Summary:

In this account of early practitioners and advocates of 'inoculation,' or the use of tiny amounts of smallpox contagion to induce a mild case of smallpox and immunity, author Carrell weaves prodigious historical research with fictionalized dialogue to create a tale of two prominent figures: Lady Mary Wortley Montagu of London and Dr. Zabdiel Boylston of Boston. Both Lady Mary and Boylston suffered scarring from smallpox, and, by living in the early 18th century, both witnessed the devastation of epidemics in terms of public health and private loss.

Both were also aware of the use of inoculation to prevent severe disease in Turkey (Lady Mary visited with her ambassador husband) and in Africa (on the advice of Cotton Mather, Boylston interviewed Africans, slave and freemen, living in Boston). Both faced formidable challenges and risked personal security to promote the use of this technique. Both proved their belief in the technique by the inoculation of their own children. And both, perhaps, met. At the behest of the Royal Society, Boylston traveled to London, witnessed numerous inoculations, and presented his Boston experience to the Society.

The book also chronicles the natural course of the disease, its various symptoms, forms and popular treatments, and the political impact of smallpox on the royal families of Europe and business interests in Boston. The medical research of various doctors is detailed. In particular, selected Newgate prisoners were offered pardon in return for participation in an experiment conducted by Mr. Maitland, who also inoculated Lady Mary's children. These experiments were used to test the safety and efficacy of inoculation prior to royal inoculation.

Ultimately, detractors of inoculation ceased their vitriolic attacks, as the risks of inoculation were proven to be far lower than exposure without such protection. The success of inoculation paved the way for Edward Jenner, often called 'the father of immunology,' to successfully use cowpox to induce smallpox immunity later in the 18th century.

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In the not too distant future, the morose Egyptian, Antar, works in New York City, as a home-based computer employee, monitoring artifacts which he can study holographically through cyber space. He conjures up the I.D. card of one L. Murugan, who had supposedly disappeared in Calcutta back in 1995. Murugan is/was an expert on Nobel laureate Ronald Ross, discoverer of the role of the anopheles mosquito in the transmission of malaria.

Through flashbacks to the intense week of his disappearance and to episodes in the late nineteenth century, the virtual Murugan roams Calcutta trying desperately to understand and expose a subtext of counter science in Ross's laboratory. He is joined by Urmila, a journalist whose life is endangered by their collaboration.

Murugan theorizes that Ross was sloppy, intent on fame and fortune though a simplistic rendering of the parasite-host relationship; his discoveries were fed to him by others and he was blind to the spiritualistic ambitions of Mangala, his Indian laboratory technologist. Conceiving of the powerful significance of malaria prevention and control, Mangala held different views on the purpose and means of investigating the disease and, Murugan thinks, she anticipated the later discovery of another Nobel laureate, J. Wagner-Jauregg, in the use of malaria for the treatment of syphilis. The travels of Murugan and Urmila imply that these views are still there awaiting their own discovery.

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The book opens with a thought "exercise": thirteen short essays, each in a different national voice and beginning "We, the people of a nation . . . " The honest, intelligent "speakers" love their countries and traditions; however, they try to express the ugly truths about their homelands as challenges for the future.

For example, American smugness over its know-how and wealth combines with American failure to recognize the resentment sparked elsewhere by these same attributes. Similarly, the mutual intolerance of Canada's linguistic and religious duality is portrayed as a grotesque irony. The U.S.S.R. has exchanged an old tyranny for a new; Japan must face the issue of controlling its population, if it is to control its impulse to aggression.

Chisholm then returns to his role as a socially committed psychiatrist who hopes to avert a war that could annihilate the human species. World aggression, he writes, is caused by the "anxiety" that emerges from intolerance typifying narrow parental guidance and even narrower systems of education and religion. People must learn to be comfortable with differences in population, race, language, and wealth. The message is simple: "anxiety" leads to "aggression." The book ends with a ideal curriculum for "world citizenship," surprisingly different from any currently in use.

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In 1921, the twenty-four year-old Scottish medical graduate, Andrew Manson, takes up an assistant’s position in a small Welsh mining town. He is idealistic, but he quickly learns that his training is inadequate and that his hemiplegic employer will never return to practice. Manson must do all the work for a pittance and bad food. He befriends another assistant, the surgeon Phillip Denny, whose fatal flaw is devotion to drink. Together they solve the town’s problem with typhoid by blowing up the sewer.

Manson’s escape comes in a new job in a larger town and marriage to the equally idealistic Christine. She encourages him to continue his studies and to conduct research on the relationship between dust inhalation and tuberculosis. The results include higher degrees and international recognition, but they also bring about the wrath of the town’s antivivisectionists. To add to the gloom, Christine looses a much wanted pregnancy and the ability to have children.

