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(alchemists have always been important and studied in the history of science, especially by medievalist... but, anyway...)
Transforming the Alchemists
By JOHN NOBLE WILFORD, The New York Times, August 1, 2006
PHILADELPHIA — Historians of science are taking a new and lively interest in alchemy, the often mystical investigation into the hidden mysteries of nature that reached its heyday in Europe in the 16th and 17th centuries and has been an embarrassment to modern scientists ever since.
There was no place in the annals of empirical science, beginning mainly in the 18th century, for the occult practices of obsessed dreamers who sought most famously and impossibly to transform base metals into pure gold. So alchemy fell into disrepute.
But in the revival of scholarship on the field, historians are finding reasons to give at least some alchemists their due. Even though they were secretive and self-deluded and their practices closer to magic than modern scientific methods, historians say, alchemists contributed to the emergence of modern chemistry as a science and an agent of commerce.
“Experimentalism was one of alchemy’s hallmarks,” said Lawrence M. Principe, a historian of science at Johns Hopkins University and a trained chemist. “You have to get your hands dirty, and in this way alchemists forged some early ideas about matter.”
Bent over boiling crucibles in their shadowy laboratories, squeezing bellows before transformative flames and poring over obscure formulas, some alchemists stumbled on techniques and reactions of great value to later chemists. It was experimentation by trial and error, historians say, but it led to new chemicals and healing elixirs and laid the foundations of procedures like separating and refining, distilling and fermenting.
“What do chemists do? They like to make stuff,” Dr. Principe said. “Most chemists are interested not so much in theory as in making substances with particular properties. The emphasis on products was the same with some alchemists in the 17th century.”
Pamela H. Smith, a history professor at Columbia, said alchemy “was the matter theory of its day” and was “incredibly multilayered and therefore a powerful way of viewing nature.”
Yet on the whole, historians say, the widespread practice of alchemy impeded the rise of modern chemistry. While physics and astronomy marched slowly but inexorably from Galileo to Kepler to Newton and the Scientific Revolution, chemistry slumbered under alchemy’s influence through what historians call its “postponed scientific revolution.”
The new research and revised interpretations concerning the role of alchemy in the history of chemistry as well as pharmacology and medicine were discussed at a three-day conference late last month at the Chemical Heritage Foundation in Philadelphia. The meeting, attended by more than 80 scientists and historians, was organized by Dr. Principe, who said, “Only in the last 15 or 20 years have we learned how crucial alchemy was to the emergence of modern science.”
No one at the meeting tried to turn lead into gold. But the historians conjured up quite a lode of pyrite, fool’s gold, in the colorful characters they had found buried in previously neglected archives.
A few practicing alchemists, it seems, may have been certifiably mad — probably, like mad hatters, from sniffing the mercury they worked with.
One notable alchemist of the 16th century, a Swiss named Paracelsus, was not mad, but cantankerous and iconoclastic. “He was equal parts metallurgist, pharmacist, physician and crackpot,” Dr. Principe said.
Historians have found that Paracelsus made some advances in the detection of disorders by analyzing urine and claimed marvelous cures through alchemy.
In his chemical cosmology, he saw the world as a great distillation vessel and its changes as parallel to the operations carried out in a laboratory. But he recorded his material and spiritual ideas in the deliberately opaque writing typical of many alchemists, who expressed themselves in codes, symbols and emblems to conceal their findings from the uninitiated.
From his study, Dane Thor Daniel of Wright State University in Dayton, Ohio, concluded that Paracelsus’s unwavering objective was to find a Christian alternative to pagan natural philosophy — science.
Other alchemists were outright charlatans or fools, ridiculed in contemporary art and literature. On display in a gallery at the conference hall were several 17th-century paintings by Flemish and Dutch artists, who depicted alchemists toiling in the disorder of dark workshops and the poverty of futile quests. The paintings were said to be popular among Dutch burghers as a caution to anyone contemplating a life in alchemy instead of steady trade.
But many an alchemist drew support from royal courts where visions of newfound wealth and power danced in crowned heads. It was not always a happy alliance.
In 1601, Hans Heinrich Nüschler signed a contract with his patron, Duke Friedrich of Württemberg in Stuttgart, to demonstrate his process for extracting a substantial amount of gold from a sample of silver. The duke, keen on mining technology, promised a generous reward. Nüschler agreed to conduct the experiments at his own expense.
After several months of failure and mounting debt, the desperate alchemist resorted to fraud. He asked his brother to help by surreptitiously adding gold to the alchemical sample. His ploy exposed, Nüschler was tried, convicted and hanged.
“Only a handful of alchemists actually ended their careers on the gallows,” said Tara E. Nummedal, a historian at Brown. “But this underscored that alchemy was very serious business in the Holy Roman Empire.”
In her report, Dr. Nummedal concluded that the relationships of patrons and alchemists showed that “alchemy was a direct engagement with the political, economic, religious and intellectual realities of the early modern world.”
At the turn of the 17th century, King Henry IV of France surrounded himself with alchemists who sought to resurrect plants from their ashes and experimented with ways to extend the monarch’s life. Even the diplomats had orders to seek out the cryptic methods of alchemists in other countries.
An alchemist in the court of a German prince scored a profitable success quite by accident. Looking for materials for creating precious metals, Johann Friedrich Böttger analyzed a “white earth” that duplicated the ingredients for imported Chinese porcelain. The discovery was the beginning of the Dresden china industry.
Even geniuses of the first order, like Isaac Newton, found alchemy irresistible. It was an accepted method of seeking knowledge — or confirmation of received truth — in early modern history.
Newton, whose laws of gravity and optics ushered in modern physics, also delved into alchemy with relentless energy. His notebooks contain thousands of pages on alchemic thoughts and experiments over 30 years.
William R. Newman, a professor of the history and philosophy of science at Indiana University, said many manuscripts had not received the scrutiny they deserved. He reported on a text in the Smithsonian Institution that he called “an overlooked gem.”
In these notebook entries, Newton cited the ideas of German alchemists for imitating the processes by which metals were generated in nature, deep inside the earth. These involved the familiar alchemical theory of metallic generation through interactions of sulfur and mercury.
But Newton, expanding on the theory, wrote: “These two spirits above all wander over the earth and bestow life on animals and vegetables. And they makes stones, salts and so forth.”
As Dr. Newman noted, “Thus we have passed from a theory of mere metallic generation to one that is intended to explain the totality of life on earth, as well as the production of all mineral materials, not just metallic ones.”
In this sense, Dr. Newman continued, Newton’s repeated experiments for the rest of his life were aimed at fulfilling the words of the Emerald Tablet of Hermes, considered the founding text of alchemy in ancient Egypt. Newton expected to achieve what the tablet said was the una res, “the one thing” by which “the world was created” and with which one could “perform miracles.”
So it seems that Newton was no ordinary alchemist interested in making gold. He apparently aspired to a theory of alchemy more comprehensive than even his laws of gravity. But it could be said, in a paraphrase of Newton’s famous expression of modesty, that the giants on whose shoulders he stood in this endeavor did not measure up to his antecedents in physics and astronomy.
Newton’s alchemical bent was not out of character, Dr. Smith of Columbia said. “He was drawn to the occult,” she said. “Gravity for him was an occult force, and so was alchemy as an explanation of how things transform into other things.”
The British chemist Robert Boyle, a Newton contemporary, also had a foot on each side of the alchemy-modern science divide. He dabbled for years in an alchemical obsession, the search for the philosopher’s stone — the long-sought agent for transmuting lead to gold and unlocking other material and spiritual secrets. The stone was the unified theory of everything in that time.
Boyle wrote enviously in 1680 that “there exists conceal’d in the world” a group of chemists “of a much higher order able to transmute baser Metalls into perfect ones.”
At the same time, Boyle hurled harsh criticism at alchemists, particularly Paracelsians and the obscurity of their language and concepts. His purpose, he wrote, was to draw “the Chymists Doctrine out of their Dark and Smoakie Laboratories into open light” and to engage in “better Experiments and Arguments.”
Citing Boyle’s “swinging critique” and even earlier attacks on alchemical practices, Stephen Clucas, a University of London historian, raised questions that he said require deeper research by historians: Why did a “scientific revolution” in experimental chemistry not occur earlier in the 17th century? Why was a clear separation of alchemy and exact chemistry delayed until the 18th century?
Bruce T. Moran, a historian at the University of Nevada at Reno and the University College London, said it was not all that unreasonable at the time to be attracted to alchemy. “For a variety of practical and intellectual reasons,” Professor Moran said, “the idea of transforming one thing into another was to be expected.”
In everyday life, grapes were turned to wine and wheat to bread. A sour green apple grew into a sweet red one. It was in the nature of things to change, even metals. Miners and refiners already knew that lead ore almost always contains some silver, and silver ore almost always contains some gold. This implied that the metals changed one into the other over time.
In the booklet “Transmutations: Alchemy in Art,” written with Lloyd DeWitt, an art historian, Dr. Principe noted that in 1600, chemists knew of just seven metals — gold, silver, iron, copper, tin, lead and mercury. (Since then scientists have discovered another 60.) The original seven known metals had properties in common. They were shiny and, except for the liquid mercury, could be hammered, shaped and cast.
“The commonality of properties implied to early thinkers a commonality of composition,” Dr. Principe wrote., “And thus it was theorized that all the metals were composed of the same essential ingredients in different proportions and degrees of purity.”
“Even if in the modern view alchemy is all nonsense or very spiritual,” Dr. Moran said, “many people drawn to it for whatever reasons were actually creating very useful, practical chemistry and bringing to it an artisan know-how.”
The conference on the history of alchemy opened with a program of chamber music called “The Philosophers’ Tone.” The scholars delighted in Handel’s transmutation of Ben Jonson’s “The Alchemist” into pure gold. Over coffee between sessions, they pondered new directions of research and topics for dissertations. They said, for example, that more attention should be paid to alchemy’s role in the history of medicine.
They also remarked, somewhat conspiratorially, over parallels between the misguided certainties and self-delusion of alchemy and today’s political and religious attacks on modern science. Of Boyle’s efforts to replicate experiments from alchemical writings, Joseph E. Early, a retired Georgetown University professor who studies the philosophy of chemistry, said, “He couldn’t do it any more than we could find the weapons of mass destruction in Iraq.”
Then the scholars departed Philadelphia, leaving the city’s lead-to-gold ratio unchanged.
