was coming simply from a decrease in average family size. that was the bulk of it. not quite so poor countries. so that was a lesson to me. every family size, for example, 55 and 25. that is a result. they think of affluence. it also brought home to me this simple fact. everyone to influence overall population we know how to do it. we have a foreign aid budget on women. ..

>> india, china, brazil and south africa. and they signed on to a thing called the copenhagen accord along with many other countries, including the united states. and under the accord those countries all pledged a certain emissions reduction target to be achieved by 2020. if you total up the pledges for emissions reductions under the accord, they get us about two-thirds of the way to where we need to be to avoid dangerous climate change. so we only need another third, right? you might say, well, they're just pledges. is anyone actually with doing

mig? well, in fact, they are rather surprisingly. even the united states is doing things. your target here in this country is a 17% reduction by 2020. you're already at -9% as a result of a lot of initiatives that are not happening necessarily at the federal level, but at the state level as well. in a few months' time, we'll see the opening of the first large emissions trading scheme here in this country in california, adopts their ets. there are a number of government initiatives here including the new cafe standards and proposals for putting fuel efficiency standards on power plants that will have an impact as well. and i'm quietly confident the u.s. is going to achieve that argument of -17%. australia's target is -5%. we're having a battle at the moment in order to do that. the most surprising of all the players have been china, and we

were very close to the chinese. we had a number of chinese leading business people on the copenhagen climate council. and, um, i remember when the announcement was made by the department in china that they were going to target a 45% reduction in be emissions intensity, that our chinese colleagues were saying, technocrats were telling i, this is impossible. it just won't happen. and yet it did happen. and they're on target to do more. just the week before last we had the premier visiting australia who's the fourth most powerful man in china. they announced seven emissions trading schemes in china, and it's widely anticipated that within the next five years or so china may well join the european trading scheme which will create a global bloc, very, very powerful emissions trading unit. so there's a lot happening, there's no guarantee of success, but i think we're on a path to start dealing with the problem.

hello. have you got a question? very good. >> why are there clouds on that book? >> why are there clouds on that book? [laughter] well, that's a great question. see, my publisher in australia thought clouds would suggest a lot of thinking, you know? great intellectual activity and all that sort of stuff and aspiration and hope and all of that. but i think in this country here people think it might suggest heaven and all that stuff, so it might be what you see on a religious book and not a scientific one. that's why it's different here. >> um, even if population were to cap out at nine billion, um, like you said the thing that would be causing it would be increased affluence, right? so it'd be nine million people all consuming more. so if population were to cap out would it really matter?

because the consumption would still increase, and americans, like, consume for more -- what if there's nine billion americans? is. [laughter] >> sure. everyone wants a quality of life like you guys enjoy, there's no doubt about that. it's how they actually a achieve it that really counts at the end of the day. our problem has been we've been tied to a fossil fuel-based economy, that's one of the major problems for climate change. so if you shift from that to a clean tech economy, a lot of things become possible. just think about the entire planetary budget is driven by the capture of just 4% of the sunlight that falls on the surface of the planet. so it's the entire budget for the whole planet, right? um, if we can't get a decent whack of energy from the sun, there's something right with us, right? and photovoltaics, the cost is dropping by about 20% per your.

there is -- and just last year renewable energy as a source of electricity overtook nuclear power, so it's growing very quickly. in places like china, widely seen as the future, i don't think your average chinese is going to be driving a petrol-driven car in the future. they'll be using public transport or driving electric cars in the future. so things are changing. there's no guarantee we'll be able to feed all nine billion people on the planet indeft and provide high quality protein for them and so forth, but there is some cause for hope. and i talk in the book, there's a chapter, actually, about, about how people are now starting to work with nature to enhance the productivity of agricultural systems. and just one example of that from my own country that i know reasonably well, um, in australia we have been beset with one natural disaster after the other over the last 20 years including prolonged droughts that have had a big impact on

agriculture, tropical storms and so forth. and yet through that period we've been able to increase both grain and beef production by 50%. now, how was that achieved? if you look at the facts on the ground in australia, that has been achieved by people leaving behind the sort of mind seth of a war -- mindset of a war on nature to grow crops. the best example, i'll be quite quick with it, concerns grain production in australia. it used to be the old practice you'd go out there with a plow, rip up every living thing in the paddock until it was bare earth, and then you'd put pesticides on it so nothing would compete with your crops, and then australia being australia, there'd be a drought and your topsoil would blow away, and you wouldn't get a crop at all. smart farmers started using zero-killing a church some don't use fossil fuels anymore.

