The nineteenth-century invention of smallpox vaccination in Great Britain has been well studied for its significance in the history of medicine as well as the ways in which it exposes Victorian anxieties regarding British nationalism, rural and urban class struggles, the behaviors of women, and animal contamination. Yet inoculation against smallpox by variolation, vaccination’s predecessor and a well-established Chinese medical technique that was spread from east to west to Great Britain, remains largely understudied in modern scholarly literature. In the early 1700s, Lady Mary Wortley Montagu, credited with bringing smallpox variolation to Great Britain, wrote first about the practice in the Turkish city of Adrianople and describes variolation as a “useful invention,” yet laments that, unlike the Turkish women who variolate only those in their “small neighborhoods,” British doctors would be able to “destroy this [disease] swiftly” worldwide should they adopt variolation. Examined through the lens of Edward Said’s Orientalism, techno-Orientalism, and medical Orientalism and contextualized by a comparison to British attitudes toward nineteenth century vaccination, eighteenth century smallpox variolation’s introduction to Britain from the non-British “Orient” represents an instance of reversed Orientalism, in which a technologically deficient British “Occident” must “Orientalize” itself to import the superior medical technology of variolation into Britain. In a scramble to retain technological superiority over the Chinese Orient, Britain manufactures a sense of total difference between an imagined British version of variolation and a real, non-British version of variolation. This imagination of total difference is maintained through characterizations of the non-British variolation as ancient, unsafe, and practiced by illegitimate practitioners, while the imagined British variolation is characterized as safe, heroic, and practiced by legitimate British medical doctors. The Occident’s instance of medical technological inferiority brought about by the importation of variolation from the Orient, which I propose represents an eighteenth-century instance of what I call medical techno-Orientalism, represents an expression of British anxiety over a medical technologically superior Orient—anxieties which express themselves as retaliatory attacks on the Orient and variolation as it is practiced in the Orient—and as an expression of British desire to maintain medical technological superiority over the Orient.

Neurological manifestations may be more prominent and have a larger role in ankylosing spondylitis than previously thought. Ankylosing Spondylitis is a rheumatic disease primarily identified by its autoinflammatory characteristics and is highly associated with the HLA-B27 gene. While it’s cause is not yet fully understood and it’s symptoms widely vary, neurological impairment is not uncommon. The neurological manifestations of Ankylosing Spondylitis include but are not limited to pain sensitization, altered brain phenotype, and disrupted cardiac conduction. Central and peripheral nervous system involvement may be more significant than previously thought and have the potential to cause demyelinating diseases, spinal cord, and nerve root injuries. Altered connectivity throughout various regions within the brain further exemplify the need for a better understanding of the disease and better treatment development. Higher instances of depression and dementia were also reported and coincide with not only a less active lifestyle, but altered brain activity. Studies on cardiac conduction and arrhythmias in AS patients revealed parasympathetic and sympathetic nervous system dysregulation. These studies have explored the possibility of new targets for treatment involving cardiac mechanisms. Treatments for diseases of a similar suspected pathology, new prospective targets for therapy, and a more thorough understanding of current treatments for the disease may be the key in providing more substantial relief. By further investigation in the role of the nervous system in Ankylosing Spondylitis, the disease may become more manageable for patients and greatly increase quality of life in the future.