A Small Charity Takes Lead in Fighting a Disease
By STEPHANIE STROM, The New York Times, July 31, 2006
PATNA, India — The drug that could have cured Munia Devi through a series of cheap injections was identified decades ago but then died in the research pipeline because there was no profit in it.
So Mrs. Devi lay limp in a hospital bed here recently, her spleen and liver bulging from under her rib cage as a bilious yellow liquid dripped into her thin arm. The treatment she was receiving can be toxic, and it costs $500. But it was her best hope to cure black fever, a disease known locally as kala azar, which kills an estimated half-million people worldwide each year, almost all of them poor like Mrs. Devi.
Soon, however, all that may change. A small charity based in San Francisco has conducted the medical trials needed to prove that the drug is safe and effective. Now it is on the verge of getting final approval from the Indian government. A course of treatment with the drug is expected to cost just $10, and experts say it could virtually eliminate the disease.
If approval is granted as expected this fall, it will be the first time a charity has succeeded in ushering a drug to market.
This novel way of helping people whose needs have not been met by for-profit pharmaceutical companies is gaining traction. Several partnerships are working to develop drugs to fight neglected diseases, underwritten by the Bill and Melinda Gates Foundation, Doctors Without Borders and other groups. Another nonprofit agency, the Aeras Global TB Vaccine Foundation, is searching for a means to prevent tuberculosis.
For its first project, the San Francisco charity, the Institute for OneWorld Health, focused on reclaiming the all but abandoned drug, paromomycin, which research found promising in the 1960’s.
That was the easy part. Its hurdles lay elsewhere. The Internal Revenue Service at first denied the charity nonprofit status, concerned that it looked too much like a for-profit enterprise. The World Health Organization, which controlled the drug, was reluctant to hand over the data needed for further development. And OneWorld Health had to set up clinical trials matching United States and European standards in one of the poorest parts of the world.
Nor was it obvious where the money would come from. The idea of a nonprofit drug company struck many as folly when Dr. Victoria Hale, a former Genentech executive and Food and Drug Administration official, founded OneWorld Health in 2001. So Dr. Hale and her husband started the project using their own money, though they have since won support from the Gates foundation, among others.
“My colleagues and mentors in the pharmaceuticals industry told me it was a wild idea, that it would never work out, that I was jeopardizing my reputation,” Dr. Hale said. “I started this organization knowing our first project had to be a winner or we wouldn’t survive.”
An Ambitious Goal
Dr. Hale hopes to stamp out black fever eventually, a goal that many doctors regard as impossible. “The last disease we truly eradicated was smallpox,” she said. “There’s no urgency to eradicating diseases anymore. Why not?”
Black fever is the second-largest parasitic killer in the world after malaria. It is spread by sand flies, and Banthu, the squalid village about an hour’s drive from here that Mrs. Devi calls home, is an ideal breeding ground for them.
The flies multiply in the cow dung that Mrs. Devi uses as fuel for cooking. They relish the sap in the banana groves and bamboo stands, and they thrive in the thatch used to make the tiny houses. Flies that have bitten infected humans transmit the disease when they bite another person. Smaller than mosquitoes, they can pass through most netting.
Roughly 90 percent of black fever cases worldwide are found here in Bihar State in India and in Bangladesh, Nepal, Sudan and northeastern Brazil.
Mrs. Devi’s daughter was the first in the family to contract the disease, and she died from it. Then Mrs. Devi’s youngest son, Rajesh, got it, and she brought him to the Rajendra Memorial Research Institute of Medical Science here, where he was treated and recovered. Now she, too, is receiving treatment.
It is at the Rajendra Institute, a government research facility, that OneWorld Health set up one of the trials needed to make paromomycin widely available.
Many Early Battles
Dr. Hale first set her sights on the drug after she attended a conference in Belgium in 1999, where Dr. Shyam Sundar, an expert on black fever, was railing against the world’s failure to fight the disease.
“The tragedy, maybe even the crime, is that we have known that this drug is an effective treatment for kala azar since the 1960’s,” said Dr. Sundar, whose free clinic in Muzaffarpur was also a site for a trial by OneWorld Health. “We could do something, but we were choosing not to.”
After visiting Dr. Sundar’s clinic in 2000, Dr. Hale, who was doing consulting work at the time, hired a law firm to help her get the tax exemption necessary to create a nonprofit drug company. The I.R.S. turned her down three times over 10 months, suspicious that her plan was a scheme by the drug industry to shelter profits. The tax agency challenged her to find an example of an existing charity that mirrored a for-profit business.
“It took me five days, and then at dinner, it hit me: N.P.R. and public television,” she said. “They look an awful lot like for-profit radio and television, but they serve a different audience with programs that their for-profit counterparts don’t provide because they can’t profit from them.”
Two weeks later, OneWorld Health received I.R.S. approval and set out to tackle black fever.
The immediate challenge was financing. For a time, OneWorld Health survived on the largesse of Dr. Hale and her husband, Dr. Ahvie Herskowitz. They put up $100,000, signed a $315,000 promissory note, used the ground floor of their house as offices, and worked without pay for two years.
The Gates foundation, which at the time was primarily underwriting vaccines and other preventive strategies, eventually offered a grant of $4.2 million that grew to $47.2 million for the development of paromomycin. Dr. Hale also got help from others, including the Skoll Foundation, which has provided financing to underwrite salaries for new senior executives.
An Abandoned Drug
An initial, formal test of paromomycin, an antibiotic sold in some countries as an oral treatment for diarrhea and as a topical treatment for cutaneous leishmaniasis, which causes lesions, was done in the late 1980’s in Africa, two decades after it was identified as a simple, cheap, effective cure for black fever.
Through a series of company mergers it was consigned to the corporate shelf and forgotten, ending up with the World Health Organization, which lacked the money to develop it beyond the Phase II clinical trials.
But negotiations with the World Health Organization to hand over the data that would allow OneWorld Health to organize the Phase III clinical trials necessary for regulatory approval dragged on for almost two years. At the time, the W.H.O was developing another drug for black fever with Zentaris, a large pharmaceutical company, and the Indian government. That drug, miltefosine, has the advantage of being an oral treatment, while paromomycin is administered by injection.
But miltefosine, an anticancer drug, also has drawbacks. In trials, it caused gastrointestinal problems in one-third of the patients. And patients must be strictly supervised to ensure that they take the full 21-day course of treatment and that women of child-bearing age are using birth control. By contrast, paromomycin has shown almost no side effects in trials.
With a price of $100 to $200 a treatment, miltefosine is out of reach for most patients and government purchasing programs.
Dr. T. K. Jha, a specialist in black fever who oversaw one of the OneWorld Health trials, said the W.H.O. wanted to make sure miltefosine made it onto the market before handing over its data on paromomycin. “Commerce got in the way,” Dr. Jha said.
But Dr. Robert G. Ridley, director of the W.H.O.’s special program for research and training in tropical diseases, disputed that. Dr. Ridley wrote in an e-mail message that the “time lag” had to do with getting financing from the Gates foundation and the process of negotiating an agreement with OneWorld Health.
The subject of the commercial aspects of drugs is a difficult one for OneWorld Health, which is careful to avoid criticism of its for-profit cousins, as well as competition with them.
“We look a lot like each other,” Dr. Herskowitz said. “But we fill a gap pharma companies cannot because they have to make a profit.”
But given the choice of paying more than $100 for Zentaris’s miltefosine or $10 for paromomycin, governments and most patients will no doubt choose the cheaper drug.
OneWorld Health does not intend to gain income from the drug. It has given a license to Gland Pharma, an Indian drug company that has agreed to manufacture the drug and sell it at cost when it is approved. But Dr. Hale can foresee a time when, say, a drug OneWorld Health hopes to develop to treat childhood diarrhea could be sold to travelers by a for-profit drug maker in exchange for royalties that would help sustain her organization’s charitable work.
Still More Difficulties
Approval of paromomycin will not end OneWorld Health’s challenges. Distribution looms as the next hurdle.
In Patepur, a somewhat more prosperous village than Mrs. Devi’s, Dr. Syed Misbah Hassan, a clinical research coordinator for OneWorld Health, diagnosed kala azar in one boy after another.
Dilip Manjhi, who is about 15, lay listless on a string bed as Dr. Hassan examined his abdomen for the telltale signs of the disease, a swollen spleen and liver. Dilip’s spleen extended eight centimeters below his rib cage and was rock hard. His liver protruded three centimeters below his ribs.
Getting paromomycin to remote villages like Patepur at the end of pothole-pocked roads will be difficult. Dr. Hale is trying to enlist a British nonprofit group, Riders for Health, to help. The group uses motorcycles to connect poor people to medical services. In Zimbabwe, for instance, it has taken pregnant women in need of Caesarean sections to hospitals.
“My thinking,” Dr. Hale said, “is that we could equip a motorcycle with a cooler to transport the drug and equip the driver to give the injections and maintain records.”
But first, the Bihar State government and India’s central government must create a system that encompasses diagnosing the disease, buying and administering the drug, keeping records and spraying to reduce the sand fly population.
Some experts wonder whether the government has the will to create such a system, when hundreds of thousands of Indian children die each year of measles, which can be prevented with a 15-cent vaccine. But Dr. C. P. Thakur, a former Indian health minister who oversaw a OneWorld Health trial of paromomycin, noted that black fever was one of five insect-borne diseases the Indian government had pledged to eliminate.
India has also signed an agreement with the governments of Nepal and Bangladesh to eradicate the disease, and the Bihar State government has shown a willingness to work with OneWorld Health.
“The government will be the biggest challenge,” Dr. Thakur said. “But I believe the opportunities to end this disease have never been better, and also that the government’s will has never been stronger.”
The Doctor's World: In Philadelphia 30 Years Ago, an Eruption of Illness and Fear
By LAWRENCE K. ALTMAN, The New York Times, August 1, 2006
In late July 1976, American Legionnaires returning from a state convention in Philadelphia began to fall ill with mysterious symptoms: pneumonia and fevers topping 107 degrees.
By early August, news organizations across the country were reporting that 6 to 14 of the men in Pennsylvania had died. Others were in hospitals fighting for their lives. No laboratory tests could determine the cause of their illness, which quickly became known as Legionnaires’ disease. No one knew the health status of the 10,000 other convention participants.