they have solar-driven plows. they're very rare, but they do do it. they put a tiny incision through standing pastures, so they crop into that. and the grasses then protect the crop, they protect the soil moisture, there's carbon and nutrients in the soil that help the crop spring up through the perennial grass. if they get a good year, they have a good crop. if they don't, the sheep have got something else to eat, and they don't ever lose their topsoil. so those kind of practices are having a big impact and as they spread globally, i think, will give us the opportunity to produce our food more sustainably. one final question. does anyone have a really burning one they want to ask? i think this lady over here. >> thanks. um, thank you. your talk made me feel like i have hope that star trek was right and they solved all of our problems. [laughter] you know, we manage to do it somehow, and we're out there in the glax galaxy.

but what do you see the role of one of the unique superblues of -- superglues of the superorganism of humanity being religion? what do you see the role of that superglue? um, and -- >> well, a really -- >> -- on the future. >> well, that's a really difficult question because everyone thinks that their religion is the right one and everyone else, therefore, is wrong. so it's really hard to kind of use that as a superglue to kind of hold that together. >> [inaudible] >> yeah. it's sort of, i think -- i haven't thought about that question, but that was just my first sort of reaction. to thinking about it. i think that probably what will form a more coherent glue for our superorganism is the basic dignity of humanity. so a humanist understanding that everyone has certain rights, you know? unalienable rights that need to

be respected. and that sort of thing, i think, forms a much more firm basis for international cooperation would be my guess. but could i just use your question to point something out? one of the things about superorganisms is that as the superorganism itself becomes more competent and more powerful, each individual within the superorganism becomes less independent and less capable. so in the ant colonies, you know, some ants can't feed themselves. some can't reproduce. some can't defend the colony. everyone's got a specialized job. and you see that in our society. just a couple of months ago scientists in the u.s., actually, published an article that human brain size has slunk by 10% -- shrunk by 10% over the past ten years. i know why. because we're a superorganism. we don't have to be a hunter that gets up in the morning makes their own tools, finds

their own food, defends their family. we just have to do one simple little job. and adam smith foresaw this. he said if you want to see the most stupid person of all, go to a pen factory. look at the bloke that puts the head on pens. and he makes a very valid point that if we want to be fully rounded, engaged, competent individuals, we need to use our leisure time wisely in order to cultivate our minds. and it was just a point, i think, worth thinking about in terms of superorganisms. thank you. [applause] >> that was tim flannery on the evolution of the earth. for more on mr. flannery and his work, visit timflannery.com.au. >> we asked, what are you

reading this summer? here's what you had to say. >> send us a tweet at booktv to let us know what you plan on reading this summer. you can also e-mail us, booktv at c-span.org.

>> susana ashton, how did you select the narrative you included in your edited work? >> we were looking, um, my research team and i were looking for out of print narratives, narratives which weren't largely known, and also narratives which might be known but weren't known in south carolina. boston kings is one of the 18th century slaves, he's known in british abolitionist circles, he's been identified with transatlantic connections, but he actually was from south carolina and defected to british lines during the american revolution, then went to canada and nova scotia and then to africa where he ended up writing his memoir. so including him as a south carolinian was a new way to conceive of his history. so people like that. we had a collection of seven people that weren't well known or known in other contexts and for the first time ever we could bring them back into print and put them together and see the connections between the more

coherent narrative of what the story of south carolina slavery was like. >> and what were the major theme included in the reflections? >> well, um, there were both small and big themes. there were small patterns. three of the seven people were child jockeys. two of the seven individuals, actually, were slaves to confederate forces in fort sumter and the coastal war in the carolinas, they were not confederates, they were slaves to the confederate forces. um, so there were odd little connections to that. but the bigger connection was that even the people who left south carolina and were very glad to escape or survive slavery and otherwise left the state all wrote of their lives as south carolinians, all firmly identified themselves as sort of having a fraught relationship to where they're from. but, oh, they weren't going to let someone take that away from them. they would not identify themselves as africans with the one exception, perhaps, of boston kings who ended up going

