What we can ensure is that from the VI th century

Here, finally, in favor of the novelty of smallpox, is a last argument which, in my opinion, is not the least serious.

If this disease had existed in the time of the ancients, we do not may admit that they had not said anything about the scars so characteristic that she leaves behind her. In a society which professed the worship of form and set up altars to Beauty, the degrading work of smallpox would have raised a concert of curses, of which the writers of Rome and Athens would have transmitted the echoes. The Latin satirics especially, who seemed to take pleasure in the picture of skin diseases and the hideous stigmata with which they mark their victims, would have found in the aftermath of smallpox a subject always reborn with epigrams. The contemporaries of Coclès, Scævola, Corvinus, Cicero, Nasica, Lentulus, would not have spared the allusions to these faces in skimmer, illustrated by modern caricature.

This fact is so compromising to Hahn’s thesis that he has decided to deny it. He therefore asserts that the ancients often write these words: scars , seams ( scars , suturæ ) and that it is impossible to recognize the traces of confluent smallpox. He does not deny that they have reported other kinds of scars, if only those resulting from burns ; but as they insist on those which succeed to charcoal, and in their anthrax tumorous and pox-knot language are synonymous, Hahn does not foresee the slightest objection to his commentary.

He knows, however, that a host of eruptions, acute or chronic, unrelated to smallpox, leave indelible marks on the region where they sit. The scrofulids , in particular, have as their characteristic the production of scars which never fail, whether they have were preceded or not by ulcerations. Their depressed form, their cross-linked appearance, their adhesion to the underlying tissues, disfigure too often the subjects who are affected. These scars certainly have their place among those that the ancients have pointed out, but their origin removes them radically from those of smallpox.

Dermatologists have even noticed that the ulcerations of the pustular scrofulid of the face , end with scars whose meeting represents a surface, purplish at first, which then passes to the white, and imitates quite well the seams scars of certain confluent smallpox . Suppose the ancients, who no doubt knew them, would have given a faithful description of them, would they not have believed in the right to assert their variola origin?

Since the ancients have indeed spoken of cutaneous impressions quite foreign to smallpox, and they have never indicated these hollow features, which a very correct assimilation has compared to the effects of hail, one can not either to prejudge the mode of treatment they have prescribed to restore the normal state of the tissues.

Their writings abound in resolving, softening, caustic topicals, monstrous products of the pharmaceutical art of their time. But nothing proves that these agents are intended to repair the misdeeds of smallpox; and the efficiency attributed to them would suffice, in my opinion, to deny this conjecture. If we had once possessed a specimen capable of restoring hailed or stitched faces, we would have received it from tradition, and we would not deplore, after so many unsuccessful attempts, this lacuna in medical matters.

Criton, Trajan’s doctor, advises a series of topics against roughness , cracks , black scars , and guarantees the infallible virtue of certain lotions against the traces left on the figure by the kind of pimples called vari . Some physicians, deceived by the similarity of names have understood the marks of smallpox, and Hahn has adopted this interpretation eagerly ; but the question is emptied a long time ago. The eruption in question is different from that of smallpox, by its form, its course, its origin, and the internal morbid mode which it translates.

Dioscorides also extolled substances capable of effacing the deformed scars of the face, which he has carefully distinguished from those which follow the wounds of war; there is no reason to suppose that he had in view the smallpox marks.

Pliny, her contemporary, insists on the same remedies, and recommends to women the use of litharge as the best remedy of unsightly imprints, so detrimental to their beauty. It is exclusively for women that gives this advice under the pretext highly questionable, that men are much more accommodating to the chapter of their physical attractions .

This remark is not indifferent, because it suggests that Pliny has meant only those skin eruptions, transient or obstinate, which despair all the more women that their sex is more subject ( lentigo , ephelis , acne miliaris , rosacea , etc. ). What supports this conjecture is that Celsus makes the same restriction as Pliny, on the treatment of stigmata of the face. “How,” he says, “distract women from the importance they place on their beauty Whatever may be the degree of modesty of men, it is not acceptable that those who bore the marks of smallpox should have left to female coquetry the exclusive usufruct of a heroic means of restoration. In Pliny’s passage, therefore, it is only a special application of this cosmetics, of which Galen has faked the abuses with so much energy. All these drugs, these ointments, these oils, these powders, attributed to themselves the virtue of rendering to the complexion its freshness, to the skin its suppleness and its polish. I do not have to inquire to what extent the effects fulfilled the promises; but we will agree that we are far from the scars of smallpox and their panacea.

Avicenna, reproducing the passage of Dioscorides which I have indicated above, adds that he recommended silver scum ( argenti spuma ) against certain ophthalmias and against the traces of smallpox ( vestigia variolarum ) .

This time, Hahn sings victory, hearing appoint smallpox from the I st century AD. How did he not see that these words vestigia variolarum , were written by Avicenna, who lived in the X th century, or better to say, through his translator, and not by Dioscorides who, for good reasons, n never thought of using it. Whether the anachronism is due to the Arab author or his interpreter, Hahn deserves no less than the accuses him of being caught, for lack of reflection.