As the news began to break, 30 years ago this week, Americans were primed for the threat of an epidemic. The Ford administration was making plans to vaccinate every American against a new strain of influenza, known as swine flu, after repeated warnings from government officials that a devastating epidemic could strike without warning. Michael Crichton’s “Andromeda Strain” had become a best seller. And some scientists were calling for a moratorium on laboratory efforts to genetically engineer microbes for fear they might create a monster germ.
These factors made the unexpected attack on American veterans, which occurred shortly after the country’s bicentennial celebration, front-page news.
When I first heard about the mysterious cases from news agency bulletins on Aug. 2, I initially viewed them with some skepticism. A few months earlier, Dr. Leonard Bachman, the Pennsylvania health secretary, issued a news release saying that a staff member, Dr. Buford S. Washington, had discovered an often fatal new disease, pantosomatitis, that was spreading throughout the eastern United States. Looking into the claim, I found there was no documented case and no such disease.
Disease outbreaks were familiar territory for me. Before coming to The New York Times, I’d been an Epidemic Intelligence Service officer at the Communicable Disease Center, now the Centers for Disease Control and Prevention, in Atlanta. If the Legionnaires’ outbreak had occurred a decade sooner, I might have been one of the investigators sent to Pennsylvania.
Health officials there urged the public not to panic, and some initially denied that the cluster of cases was an outbreak of an infectious disease. But behind the scenes, the same officials were bracing themselves for a medical catastrophe.
“We thought we might be faced with an unprecedented condition in modern medicine, one for which we had no really effective antibiotics, drugs or therapy,” Dr. Bachman told me in 1976. Because there was no way to predict how many more Legionnaires would fall ill, Dr. Bachman said he had contemplated seizing control of all hospitals in the state and imposing quarantines.
It took six months to determine that the illness had been caused by a bacterium, Legionella pneumophilia, which we now know usually succumbs to the timely prescription of proper antibiotics. The bacterium, which in this case was apparently spread from the hotel’s air-conditioning system, is a cause of pneumonia and other illnesses worldwide.
The investigation that solved the mystery took an array of surprising twists and turns. It revealed the strengths and weaknesses of the nation’s health system in response to an outbreak from an unknown agent.
Some lessons learned from the outbreak improved investigations of later outbreaks like avian flu, SARS and the deliberate release of anthrax spores in the postal system shortly after the Sept. 11 attacks. But many authorities have not learned other important lessons, like the need for more effective communication.
Intense news coverage of the Legionnaires’ outbreak continued for weeks, providing one of the rare opportunities for the public to see how medical detectives work and how scientists make discoveries.
The epic challenged the widespread notion that medicine was all-knowing, able to lick almost any problem, and that antibiotics and vaccines had turned once lethal infectious diseases into minor threats.
The news coverage also marked a turning point in journalism’s efforts to hold officials accountable for their response to epidemics that can threaten the lives of thousands of people, as well as tourism, international trade and world economies. News about the outbreak led to the temporary closing of the Bellevue-Stratford Hotel, a Philadelphia landmark that was the headquarters of the American Legion convention and a focus of suspicion about the spread of the bacterium.
The C.D.C. sent 20 epidemiologists — the largest squad of medical detectives to investigate an outbreak in the federal agency’s history — to Pennsylvania where they joined scores of state health workers.
The sleuths fanned across the state to review the medical records of all the ill Legionnaires and to study the autopsy findings in the fatal cases. Epidemiologists also checked every hospital to identify new cases and interview patients’ families and doctors, in part to determine whether one or more Legionnaires might have taken the illness to Philadelphia.
On Aug. 2, when news agencies began issuing dispatches, a quick look convinced me that the Legionnaires’ cases were real, not another false alarm. Late that evening, I finished my first article about the still-unnamed mysterious disease.
Then I drove to Harrisburg, listening to the radio to keep me awake but unable to escape the repetitious news accounts about the outbreak, the speculation that the illness was swine flu and the safety concerns about visiting Philadelphia.
The Times handled the story more cautiously than radio and television. My article, on Page 12, was not even included in the news summary.
Over the next few days, the toll of the illness rose. The final count was 221 cases, including 34 deaths.
As a physician, I wanted to see the patients who were recovering or fighting to stay alive and to learn what leads were being developed from the interviews.
In Chambersburg, Pa., I joined Dr. Stephen B. Thacker, then a rookie in the C.D.C. epidemiology program. We interviewed a Legionnaire, Thomas A. Payne, 48, whose temperature rose to 107.4 degrees before he was put in a cooling blanket.
We felt safe entering his room because we followed standard precautions, wearing yellow masks, white gowns and gloves. In introducing us, Dr. Thacker told Mr. Payne that he “was part of the medical team investigating this weird disease.”
Dr. Thacker, who later became the head of the epidemiology program, asked Mr. Payne a number of questions related to the onset of his illness, how he had felt since, where he had stayed in Philadelphia and what convention events he had attended. Then Dr. Thacker sent the information to colleagues in Harrisburg.
Two weeks later, I interviewed another hospital patient who had driven with four Legionnaires from their home in Saltillo, Pa., to Philadelphia where they had stayed at the same hotel and were together for nearly all the convention events. But no one could figure out why only that patient had developed the disease.
The anecdote illustrates the kinds of dead ends that epidemiologists, like criminal detectives, encounter and that scientific journals rarely publish. They and other factors create a false impression that investigations and discoveries are simpler than they really are.
A week into the investigation, health officials were relieved as a second outbreak failed to develop among those attending an international religious meeting in Philadelphia and no spread of the ailment occurred from Legionnaires’ patients to their families and friends.
Tests also excluded all forms of influenza as a cause of the outbreak. “All of us can breathe a sigh of relief it was not the flu,” said Dr. David J. Sencer, then the C.D.C. director.
If not influenza, what was the illness? Earlier tests had ruled out poisoning from 17 metals. But experts in a variety of specialties who were not connected with the outbreak had called or written to me and health officials to suggest a number of toxins.
Stumped, health officials re-examined the possibility of other toxins or poison gases. One poison, nickel carbonyl, was a long shot that health officials took seriously, only to be embarrassed by flaws in the collection of the tissues for testing. The initial nickel findings were ruled invalid because of probable contamination from the use of metal instruments in autopsies. Pathologists were then ordered to use plastic knives.
Reports of the lapses in investigation technique jarred public confidence about the ability of health departments to detect outbreaks from hazardous chemicals. The flaws also led to a Congressional hearing in the fall on the medical investigation, causing federal and state health officials further embarrassment.
By winter, many of the authorities said the outbreak’s cause was definitely not a bacterium and that it would never be known. But the doubters overlooked the importance that human factors like compulsiveness, embarrassment and public pressure can play in solving scientific riddles and making discoveries.
At Christmastime in 1976, Dr. Joseph McDade, a C.D.C. laboratory scientist who had tested specimens from the outbreak, was harshly criticized at a party for his agency’s failure to solve the mystery.
Dr. McDade said his usual custom at that time of year was to “tidy up loose ends,” so when he went to his laboratory “to put to rest some hunches about something” he had seen in the specimens, the insult lurked in the background.
Within a month, Dr. McDade had identified the culprit and showed that Legionnaires’ was a newly recognized old disease. The bacterium had been isolated at least twice before by different groups of researchers at the Walter Reed Army Institute of Research in Washington starting in 1947. Each group believed it was dealing with a bacterium that affected animals, not humans.
Dr. McDade’s discovery quickly led scientists to document a number of earlier outbreaks in Pontiac, Mich.; Washington; and elsewhere. Legionnaires’ disease now accounts for an estimated 18,000 hospital admissions in this country each year, and C.D.C. scientists have said that doctors miss the diagnosis in many more patients. Most outbreaks and cases have been traced to contaminated water in places like shower heads, air-conditioning systems and medical respiratory devices. The largest outbreak, in Spain in 2001, affected nearly 700 people.
The Legionnaire bacterium can produce two forms of illness that begin with flulike symptoms. One, Legionnaires’ disease, goes on to produce pneumonia and systemic illness. The other, Pontiac fever, produces only a mild illness. Why the same bacterium causes two distinct illness patterns is not known.
Seamless teamwork between epidemiologists and laboratory scientists can be a potent weapon in solving disease outbreaks caused by known and unknown agents. But the teamwork in the Pennsylvania outbreak was porous, as lapses in investigation technique showed.
From the start, the investigation encountered a number of problems, some beyond their control. One was that the American Legion had no registration list of conventioneers, leaving no easy way to contact attendees to check on their health.
In investigating outbreaks, epidemiologists often develop questionnaires, in part to make statistical comparisons between those who become ill and those who do not.
Another aim is to determine the priority in performing laboratory tests to determine the cause of an illness. But the longer the delay in starting this medical sleuthing, the fuzzier people’s recall of events becomes. A problem was that health officials could have learned of the outbreak earlier than they did. For example, a physician in Pennsylvania called health officials on July 30, a Friday afternoon, to report a Legionnaire with possible typhoid fever. It was too late in the day, call back on Monday, a nurse said.
The episode illustrated that many health departments did not provide the type of 24/7 coverage for calls and emergencies that hospitals and doctors did. Now more health departments provide such coverage.
Still another problem was that Philadelphia health officials learned belatedly about an earlier outbreak of 19 cases of an illness similar to Legionnaires’ disease, including three deaths. It affected members of the Independent Order of Odd Fellows in 1974 after they had visited the Bellevue-Stratford. The cluster was not reported until after news of the Legionnaires’ outbreak in 1976.
However, there were widespread complaints about a number of issues over which health officials had some control. One was the lack of coordination between investigators from federal, state and local health departments and determining which was in charge.
Doctors who cooperated in providing information and specimens from Legionnaires’ patients said they had received little feedback from health officials. For example, some doctors said antibiotics were effective in their patients and urged wider use of them in the outbreak. But health officials gave no advice, largely because they could not scientifically evaluate the effectiveness of the antibiotics among the patients quickly enough.
The issue of providing such evaluations of therapy during an outbreak remains an important problem; many doctors and others lodged the same complaint against the C.D.C. in the anthrax outbreak in 2001. Some critics said they learned more about the outbreak from news organizations than from the agency.
In the case of Legionnaires’, persistent pressure from the news media, a number of health officials said later, helped hold them accountable and to spur scientists to do what they rarely had done in other unsolved cases and outbreaks — taking a crucial second look that solved the Legionnaires’ outbreak.
Researchers Explore Ways Bird Flu May Spread
By DENISE GRADY, The New York Times, August 1, 2006
A new study addresses the most urgent public health question about bird flu: what would it take to make the virus more contagious in people?