back to africa. but the rest of them they distinctly wanted to claim themselves as part of history even though they may have left the state. and i think that was the most powerful theme we found from the 18th to the early 20th century of these people's memoirs. >> what story resonates the most with you? >> >> oh, a number of them speak to me in different ways. california run da is very short, mysterious sort of odd document written by her, was dictated as told. we don't quite know the providence, but we know she talked about playing the violin and leading people into sin. and when i read that, i said, i want to know clarinda. who was she? who was she about? she doesn't fit your normal slave story, what happened to her. and then another 20th century writer, sam alexson, wrote his memoirs as a very old man. it was about 1913 when he wrote

his story, he'd been a child as a slave, and that meant he had an edge to him. and he wrote i think one of his famous lines had something to the gist of there are many people who were talk of the better sides of slavery and how you can view it with a good lens. the only thing good about it as far as i'm concerned is the emancipation prola mission. so that's a man i would have liked to know. they all spoke to me in different ways with different voices. >> what do you hope readers will learn there this book? >> oh. i hope they learn to get rid of their expectations, i think. um, the voices were hard. for example, the 18th century narratives, these are two individuals who spoke about slavery, indeed, and led their lives against slavery, but they also defined their lives as slaves -- [inaudible] their memoir are also about religious awakening and the freedom that they found through

their spiritual awakening. and that, that doesn't fit what you think a slave narrative should be about, right? um, and i respect that term, and i really learned from that tone. two of the narratives written during the abolitionist era are by men who escaped. and there, they depict a lot of really violent and stressing scenes, but they're witnesses. their testimony is witnessing, and i hope readers come away with the respect for the personal and political goals they're trying to tell but also about their community and these other voices that aren't allowed to speak, and those are the two really powerful and terrifying narratives. one is anonymous, we don't know his name because he's a fugitive when he wrote still running from bounty hunters when his story was published. and then the last three although sam alexson who i mentioned had

a really little edge to him, but the other two, irving sawyer and jacob lowery, were much more anti-narratives. i wouldn't say they had good things to say about slavery, but they weren't testimony to violence. they spoke about a lot of love they experienced in their lives as slaves. they'd be heartily glad they were no longer slaves, but lowery was almost nostalgic at the moment, and that's very hard and troubling and fascinating to understand why he would articulate his life story in such a way and make sense of that. so what i hope readers come away from is that south carolina slavery across the state was different for each individual. the voices of people wanting to be read, these weren't sort of general interviews. they took time to write their life stories and make sure their stories got out in the way they wanted to frame them.

and it's beautiful, and it's troubling and frightening in some ways some of them, but i think they all, um, they all speak to, oh, a new way we can learn to listen to people's stories perhaps. >> thank you very much. >> sure thing. >> what are you reading this summer? booktv wants to know. >> well, i just finished reading "decision points" by president bush, and it was really good. i enjoyed the conversational tone that he took in describing his presidency and the events, the big events like 9/11 and some of the other events that were a part of his eight-year presidency. i'm in the process of getting to karl rove's new book as well as hank paulson's book. i don't know that anything has had more of a lasting impact on

what we're talking about today than what happened a couple of years ago with regard to the economic meltdown. and i think reading secretary paulson's new autobiography will be enlightening. i got pretty frustrated with him by the end of his time as secretary, but i wanted to give him the benefit of the doubt and see his side of the story since he was there. and front and center in all of the discussions. i'm also reading a new book that andy andrews who's a local alabama author wrote called "the final summit." because it's an inspirational journey. he takes real people from the past, winston churchill, abraham lincoln, joan of arc, george washington carver, and he weaves them in in a fictitious way but

using real-life examples to inspire us to be better leaders. and andy's a personal friend. and i also just finished the rereading, which i do every year, of my favorite book of all time, and that's harper lee's "to kill a mockingbird." she's not only a friend, a resident of my district, but is someone that has touched the world. i think it's second only to the bible in terms of the most number of copies printed in the most number of languages around the world. so every year i make it a point to read "to kill a mocking build bird." >> visit booktv.org to see this and other summer reading lists. >> and the core issue, just to kind of pan out a little bit, is how do you get young people into the work force, and in this case usually specifically into the white collar work force.

