvy, beriberi, and rickets were common and weakened the people Ergotism (fungal toxin in grain) presented recurrent problems, especially in damp seasons and in marshy soils Heavy outdoor labor with metal cutting tools brought wounds, lock jaw/tetanus The rural areas were less likely to be affected by diseases of crowds, especially such airborne diseases as tuberculosis, smallpox, measles, influenza, and diphtheria Western Cities & Crowding Europe’s urban population grew, and the number of cities increased Population density (crowding) was a life-and-death problem in England, France, parts of Germany, Italy and elsewhere Intensely crowded early modern cities provided the critical mass of population required for airborne diseases (tuberculosis, smallpox, influenza) to sustain themselves Crowded urban conditions also supported diseases dependent on fecal-oral transmission: dysentery, diarrhea, and typhoid fever because rivers were used as both sewers and sources of water Building Healthier European Cities In the 17th & 18th centuries Europeans began to view cleanliness of the body as a positive/healthy trait Cities improved with central planning and greater use of such construction materials as stone, slate, and brick London was rebuilt with new materials following a disastrous fire in 1666 The rebuilding and city planning likely reduced some crowding but density was still very high Increased trips to the tropics (especially the “Indies”) brought additional diseases such as yellow fever to Europe’s cities where they spread rapidly The Agricultural Revolution Agricultural change in England, France Germany, brought new crops and more cultivation of protein-bearing legumes Wealth from the "agricultural revolution" plus other economic forces, especially the developing instruments of capitalism (credit, insurance) improved life By the 18th century northwestern Europe had a market economy, that had the power to overcome local famines and other subsistence crises typical of earlier times Food and Increased health Good news: potatoes in Europe & Ireland provided a rich new source of calories Bad news: encouraged a dangerous monoculture and continued exploitation of farm laborers who produced cash crops for export – to the benefit of wealthy landlords Maize corn brought calories to Europe, but also added another nutritional disease, pellagra Pellagra: niacin (a B vitamin) deficiency disease Pellagra symptoms. The four D’s: Diarrhea, Dermatitis, Dementia, Death. Also mouth ulcers, nausea, vomiting, seizures and balance disorder (ataxia). Enlightenment Conceptions of Disease Environment Enlightenment thinkers believed that the environment brought disease Connection between environment and human health/disease changed European views regarding human cleanliness & odors In 18th century France, the use of water in bathing acquired associations with health Bathing with water was thought to contract the body's organs and thus harden or toughen them. Enlightenment - the importance of the environment The odors of cemeteries, rubbish, cesspools, and sewers came under attack Air had become the health problem, the nose was a diagnostic tool, and clean water was the solution to the filthy atmosphere that bred disease Through drainage, ventilation, washing (lavation), and re-interment (burying the dead) Europeans fought the vectors of disease though they did not understand the causes of diseases Liberal Enlightenment opinion opposed governments infringements on liberty. They did not approve of quarantines and health passes Changing Views of Disease In medieval time disease was thought to be primarily internal In the 19th century, disease was thought to have an external cause; and to be due to an invading microorganism (Anton van Leeuwenhoek discovers “animalcules” in around 1683) Development of specific remedies for specific diseases furthered the idea that diseases were caused by particular disease entities Medical Credentialing & Hospitals Following 1794, more hospitals opened, overcrowding was reduced, and doctors and hospitals began to specialize specialization contributed to the idea of separate disease entities In 1803 the government provided for a uniform state licensing system for physicians and surgeons each was now required to complete 4 years of medical education and then a state examination. Insanity and Madness 18th century views on madness departed from traditional ideas based on religion (possession by evil spirits) or humoral imbalances Instead scientific thinkers associated madness with chemical or mechanical causes in digestive or nervous systems Enlightenment thinkers believed the social environment was important as a cause and as a solution This led to a different view of the mad, and to different forms of care; the mad were now viewed more as victims Care of the insane came to be viewed as a medical problem that could possibly be cured possibly by opium, chemical preparations, electric shock Some doctors specialized Ethical Dilemmas in the treatment of the Mentally Ill In the past mentally ill people were often committed and “locked up” in insane asylums against their will. 1. Was this necessary and appropriate given the state of medical knowledge, extent of governmental authority and the socio/economic systems of the day? Why or why not? 2. How are the mentally ill treated in the present-day USA? Are people still locked up in insane asylums, dosed with medication, or forced undergo dangerous or invasive treatments against their will? Under what circumstances, if any, would it be necessary and appropriate to do so? What is the role of government? 3. What is the relationship between the Criminal Justice system and mental illness? The Enlightenment Attacks Disease Enlightenment responses to smallpox and scurvy illustrate how the new science employed experimental methods and strove to reduce disease The eradication of smallpox is one of humankind’s greatest medical achievements Smallpox in Europe Smallpox, once a common childhood disease became much more serious & deadly in 16th century, killing thousands Three orthopox viruses cause human disease: Variola major causes smallpox Variola minor much less lethal; death in 1% of cases Variola intermedius - illness of intermediate severity Immunity to one orthopox virus confers some level of immunity to the others Definitions Variolation: inoculation using material from smallpox lesions; (variola = smallpox) - rub material into small scratch of healthy person Vaccination: inoculation using material from cowpox; from Jenner’s use of the Variolae vaccinae = smallpox of the cow; safer procedure in 19th century Louis Pasteur proposed that smallpox inoculation technique be referred to as vaccine and vaccination Immunization: all vaccines plus use of antitoxins which uses preformed antibodies against such toxins as the diphtheria or tetanus toxin Variolation Material from smallpox lesion placed in nose or skin of healthy