October 26

1689: Fire sweeps through Skopje. Enea Silvio Piccolomini was an Italian nobleman born around 1640. His family had a history of serving with the Habsburg army and he was no exception, taking a position in Vienna. He led a campaign against the Ottomans in Kosovo, Bosnia, and Macedonia. Skopje is the present day capital of Macedonia. Vienna had been the subject of an Ottoman siege in 1683 and emperor Leopold I retaliated against the assailants with the resulting Great Turkish War. Piccolomini was attempting to conquer the Balkan states when he entered the city. There are conflicting stories as to what his motivation was.

Either the city was wracked by an outbreak of cholera and the disease was spreading rapidly or Piccolomini wanted to even the score for the siege against Vienna. He set the city on fire on this day. The city burned for two days, destroying all but a few stone-built structures. The fortress and some churches and mosques were made of stone and able to withstand, mostly intact. Before the fires were set, the city was home to about 60,000 people. After the devastation, only about 10,000 remained. The once thriving trading center was no longer able to provide that service and went into a steep decline, lasting for years.

Cholera is an infection of the small intestines which can lead to vomiting, muscle cramps, and most importantly severe diarrhea. The resulting dehydration and electrolyte imbalance can be treated with modern medicine. However, that was not the case in earlier times and the disease could lead to death. The disease is thought to have gotten its start in the Indian subcontinent and spread via trade routes. The disease spread overland and via ships. The sea routes were able to quarantine ships with the disease and help to slow the spread. Overland was not as easily contained. At the time of this incident cholera was a very deadly disease and Piccolomini succumbed to it soon after he razed the city.

There have been seven cholera pandemics in the past 200 years with the last originating in Indonesia in 1961. Today, with intravenous administration, electrolyte supplements, and antibiotics, the disease is not a threat in developed parts of the world. The same is not true in the developing countries and tens of millions have died of the disease since it became widespread in the late 19^th century. In order to limit the affects of the disease, it is best to prevent the spread. This is done through proper sanitation practices including water treatment and proper treatment of sewage. Water purification systems help to remove the bacteria before ingestion, the best way to halt the disease.

Cholera is even more severe among populations who are immunologically naive. – Christy Turlington

When Peru had a cholera outbreak in 1991, losses from tourism and agricultural revenue were three times greater than the total money spent on sanitation in the previous decade. – Rose George

While eliminating smallpox and curtailing cholera added decades of life to vast populations, cures for the chronic diseases of old age cannot have the same effect on life expectancy. A cure for cancer would be miraculous and welcome, but it would lead to only a three-year increase in life expectancy at birth. – S. Jay Olshansky

The cholera had broken out at the post, and five or six men were dying daily. – Buffalo Bill

 

 

Last of the Line

Ali Maow Maalin in 1977*

October 26, 1977: Ali Maow Maalin gets sicker. He was born in 1954 in Merca, Somalia. He worked there at the regional hospital as a cook. He also was an occasional vaccinator for a WHO smallpox eradication team. He had not been successfully vaccinated even though it was a mandatory policy at his place of employment. According to CDC epidemiologists, he had been vaccinated, but the vaccine did not take effect and he was unprotected. Other sources state that he had never been vaccinated at all. Maalin himself denied having received the shot stating it looked like it hurt and he therefore avoided it.

In August 1977 there was an outbreak of smallpox in a Somalian group of about 20 families of nomads. Between August and October, eight children developed symptoms of the disease and on October 12, two children were discovered with the disease in a small settlement of Kurtunawarey – about 55 miles inland from Merca. Officials drove there to contain the outbreak and 23-year-old Maalin served as a guide. It is believed that it was during this trip that he became infected with the virus. On October 14, Habiba Nur Ali (6) died of smallpox, the last person to die naturally from the disease. By October 18, WHO workers successfully contained the outbreak among the nomadic group but they did not list Maalin as a contact.