how do you move students especially from psych 101 classrooms in this a building like this into the office jobs where they will probably be in our service economy? what is that process, what's the best way to do that, what's the most humane way to do that, and what's the way that insures the sort of highest level of social justice that's possible in terms of making that an equitable process? and i, essentially, find this current very happen haphazard, unregulated free-for-all system of internships that's grown up to be inadequate, to sort of fail our tests of what would be a rational, humane and even efficient way of getting people from point a to point b just to kind of see it on a very, on a very macro level. but anyway, a potted history. so internships originate, the term intern originally from

french probably for several hundred years used in kind of french hospitals as a term for a junior doctor, kind of apprenticing doctors. and comes to the states probably sometime in the mid 19th century, the world itself. at the time it was still smelled interne with an e on the end in a kind of french mode, and it essentially means a young doctor who has interned within the four walls of a hospital for a year or so, usually a couple of years, performing junior sort of tasks; blood letting, maybe applying leeches still at that point, whatever it was. some grisly, grisly things. probably overworked, possibly with some resemblance to today's interns. but in any case, working within a hospital before they get to become a full-on medical practitioner. um, and i think -- this is kind

of more speculative -- but i think there are probably a number of workplace practices that you can trace to fields like medicine and law because these are prestigious fields that other fields want to copy. and that's certainly the case with internships. you see it become common practice in the medical profession in the early 20th century just at the time when the medical profession is kind of rationalizing and modernizing itself, when they're shutting down. the country used to be full of kind of substandard medical schools producing people of doctors of highly-varying quality, and the american medical association in particular kind of steps in and says we need to, you know, we need to get rid of the quacks, we need to have certification, accreditation, all of these things which are arrive anything the early 20th century in lots of different areas, but in medicine one of the results is the internship as a period of

applied postgraduate, as it were, kind of learning, a transition period between your school years as -- in medical school essentially and your work as a medical practitioner. so those are the origins. and it takes, it takes a long time. it's, essentially, not until -- it take several decades, not until the 1930s, 1940s that you see other fields, other industries kind of looking to this internship model and borrowing the word. and as far as i could tell -- people may yet find other examples -- in the 1930s you see the field of public administration going through the same sort of process. so the city governments of new york, los angeles, detroit, the state government of california in the 1930s establishing internship programs, essentially, just at the time when with -- no surprise -- governments are vastly expanding because of the new deal and various social programs, and there's a push to kind of

rationalize public administration. and one of the things you rationalized when you do your sort of standardization and rationalization of a field is the process by which people enter. so internships fill that role. so it seems like public administration really, not politics so much, not what you might think of capitol hill internships which is a species unto itself, but the field of public administration is the first place after medicine that you see adopting the internship model. and after world war ii it begins to go much more general, and you see corporate america looking to the internship. you see the growth of human resources in firms, you know, such that it becomes any firm of any size is going to have a human resources department, and a human resources department is tasked with having a rational means of recruiting and bringing in new, bringing in new employees, and they establish

internship programs. so you begin to see it in all kinds of fields; insurance companies and, you know, large companies like general electric, you know, at&t, these kinds of companies. um, but at that time these are mostly paid situations. they're paid, they're training-based. it seemed to be about recruit ment. it's about, you know, going to the local colleges and universities especially and bringing in the best and the brightest. and then, you know, paying them while you're training them and sort of drawing them in to the corporate culture. and then they will work for you. um, and it's, you know, we take a certain number of interns each year. these were sort of very structured programs based around ideas about structured training. so a new thread kind of enters in the 1960s and '70s. as far as i can tell, this is where the academy becomes more interested in internships as a kind of applied learning,

learning beyond the classroom. it's not the first example of experiencial education. there are ideas about applied learning and learning beyond the class room going back 100 years, but the specific model of internships, for instance, sociology departments in the 1960s and '70s, they begin to contact, say, a city planning department. i know this happened in new york. and say, can you take a few of our students, you know, each year, each semester, you know, to show them how a city planning office works, that sort of thing. and so it's, you know, you see the academy begin to be involved. this is, especially, at this time this isal a very american kind of phenomenon, i should note on the side, although i want to mention the kind of international dimensions of the intership explosion in a little bit. and, essentially, schools are saying that they're responding