The Mansons leave Wales for London, where Manson hopes to extend his research within a government agency. Quickly disillusioned by bureaucracy, he is lured into society practice and slowly abandons his ideals in exchange for prestige and wealth. Christine is increasingly unhappy, but his response is annoyance with her and an affair with a married woman. When one of his new associates botches an elective operation on a trusting patient, he realizes the colleague is nothing more than a society abortionist and that he and his new friends are little better.

He decides to sell his practice and renews contact with Denny to establish a group consulting practice "on scientific principles" in a carefully chosen Midland town. He also helps the tubercular daughter of an old friend to an unorthodox (but effective) pneumothorax in a clinic run by Stillman, an American who does not have an MD. Just as he and Christine have rediscovered joy in each other and their future together, she is killed in a freak accident. Only days later in the depths of grief, he is brought before the General Medical Council on charges of unprofessional conduct laid by his former associates. He acquits himself brilliantly and leaves with his old friend Denny for work in the Midlands.

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Please note that in order to properly annotate this novel, the novel's surprise ending will be revealed here. Snowman--who used to be called, Jimmy--is a rare survivor of a dreadful catastrophe that seems to have been both the product and the demise of modern science. He lives in a tree, clad in rags, hiding from relentless heat and hoarding his precarious cache of food and alcohol, while he tries to obliterate consciousness and avoid contact with a peculiar race of beings, the Crakers. Through a series of reminiscences as he makes his way back to where he once worked, Snowman's past slowly advances to meet his future.

The world heated up to be uninhabitable desert and genetic engineering created more problems (and species! [pigoons, rakunks, wolvogs]) than solutions. People became increasingly reliant on artificial environments--both internal and external--while their purveyors--drug and technology firms--held ever greater but unthinking power. The world was divided into two: the rich, safe controlled spaces and the dangerous chaotic realm of the poor. Then an epidemic wiped out most of the human race.

Two friends are central to the story: brilliant but inscrutable Crake whose nerdy gift for science had a role in engineering the 'pure' Crakers and the horrifying world that they occupy; and beautiful, seductive Oryx whose regard of knowing innocence heaps scorn upon messy human desire and emotion. They are the Yin and Yang of the "constructed" world. Only at the end, the reader learns that Oryx was murdered by Crake, who was slain by Snowman. It seems that his arduous journey was simply to destroy the history of the events that he had written and left behind.

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This documentary film is narrated by Dustin Hoffman; all other characters play themselves. Five stories (pathographies) introduced as panels from the 14-acre AIDS quilt are interwoven with each other, together with personal photos, newsreels and radio reports to recount the history of the first decade of AIDS in the United States.

Tom was a highly educated and athletic, gay man whose story is told by his lesbian friend and co-parent of his adored little daughter. Rob was a married Afro-American, I.V.-drug-user whose loving wife recounts his battle with drugs as well as his disease and who views her own HIV seropositivity as "God’s will." Jeff’s story is told by his grieving male lover over images of his once golden health.

The parents of twelve-year-old hemophiliac, David, tell the story of his entire life as a rush to consume, from his babyhood forward until the sadness of his last Christmas. The shy, handsome architect, David, is mourned by his bisexual lover, a naval officer at the Pentagon, who now lies dying with the lesions of Kaposi’s sarcoma quite visible on his face.

The narrators describe solace they derived from quilting memorial panels for their loved ones. In the final scene, the AIDS quilt lies on the Mall in Washington as names of hundreds of loved ones are read by grieving families and friends.

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Idealistic, nervous, and rigid, Andrew Manson (Robert Donat) takes his first medical job as an assistant to a doctor in a Welsh mining community. The greedy wife of his invalid employer obliges Manson to hand over most of his earnings. But he finds a local kindred spirit in the outspoken Dr. Denny (Ralph Richardson). In a drunken prank, they blow up the town sewer forcing the unwilling government to repair a notorious source of typhoid.

Manson marries a beautiful school teacher (Rosalind Russell) who leaves her beloved classroom to follow him to an even larger mining town. There he is employed by a group practice run on a capitation basis by the miners. In their evenings, the Mansons investigate the problem of chronic cough in miners, linking it to tuberculosis and coal dust--a discovery that they publish. But suspicious miners destroy their laboratory and force them to London and poverty.

A chance encounter with a wealthy hysteric and an old mate (Rex Harrison) raises Manson’s social standing. He opens a Harley Street practice and makes a fortune. His wife regrets the loss of his ideals and the death of his research. She begs him to remember how happy they were in poverty when each day was a noble challenge to take "the citadel" of life. Denny returns to entice Manson into a new group practice funded by community insurance, but Manson flatly refuses. Denny’s accidental death and a blunder by an elite, unethical Harley Street surgeon bring Andrew back to his idealistic senses.

The film closes with his eloquent self defense against charges of irregular practice for having intervened (successfully) in the case of a little girl with tuberculosis. Manson assists as the child is treated gratis with the controversial new pneumothorax operation administered by an American who does not hold a medical degree. Whether or not Manson keeps his license, the audience is confident that his sense of purpose has been restored and that his wife loves him more than ever. He will return both to the comfortably compatible pursuits of research and serving the sick poor.