On October 22, he began to feel bad and presented with a fever and headache. Malaria treatment was begun. On this day, the telltale rash appeared but yet it was ignored. Since he worked in the hospital, it was assumed he had been vaccinated against smallpox and so he was diagnosed with chickenpox and sent home. Over the next few days, his symptoms grew worse but he did not want to be isolated and so failed to report his distress to authorities. On October 30, a male nurse colleague reported him. It may not have been altruism, but rather the reward of 200 Somali shillings (about $35). Maalin was taken to isolation camp and diagnosed with smallpox, the last person to ever be diagnosed with naturally occurring smallpox. He did not suffer any complications and was discharged in November.

Donald Henderson had directed the WHO eradication program from 1967 to 1976. When he looked at the Maalin case, he was appalled. Maalin had been a popular young man and was visited by many relatives and friends before he was finally put in isolation. While he had been hospitalized with the initial fever, he had been permitted to walk freely throughout the hospital and interacted with many patients. There had been 91 people who had had face-to-face contact with Maalin and 12 of them were unvaccinated. All contacts were monitored for the following six weeks and face-to-face contacts were vaccinated. Merca Hospital was closed to new patients and all staff were vaccinated. No one was discharged. A total of 54,777 people were vaccinated in the two weeks following Maalin’s isolation. The program was effective and smallpox has been wiped out. Maalin died in 2013 at the age of 58.

I was scared of being vaccinated then. It looked like the shot hurt. – Ali Maow Maalin

Now when I meet parents who refuse to give their children the polio vaccine, I tell them my story. I tell them how important these vaccines are. I tell them not to do something foolish like me. – Ali Maow Maalin

Somalia was the last country with smallpox. I wanted to help ensure that we would not be the last place with polio too. – Ali Maow Maalin, explaining why he volunteered to help eradicate polio

A classic one in depicting omissions and mistakes in program operations. – Donald Henderson, describing this case

Also on this day: Tombstone, Arizona – In 1881, the gunfight at the OK Corral took place.
Whoa! – In 1861, Pony Express service officially ended.
Cloud of Death – In 1948, Donora, Pennsylvania was shrouded in a toxic fog.
Outnumbered – In 1597, the Battle of Myeongnyang was fought.
Baby Fae – In 1984, the baby was given a baboon’s heart.

* “Ali Maow Maalin (1977)en” by Source (WP:NFCC#4). Licensed under Fair use via Wikipedia – https://en.wikipedia.org/wiki/File:Ali_Maow_Maalin_(1977)en.jpeg#/media/File:Ali_Maow_Maalin_(1977)en.jpeg

Baby Fae

Baby Fae

October 26, 1984: Stephanie Fae Beauclair undergoes surgery. She was born on October 14 and diagnosed with hypoplastic left heart syndrome. This is a rare congenital defect in which the left ventricle (main chamber of the heart) is severely underdeveloped. Usually, both the aorta (main artery carrying blood to the heart) and the ventricle are too small and the aortic and mitral valves (muscular “doors” between the vessels and chambers of the heart) are too small to permit sufficient blood flow. Usually, there is also an defect between the right and left ventricles allowing the freshly oxygenated blood to mix with blood returning from the body. Without surgical intervention, the condition is fatal. One of the options is a full heart transplant.

Leonard L. Bailey at the Loma Linda University Medical Center opted for a full heart transplant. The difference with this one was that the donor was a baboon rather than another human. Baby Fae survived the operation itself but died 21 days later of heart failure due to rejection of the transplant. Baby Fae was type O blood. Most baboons are type AB blood with only about 1% of them having type O. There were seven young, female baboons which could have been used for the transplant and all of them were type AB. It was hoped that a second graft would be available for Baby Fae before her body rejected the baboon heart. A suitable donor could not be found in time.

Xenotransplants are living cells transplanted from one species to another. These can either be simply cells or tissues or entire organs. They are called xenografts from the Greek for foreign – xenos. Allografts or allotransplants refer to same species transplants and was the hoped for treatment for Baby Fae. Human xenografts are sometimes used as a potential treatment for end-stage organ failure but there are many medical, legal, and ethical issues involved. One of the issues is that most animals have shorter life spans than humans and so their organs age more quickly than human organs do. There is also the possibility of transferring a disease along with the tissue. There have been few successful cases of xenografts.

