The Drug Hunters by Donald R Kirsch & Ogi Ogas

Author:Donald R Kirsch & Ogi Ogas [Kirsch, Donald R & Ogas, Ogi]
Language: eng
Format: epub
ISBN: 9781628727180
Publisher: Arcade Publishing
Published: 2016-12-12T20:00:00+00:00

10

From Blue Death to Beta Blockers

The Library of Epidemiological Medicine

John Snow’s map of cholera

“Superior doctors prevent the disease from happening, mediocre doctors treat the disease before fully evident, inferior doctors treat the disease after it is apparent to everyone.”

—Huang Dee Nai-Ching, 2600 BC

Cholera is a particularly nasty disease of the small intestine whose prime symptom is “rice water,” a watery diarrhea redolent of fish. A victim may excrete up to five gallons of diarrhea each day. Vomiting and muscle cramps are common. The resulting dehydration is often so drastic that a victim’s electrolytes become unbalanced, debilitating the heart and brain. Cholera is called “the blue death” because the afflicted’s skin can turn bluish-gray from the extreme loss of fluids. Without treatment, about half of the disease’s victims die.

Throughout the nineteenth century, wave after wave of cholera pandemics swept through Europe and much of the world. The second wave decimated Ireland in 1849, killing off many of those who had been lucky enough to survive the Irish potato famine. The epidemic then washed up on American shores via ships crammed with Irish immigrants, eventually infecting President James K. Polk. The disease swept west and extinguished some six thousand to twelve thousand travelers along the California, Mormon, and Oregon trails, mostly pioneers hoping to make their fortune in the California Gold Rush before the ill fortune of rice water put an end to their dreams. As this virulent wave was finally winding down, a brand new globe-hopping wave of cholera came bursting out of India and smashed into London in 1853.

The Blue Death claimed the lives of more than ten thousand Londoners in a single year. One man who became obsessed with the terrifying intestinal disease was an English physician named John Snow. The son of a coal laborer, Snow had grown up in poverty in one of the poorest neighborhoods in York, where his family’s ramshackle house was flooded every time the nearby River Ouse overflowed its banks—and it overflowed often. Snow was working as an anesthesiologist at St. George’s Hospital in London during the new pandemic, and on August 31, 1854, he took charge of treating cholera patients in the Soho district where he lived. Over the next three days, 127 Soho residents died. By the end of the following week, three quarters of the entire population of Soho had fled, rendering the vacant neighborhood a ghost town. By the end of the next month, out of the scant citizenry left behind, another five hundred had died, with far greater losses throughout the rest of England. Snow later called it “the most terrible outbreak of cholera which ever occurred in this kingdom.”

Nobody had the vaguest idea what caused cholera or what its risk factors might be. The London outbreak occurred seven years prior to Louis Pasteur’s publication of the germ theory of disease and forty years before Robert Koch (who won the Nobel for showing that a bacterium caused tuberculosis) finally convinced the medical community that cholera and other diseases were truly caused by germs.

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