The study did not exactly answer the question, but it did show what does not work — simple genetic changes are not enough to transform the virus into a strain that could cause a pandemic.
Researchers from the federal Centers for Disease Control and Prevention tried to make the A(H5N1) bird flu virus more contagious, but could not, they are reporting this week in the online edition of The Proceedings of the National Academy of Sciences.
That result may sound like good news, but the scientists urge caution. “These data do not mean H5N1 cannot convert to being transmissible person to person,” said Dr. Julie Gerberding, director of the disease centers. “They mean it is not simple.”
Since 2003, the virus spread from Asia to Europe and Africa, infecting millions of birds and some humans, mostly through contact with birds. So far, 232 people in 10 countries have contracted bird flu, and 134 have died.
The one thing that has prevented the disease from causing a human pandemic is its inability to spread easily among people. But that could change. Scientists’ biggest fear has been that A(H5N1) may mix with a human flu virus that does spread in people, swap a few genes and morph into a new, highly contagious strain that could cause a deadly pandemic.
To test whether that could happen, scientists at the disease centers did the kind of mixing and swapping that might occur in nature. Experiments like this must be done in a sealed-off, high-security room known as an enhanced Biosafety Level 3 laboratory, designed to keep viruses from escaping or infecting workers.
The researchers started with a bird flu virus and exchanged some of its genes with those from a human flu virus, A(H3N2), a very contagious strain that causes most of the seasonal flu outbreaks worldwide.
They then tested the new hybrids in ferrets, to see if they were deadly like bird flu and contagious like the human strain. Ferrets are considered a good model for people in flu experiments because they are highly susceptible to human strains and transmit them easily. Also like people, they can be infected with bird flu but do not spread it easily.
The new viruses did not transmit efficiently among the animals, and also did not cause as severe an illness as the original A(H5N1).
But at a telephone news conference on Friday, an author of the study, Dr. Jacqueline M. Katz, said the scientists had tested only a few of the many hybrids that could be created. Further studies will examine more.
Meanwhile, as bird flu continues to spread in the wild, evolving along the way, scientists continue to hope the virus does not stumble upon the deadly genetic combination they are trying to understand.
Dr. Gerberding warned: “We are far from out of the woods with H5N1.”
Really? The Claim: Wounds Heal Better When Exposed to Air
By ANAHAD O’CONNOR, The New York Times, August 1, 2006
THE FACTS Most parents and school nurses have a time-honored approach to treating a small wound: clean it up, stop the bleeding and then let it get some air.
The point of this approach, as described in medical texts, is to lower the odds of infection and to speed the healing process. But over the years, researchers have found that what many people know about treating small cuts and scrapes is wrong.
Exposing a wound to the air so it can breathe is a terrible mistake, experts say, because it creates a dry environment that promotes cell death.
A handful of studies have found that when wounds are kept moist and covered, blood vessels regenerate faster and the number of cells that cause inflammation drop more rapidly than they do in wounds allowed to air out. It is best to keep a wound moist and covered for at least five days.
Another common mistake is applying antibiotic ointments, said Dr. Mark D. P. Davis, a professor of dermatology at the Mayo Clinic in Rochester, Minn. These ointments may keep the wound moist, he said, but they can also lead to swelling and an allergic reaction called contact dermatitis. Plain and simple Vaseline, applied twice a day, works fine.
And as awful as removing scabs may sound, it may actually be a good idea, Dr. Davis said. A small initial scab will help stop the bleeding, but if left for too long it will do more harm than good.
“You don’t want it to mature too much because it increases scarring,” he said. “That’s the general thinking.”
THE BOTTOM LINE Exposing a cut so it can breathe slows healing.
Evolution’s Backers in Kansas Mount a Counterattack
By RALPH BLUMENTHAL, The New York Times, August 1, 2006
KANSAS CITY, Kan., July 29 — God and Charles Darwin are not on the primary ballot in Kansas on Tuesday, but once again a contentious schools election has religion and science at odds in a state that has restaged a three-quarter-century battle over the teaching of evolution.
Less than a year after a conservative Republican majority on the State Board of Education adopted rules for teaching science containing one of the broadest challenges in the nation to Darwin’s theory of evolution, moderate Republicans and Democrats are mounting a fierce counterattack. They want to retake power and switch the standards back to what they call conventional science.
The Kansas election is being watched closely by both sides in the national debate over the teaching of evolution. In the past several years, pitched battles have been waged between the scientific establishment and proponents of what is called intelligent design, which holds that nature alone cannot explain life’s origin and complexity.
Last February, the Ohio Board of Education reversed its 2002 mandate requiring 10th-grade biology classes to critically analyze evolution. The action followed a federal judge’s ruling that teaching intelligent design in the public schools of Dover, Pa., was unconstitutional.
A defeat for the conservative majority in Kansas on Tuesday could be further evidence of the fading fortunes of the intelligent design movement, while a victory would preserve an important stronghold in Kansas.
The curriculum standards adopted by the education board do not specifically mention intelligent design, but advocates of the belief lobbied for the changes, and students are urged to seek “more adequate explanations of natural phenomena.”
Though there is no reliable polling data available, Joseph Aistrup, head of political science at Kansas State University, said sharp ideological splits among Republicans and an unusual community of interest among moderate Republicans and some Democrats were helping challengers in the primary.
Kansas Democrats, moreover, have a strong standard-bearer in the incumbent governor, Kathleen Sebelius, who has distanced herself from the debate.
“And if a conservative candidate makes it through the primary, there’s a Democratic challenger waiting” in the general election, Professor Aistrup said.
Several moderate Republican candidates have vowed, if they lose Tuesday, to support the Democratic primary winners in November. With the campaign enlivened by a crowded field of 16 candidates contending for five seats — four held by conservatives who voted for the new science standards last year — a shift of two seats could overturn the current 6-to-4 majority. The four-year terms are staggered so that only half the 10-member board is up for election each two years.
The acrimony in the school board races is not limited to differences over the science curriculum but also over other ideologically charged issues like sex education, charter schools and education financing. Power on the board has shifted almost every election since 1998, with the current conservative majority taking hold in 2004.
“Can we just agree God invented Darwin?” asked a weary Sue Gamble, a moderate member of the board whose seat is not up for re-election.
The chairman of the board, Dr. Steve E. Abrams, a veterinarian and the leader of the conservative majority, said few of the opposition candidates were really moderates. “They’re liberals,” said Dr. Abrams, who is not up for re-election.
He said that the new science curriculum in no way opened the door to intelligent design or creationism and that any claim to the contrary “is an absolute falsehood.”
“We have explicitly stated that the standards must be based on scientific evidence,” Dr. Abrams said, “what is observable, measurable, testable, repeatable and unfalsifiable.”
In science, he said, “everything is supposedly tentative, except the teaching of evolution is dogma.”
Harry E. McDonald, a retired biology teacher and self-described moderate Republican who has been going door to door for votes in his district near Olathe, said the board might have kept overt religious references out of the standards, “but methinks they doth protest too much.”
“They say science can’t answer this, therefore God,” Mr. McDonald said.
Connie Morris, a conservative Republican running for re-election, said the board had merely authorized scientifically valid criticism of evolution. Ms. Morris, a retired teacher and author, said she did not believe in evolution.
“It’s a nice bedtime story,” she said. “Science doesn’t back it up.”
Dr. Abrams said his views as someone who believes that God created the universe 6,500 years ago had nothing to do with the science standards adopted.
“In my personal faith, yes, I am a creationist,” he said. “But that doesn’t have anything to do with science. I can separate them.” He said he agreed that “my personal views of Scripture have no room in the science classroom.”
Dr. Abrams said that at a community meeting he had been asked whether it was possible to believe in the Bible and in evolution, and that he had responded, “There are those who try to believe in both — there are theistic evolutionists — but at some point in time you have to decide which you’re going to put your credence in.”
Last year’s changes in the science standards followed an increasingly bitter seesawing of power on the education board that began in 1998 when conservatives won a majority. They made the first changes to the standards the next year, which in turn were reversed after moderates won back control in 2000. The 2002 elections left the board split 5-5, and in 2004 the conservatives won again, instituting their major standards revisions in November 2005.
Critics said the changes altered the science standards in ways that invited theistic interpretations. The new definition called for students to learn about “the best evidence for modern evolutionary theory, but also to learn about areas where scientists are raising scientific criticisms of the theory.”
In one of many “additional specificities” that the board added to the standards, it stated, “Biological evolution postulates an unguided natural process that has no discernable direction or goal.”
John Calvert, manager of the Intelligent Design Network in Shawnee Mission and a lawyer who wrote material for the board advocating the new science standards, said they were not intended to advance religion.
“What we are trying to do is insert objectivity, take the bias out of the religious standard that now favors the nontheistic religion of evolution,” Mr. Calvert said.
Janet Waugh, a car dealer and the only moderate Democrat on the board whose seat is up for election, said that just because some people were challenging evolution did not mean their views belonged in the curriculum.
“When the mainstream scientific community determines a theory is correct, that’s when it should be in the schools,” Ms. Waugh said. “The intelligent design people are trying to cut in line.”
The races have been hard-fought. With the majority of the 100,000 registered Republicans in Mr. McDonald’s northeast Kansas district usually ignoring primary elections, a few hundred ballots could easily be the margin of victory.
So Mr. McDonald, who with $35,000 is the lead fund-raiser among the candidates, printed newsletters showing his opponent, the conservative board member John W. Bacon, with a big red slash through his face and the slogan, “Time to Bring Home the Bacon.” Mr. Bacon did not respond to several calls for a response.
But many of the homeowners Mr. McDonald visited Friday night showed little interest in the race. Jack Campbell, a medical center security director, opened the door warily, and when Mr. McDonald recited his pitch, seemed disappointed. “I thought I won some sweepstakes,” Mr. Campbell said.
Last Thursday night at Fort Hays State University, Ms. Morris debated her moderate Republican challenger, Sally Cauble, a former teacher, and the Democratic candidate, Tim Cruz, a former mayor of Garden City, whom Ms. Morris once accused of being an illegal immigrant. (He said he was third-generation American, and Ms. Morris apologized.)
The audience asked about Kansas being ridiculed across the country for its stance on evolution.
“I did not write the jokes,” Ms. Morris said.
Spectators split on the winner.
“There are so many more important issues in Kansas right now,” said Cheryl Shepherd-Adams, a science teacher. “The issue is definitely a wedge issue, and I don’t want to see our community divided.”