to student needs. this is a generation of baby boomers and universities saying we want to apply our learning and get academic credit for it. we want to, you know, go beyond the classroom and be, in a sense, active in the community. and that's seen as a kind of, um, you know, it's seen as an interest in the broader society, going beyond the ivory tower. so that's kind of another theme that enters the internship discourse. but particularly what interests me and what i cover in the week is what i -- in the book is what i call the internship explosion. >> watch this and other booktv programs online at booktv.org. up next, michael willrich examines the american smallpox epidemic in the early 1900s. he details the government's initiatives to deter the spread of the disease by requiring vaccinations and instituting virus squads who enforced warn tees. -- worn -- quarantines.

this is about an hour. [applause] >> thank you. and thank you to carrie, thank you to the college for hosting such a wonderful event and bringing dr. willrich here to talk about his very important book. in 1736 i lost one of my sons, a fine boy of 4 years old, by the smallpox taken in a common way. i long regretted bitterly and still regret that i had not given it to him by inoculation. this i mention for the sake of participants who mitt that operation on the supposition that they could never forgive themselves if child died from it. so wrote benjamin franklin in his autobiography about his struggles, sadness and regrets regarding the decision not to inoculate his young son against smallpox. the intentionally-induced infection for inoculation -- far more dangerous than the vaccine that would supplant it in the

18th century -- offered lifelong immunity from the dreaded approximate. yet franklin and other americans were beginning to struggle with the very issues about vaccination that we still face today and the issues brought to life so lucidly in our distinguished speaker's book. concerns about the debunk reliefs that vaccines were the overall burden of vaccines are responsible for dramatically increased rates of autism. and while we can partially understand the rise of anti-vaccine sentiments in the context of the history of that disorder, dr. lillerich trace -- willrich traces a much longer history. one that examines the relationship to concerns about the expanding power of government, of the police powers of public health, of the tensions between individual liberty and community interests, of scientific and medical hubris and of the ways social class and race mediate these debates. the success of pox, and i mean

the book -- not the disease -- is that to it is not simply a wl researched book, but an elegantly told story that weaves together the rich primary sources and the doctor's keen sense of the past to explore tensions that are at the core of the values that make us americans. so it gives me great pleasure to introduce dr. michael willrich from brandeis, university, where he is associate professor in the department of history. and, of course, as you know, dr. willrich will be talking about his book, "pox and the american history." his first book, "city of courts," won the distinguished prize awarded by the historical association for the best book on any aspect of american history and the cromwell prize. dr. willrich received his ph.d. from the university of chicago. before that he worked for

several years as a journalist in washington, d.c. writing for the washington monthly, city paper and other magazines. please dwi doctor will -- please give dr. willrich a very warm welcome. >> i've got so many wonderful public programs going on right now bringing the history of medicine and disease which are so important to our national history to people not only in functions like this, but over the internet and through publications. so it's a real honor to be here, and i want to thank carrie for inviting me and being such a gracious host. well, as everyone in this room knows, vaccines long hailed as

modern medicine's greatest invention have lately become the summit of a bitter -- subject of a bitter public controversy. according to a 2010 report from the centers for disease control and prevention, 40% of american participants of young children -- parents of young children have refused or delayed one or more shots for their child. that's up from 23% in 2003. so something's going on right now. despite overwhelming evidence to the contrary, one in five american parents believes that vaccines cause autism. this disturbing statistic seems likely to hold true even after the recent publication in the british medical journal of a report debunking the original 1998 paper that launched the global vaccine autism scare. we are already witnessing the effects of parents' decisions not to fully vaccinate their

children; the return of diseases such as measles and whooping cough, that had largely disappeared from the united states until recently. last year california weathered it worst epidemic of whooping cough in over 60 years. more than 9,000 cases of this vaccine-preventable disease were reported in the state, and ten infants -- most of whom were too young to get vaccinated -- died. still, for all of the sound and fury, today's vaccine controversy pales in comparison to the vaccine wars that took place in the united states at the turn of the 20th century. and this at the height of a nationwide epidemic of smallpox. as smallpox spread across the country between 1898 and 1903, local, state and federal health