The partisans of the antiquity of smallpox have still made many arbitrary allegations that I could ask them to consider. I have already used too much of my reader’s time to not close this debate.

In short, if we abstract from the authors who defend this opinion by theoretical rather than suspicious views; of those who, at the price of a vicious circle, maintain that the ancients saw everything and in fact knew of diseases; of those who, like a chimera, reject the revolutions of pathology in the course of ages and, consequently, the accession of new diseases, we are entitled to certify that the immense majority of serious votes sanctioned recent origin of smallpox.

Thus, after careful examination, I have judged some physicians whose science is accustomed to respecting the decisions, and which I shall be allowed to call to testify to increase my personal credit.

“Smallpox,” says Martin Lister, “is a disease of a new kind; and although the ancients have mentioned a species of pustule which has appeared to some writers to be nothing but that of smallpox, what they have said is so concise and so vague, that it may be affirmed that the disease of which they speak is not that of our days. Admittedly, they would have been very careless if they had kept silent about such a serious, widespread, and frequent illness. What sufficiently demonstrates the novelty of this affection is that it is completely unknown in certain parts of the world . ”

Freind, the historian of medicine, is no less categorical.

“Since Hippocrates to us,” he says, “I do not think there is anything so remarkable as the birth of this new and astonishing disease .”

As for those who persist in arguing that smallpox and some other diseases of recent origin are known to the ancients, although they have not given an exact description, Freind gives up discussing “with stubborn minds which, for the honor of antiquity, would perhaps make us believe that the discovery of the circulation of blood does not belong to the moderns . ”

Mead, contemporary and friend of Freind, nourished like him of the marrow of the ancients, holds the same language.

“There is no doubt that smallpox is a new disease, that is, unknown to doctors of Greek and Roman antiquity. It is in vain that some authors have claimed that anthrax , epinyctides and other similar rashes of the skin were the smallpox of our time. We must believe that the first masters of the art, who were so exact in the description and distinction of diseases, would not have been content with a quick mention, but that they would have long drawn the history, if they had known this terrible and contagious affection . ”

Listen to Sydenham, this great painter of smallpox:

“I do not see,” he said, “why we would condemn a a new method of treating a disease of which we find no trace either in Hippocrates or in Galen, unless we torture a few passages ….. It is indeed very probable, to say the least, that smallpox did not exist in antiquity. If this disease had reigned at that time, as nowadays, I am convinced that it would not have escaped the sagacity of Hippocrates. This great man, who knew diseases better and described them more exactly than any of those who came after him, would certainly have left us, as usual, a simple and faithful history of smallpox . ”

Closer to home, Pinel, so familiar with the reading of the classics of antiquity, has not found either in their writings the definite trace of smallpox.

“It is no doubt easy,” he says, “with the aid of some oblique interpretation or some equivocal term, to trace the knowledge of smallpox to the early days of ancient medicine. But if we want to be harsh in his judgments, we finally agree that this disease was known point before Rhazes and Avicenna . ”

The two French epidemiologists, Fodere and Ozanam, agree on the modern origin .

M. Littré, without being so affirmative, and while giving the reasons which may still justify certain reservations, evidently leans for novelty, as we are sure in many passages of his writings .

Mr. Rayer does not think otherwise, and this will be my last quote. “Several authors,” he says, “have suggested that smallpox has been observed by Greek physicians. Willan has fortified this opinion with numerous and learned researches that have not convinced me . ”

Here arises a difficulty which I must not omit to examine in passing.

The silence of the ancients proves, it is said, that smallpox was unknown to them; but it can not be inferred rigorously that it did not exist in their time. All that can be concluded is that she had not yet come to Greece or Rome, and that she had remained confined to her original constituency, waiting for the hour to come. or less distant from his appearance on another theater.

Such is the opinion of the Chinese. No one is ignorant of their claims to the priority of the arts and sciences over all other peoples; what is less well known is that they also claim the sad privilege of having preceded them in the knowledge of smallpox.

According to their old archives, this disease would have reigned epidemically among them for more than three thousand years, and this tradition seems to have been accepted by the missionaries of Peking . It even dates, and it is 1122 years BC would have seen it for the first time. This would explain the particular study that Chinese medicine would have made of this disease and large jobs it would have inspired.

Is the interpretation of the chronicles without reproach? Was the disease they refer to as the smallpox of our time? Has the tradition gone through thirty centuries without losing anything on the way to its primitive purity?

I ask these questions, but I have not the slightest desire to go back as far and without a guide in the past of science. I will only mention two reasons for doubts that are open to my mind and that we would like to take for what they are worth.

The first is suggested to me by this fact, that smallpox, at its advent in China, would have shown, according to the historical documents, a sweetness which contrasts with the ferocity of its authentic beginnings in Europe. It is not ordinarily with these benign pains that new diseases inaugurate their taking possession. It should at least recognize that manners have changed and it is particularly aggravated with age, unlike general observation data.

On the other hand, whatever the inviolability of the barriers which isolated the Celestial Empire from the rest of the world, one can not understand that they did not let the expansive virus of smallpox pass, and that the plague as long as you wish in your native country, have never crossed its borders, during this long series of centuries that preceded its invasion among us.

China Rifampicin