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GUEST TRIAL: History Can Teach Us Important Lessons | Local

RICHARD P. LEACH, MD

Smallpox, a viral disease, has ravaged human populations in small and massive epidemics around the world for three to four thousand years. We probably got some cattle when we started herding them. Over the centuries, we know that pandemics of smallpox and other infections have changed history many times over, usually because a terrible epidemic weakened one army more than another. Armies, city-states and empires have fallen far more from epidemics of infectious diseases than from weapons of war. Think of the indigenous peoples of North and South America, for example.

Around here, the great archaeologist David Starbuck introduced many of us to the critical role that the smallpox epidemics played in the French and Indian war, especially through its discovery and excavation at Rogers Island off Fort Edward. . There he discovered a huge hospital used for smallpox victims in the mid-1700s.

Due to a truly incredible global vaccination effort, smallpox was eradicated from the world’s human population in 1977. However, the virus still exists today in so-called highly supervised laboratories in the United States and Russia. Shortly after the terrorist attacks of September 11, 2001, there was much concern that smallpox might have been removed from the Russian laboratory and could be in the hands of terrorists. In early 2002, due to a concern that we might see and have to deal with the virus even here, I presented a science lecture at Glens Falls Hospital to educate our medical community about its potential as a bioterrorist weapon and on the disease itself.

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I had the pleasure and honor to introduce David Starbuck as co-presenter. He spoke to the fascinated public about his work on Rogers Island and Fort William Henry. He recounted the events of 1757 in our region which led to the British surrender at Fort William Henry to the French and their Indian allies. The aftermath of this British loss included the famous massacre of surrendered troops retreating to Fort Edward by the Indians, which was featured in “The Last of the Mohicans” by James Fenimore Cooper. He also recounted the murder and scalping of British troops sick with smallpox. He noted that following the French victory, these Indian allies disappeared, thus depriving General Montcalm and the French of sufficient troops to attack Fort Edward. He hypothesized that by developing smallpox these Indians fled to their Canadian homes, where outbreaks of the disease were later documented to take hold. If Montcalm had been able to conquer Fort Edward, we who live here might speak French. Of course, Starbuck also recounted that blankets infected with scales from the open wounds of soldiers dying of the disease could have been used by the British as biological weapons to infect and kill the French allied Native Americans who besieged the British at Fort Pitt in Pennsylvania in 1763.

There is another remarkable story in the history of smallpox in early America that should be much better known: its role in the War of Independence. It was understood at the time that if one survived smallpox – there was probably a death rate of 33% at the time – one would no longer be infected. The word “immunity” did not exist at the time, but of course that is. George Washington actually had the disease as a teenager in Barbados in 1751 and survived a moderately severe case that held him back for months. With this he knew firsthand how serious the disease was. He also knew that the British soldiers, which his troops faced during the Revolution, had experienced many more exposures to smallpox and disease in their home countries than the Americans had here, and that they were therefore much less likely to contract the disease than our troops. When serious epidemics began to reproduce in the colonies in 1775 and 1776, Washington’s army was in serious danger of being devastated… the British, not so much. If that had happened, we might still be flying the Union Jack.

By the early 1700s, a process called variolation – a very early and crude form of vaccination – had started to be popularized by clergyman Cotton Mather around Boston. It was a poorly understood and dangerous process that involved taking pus from a skin lesion of a smallpox victim and plunging it into an incision made in the skin of a recipient. This then led to the development of a case of the disease. Because the infection was what one might very loosely call “controlled,” it was usually a milder case, with only perhaps a nasty month-long illness and a death rate of 3. % to 5% only. Surviving the process was shown at the time to confer lasting protection against a more wicked and deadly case acquired in the usual way.

During a disease outbreak in Boston in the 1760s, John Adams decided to have smallpox. Fortunately, he survived and was therefore immune, like Washington. Later, his wife Abigail decided to have their children variolized. They too survived. Abigail, who was a strong voice against slavery and for women’s rights, became an ardent popularizer of the process. When terrible epidemics broke out in the colonies in the mid-1770s, Washington, with the wise advice of John and Abigail Adams, made the courageous decision to diversify its troops in 1776. In explaining his decision, he described smallpox as a potentially greater threat. than the sword of the enemy. Most of the time, the vaccination campaign was undertaken during the desperate winter in Valley Forge. Imagine not having enough food or firewood, maybe not even shoes to walk in the snow, and then being beaten with a “mild” case of smallpox. By the way, Washington demanded it of its troops – it mandated vaccination. And his men obeyed.

The army survived with enough force, and spring has come, and … well, you know the rest.

It is a great story in the great story of our Revolution. We should all know that. But especially now in the midst of our pandemic, it can teach us some current and really important lessons.

First, there have been terrible pandemics of all kinds that have struck humans down and have been defining for thousands of years of our history. Our COVID-19 is only the most recent. Well, that’s pretty awful too. American deaths are approaching one million. Second, there is over 300 years of vaccination history. Science has advanced considerably over these centuries, and scientists using the tools of science have developed vaccines against many diseases and have brilliantly improved their safety and effectiveness. Our COVID-19 vaccines are, of course, the most recent. At the peak of all these upgrades, they’re some of the best ever. Third, and perhaps most important, there is still an urgent need in a pandemic crisis like ours to study existing science and come to a current conclusion on how to avoid getting sick and possibly dying. . “Waiting and seeing what happens” can lead to a crucial outcome, perhaps in a bad way. The Adams and George Washington studied what was then known, concluded what was best for them and the country, accepted the then known risks of the path they chose, and then acted on their conclusions. .

We Americans are the beneficiaries of their dramatic wisdom and courage. Are you wise and courageous?

Richard P. Leach, MD, is an internist, infectious disease consultant, and travel and tropical medicine specialist. He practiced in Glens Falls for 35 years, also serving as an infection control officer and epidemiologist at Glens Falls Hospital. Retiring from private practice in 2011, he continued to provide travel medicine advice at the Warren County clinic until COVID-19 forced it to be canceled. Warren County keeps him as medical director and consultant for the TB program. Dr Leach is known for his role as co-founder and chairman of the Adirondack AIDS Task Force in the 1980s and 1990s, as the founder and chairman of the Glens Falls medical mission and its Guatemala project in the 1990s. , as husband of Dr Loren Baim, as father of Christina Johnston, Timothy Leach, Molly Leach and Marta Leach, and as grandfather of Rhone and Thatcher James, 3 weeks.


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