officials enforced vaccination aggressively, sometimes even by physical force. at the nation's borders, along its railroad lines and in its public schools, factories, tenement districts and work camps. the government's vaccination campaign triggered massive resistance from the american people. americans formed anti-vaccination societies, and although they were ridiculed by the press and the medical profession as deranged cranks, the anti-vaccination's arguments, in fact, resonated quite deeply with broader social concerns of the period, concerns about the growing scale and scope of the american state. concerns about medical liberty and the rights of parents. americans also mobilized statehouses to win laws banning compulsory vaccinations. they challenged come compulsory

vaccination in the courts, carrying the vaccination question all the way to the u.s. supreme court in 1905. they rioted in tenements and in the streets. they forged certificates so their unvaccinated children could attend school. and perhaps most commonly and especially most commonly among recent immigrants to the united states in american cities, they hid infected family members from the authorities in order to prevent them from being hauled off to the local pesthouse, as isolation hospitals of the period were called. well, the scale of this popular opposition is all the more remarkable because smallpox was still the most feared of all the terrible diseases that afflicted human ciepped. smallpox was the deadliest

killer in human history. in a typical outbreak, the disease killed roughly a third of all the people it infected. smallpox killed 300 million people worldwide in the 20th century alone. that's more than all of the bloody century's wars combined. but smallpox, as you all know, enjoys another distinction. it was the only contagious disease ever eradicated from the human species. vaccination was crucial to that story. with each passing year, fewer and fewer people across the world have ever seen a case of smallpox, that goes for doctors and epidemiologists as well. so what was smallpox like? well, the disease, as we scientists have been able to see more recently under the electron microscope which did not exist 110 years ago, is caused by a

brick-shaped virus, a bunch of proteins containing some dna. the disease caused by this virus was with highly contagious. it could be spread like a common cold or flu, by saliva droplets, from person to person, through close contact. it could also be spread by virus particles on blankets and clothes. but that was far less common than face to face contact. once the disease had entered, once the virus had entered a new host, the incubation period began. incubation period lasted for about 12 days. this was long enough in the age of steam for a, say, an italian immigrant to travel from a small village to the coast at naples, board a steamship and travel all the way to the united states,

pass through ellis island and the medical inspection there, board a train for chicago and get off there and then come down with the symptoms, the early symptoms of smallpox. those early symptoms were a very high fever and severe back pain, often vomiting. it was a terrible and a flu-like condition. but then, miraculously, the fever started to subside, and the person felt better. the person might even feel good enough to go the work or off to school. and that was when they started to become contagious. the virus had been replicating very rapidly in the throat and the nose, um, and ultimately, it would produce this terrible skin eruption, right? this rash that ravaged the skin and was the most horrific visible sign of smallpox.

but as all of this was going on, the virus was replicate anything the internal organs as well and attacking them. so people usually, when they died, died of acute respiratory failure. it was not a pleasant experience, any of it. most survivors, meanwhile, of smallpox were left scarred for life, usually with deep scars all over their faces. many of them were blinded. so that -- but the turn of the century epidemics brought a medical mystery. between 1898 and 1903, hundreds of thousands of americans were infected with smallpox. these are according to the medical reports. i actually think many more than that were infected. but fewer than 10,000 people died. how could this be?

well, we now know, we now understand that this was the first appearance in north america of a new form of smallpox that would come to be known as viriola minor. it killed only about, and let's put that in quotation marks, about 1% of all that it infected. so ordinary americans seeing this disease sweeping rapidly through their communities and many people felt afflicted with it felt just well enough to go to work and earn their daily bread. ordinary americans seeing this disease would not readily accept that it was smallpox at all. there was enormous diagnostic confusion even among the medical profession, particularly among country doctors who thought this

was just another, as they called it, breaking out disease. public officials understood this to be smallpox, and they believed at any moment a horrific epidemic of classical smallpox, the smallpox they read about in the history books, at any moment such an epidemic would break out. and their fears seemed to be confirmed by the fact that in a number of places epidemics of mild smallpox were followed closely by serious smallpox. so during this wave of epidemics epidemics -- many of them mild, killing 1-2% of the people that it affected -- new york lost 730 people to smallpox. in the new orleans, 500 people died. in boston 270 people died n. philadelphia there were 2500 reported cases and 400 deaths.