Transforming the Alchemists
By JOHN NOBLE WILFORD, The New York Times, August 1, 2006
PHILADELPHIA — Historians of science are taking a new and lively interest in alchemy, the often mystical investigation into the hidden mysteries of nature that reached its heyday in Europe in the 16th and 17th centuries and has been an embarrassment to modern scientists ever since.
There was no place in the annals of empirical science, beginning mainly in the 18th century, for the occult practices of obsessed dreamers who sought most famously and impossibly to transform base metals into pure gold. So alchemy fell into disrepute.
But in the revival of scholarship on the field, historians are finding reasons to give at least some alchemists their due. Even though they were secretive and self-deluded and their practices closer to magic than modern scientific methods, historians say, alchemists contributed to the emergence of modern chemistry as a science and an agent of commerce.
“Experimentalism was one of alchemy’s hallmarks,” said Lawrence M. Principe, a historian of science at Johns Hopkins University and a trained chemist. “You have to get your hands dirty, and in this way alchemists forged some early ideas about matter.”
Bent over boiling crucibles in their shadowy laboratories, squeezing bellows before transformative flames and poring over obscure formulas, some alchemists stumbled on techniques and reactions of great value to later chemists. It was experimentation by trial and error, historians say, but it led to new chemicals and healing elixirs and laid the foundations of procedures like separating and refining, distilling and fermenting.
“What do chemists do? They like to make stuff,” Dr. Principe said. “Most chemists are interested not so much in theory as in making substances with particular properties. The emphasis on products was the same with some alchemists in the 17th century.”
Pamela H. Smith, a history professor at Columbia, said alchemy “was the matter theory of its day” and was “incredibly multilayered and therefore a powerful way of viewing nature.”
Yet on the whole, historians say, the widespread practice of alchemy impeded the rise of modern chemistry. While physics and astronomy marched slowly but inexorably from Galileo to Kepler to Newton and the Scientific Revolution, chemistry slumbered under alchemy’s influence through what historians call its “postponed scientific revolution.”
The new research and revised interpretations concerning the role of alchemy in the history of chemistry as well as pharmacology and medicine were discussed at a three-day conference late last month at the Chemical Heritage Foundation in Philadelphia. The meeting, attended by more than 80 scientists and historians, was organized by Dr. Principe, who said, “Only in the last 15 or 20 years have we learned how crucial alchemy was to the emergence of modern science.”
No one at the meeting tried to turn lead into gold. But the historians conjured up quite a lode of pyrite, fool’s gold, in the colorful characters they had found buried in previously neglected archives.
A few practicing alchemists, it seems, may have been certifiably mad — probably, like mad hatters, from sniffing the mercury they worked with.
One notable alchemist of the 16th century, a Swiss named Paracelsus, was not mad, but cantankerous and iconoclastic. “He was equal parts metallurgist, pharmacist, physician and crackpot,” Dr. Principe said.
Historians have found that Paracelsus made some advances in the detection of disorders by analyzing urine and claimed marvelous cures through alchemy.
In his chemical cosmology, he saw the world as a great distillation vessel and its changes as parallel to the operations carried out in a laboratory. But he recorded his material and spiritual ideas in the deliberately opaque writing typical of many alchemists, who expressed themselves in codes, symbols and emblems to conceal their findings from the uninitiated.
From his study, Dane Thor Daniel of Wright State University in Dayton, Ohio, concluded that Paracelsus’s unwavering objective was to find a Christian alternative to pagan natural philosophy — science.
Other alchemists were outright charlatans or fools, ridiculed in contemporary art and literature. On display in a gallery at the conference hall were several 17th-century paintings by Flemish and Dutch artists, who depicted alchemists toiling in the disorder of dark workshops and the poverty of futile quests. The paintings were said to be popular among Dutch burghers as a caution to anyone contemplating a life in alchemy instead of steady trade.
But many an alchemist drew support from royal courts where visions of newfound wealth and power danced in crowned heads. It was not always a happy alliance.
In 1601, Hans Heinrich Nüschler signed a contract with his patron, Duke Friedrich of Württemberg in Stuttgart, to demonstrate his process for extracting a substantial amount of gold from a sample of silver. The duke, keen on mining technology, promised a generous reward. Nüschler agreed to conduct the experiments at his own expense.
After several months of failure and mounting debt, the desperate alchemist resorted to fraud. He asked his brother to help by surreptitiously adding gold to the alchemical sample. His ploy exposed, Nüschler was tried, convicted and hanged.
“Only a handful of alchemists actually ended their careers on the gallows,” said Tara E. Nummedal, a historian at Brown. “But this underscored that alchemy was very serious business in the Holy Roman Empire.”
In her report, Dr. Nummedal concluded that the relationships of patrons and alchemists showed that “alchemy was a direct engagement with the political, economic, religious and intellectual realities of the early modern world.”
At the turn of the 17th century, King Henry IV of France surrounded himself with alchemists who sought to resurrect plants from their ashes and experimented with ways to extend the monarch’s life. Even the diplomats had orders to seek out the cryptic methods of alchemists in other countries.
An alchemist in the court of a German prince scored a profitable success quite by accident. Looking for materials for creating precious metals, Johann Friedrich Böttger analyzed a “white earth” that duplicated the ingredients for imported Chinese porcelain. The discovery was the beginning of the Dresden china industry.
Even geniuses of the first order, like Isaac Newton, found alchemy irresistible. It was an accepted method of seeking knowledge — or confirmation of received truth — in early modern history.
Newton, whose laws of gravity and optics ushered in modern physics, also delved into alchemy with relentless energy. His notebooks contain thousands of pages on alchemic thoughts and experiments over 30 years.
William R. Newman, a professor of the history and philosophy of science at Indiana University, said many manuscripts had not received the scrutiny they deserved. He reported on a text in the Smithsonian Institution that he called “an overlooked gem.”
In these notebook entries, Newton cited the ideas of German alchemists for imitating the processes by which metals were generated in nature, deep inside the earth. These involved the familiar alchemical theory of metallic generation through interactions of sulfur and mercury.
But Newton, expanding on the theory, wrote: “These two spirits above all wander over the earth and bestow life on animals and vegetables. And they makes stones, salts and so forth.”
As Dr. Newman noted, “Thus we have passed from a theory of mere metallic generation to one that is intended to explain the totality of life on earth, as well as the production of all mineral materials, not just metallic ones.”
In this sense, Dr. Newman continued, Newton’s repeated experiments for the rest of his life were aimed at fulfilling the words of the Emerald Tablet of Hermes, considered the founding text of alchemy in ancient Egypt. Newton expected to achieve what the tablet said was the una res, “the one thing” by which “the world was created” and with which one could “perform miracles.”
So it seems that Newton was no ordinary alchemist interested in making gold. He apparently aspired to a theory of alchemy more comprehensive than even his laws of gravity. But it could be said, in a paraphrase of Newton’s famous expression of modesty, that the giants on whose shoulders he stood in this endeavor did not measure up to his antecedents in physics and astronomy.
Newton’s alchemical bent was not out of character, Dr. Smith of Columbia said. “He was drawn to the occult,” she said. “Gravity for him was an occult force, and so was alchemy as an explanation of how things transform into other things.”
The British chemist Robert Boyle, a Newton contemporary, also had a foot on each side of the alchemy-modern science divide. He dabbled for years in an alchemical obsession, the search for the philosopher’s stone — the long-sought agent for transmuting lead to gold and unlocking other material and spiritual secrets. The stone was the unified theory of everything in that time.
Boyle wrote enviously in 1680 that “there exists conceal’d in the world” a group of chemists “of a much higher order able to transmute baser Metalls into perfect ones.”
At the same time, Boyle hurled harsh criticism at alchemists, particularly Paracelsians and the obscurity of their language and concepts. His purpose, he wrote, was to draw “the Chymists Doctrine out of their Dark and Smoakie Laboratories into open light” and to engage in “better Experiments and Arguments.”
Citing Boyle’s “swinging critique” and even earlier attacks on alchemical practices, Stephen Clucas, a University of London historian, raised questions that he said require deeper research by historians: Why did a “scientific revolution” in experimental chemistry not occur earlier in the 17th century? Why was a clear separation of alchemy and exact chemistry delayed until the 18th century?
Bruce T. Moran, a historian at the University of Nevada at Reno and the University College London, said it was not all that unreasonable at the time to be attracted to alchemy. “For a variety of practical and intellectual reasons,” Professor Moran said, “the idea of transforming one thing into another was to be expected.”
In everyday life, grapes were turned to wine and wheat to bread. A sour green apple grew into a sweet red one. It was in the nature of things to change, even metals. Miners and refiners already knew that lead ore almost always contains some silver, and silver ore almost always contains some gold. This implied that the metals changed one into the other over time.
In the booklet “Transmutations: Alchemy in Art,” written with Lloyd DeWitt, an art historian, Dr. Principe noted that in 1600, chemists knew of just seven metals — gold, silver, iron, copper, tin, lead and mercury. (Since then scientists have discovered another 60.) The original seven known metals had properties in common. They were shiny and, except for the liquid mercury, could be hammered, shaped and cast.
“The commonality of properties implied to early thinkers a commonality of composition,” Dr. Principe wrote., “And thus it was theorized that all the metals were composed of the same essential ingredients in different proportions and degrees of purity.”
“Even if in the modern view alchemy is all nonsense or very spiritual,” Dr. Moran said, “many people drawn to it for whatever reasons were actually creating very useful, practical chemistry and bringing to it an artisan know-how.”
The conference on the history of alchemy opened with a program of chamber music called “The Philosophers’ Tone.” The scholars delighted in Handel’s transmutation of Ben Jonson’s “The Alchemist” into pure gold. Over coffee between sessions, they pondered new directions of research and topics for dissertations. They said, for example, that more attention should be paid to alchemy’s role in the history of medicine.
They also remarked, somewhat conspiratorially, over parallels between the misguided certainties and self-delusion of alchemy and today’s political and religious attacks on modern science. Of Boyle’s efforts to replicate experiments from alchemical writings, Joseph E. Early, a retired Georgetown University professor who studies the philosophy of chemistry, said, “He couldn’t do it any more than we could find the weapons of mass destruction in Iraq.”
Then the scholars departed Philadelphia, leaving the city’s lead-to-gold ratio unchanged.
