with them. And later, when Europe caught discovery fever and sent explorers and emissaries sailing over the seas to the new lands to the West, smallpox hitched a ride.
In England and in the new American colonies, the death toll was enormous. A bad case of smallpox meant a 60 per cent chance of death. By the eighteenth century in England, 400,000 people a year were dying of smallpox, and there was no cure in sight.
But in countries like China, Turkey, and Africa – which had been suffering the ravages of smallpox for eons – a traditional “folk” treatment was helping to stem the tide. In China, a process called inoculation had developed as early as 1100, when it was observed that those who survived smallpox became resistant to the disease. Healers began inserting smallpox-infected needles into otherwise healthy people to deliberately make them sick. This treatment not only helped people survive their case of smallpox, but granted them immunity from future exposure.
Turkish tradesmen had attempted to tell the Europeans about this process, but in England, they weren’t buying it. Variolation needed a champion in order to be accepted by Western medicine, and it found one in a woman named Lady Mary Montagu, the wife of England’s ambassador to Turkey.
In 1715, Lady Montagu travelled with her husband to Constantinople, and her visit changed the world. In Turkey, Lady Montagu learned about the local method of managing smallpox.
“There is a set of old women who make it their business to perform the operation every autumn”, she wrote. “The old woman comes with a nut-shell full of the matter of the best sort of smallpox, and asks what veins you please to have opened … She immediately rips open that you offer her with a large needle … and puts into the vein as much venom as can lie upon the head of her needle.”
Lady Montagu had an intimate relationship with smallpox. It had killed her brother, and it had left her face badly scarred, a daily reminder of what could happen to her children if they contracted the disease. She wanted to do whatever she could to protect them.
First, she had her young son inoculated by the embassy doctor. Then she brought the procedure back to England and had the same physician inoculate her young daughter in front of an audience of court doctors. Eventually the procedure became widely accepted – a precursor to our modern-day vaccinations.
FIGHTING AN INVISIBLE ENEMY
The first breakthrough in extending the human life span was learning to recognize what was invisible: the microbes that swarm around us – in the air, on our skin, in our food – and have the potential to make us sick. Bacteria and viruses are both types of microbes, invisible to our eyes without a microscope and easily transmitted from organism to organism or via food, water, or air. Basically, everywhere you go, everything you eat, everyone you touch, there they are. Microbes.
Bacteria are tiny one-celled living organisms that have a remarkable ability to flourish in inhospitable conditions, from the iciest regions on earth to the hottest vents beneath the ocean floor. Some bacteria are pathogenic, or capable of causing disease, and have the potential to make us very sick; bacteria cause illnesses like cholera, tuberculosis, and gonorrhea. Many harmful bacteria can be killed simply by washing your hands with soap and warm water. But before the middle of the 1800s, people only washed their hands when they looked dirty – not because they suspected that an invisible bacterial army could really ruin their day.
Until the modern era, in the war between humans and microbes, the microbes were winning. In order to push the limits of life expectancy, doctors first had to understand that much of human illness could be traced to the bacteria and viruses that creep onto and into our bodies. To create medicines that killed germs and saved lives, they had to see what had been unseen.
And once they figured out all of that, there was another battle to win: they had to convince people that they were right.
THE REVOLUTIONARY IDEA OF WASHING YOUR HANDS
In mid-nineteenth-century Europe, one in two hundred women who had a baby did not survive the year after giving birth. It was basically taken for granted that after childbirth, a lot of women would catch something called puerperal fever, an infection of the reproductive organs that often leads to death.
One physician wanted to know why. In 1860, Ignaz Philipp Semmelweis, a doctor at a Viennese hospital, noted that in the hospital’s two delivery rooms, the rates of infection were skewed. Women in the delivery room where medical students assisted births were three times more likely to come down with puerperal fever than the women in the delivery room staffed by midwives.
Though the chief of his hospital urged him to leave the matter alone, Dr Semmelweis wanted to investigate the discrepency. Why were so many women and babies dying? Why did more women survive when their babies were delivered by midwife?
Dr Semmelweis figured out that while the midwives did have better training and more experience than the students, skill wasn’t the only reason the patients survived. Remember, nobody understood how germs spread yet. The medical students weren’t thinking twice about where they were before they stepped into the room to help deliver babies. But Dr Semmelweis noted where they were: in class, dissecting diseased cadavers. That’s right. The students would go straight from the dissection room to the delivery room without washing their hands. They were transmitting bacteria, and ultimately, infection.
LONGEVITY VOCABULARY
• LIFE EXPECTANCY: How long you can be expected to live if you are born in a certain time and in a certain environment
• LIFE SPAN: How long an individual actually lives
• MAXIMUM LIFE SPAN: The longest recorded life span for the species (122.5 years for a human female)
• HEALTH SPAN: The healthy years of your life
• LONGEVITY: How long you can live
• STRONGEVITY: How strong you are over the course of your long life
When Dr Semmelweis instructed students to wash their hands before each examination, the maternal and infant mortality rates from puerperal fever dropped sharply. Once one of the top causes of postpartum infection, this disease is now barely seen in the developed world.
Dr Semmelweis is credited with introducing the idea of antisepsis: sanitizing your hands and keeping surfaces free of germs. His discovery changed our entire understanding of germs and illness. This was a crucial shift for the human life span, because it gave more women and more children a fighting chance at survival. Dr Semmelweis’s investigation is the reason why there are signs in public toilets around the world today reminding people to wash their hands.
Another breakthrough for the human life span was the introduction of antibiotic drugs like penicillin. Before the mid-twentieth century, simply trimming your rose garden could be a dangerous pastime. The discovery of antibiotics changed the way people lived their lives. As researchers beat back the bacteria, children, young adults, and women were all afforded a better chance of living longer. After penicillin was invented, the human life span jumped another ten years.
As more people aged, the ratio of what was killing us shifted from infectious