Baby Fae was the first human to receive a xenotransplant. The case has been used often since this time as a study of medical ethics. Bailey did not look for a human heart for Baby Fae. Were the parents able to make the judgment call to offer up their daughter for an experimental procedure? There is some question as to whether or not the parents were adequately informed of the risks and consequences. Since it was the first time the procedure was done, did anyone actually completely understand the risks and consequences? The parents were uninsured and could not afford to pay for a regular heart transplant and the xenograft was offered for free – how much did this influence their decision?

Er, I find that difficult to answer. You see, I don’t believe in evolution. – Leonard Bailey, when asked why he chose a baboon’s heart rather than a more closely related primate

The placing of a baboon heart into the chest of little Baby Fae caused indignation in many quarters. For some, who might safely be called eccentric, the concern was animal rights.  – Charles Krauthammer

At Loma Linda, doctors told the mother that Fae would soon die; she was kept overnight in the hospital and then released. The mother had Fae baptized and took her to a motel to wait for her to die. – Gregory Pence

Within a year, Dr. Bailey performed the first infant-to-infant heart transplantation on Baby Moses, whose actual name is Eddie. Now 24 years old, Eddie holds the distinction of being the oldest living infant heart transplant recipient. – from Loma Linda University

Also on this day: Tombstone, Arizona – In 1881, the gunfight at the OK Corral took place.
Whoa! – In 1861, Pony Express service officially ended.
Cloud of Death – In 1948, Donora, Pennsylvania was shrouded in a toxic fog.
Outnumbered – In 1597, the battle of Myeongnyang was fought.

Whoa!

Pony Express

October 26, 1861: The legendary Pony Express officially ends. The Pony Express was devised to quickly get mail across the vast spaces of the American West. People moved ever westward and ended up far away from the bustling and crowded East Coast. In 1842 the Oregon Trail beckoned to frontier families in Iowa, Illinois, Missouri, and Kentucky. By 1848 some type of regular mail service was called for. The Mexican-American War added the California territory to the new country and word of gold in the hills sent even more people west. San Francisco was established in 1848 and Salt Lake City in 1849.

What was the best way to get communications from the east to west and back? The ocean route was tried when Congress passed legislation authorizing the Navy to transport mail in 1847. Mail was sent via ship from the Atlantic coastal cities to the isthmus of Panama. Then it was taken across land and once again taken by sea to the Pacific coast. The trip was long and relatively costly. Mail was the only link to the past for many who came west in search of a better life. The Gold Rush brought more people – and higher costs to the mail.

There was overland service in competition with the ocean service. It also ran into problems. Service was irregular and erratic at best. Delivery could be slowed or stopped by snows. Mail was expected to arrive in a month, but could take twice as long. Service to Missouri was better established. The Pony Express was to carry mail from St. Joseph, Missouri to Sacramento, California and manage the trip is mere days. Their premise was based on a relay race with riders handing off the mail across nearly 2,000 miles.

There were approximately 190 Pony Express stations set up at 10 mile intervals, on average. Letters were able to get from New York City to San Francisco in only ten days. The mail pouch was passed from rider to rider, who sat on the precious cargo to keep from losing it. The pouch was moved short distances quickly. It was the most important item with man and horse coming in a distant second. The mail was quickly delivered until … a new type of information system replaced it. The Transcontinental Telegraph was finished on October 24, 1861 and able to send vital information coast to coast. Two days later, the Pony Express, 18 months old, closed.

“Excitement was plentiful during my two years’ service as a Pony Express rider.”

“The first trip of the Pony Express was made in ten days – an average of two hundred miles a day. But we soon began stretching our riders and making better time.”

“You who live your lives in cities or among peaceful ways cannot always tell whether your friends are the kind who would go through fire for you. But on the Plains one’s friends have an opportunity to prove their mettle.”

“I was persuaded now that I was destined to lead a life on the Plains.” – all from William “Buffalo Bill” Cody

This article first appeared at examiner.com in 2009. Editor’s update: When California joined the Union as a free state in 1860 there were already 380,000 people out there. They were demanding better mail service. As the US Civil War was looming on the horizon, the need became ever greater. William Russell, Alexander Majors, and William Waddell were already in the shipping business by the late 1850s. These founders of the Pony Express had more than 4,000 men, 3,500 wagons, and about 40,000 oxen at their disposal. During the 1850s the three businessmen merged their companies together and held government contracts for moving army supplies out west. Since they already had an idea of how to move goods, they knew how to move the mail. The routes were established and moving from coaches to horses alone made the trip quicker. The relay race method also sped the mail swiftly across the growing nation.