A Small Charity Takes Lead in Fighting a Disease
By STEPHANIE STROM, The New York Times, July 31, 2006
PATNA, India — The drug that could have cured Munia Devi through a series of cheap injections was identified decades ago but then died in the research pipeline because there was no profit in it.
So Mrs. Devi lay limp in a hospital bed here recently, her spleen and liver bulging from under her rib cage as a bilious yellow liquid dripped into her thin arm. The treatment she was receiving can be toxic, and it costs $500. But it was her best hope to cure black fever, a disease known locally as kala azar, which kills an estimated half-million people worldwide each year, almost all of them poor like Mrs. Devi.
Soon, however, all that may change. A small charity based in San Francisco has conducted the medical trials needed to prove that the drug is safe and effective. Now it is on the verge of getting final approval from the Indian government. A course of treatment with the drug is expected to cost just $10, and experts say it could virtually eliminate the disease.
If approval is granted as expected this fall, it will be the first time a charity has succeeded in ushering a drug to market.
This novel way of helping people whose needs have not been met by for-profit pharmaceutical companies is gaining traction. Several partnerships are working to develop drugs to fight neglected diseases, underwritten by the Bill and Melinda Gates Foundation, Doctors Without Borders and other groups. Another nonprofit agency, the Aeras Global TB Vaccine Foundation, is searching for a means to prevent tuberculosis.
For its first project, the San Francisco charity, the Institute for OneWorld Health, focused on reclaiming the all but abandoned drug, paromomycin, which research found promising in the 1960’s.
That was the easy part. Its hurdles lay elsewhere. The Internal Revenue Service at first denied the charity nonprofit status, concerned that it looked too much like a for-profit enterprise. The World Health Organization, which controlled the drug, was reluctant to hand over the data needed for further development. And OneWorld Health had to set up clinical trials matching United States and European standards in one of the poorest parts of the world.
Nor was it obvious where the money would come from. The idea of a nonprofit drug company struck many as folly when Dr. Victoria Hale, a former Genentech executive and Food and Drug Administration official, founded OneWorld Health in 2001. So Dr. Hale and her husband started the project using their own money, though they have since won support from the Gates foundation, among others.
“My colleagues and mentors in the pharmaceuticals industry told me it was a wild idea, that it would never work out, that I was jeopardizing my reputation,” Dr. Hale said. “I started this organization knowing our first project had to be a winner or we wouldn’t survive.”
An Ambitious Goal
Dr. Hale hopes to stamp out black fever eventually, a goal that many doctors regard as impossible. “The last disease we truly eradicated was smallpox,” she said. “There’s no urgency to eradicating diseases anymore. Why not?”
Black fever is the second-largest parasitic killer in the world after malaria. It is spread by sand flies, and Banthu, the squalid village about an hour’s drive from here that Mrs. Devi calls home, is an ideal breeding ground for them.
The flies multiply in the cow dung that Mrs. Devi uses as fuel for cooking. They relish the sap in the banana groves and bamboo stands, and they thrive in the thatch used to make the tiny houses. Flies that have bitten infected humans transmit the disease when they bite another person. Smaller than mosquitoes, they can pass through most netting.
Roughly 90 percent of black fever cases worldwide are found here in Bihar State in India and in Bangladesh, Nepal, Sudan and northeastern Brazil.
Mrs. Devi’s daughter was the first in the family to contract the disease, and she died from it. Then Mrs. Devi’s youngest son, Rajesh, got it, and she brought him to the Rajendra Memorial Research Institute of Medical Science here, where he was treated and recovered. Now she, too, is receiving treatment.
It is at the Rajendra Institute, a government research facility, that OneWorld Health set up one of the trials needed to make paromomycin widely available.
Many Early Battles
Dr. Hale first set her sights on the drug after she attended a conference in Belgium in 1999, where Dr. Shyam Sundar, an expert on black fever, was railing against the world’s failure to fight the disease.
“The tragedy, maybe even the crime, is that we have known that this drug is an effective treatment for kala azar since the 1960’s,” said Dr. Sundar, whose free clinic in Muzaffarpur was also a site for a trial by OneWorld Health. “We could do something, but we were choosing not to.”
After visiting Dr. Sundar’s clinic in 2000, Dr. Hale, who was doing consulting work at the time, hired a law firm to help her get the tax exemption necessary to create a nonprofit drug company. The I.R.S. turned her down three times over 10 months, suspicious that her plan was a scheme by the drug industry to shelter profits. The tax agency challenged her to find an example of an existing charity that mirrored a for-profit business.
“It took me five days, and then at dinner, it hit me: N.P.R. and public television,” she said. “They look an awful lot like for-profit radio and television, but they serve a different audience with programs that their for-profit counterparts don’t provide because they can’t profit from them.”
Two weeks later, OneWorld Health received I.R.S. approval and set out to tackle black fever.
The immediate challenge was financing. For a time, OneWorld Health survived on the largesse of Dr. Hale and her husband, Dr. Ahvie Herskowitz. They put up $100,000, signed a $315,000 promissory note, used the ground floor of their house as offices, and worked without pay for two years.
The Gates foundation, which at the time was primarily underwriting vaccines and other preventive strategies, eventually offered a grant of $4.2 million that grew to $47.2 million for the development of paromomycin. Dr. Hale also got help from others, including the Skoll Foundation, which has provided financing to underwrite salaries for new senior executives.
An Abandoned Drug
An initial, formal test of paromomycin, an antibiotic sold in some countries as an oral treatment for diarrhea and as a topical treatment for cutaneous leishmaniasis, which causes lesions, was done in the late 1980’s in Africa, two decades after it was identified as a simple, cheap, effective cure for black fever.
Through a series of company mergers it was consigned to the corporate shelf and forgotten, ending up with the World Health Organization, which lacked the money to develop it beyond the Phase II clinical trials.
But negotiations with the World Health Organization to hand over the data that would allow OneWorld Health to organize the Phase III clinical trials necessary for regulatory approval dragged on for almost two years. At the time, the W.H.O was developing another drug for black fever with Zentaris, a large pharmaceutical company, and the Indian government. That drug, miltefosine, has the advantage of being an oral treatment, while paromomycin is administered by injection.
But miltefosine, an anticancer drug, also has drawbacks. In trials, it caused gastrointestinal problems in one-third of the patients. And patients must be strictly supervised to ensure that they take the full 21-day course of treatment and that women of child-bearing age are using birth control. By contrast, paromomycin has shown almost no side effects in trials.
With a price of $100 to $200 a treatment, miltefosine is out of reach for most patients and government purchasing programs.
Dr. T. K. Jha, a specialist in black fever who oversaw one of the OneWorld Health trials, said the W.H.O. wanted to make sure miltefosine made it onto the market before handing over its data on paromomycin. “Commerce got in the way,” Dr. Jha said.
But Dr. Robert G. Ridley, director of the W.H.O.’s special program for research and training in tropical diseases, disputed that. Dr. Ridley wrote in an e-mail message that the “time lag” had to do with getting financing from the Gates foundation and the process of negotiating an agreement with OneWorld Health.
The subject of the commercial aspects of drugs is a difficult one for OneWorld Health, which is careful to avoid criticism of its for-profit cousins, as well as competition with them.
“We look a lot like each other,” Dr. Herskowitz said. “But we fill a gap pharma companies cannot because they have to make a profit.”
But given the choice of paying more than $100 for Zentaris’s miltefosine or $10 for paromomycin, governments and most patients will no doubt choose the cheaper drug.
OneWorld Health does not intend to gain income from the drug. It has given a license to Gland Pharma, an Indian drug company that has agreed to manufacture the drug and sell it at cost when it is approved. But Dr. Hale can foresee a time when, say, a drug OneWorld Health hopes to develop to treat childhood diarrhea could be sold to travelers by a for-profit drug maker in exchange for royalties that would help sustain her organization’s charitable work.
Still More Difficulties
Approval of paromomycin will not end OneWorld Health’s challenges. Distribution looms as the next hurdle.
In Patepur, a somewhat more prosperous village than Mrs. Devi’s, Dr. Syed Misbah Hassan, a clinical research coordinator for OneWorld Health, diagnosed kala azar in one boy after another.
Dilip Manjhi, who is about 15, lay listless on a string bed as Dr. Hassan examined his abdomen for the telltale signs of the disease, a swollen spleen and liver. Dilip’s spleen extended eight centimeters below his rib cage and was rock hard. His liver protruded three centimeters below his ribs.
Getting paromomycin to remote villages like Patepur at the end of pothole-pocked roads will be difficult. Dr. Hale is trying to enlist a British nonprofit group, Riders for Health, to help. The group uses motorcycles to connect poor people to medical services. In Zimbabwe, for instance, it has taken pregnant women in need of Caesarean sections to hospitals.
“My thinking,” Dr. Hale said, “is that we could equip a motorcycle with a cooler to transport the drug and equip the driver to give the injections and maintain records.”
But first, the Bihar State government and India’s central government must create a system that encompasses diagnosing the disease, buying and administering the drug, keeping records and spraying to reduce the sand fly population.
Some experts wonder whether the government has the will to create such a system, when hundreds of thousands of Indian children die each year of measles, which can be prevented with a 15-cent vaccine. But Dr. C. P. Thakur, a former Indian health minister who oversaw a OneWorld Health trial of paromomycin, noted that black fever was one of five insect-borne diseases the Indian government had pledged to eliminate.
India has also signed an agreement with the governments of Nepal and Bangladesh to eradicate the disease, and the Bihar State government has shown a willingness to work with OneWorld Health.
“The government will be the biggest challenge,” Dr. Thakur said. “But I believe the opportunities to end this disease have never been better, and also that the government’s will has never been stronger.”
The Doctor's World: In Philadelphia 30 Years Ago, an Eruption of Illness and Fear
By LAWRENCE K. ALTMAN, The New York Times, August 1, 2006
In late July 1976, American Legionnaires returning from a state convention in Philadelphia began to fall ill with mysterious symptoms: pneumonia and fevers topping 107 degrees.
By early August, news organizations across the country were reporting that 6 to 14 of the men in Pennsylvania had died. Others were in hospitals fighting for their lives. No laboratory tests could determine the cause of their illness, which quickly became known as Legionnaires’ disease. No one knew the health status of the 10,000 other convention participants.
As the news began to break, 30 years ago this week, Americans were primed for the threat of an epidemic. The Ford administration was making plans to vaccinate every American against a new strain of influenza, known as swine flu, after repeated warnings from government officials that a devastating epidemic could strike without warning. Michael Crichton’s “Andromeda Strain” had become a best seller. And some scientists were calling for a moratorium on laboratory efforts to genetically engineer microbes for fear they might create a monster germ.
