Birth Story

Glass-making is an ancient art, originally developed in the Middle East. Its secrets have been lost, re-discovered at different times and in different processes, and eventually spread around the world. The magnifying properties of glass were obvious and often remarked upon.

Modern lenses evolved from reading stones — rock crystal, for example, that was shaped into magnifiers, the first step toward creating instruments that would make the minute world visible.

Reading stone

The scientist and mathematician Abu Ali Hasan Ibn Al-Haitham, also known as Alhazen, "the father of modern optics," working in 11th-century Spain, described many of the properties of light, including refraction and color, as well as the magnifying properties of  lenses.

In 1604, Johannes Kepler, the great German mathematician, astronomer and inventor, published Optics, an astonishing treatise that covered the nature and action of light, as well as the mechanics of sight. Optics became part of the bedrock of physics.

In 1611, Kepler improved on Galileo's telescope by replacing its concave eyepiece with a convex one. (Candidates abound for the honor of inventing the telescope, around 1600.)

Incidentally, Kepler's mother, Katharina, was accused of witchcraft in 1615, when she was about 70. He handled her defense himself, eventually winning her acquittal. Katharina Kepler reportedly had played a part in her son's lifelong love affair with the heavens: When he was six years old, she took him to "a high place" so he could see the spectacle of the Great Comet of 1577 in the night sky.

Image from Zeiss Optical Museum

President Franklin Roosevelt founded the forerunner of the March of Dimes, the National Foundation for Infantile Paralysis, in 1938, to raise money for research to find a cure for poliomyelitis, and to care for victims of the disease.

Roosevelt himself was paralyzed after being stricken by "polio," also called infantile paralysis, in 1921. The NFIP itself was an expansion of Roosevelt's Warm Springs Foundation, which sponsored a rehabilitation center for polio victims in Warm Springs, Ga.

In 1938, during a radio fund-raising campaign for the NFIP, the entertainer Eddie Cantor coined the term "The March of Dimes" as he urged listeners to contribute their spare change to defeat polio. The term, as Cantor used it, was a play on the popular newsreel series "The March of Time."

The campaign against polio is one of the great medical success stories. The March of Dimes provided the money for the development of two effective vaccines, by Jonas Salk and Albert Sabin. Within little more than a decade, polio was reduced from one of the scourges of the 20th century to a footnote in the 21st.

A global effort to eradicate polio altogether by the year 2000 fell short; the latest target date for eradication, in parts of Africa and Asia, is 2013.

In 1958, with polio under control in the United States, the March of Dimes re-directed its efforts toward a new campaign, to eliminate birth defects. The following year, Dr. Virginia Apgar, who in 1953 had devised a scoring system for the well being of newborns, joined the organization that was then still headed by President Roosevelt's former law partner, Basil O'Connor.

For the past half-century, the March of Dimes has been involved in virtually every effort undertaken to improve the health of babies in this country and, more recently, around the world.

The March of Dimes supported research that showed that a pregnant woman's consumption of alcohol could cause birth defects, as well as the development of surfactant therapy for premature babies with respiratory distress, to name a couple.

Image from Wikimedia Commons

The Black Plague, which wiped out perhaps a third of the population of Europe, demanded an explanation, and the medical establishment of the time responded as well as it could.

The most popular conjectures about the pestilence were variations on the miasmic theory of disease, an idea that went back at least to the ancient Greeks — that disease was essentially bad air. ("Miasma" was the Greek word for pollution.)

Hundreds of treatises about the epidemic survive, many of them written in the mid-14th century, when the plague was at its height. One written by members of the faculty at the medical school at the University of Paris, in response to a request from their king, Philip VI, mixed humoral and miasmic theories: The planets had aligned in such a way as to poison the air.

Another theory held that a series of earthquakes in Europe had released corrupt air from the middle of the earth. A third had the plague wafting in on noxious winds from the equator.

The cause of the plague was actually Yersinia pestis, a murderous bacterium spread by the bite of rodent fleas in the primary, "bubonic" phase, characterized by swollen lymph nodes and other symptoms. The plague can also be spread by infected droplets exhaled by its victims in a less common but deadlier "pneumonic" phase.