Also on this day: Tombstone, Arizona – In 1881, the gunfight at the OK Corral took place.
Cloud of Death – In 1948, Donora, Pennsylvania was shrouded in a toxic fog.
Outnumbered – In 1597, the battle of Myeongnyang was fought.

Outnumbered

Battle of Myeongnyang

October 26, 1597: The Battle of Myeongnyang is fought. A series of attacks between a newly unified Japan and modern day Korea took place between 1592 and 1598. Toyotomi Hideyoshi of Japan led attacks against the Joseon Dynasty of Korea, the Jurchens (people of Manchuria), and eventually the Ming Dynasty of China. There are several names for this: Hideyoshi’s invasions of Korea, the Seven Year War, or the Imjin War. The last name is in reference to the first attack led by the Japanese in the the imjin year of the sexagenary cycle of the Korean calendar. In China, it is also called the Wanli Korean Campaign, after the reigning emperor of that country.

The Josean admiral Yi Sunsin had been in trouble with the leaders of the fractious dynasty court. He was impeached and nearly put to death. Rather than a death sentence, he was tortured and reduced in rank to a common soldier. His rival, Admiral Won Gyun took over the fleet which Yi and carefully built from 63 heavy ships to 166. Admiral Won was a master of political intrigue but a buffoon at logistical and tactical maneuvers in war. At the Battle of Chilchonryang on August 27, 1597 the Japanese under the command of Todo Takatora nearly wiped the Korean navy out.

Admiral Won was killed at Chilchonryang. There were only 12 panokseon ships left to the navy. These were oar and sail propelled ships and were the major type of warship used by the Josean Dynasty. King Seonjo opted to disband the navy. Yi wrote him a letter proclaiming that there were still 12 ships and he would never allow the Japanese into the Western Sea. One more ship was added to Yi’s fleet before this day’s battle. Yi placed his fleet guarding the Myeongnyang Strait, a place with strong currents which switched directions every three hours. The narrowness of the strait would also make it impossible for his small fleet to be flanked by the approaching Japanese fleet of over 300 ships.

Using his understanding of the currents and his military knowhow, Yi managed to damage many Japanese ships. His ships, in the shadows of the surrounding hills, were difficult to target. Early in the battle, a body was seen floating in the water wearing the distinctive clothing of a daimyo, or Japanese leader. The body was hauled aboard and was identified as Kurushima Michifusa, a leader met in battle prior to this day. His head was cut off and posted on the mast of the Josean flagship. As the tide shifted, the Japanese ships were pulled back out of the strait and ran into other ships behind them. They lost 31 ships and many others suffered significant damage. The Japanese withdrew. With supplies cut off from the mainland, the Japanese had to institute an general retreat as well.

A country’s strategy is always based on a fundamental philosophical outlook. – Marc Forne Molne

Finally, strategy must have continuity. It can’t be constantly reinvented. – Michael Porter

Leaders establish the vision for the future and set the strategy for getting there. – John P. Kotter

Thus, what is of supreme importance in war is to attack the enemy’s strategy. – Sun Tzu

Also on this day:

Tombstone, Arizona – In 1881, the gunfight at the OK Corral took place.
Whoa! – In 1861, Pony Express service officially ended.
Cloud of Death – In 1948, Donora, Pennsylvania was shrouded in a toxic fog.

Cloud of Death

Taken at noon on October 29, 1948, this picture shows the deadly smog blanketing Donora. (NOAA Oceanservice Education)

October 26, 1948: Skies over Donora, Pennsylvania darken as fog settles onto the small river valley town. Donora of the 1940s was a thriving town with a population of about 14,000. Today, as part of the Rust Belt, that population is dwindling along with job opportunities and there are fewer than 2,500 households in the town that is 20 miles south of Pittsburgh and located on the Monongahela River.