These factors made the unexpected attack on American veterans, which occurred shortly after the country’s bicentennial celebration, front-page news.
When I first heard about the mysterious cases from news agency bulletins on Aug. 2, I initially viewed them with some skepticism. A few months earlier, Dr. Leonard Bachman, the Pennsylvania health secretary, issued a news release saying that a staff member, Dr. Buford S. Washington, had discovered an often fatal new disease, pantosomatitis, that was spreading throughout the eastern United States. Looking into the claim, I found there was no documented case and no such disease.
Disease outbreaks were familiar territory for me. Before coming to The New York Times, I’d been an Epidemic Intelligence Service officer at the Communicable Disease Center, now the Centers for Disease Control and Prevention, in Atlanta. If the Legionnaires’ outbreak had occurred a decade sooner, I might have been one of the investigators sent to Pennsylvania.
Health officials there urged the public not to panic, and some initially denied that the cluster of cases was an outbreak of an infectious disease. But behind the scenes, the same officials were bracing themselves for a medical catastrophe.
“We thought we might be faced with an unprecedented condition in modern medicine, one for which we had no really effective antibiotics, drugs or therapy,” Dr. Bachman told me in 1976. Because there was no way to predict how many more Legionnaires would fall ill, Dr. Bachman said he had contemplated seizing control of all hospitals in the state and imposing quarantines.
It took six months to determine that the illness had been caused by a bacterium, Legionella pneumophilia, which we now know usually succumbs to the timely prescription of proper antibiotics. The bacterium, which in this case was apparently spread from the hotel’s air-conditioning system, is a cause of pneumonia and other illnesses worldwide.
The investigation that solved the mystery took an array of surprising twists and turns. It revealed the strengths and weaknesses of the nation’s health system in response to an outbreak from an unknown agent.
Some lessons learned from the outbreak improved investigations of later outbreaks like avian flu, SARS and the deliberate release of anthrax spores in the postal system shortly after the Sept. 11 attacks. But many authorities have not learned other important lessons, like the need for more effective communication.
Intense news coverage of the Legionnaires’ outbreak continued for weeks, providing one of the rare opportunities for the public to see how medical detectives work and how scientists make discoveries.
The epic challenged the widespread notion that medicine was all-knowing, able to lick almost any problem, and that antibiotics and vaccines had turned once lethal infectious diseases into minor threats.
The news coverage also marked a turning point in journalism’s efforts to hold officials accountable for their response to epidemics that can threaten the lives of thousands of people, as well as tourism, international trade and world economies. News about the outbreak led to the temporary closing of the Bellevue-Stratford Hotel, a Philadelphia landmark that was the headquarters of the American Legion convention and a focus of suspicion about the spread of the bacterium.
The C.D.C. sent 20 epidemiologists — the largest squad of medical detectives to investigate an outbreak in the federal agency’s history — to Pennsylvania where they joined scores of state health workers.
The sleuths fanned across the state to review the medical records of all the ill Legionnaires and to study the autopsy findings in the fatal cases. Epidemiologists also checked every hospital to identify new cases and interview patients’ families and doctors, in part to determine whether one or more Legionnaires might have taken the illness to Philadelphia.
On Aug. 2, when news agencies began issuing dispatches, a quick look convinced me that the Legionnaires’ cases were real, not another false alarm. Late that evening, I finished my first article about the still-unnamed mysterious disease.
Then I drove to Harrisburg, listening to the radio to keep me awake but unable to escape the repetitious news accounts about the outbreak, the speculation that the illness was swine flu and the safety concerns about visiting Philadelphia.
The Times handled the story more cautiously than radio and television. My article, on Page 12, was not even included in the news summary.
Over the next few days, the toll of the illness rose. The final count was 221 cases, including 34 deaths.
As a physician, I wanted to see the patients who were recovering or fighting to stay alive and to learn what leads were being developed from the interviews.
In Chambersburg, Pa., I joined Dr. Stephen B. Thacker, then a rookie in the C.D.C. epidemiology program. We interviewed a Legionnaire, Thomas A. Payne, 48, whose temperature rose to 107.4 degrees before he was put in a cooling blanket.
We felt safe entering his room because we followed standard precautions, wearing yellow masks, white gowns and gloves. In introducing us, Dr. Thacker told Mr. Payne that he “was part of the medical team investigating this weird disease.”
Dr. Thacker, who later became the head of the epidemiology program, asked Mr. Payne a number of questions related to the onset of his illness, how he had felt since, where he had stayed in Philadelphia and what convention events he had attended. Then Dr. Thacker sent the information to colleagues in Harrisburg.
Two weeks later, I interviewed another hospital patient who had driven with four Legionnaires from their home in Saltillo, Pa., to Philadelphia where they had stayed at the same hotel and were together for nearly all the convention events. But no one could figure out why only that patient had developed the disease.
The anecdote illustrates the kinds of dead ends that epidemiologists, like criminal detectives, encounter and that scientific journals rarely publish. They and other factors create a false impression that investigations and discoveries are simpler than they really are.
A week into the investigation, health officials were relieved as a second outbreak failed to develop among those attending an international religious meeting in Philadelphia and no spread of the ailment occurred from Legionnaires’ patients to their families and friends.
Tests also excluded all forms of influenza as a cause of the outbreak. “All of us can breathe a sigh of relief it was not the flu,” said Dr. David J. Sencer, then the C.D.C. director.
If not influenza, what was the illness? Earlier tests had ruled out poisoning from 17 metals. But experts in a variety of specialties who were not connected with the outbreak had called or written to me and health officials to suggest a number of toxins.
Stumped, health officials re-examined the possibility of other toxins or poison gases. One poison, nickel carbonyl, was a long shot that health officials took seriously, only to be embarrassed by flaws in the collection of the tissues for testing. The initial nickel findings were ruled invalid because of probable contamination from the use of metal instruments in autopsies. Pathologists were then ordered to use plastic knives.
Reports of the lapses in investigation technique jarred public confidence about the ability of health departments to detect outbreaks from hazardous chemicals. The flaws also led to a Congressional hearing in the fall on the medical investigation, causing federal and state health officials further embarrassment.
By winter, many of the authorities said the outbreak’s cause was definitely not a bacterium and that it would never be known. But the doubters overlooked the importance that human factors like compulsiveness, embarrassment and public pressure can play in solving scientific riddles and making discoveries.
At Christmastime in 1976, Dr. Joseph McDade, a C.D.C. laboratory scientist who had tested specimens from the outbreak, was harshly criticized at a party for his agency’s failure to solve the mystery.
Dr. McDade said his usual custom at that time of year was to “tidy up loose ends,” so when he went to his laboratory “to put to rest some hunches about something” he had seen in the specimens, the insult lurked in the background.
Within a month, Dr. McDade had identified the culprit and showed that Legionnaires’ was a newly recognized old disease. The bacterium had been isolated at least twice before by different groups of researchers at the Walter Reed Army Institute of Research in Washington starting in 1947. Each group believed it was dealing with a bacterium that affected animals, not humans.
Dr. McDade’s discovery quickly led scientists to document a number of earlier outbreaks in Pontiac, Mich.; Washington; and elsewhere. Legionnaires’ disease now accounts for an estimated 18,000 hospital admissions in this country each year, and C.D.C. scientists have said that doctors miss the diagnosis in many more patients. Most outbreaks and cases have been traced to contaminated water in places like shower heads, air-conditioning systems and medical respiratory devices. The largest outbreak, in Spain in 2001, affected nearly 700 people.
The Legionnaire bacterium can produce two forms of illness that begin with flulike symptoms. One, Legionnaires’ disease, goes on to produce pneumonia and systemic illness. The other, Pontiac fever, produces only a mild illness. Why the same bacterium causes two distinct illness patterns is not known.
Seamless teamwork between epidemiologists and laboratory scientists can be a potent weapon in solving disease outbreaks caused by known and unknown agents. But the teamwork in the Pennsylvania outbreak was porous, as lapses in investigation technique showed.
From the start, the investigation encountered a number of problems, some beyond their control. One was that the American Legion had no registration list of conventioneers, leaving no easy way to contact attendees to check on their health.
In investigating outbreaks, epidemiologists often develop questionnaires, in part to make statistical comparisons between those who become ill and those who do not.
Another aim is to determine the priority in performing laboratory tests to determine the cause of an illness. But the longer the delay in starting this medical sleuthing, the fuzzier people’s recall of events becomes. A problem was that health officials could have learned of the outbreak earlier than they did. For example, a physician in Pennsylvania called health officials on July 30, a Friday afternoon, to report a Legionnaire with possible typhoid fever. It was too late in the day, call back on Monday, a nurse said.
The episode illustrated that many health departments did not provide the type of 24/7 coverage for calls and emergencies that hospitals and doctors did. Now more health departments provide such coverage.
Still another problem was that Philadelphia health officials learned belatedly about an earlier outbreak of 19 cases of an illness similar to Legionnaires’ disease, including three deaths. It affected members of the Independent Order of Odd Fellows in 1974 after they had visited the Bellevue-Stratford. The cluster was not reported until after news of the Legionnaires’ outbreak in 1976.
However, there were widespread complaints about a number of issues over which health officials had some control. One was the lack of coordination between investigators from federal, state and local health departments and determining which was in charge.
Doctors who cooperated in providing information and specimens from Legionnaires’ patients said they had received little feedback from health officials. For example, some doctors said antibiotics were effective in their patients and urged wider use of them in the outbreak. But health officials gave no advice, largely because they could not scientifically evaluate the effectiveness of the antibiotics among the patients quickly enough.
The issue of providing such evaluations of therapy during an outbreak remains an important problem; many doctors and others lodged the same complaint against the C.D.C. in the anthrax outbreak in 2001. Some critics said they learned more about the outbreak from news organizations than from the agency.
In the case of Legionnaires’, persistent pressure from the news media, a number of health officials said later, helped hold them accountable and to spur scientists to do what they rarely had done in other unsolved cases and outbreaks — taking a crucial second look that solved the Legionnaires’ outbreak.
Researchers Explore Ways Bird Flu May Spread
By DENISE GRADY, The New York Times, August 1, 2006
A new study addresses the most urgent public health question about bird flu: what would it take to make the virus more contagious in people?