that's more on a par with historical smallpox. and yet even after this great wave of epidemics, america remained the least vaccinated of any civilized country. well, my book spends many pages and words trying to understand exactly why this was so. i can give you a short answer right now which is that vaccinations a century ago was a nasty business and far riskier than it is today. and further, the vaccination question posed a real dilemma. the united states, after all, was a nation fiercely devoted to the principles of individual liberty. but the public health movement that had emerged here by 1900 was one of the most violently invasive of individual rights in

this all the world. in all the world. although public health has come a long way since 1900, this dilemma still resonates today. so "pox" tells the story of a forgotten american smallpox epidemic that killed relatively few people but left a surprisingly deep impression upon american society, government and the law. the book is a national story, but as epidemics are inherently local in their experience, it is a national story made up of many local stories. so to give you a flavor of those local stories, i want to take a few minutes and tell you about one local place that through no fault of its own played a starring role in this american saga. cam ten. camden.

in october 1901, smallpox broke out in camden which was then a prosperous industrial city of 76,000 souls. the trouble started when 8-year-old pearl ludwig took ill with the smallpox followed closely by her father and all seven of her brothers and sisters. somehow her mother was not infected. she must have had smallpox at another time or been vaccinated. and i can only feel for her. there's nothing about her in the record, but i can only feel for her being the only one in that house capable of taking care of all the others. in the middle of the night, pearl's father awoke. in his dally rum, he bumped a table which knocked over a kerosene lamp. the ensuing blaze burned the ludwig house to the ground, but not before the ludwigs got out, and hundreds of neighbors rushed

to the scene. all, of course, were exposed to smallpox. with this improbable chain of events so reminiscence of mrs. o'leary's cow starting the chicago fire of 1871, the camden smallpox epidemic of 1901 began. well, camden city officials jumped into action. they set up a municipal pesthouse, and the board of education announced that all public school children must be vaccinated immediately. but what did that mean exactly? well, vaccination a century ago was conducted not this a private pediatrician's office under the trusted hand of a family physician, but often outdoors, right? in clinics, schools, workplaces and the like. the process involved taking ahold of someone's arm, a bare

arm of course, taking a very sharp lancet or needle, scoring the skin usually drawing a little bit of blood but not too much and then taking some vaccine material which was made up of it's a live cow pox virus that had been, literally, harvested from infected sores on the belly of a calf. okay? take a moment and think about that. taking that and dabbing it into the scored area, and people would experience fever, often a very sore or swollen arm, and when all was done, they were left with a little scar that any of y'all over maybe 40, 45 might

have from a different process because the smallpox vaccine would produce it if it takes. anyway, that was vaccination. the vaccine used in camden came from where do you think? philadelphia, right? just across the river. philadelphia was a major center of the nation's rising vaccine and pharmaceutical industry. philadelphia was the place where andrew wyeth and brothers in addition to sort of creating some chemical compounds and the like had a couple of cows. and created their own vaccine. h.m. alexander, a lost company but one that was important at the period, and the most important company for our story which was a u.s. forerunner of merck pharmaceuticals.

well, the process involved a combination of a stable and a laboratory, right? mullford had a full-on laboratory to sort of process its vaccines, but they were harvested from infected calves housed in stables. so within a month a third of the city's population had been vaccinated including 5,000 of the city's 8,000 school children. then the news spread. the news spread in many camden that a 16-year-old boy named william brower had fallen ill with tetanus. now, tetanus was another one of those terrible diseases that vaccines have helped to bring in check. most people at the time called tetanus by another name. they called it lockjaw.