The plague was a catastrophe for Europe, but it did usher in reforms. It pushed the medical community toward a more professional approach to its practice, an increased emphasis on public health and the establishment of hospitals that would treat the sick, rather than merely warehouse them away from the healthy population, according to The Black Death: Natural and Human Disaster in Medieval Europe, by Robert S. Gottfried.

Frustration with the utter failure of the medical establishment to discern the pandemic's cause, stop its spread or treat it effectively helped create an environment from which the scientific method emerged.

The Black Death came to Europe in the 14th century, probably mostly aboard merchant ships from the Crimean peninsula in the Black Sea, though soldiers returning from late, intermittent Crusade-type forays likely contributed to the pandemic as well.

One early episode in this notorious outbreak of plague demonstrates that its victims had the misfortune to learn firsthand that the disease could be transmitted from person to person.

In 1346, a Tartar army laid seige to Caffa, a port in Crimea, now an autonomous republic just south of Ukraine. Caffa, now called Feodosija, was then held by Genoa, a mighty Italian city-state and commercial power. The seige lasted three years, and the residents and refugees in Caffa were in a bad way by the end. But then the Tartars began to die in great numbers from a horrific disease, and the tide appeared to be turning.

The remaining Tartars got the idea of catapulting the rotting corpses of their plague victims into the walled city of Caffa. Apparently, the Tartars' hope was that the "intolerable stench would kill everyone inside," according to an account by the Italian notary and writer Gabriele de’ Mussi. At the time, "miasmas," or noxious airs from rotting organic matter, were thought to be one source of disease.

Soon, even though the cadavers were dumped into the sea, people began to die in the besieged city. And then, the survivors began to flee.

De' Mussi writes:

Among those who escaped from Caffa by boat were a few sailors who had been infected with the poisonous disease. Some boats were bound for Genoa, others went to Venice and to other Christian areas. When the sailors reached these places and mixed with the people there, it was as if they had brought evil spirits with them: every city, every settlement, every place was poisoned by the contagious pestilence, and their inhabitants, both men and women, died suddenly. And when one person had contracted the illness, he poisoned his whole family even as he fell and died, so that those preparing to bury his body were seized by death in the same way.

De' Mussi was not an eye-witness to the events in Caffa. However, his account preserved not only the details of what has been remarked upon as an early instance of biological warfare, but also what the survivors learned about how diseases can be transmitted.

The germ theory of disease, which holds that certain diseases are caused by living organisms, occurred to people thousands of years ago, but  it was proved only in the 19th century.

In the western tradition, the Roman scholar Marcus Terentius Varro first laid out the germ theory in his book, On Agriculture, a practical guide published in about 36 B.C. In it, Varro advises the farmer against building near swamps because “certain minute animals, invisible to the eye, breed there and, borne by the air, reach inside the body by way of the mouth and nose and cause diseases that are difficult to get rid of.”

Varro was a prodigious scholar and well known public figure, and his works were highly influential. However, at least some of his contemporaries, apparently including the writer/philosopher/statesman Marcus Tullius Cicero, considered his germ theory a crackpot idea.

It is worth noting that the Atharva Veda, the first Indian book that addresses medical topics, includes a fairly detailed germ theory. The book identifies a number of living organisms that were deemed responsible for causing various diseases, and prescribes cures to kill the organisms. The Atharva Veda was written down about 200 B.C., but its ideas may date as far back as 1,000 B.C.

The "humoral theory" of disease, which originated with Hippocrates (who lived from about 460 to about 370 B.C.) and lasted until the early 20th century, held that a balance had to be maintained among four humors or liquid substances in the human body. If that balance got out of whack, the thinking was, people got sick.

The four humors were black bile, red or yellow bile, blood and phlegm. The ancients believed that these substances ruled our personalities as well as our bodies. They divided all the possible character types into these four — melancholic, choleric, sanguine and phlegmatic — depending on which substance dominated that particular person.

Treatments for disease were designed to restore the balance among the humors, but what worked for one person might not work for another, which helped let practitioners off the hook if a "cure" didn't work. Purges like enemas and emetics were popular, and physicians often advised changes to a patient's diet or routine. Blood-letting was an especially durable cure for just about anything.