The study did not exactly answer the question, but it did show what does not work — simple genetic changes are not enough to transform the virus into a strain that could cause a pandemic.
Researchers from the federal Centers for Disease Control and Prevention tried to make the A(H5N1) bird flu virus more contagious, but could not, they are reporting this week in the online edition of The Proceedings of the National Academy of Sciences.
That result may sound like good news, but the scientists urge caution. “These data do not mean H5N1 cannot convert to being transmissible person to person,” said Dr. Julie Gerberding, director of the disease centers. “They mean it is not simple.”
Since 2003, the virus spread from Asia to Europe and Africa, infecting millions of birds and some humans, mostly through contact with birds. So far, 232 people in 10 countries have contracted bird flu, and 134 have died.
The one thing that has prevented the disease from causing a human pandemic is its inability to spread easily among people. But that could change. Scientists’ biggest fear has been that A(H5N1) may mix with a human flu virus that does spread in people, swap a few genes and morph into a new, highly contagious strain that could cause a deadly pandemic.
To test whether that could happen, scientists at the disease centers did the kind of mixing and swapping that might occur in nature. Experiments like this must be done in a sealed-off, high-security room known as an enhanced Biosafety Level 3 laboratory, designed to keep viruses from escaping or infecting workers.
The researchers started with a bird flu virus and exchanged some of its genes with those from a human flu virus, A(H3N2), a very contagious strain that causes most of the seasonal flu outbreaks worldwide.
They then tested the new hybrids in ferrets, to see if they were deadly like bird flu and contagious like the human strain. Ferrets are considered a good model for people in flu experiments because they are highly susceptible to human strains and transmit them easily. Also like people, they can be infected with bird flu but do not spread it easily.
The new viruses did not transmit efficiently among the animals, and also did not cause as severe an illness as the original A(H5N1).
But at a telephone news conference on Friday, an author of the study, Dr. Jacqueline M. Katz, said the scientists had tested only a few of the many hybrids that could be created. Further studies will examine more.
Meanwhile, as bird flu continues to spread in the wild, evolving along the way, scientists continue to hope the virus does not stumble upon the deadly genetic combination they are trying to understand.
Dr. Gerberding warned: “We are far from out of the woods with H5N1.”
Really? The Claim: Wounds Heal Better When Exposed to Air
By ANAHAD O’CONNOR, The New York Times, August 1, 2006
THE FACTS Most parents and school nurses have a time-honored approach to treating a small wound: clean it up, stop the bleeding and then let it get some air.
The point of this approach, as described in medical texts, is to lower the odds of infection and to speed the healing process. But over the years, researchers have found that what many people know about treating small cuts and scrapes is wrong.
Exposing a wound to the air so it can breathe is a terrible mistake, experts say, because it creates a dry environment that promotes cell death.
A handful of studies have found that when wounds are kept moist and covered, blood vessels regenerate faster and the number of cells that cause inflammation drop more rapidly than they do in wounds allowed to air out. It is best to keep a wound moist and covered for at least five days.
Another common mistake is applying antibiotic ointments, said Dr. Mark D. P. Davis, a professor of dermatology at the Mayo Clinic in Rochester, Minn. These ointments may keep the wound moist, he said, but they can also lead to swelling and an allergic reaction called contact dermatitis. Plain and simple Vaseline, applied twice a day, works fine.
And as awful as removing scabs may sound, it may actually be a good idea, Dr. Davis said. A small initial scab will help stop the bleeding, but if left for too long it will do more harm than good.
“You don’t want it to mature too much because it increases scarring,” he said. “That’s the general thinking.”
THE BOTTOM LINE Exposing a cut so it can breathe slows healing.
Evolution’s Backers in Kansas Mount a Counterattack
By RALPH BLUMENTHAL, The New York Times, August 1, 2006
KANSAS CITY, Kan., July 29 — God and Charles Darwin are not on the primary ballot in Kansas on Tuesday, but once again a contentious schools election has religion and science at odds in a state that has restaged a three-quarter-century battle over the teaching of evolution.
Less than a year after a conservative Republican majority on the State Board of Education adopted rules for teaching science containing one of the broadest challenges in the nation to Darwin’s theory of evolution, moderate Republicans and Democrats are mounting a fierce counterattack. They want to retake power and switch the standards back to what they call conventional science.
The Kansas election is being watched closely by both sides in the national debate over the teaching of evolution. In the past several years, pitched battles have been waged between the scientific establishment and proponents of what is called intelligent design, which holds that nature alone cannot explain life’s origin and complexity.
Last February, the Ohio Board of Education reversed its 2002 mandate requiring 10th-grade biology classes to critically analyze evolution. The action followed a federal judge’s ruling that teaching intelligent design in the public schools of Dover, Pa., was unconstitutional.
A defeat for the conservative majority in Kansas on Tuesday could be further evidence of the fading fortunes of the intelligent design movement, while a victory would preserve an important stronghold in Kansas.
The curriculum standards adopted by the education board do not specifically mention intelligent design, but advocates of the belief lobbied for the changes, and students are urged to seek “more adequate explanations of natural phenomena.”
Though there is no reliable polling data available, Joseph Aistrup, head of political science at Kansas State University, said sharp ideological splits among Republicans and an unusual community of interest among moderate Republicans and some Democrats were helping challengers in the primary.
Kansas Democrats, moreover, have a strong standard-bearer in the incumbent governor, Kathleen Sebelius, who has distanced herself from the debate.
“And if a conservative candidate makes it through the primary, there’s a Democratic challenger waiting” in the general election, Professor Aistrup said.
Several moderate Republican candidates have vowed, if they lose Tuesday, to support the Democratic primary winners in November. With the campaign enlivened by a crowded field of 16 candidates contending for five seats — four held by conservatives who voted for the new science standards last year — a shift of two seats could overturn the current 6-to-4 majority. The four-year terms are staggered so that only half the 10-member board is up for election each two years.
The acrimony in the school board races is not limited to differences over the science curriculum but also over other ideologically charged issues like sex education, charter schools and education financing. Power on the board has shifted almost every election since 1998, with the current conservative majority taking hold in 2004.
“Can we just agree God invented Darwin?” asked a weary Sue Gamble, a moderate member of the board whose seat is not up for re-election.
The chairman of the board, Dr. Steve E. Abrams, a veterinarian and the leader of the conservative majority, said few of the opposition candidates were really moderates. “They’re liberals,” said Dr. Abrams, who is not up for re-election.
He said that the new science curriculum in no way opened the door to intelligent design or creationism and that any claim to the contrary “is an absolute falsehood.”
“We have explicitly stated that the standards must be based on scientific evidence,” Dr. Abrams said, “what is observable, measurable, testable, repeatable and unfalsifiable.”
In science, he said, “everything is supposedly tentative, except the teaching of evolution is dogma.”
Harry E. McDonald, a retired biology teacher and self-described moderate Republican who has been going door to door for votes in his district near Olathe, said the board might have kept overt religious references out of the standards, “but methinks they doth protest too much.”
“They say science can’t answer this, therefore God,” Mr. McDonald said.
Connie Morris, a conservative Republican running for re-election, said the board had merely authorized scientifically valid criticism of evolution. Ms. Morris, a retired teacher and author, said she did not believe in evolution.
“It’s a nice bedtime story,” she said. “Science doesn’t back it up.”
Dr. Abrams said his views as someone who believes that God created the universe 6,500 years ago had nothing to do with the science standards adopted.
“In my personal faith, yes, I am a creationist,” he said. “But that doesn’t have anything to do with science. I can separate them.” He said he agreed that “my personal views of Scripture have no room in the science classroom.”
Dr. Abrams said that at a community meeting he had been asked whether it was possible to believe in the Bible and in evolution, and that he had responded, “There are those who try to believe in both — there are theistic evolutionists — but at some point in time you have to decide which you’re going to put your credence in.”
Last year’s changes in the science standards followed an increasingly bitter seesawing of power on the education board that began in 1998 when conservatives won a majority. They made the first changes to the standards the next year, which in turn were reversed after moderates won back control in 2000. The 2002 elections left the board split 5-5, and in 2004 the conservatives won again, instituting their major standards revisions in November 2005.
Critics said the changes altered the science standards in ways that invited theistic interpretations. The new definition called for students to learn about “the best evidence for modern evolutionary theory, but also to learn about areas where scientists are raising scientific criticisms of the theory.”
In one of many “additional specificities” that the board added to the standards, it stated, “Biological evolution postulates an unguided natural process that has no discernable direction or goal.”
John Calvert, manager of the Intelligent Design Network in Shawnee Mission and a lawyer who wrote material for the board advocating the new science standards, said they were not intended to advance religion.
“What we are trying to do is insert objectivity, take the bias out of the religious standard that now favors the nontheistic religion of evolution,” Mr. Calvert said.
Janet Waugh, a car dealer and the only moderate Democrat on the board whose seat is up for election, said that just because some people were challenging evolution did not mean their views belonged in the curriculum.
“When the mainstream scientific community determines a theory is correct, that’s when it should be in the schools,” Ms. Waugh said. “The intelligent design people are trying to cut in line.”
The races have been hard-fought. With the majority of the 100,000 registered Republicans in Mr. McDonald’s northeast Kansas district usually ignoring primary elections, a few hundred ballots could easily be the margin of victory.
So Mr. McDonald, who with $35,000 is the lead fund-raiser among the candidates, printed newsletters showing his opponent, the conservative board member John W. Bacon, with a big red slash through his face and the slogan, “Time to Bring Home the Bacon.” Mr. Bacon did not respond to several calls for a response.
But many of the homeowners Mr. McDonald visited Friday night showed little interest in the race. Jack Campbell, a medical center security director, opened the door warily, and when Mr. McDonald recited his pitch, seemed disappointed. “I thought I won some sweepstakes,” Mr. Campbell said.
Last Thursday night at Fort Hays State University, Ms. Morris debated her moderate Republican challenger, Sally Cauble, a former teacher, and the Democratic candidate, Tim Cruz, a former mayor of Garden City, whom Ms. Morris once accused of being an illegal immigrant. (He said he was third-generation American, and Ms. Morris apologized.)
The audience asked about Kansas being ridiculed across the country for its stance on evolution.
“I did not write the jokes,” Ms. Morris said.
Spectators split on the winner.
“There are so many more important issues in Kansas right now,” said Cheryl Shepherd-Adams, a science teacher. “The issue is definitely a wedge issue, and I don’t want to see our community divided.”
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