For five days, beginning on October 26 and ending not a moment too soon on October 31, weather conditions conspired to trap air pollution over the town. The smog was a combination of noxious gases from the American Steel and Wire Plant, owned by US Steel, and Donora Zinc Works. By the time the smog lifted, 20 were dead and between 6,000 and 7,000 were ill, some suffered lifelong disabilities. A local doctor, Dr. Rongaus, claimed that the death toll would have reached 1,000 if the smog had lasted another day.

The horror did not end there.USSteel is said to have conspired with the US Public Health Service (PHS) to cover up their role in the disaster. Fifty years later, crucial PHS records are missing and US Steel continues to block access to records. The Pennsylvania State Bureau of Industrial Hygiene on October 31, 1948 conducted tests on the foul air and found excessively high contents of sulfur dioxide, soluble sulphants, and fluorides.

The steel and zinc plants did have help in creating the fluoride fog. There was also a sulfuric acid plant nearby and coal burning trains and river boats added their fetid fumes to the mix as well. A highly unusual fog held the effluvium close to ground level and the air seeped into houses and blanketed the streets. People with a history of respiratory or heart disease were the first to succumb. US Steel eventually paid an undisclosed amount to the survivors of the tragedy. The country responded by passing the Clean Air Act of 1955.

“On (Dr.) Rongaus’ advice, those with chronic heart or respiratory ailments began to leave town late Friday evening, but before noon on Saturday, 11 people died.” – from the Environmental History Review

“Before the Donora smog, neither manufacturers nor public health professionals considered air pollution an urgent issue.” – from the Environmental History Review

” I have felt the fog in my throat —
The misty hand of Death caress my face;
I have wrestled with a frightful foe
Who strangled me with wisps of gray fog-lace.” – John P. Clark

“It would have complicated things enormously for them if the public had been alerted to (the dangers of) fluoride.” – Philip Sadtler

Also on this day:
Tombstone, Arizona – In 1881, the gunfight at the OK Corral took place.
Whoa! – In 1861, Pony Express service officially ended.

Tombstone, Arizona

City Marshall Virgil Earp

October 26, 1881: Wyatt, Morgan, and Virgil Earp along with Doc Holliday meet up with Frank and Tom McLaury, Billy and Ike Clanton, and Billy Claiborne in a vacant area called lot 2, in block 17 behind the corral. A year before, Virgil Earp became the city marshal of Tombstone. The Earp brothers were recently deputized.

The McLaurys and the Clantons sold livestock in Tombstone. The Earps believed that the animals were stolen. Wyatt also believed that the Clantons had stolen one of his prize horses. Wyatt and John Behan, a sheriff in Cochise County, Arizona, argued in the past over an arrest of Doc Holliday. He was arrested on suspicion of killing a stagecoach driver during a robbery. Holliday denied any involvement and was eventually released. Virgil then arrested one of Behan’s deputies, Frank Stilwell, for robbery of a stagecoach.

On October 25, Holliday got into a barfight with Ike Clanton and Tom McLaury and invited them to “step outside” but they declined. The next day, Virgil arrested the two men for carrying weapons within the city limits which was illegal. They were disarmed and released. Clanton and McLaury were joined by their brothers who had just arrived in town. They met at the OK Corral.

The Earps and Holliday headed for the OK Corral, Behan, also in town, tried to disarm the Clantons and McLaurys, but they did not give up their weapons. The marshal and his posse arrived at the Corral. Wyatt and Billy Clanton opened the battle. Holliday shot Billy in the chest, then cut Tom McLaury down with buckshot. Ike was running from the scene when Doc shot at him, but missed. Frank shot and slightly wounded Doc and Doc’s return shot killed him. In less than 30 seconds three were dead, three were wounded. Wyatt was the only one unscathed. The Earps and Holliday were brought before Judge Spicer and found to be not guilty of murder.

“Fast is fine, but accuracy is everything.” – Wyatt Earp

“The greatest injustices proceed from those who pursue excess, not by those who are driven by necessity.” – Aristotle

“Justice! Custodian of the world! But since the world errs, justice must be custodian of the world’s errors.” – Ugo Betti

“There is no such thing as justice – in or out of court.” – Clarence Darrow

Also on this day, in 1861 the Pony Express stopped – Whoa!