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As a medical student, Martin Arrowsmith (Ronald Colman) approaches the revered Professor Gottlieb (A. E. Anson) wishing to accelerate his studies into bacteriology research. Gottlieb insists that he complete his clinical training first. But Arrowsmith meets the cheeky nurse Leora (Helen Hayes) and throws over his plans for science in order to earn a marriage-sustaining living as a general practitioner in her native South Dakota.

Assuaging his undying passion for research (in the family kitchen), he takes on the problem of an epidemic of black leg disease of cattle and earns the animus of a veterinarian and the admiration of the Swedish farmers by single-handedly disproving the efficacy of a government serum, developing his own serum, and conducting a controlled trial to prove its worth. His frustrated and unemployed wife--now displaced from her own kitchen--continues to support him, answering always "Yes, Martin. No, Martin. Whatever you say, Martin."

The couple move to New York City where Arrowsmith intends to devote himself full time to science at the side of his old hero Gottlieb in the McGurk Institute (a thinly disguised Rockefeller Institute). In his new laboratory, Arrowsmith utters a prayer for clear vision and humility--a prayer that seems to go unanswered.

Late one snowy night after two years of fruitless work, he discovers that "something" (in the novel, it is bacteriophage) has killed the bacteria he has been incubating. "Is it important, Martin?" asks Leora. He is brutal in his zealous response, his eyes gleaming with the promise of promotion, fame, and fortune. But after days of exhausting labour, he learns that he has been scooped by Felix D’Herelle a (real) researcher at the Pasteur Institute.

Arrowsmith quickly finds a new passion and travels to the Caribbean to conduct research into the effect of a serum on bubonic plague. Gottlieb makes him promise to act like a scientist (not a G.P. or a quack) and to withhold the remedy from half his patients. He tries to convince the colonial authorities of the importance of controlled testing, but is rebuffed with accusations of turning humans into guinea pigs. A black medical graduate of Howard University invites him to a different island where the epidemic is so thick that the people willingly cooperate with the controlled trial.

Leora, who had refused to remain in New York, is now left behind. The film implies clumsily that the now solitary Arrowsmith--ecstatic to be back in the research trenches--has a romantic encounter with Joyce, a beautiful stranded tourist (Myrna Loy). Meanwhile, Leora contracts plague from a cigarette, which has absorbed plague germs from Martin’s sloppy lab technique, and which she smokes because of Martin’s inattention and abandonment. She dies miserably and alone.

Crazed with remorse, Arrowsmith abandons his scientific principles and allows the entire population to be treated with the serum after all. The epidemic is arrested. But Martin knows that his success does not justify his scientific sin. Still grieving for Leora, he returns to New York to much fanfare, but is unable to find absolution from Gottlieb who has just had a stroke. He runs out on his lover, his institute, and a press conference to join a friend who is establishing a Walden-like institute dedicated to pure research in Vermont.

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Winter surveys the rise and fall of mesmerism in Victorian Britain, from animal magnetism to hypnotism, including electrobiology (a form of group hysteria), table-turning, and other fads. The book offers rich detail about the different stages of the use of mesmerism in medicine: its initial appearance in staged experiments; its uncertain status and the struggle to locate the boundary demarcating alternative medicines; its performance by professional medical men as well as travelers and quacks; its importance in the development of anesthesia; and its role in prompting skeptical scientists to consider the possibility of mental reflexes as one way to explain away mesmeric phenomena.

Winter argues that mesmerism was not "illegitimate" so much as it brought "legitimacy" itself - of medical authority, of evidence, of knowledge -- into question. Thus, she argues, mesmerism crucially inspired many of the considerable changes in nineteenth-century medicine as well as the reorganization of science and the educational reforms of the later nineteenth century. The book also discusses mesmerism as a form of religion, as a conduit for spiritualism and communication with the dead, as a catalyst in orchestral conducting, and as a model for liberal political consensus.

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Thirteen-year-old Jessie Keyser likes to accompany her mother, a midwife, to homes where there are births or illnesses. Her father is a blacksmith. She and her five siblings live in a log cabin in a small village. They believe the year is 1840. What Jessie doesn't know is that she lives in a replica of a 19th-century village and that the year is actually 1996.

When local children begin to fall ill of diphtheria, Jessie's mother takes her into the woods, provides her with food, blue jeans and a T-shirt, instructions on how to use a telephone, and amazing stories of the world outside that she and Jessie's father left when they joined the experimental colony. Jessie learns that tourists view them at their daily activities through hidden cameras. Now she is to escape and get needed medicine.

Armed guards surround the village. Safely outside the gates, Jessie wanders disoriented in 1996, looking for someone safe to ask for help. She finally talks to reporters who broadcast the news and send help immediately to the town. Medicines are brought and some children saved, though diphtheria has taken several lives. Jessie enters the present with some ambivalence, realizing there are large tradeoffs to leaving the simplicity of the past.

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