During labor, for example, "some women were bled to unconsciousness to counter delivery pains" or any other complications large or small, according to Peter Conrad's The Sociology of Health and Illness.

The acceptance of the germ theory finally put an end to humoral theory in mainstream medical thought.

"There is not a corner in Britain where this formidable disease has not made many mourners,”  John Mackintosh, an Edinburgh, Scotland "man-midwife" wrote of puerperal or "childbed" fever in the 1820s.

This bacterial disease of the upper genital tract typically began within the first three days after childbirth with abdominal pain, fever and respiratory difficulty, and very often ended with the new mother's death.

Medical writers had been remarking on childbed fever at least since Hippocrates, but in the early modern era, it began to attract attention for a number of reasons. For one, it began to appear in epidemics, with very high mortality rates. For another, accounts of outbreaks were written about and published. And at least some of the new, scientific man-midwives themselves were spreading the disease by going straight from autopsies to the birth chambers of homes and especially of hospitals, without cleaning up at all in between.

There were terrible epidemics of puerperal fever in the German city of Leipzig  in 1652 and 1665, at the Hôtel Dieu in Paris, France, in 1745 and 1746, and at the British Lying-In Hospital in London, England, in 1760. It is possible that these were the first ever epidemics of childbed fever.

Trepanning is the world's oldest surgery. A procedure in which a hole up to two inches in diameter is cut in the skull, trepanning is known to have been performed at least 8,500 years ago, and trepanned skulls have been found all over the world.

Why it was performed all those years ago is a mystery. Healing at many of the wounds tells us that at least some subjects survived — and in some places, there were many subjects.

Perhaps the ancients knew that trepanning, also known as trephination, could relieve pressure on a swollen brain. Perhaps they were hoping to rid one of their clan members of evil spirits, or cure mental illness, or clean up a head wound.

Trepanning has been performed throughout history. A modern trephination movement, founded in the Netherlands in the 1960s, holds that cutting a hole in adults' heads allows their consciousness to expand. That movement has its adherents in the United States as well.

Bernard Fantus, the Hungarian-born physician who was the director of "therapeutics" at Cook County Hospital in Chicago, Ill., established the first "blood bank" in 1937.

Until then, a donor had to be on-site at the time of a blood transfusion.

Bernard Fantus

Dr. Fantus also coined the term "blood bank," in an article in the Journal of the American Medical Association that year that set out the hospital's methodology in clear, understandable terms.

Other institutions swiftly developed their own blood-storage facilities, and helped themselves to Fantus's catchy term as well.

Cook County's blood-storage innovation came at a critical time, just a few years before the start of World War II, when blood donated by people thousands of miles from the battlefronts would make the difference between life and death for a great many injured Allied soldiers.

Blood's ability to stop flowing — to clot — is a wondrous property that keeps us from bleeding to death after minor injuries. However, that trait was a major stumbling block to perfecting blood transfusions.

Even early in the 20th century, a few minutes into any transfusion, blood would begin to clump together in the tube that was carrying it from donor to recipient, and the technician would have to start over. Letting blood sit in a container for any length of time was out of the question.

Richard Lewisohn

A number of researchers were working on the problem. The Belgian physician Albert Hustin, and the Argentinian doctor Luis Agote, both hit on the anticoagulant properties of sodium citrate in 1914, but the bad news was that the common compound was toxic in blood.

Dr. Richard Lewisohn of New York's Mount Sinai Hospital solved that problem with exhaustive experiments.  The German-born Lewisohn, who had trained at the excellent University of Freiburg, discovered the concentration at which sodium citrate could keep blood liquid without poisoning the transfusion recipient.

At first, it looked as if sodium citrate had a worrisome set of side effects, but Lewisohn proved that those were caused by infectious agents in poorly cleaned equipment. In the end, he showed that a diluted sodium citrate concentrate in blood, deployed with meticuously maintained needles and tubes, worked just about perfectly. In fact, it is still used.

Once the medical profession accepted Lewisohn's elegant solution to the clotting conundrum — and that took years — blood transfusions were transformed from a traumatic undertaking to the routine procedure they are today.

In 1916, just in time for World War I, researchers determined that sodium citrate allowed blood to be stored outside the body for up to two weeks.