the symptoms were a high fever, a telltale stiffness in the face followed by exchew shading contractions of the jaw and neck. convulsions racked the body, and the disease was often fatal. after william brower, the lockjaw struck 16-year-old lillian kardy, then 9-year-old anna cochran and 11-year-old thomas hazelton. then 11-year-old anna warrington, then 6-year-old frank cavalla, 7-year-old betsy roosevelt, and the list continued to grow. soon six of the school children were dead. within weeks, within weeks three more would die of tetanus. as the parents of camden searched for an explanation, many pointed reflexively to the vaccine and its manufacturers across the river. the participants charge --

participants charged that the vaccine was corrupted which was, after all, a plausible claim since vaccine was produced in a stable, an environment crawling with hay, and bacteria including tetanus basilli on occasion. but the camden board of health defended the vaccine makers and its own policy of compulsory vaccination. in official reports the board said that the children were dirty. they had let their vaccine wounds get filthy. and their parents were ignorant and hadn't kept those wounds clean. to sell this story to the press, the board of health hired a brilliant and eccentric young scientist who worked for the most implicated of the philadelphia vaccine companies, h.k. mullford company. that scientist's name was albert c. barnes. [laughter]

as i had hoped, that name is well known in these parts. barnes would go on to make a great fortune by inventing an antiseptic, and he would spend that fortune building one of the great private collections of french art, the barnes foundation. well, some new york newspapers bought barnes' story, but the parents of camden did not. in a later era, they might have sued. but in 1900 the case law was stacked against them. so instead they launched a school strike. hundreds of parents refused to send their children to school. soon half of the city's public school desks were empty. the camden tetanus outbreak became a national news story. newspapers across the u.s. spread the story of children dying in the terrible agony as helpless parents and physicians bore witness.

even "the new york times" which was the most outspoken paper in support of compulsory vaccination particularly among the lower orders reported from camden that, quote, vaccination has been far more fatal here than smallpox. the school strikes in the camden were repeated in communities across the country from rochester, new york, to a little bit later berkeley, california. to make matters much worse, that same fall, the fall of 1901, the coroner announced his verdict in the cases of 13 school children who had died of tetanus after taking the diphtheria antitoxin, a new life-saving measure used mostly for children. the coroner said antitoxin taken from a horse -- yes, antitoxin

for diphtheria was taken from horses -- taken from a horse infected with tetanus, a horse called jim. well, the tragedies of camden and st. louis created a crisis of public confidence in vaccine at the very worst moment, at the height of a national smallpox epidemic. but here's the point to mull over. this crisis pointed out the fundamental contradictions of american public health law at the turn of the 20th century. the government could order the public to get vaccinated whether they wanted to or not, but did absolutely nothing to insure that the vaccines used in the process were safe or effective. the crisis enflamed the already widespread public opposition to compulsory vaccination during the smallpox epidemics of the

period, and let us say many groups had their own reasons for opposing compulsory vaccinations. workers, across the board workers, men who worked with their hands were deeply concerned about the effect the vaccine might have on their ability to use their hands if only for a period of a few days. no system of workman's compensation existed during this period, they couldn't count on employers to help them out if they fell ill. they were breadwinners, they were very much resistant to compulsory vaccination. african-americans had no good reason to trust white doctors in the white public health profession during this period. during normal times white doctors and hospitals ignored african-americans, ignored their medical needs. it was only during an epidemic, like an end testimonyic of smallpox, that all of a sudden the public health officials show up at their door, usually with sheriffs and cops in the tow to

compel people to be vaccinated. so african-americans were deeply suspicious of compulsory vaccination and resisted in the large numbers. christian scientists and other faith healers from the period posed obvious religious objections to the practice, and many be of the anti-vaccination societies were led by doctors, but doctors who practiced forms of alternative medicine, now called earn medicine such as homeopath think and osteopath think and chiropractic that had been marginalized in the late 19th century and licensing. they viewed it as part of the grander conspiracy that the state itself called state med sin. medicine. well, the camden tragedies galvanized the anti-vaccination movement and triggered a national debate on vaccine safety. medical societies started to

talk seriously about the need for a system of government regulation of vaccines. some even called for turning vaccine production into a government no 40 knoply -- monopoly. but this idea was ruled out as too socialistic. back then when they used the word socialism, they had something in mind that really sounds like socialism, right? government-controlled production. anyway, while all of this was going on, a distinguished philadelphia bacteriologist named dr. joseph mcfarland was quietly investigating the tetanus cases. he collected information on similar cases from philadelphia, atlantic city, bristol, pennsylvania, cleveland and other parts of the united states. in a paper that he eventually published in the lancet which was the most prestigious medical journal of the era, mcfarland