Pox

Pox (pronounced poks)

(1) In human & animal pathology, a disease characterized by multiple skin pustules, as smallpox, associated with the pockmarks left by the purulent skin eruptions.

(2) Historically, a reference to syphilis and sometimes to other venereal diseases (now called sexually transmitted diseases (STDs)) (archaic).

(3) In plant pathology, a disease of sweet potatoes, characterized by numerous pitlike lesions on the roots, caused by a fungus, Streptomyces ipomoea (also called soil rot and distinct from the condition root rot).

(4) In idiomatic use (usually as "a pox on (someone or something)"), an interjection to express distaste, rejection, aversion etc and thus a synonym of curse; the adjective poxy is a variation of the idea.

(5) As the acronym POx, variously Pulse Oximetry, Pressure Oxidation, Partial Oxidation, Point of Exit, Plain Old XML & Purgeable Organic Halogens.

(6) As the acronym POX (or PoX), proof of X.

Circa 1480s: A spelling variant of pocks, the plural of pock, from the plural of the Middle English pocke.  Pox in the sense of “a disease characterized by eruptive sores" emerged in the late fifteenth century, a spelling alteration of pocks & pockes (used since the late thirteenth century in this context), the plural forms of the Middle English pocke (pustule).  From the sixteenth century, it became the common word with which to refer to syphilis.  Pock (pustule raised on the surface of the body in an eruptive disease) was from the Middle English pok, from the Old English poc & pocc (pock; pustule; ulcer), from the Proto-Germanic pukkaz & pukkǭ (pock; swelling) and puh & puhh (to swell up; blow us), from the primitive Indo-European beu & bew- (to grow; swell).  It was cognate with the Middle Dutch pocke, the Dutch pok, the East Frisian pok, the dialectal German Pfoche, the Low German & German Pocke, the French pocque was also from Germanic sources.  The present participle is poxing and the past participle poxed; the noun plural is poxes.

As surnames, Pox & Pocks both long pre-dated the use in pathology and were of Germanic origin, recorded in Bavaria & Austria as a variant Of the Bavaria Böck) and the North German Beck (Baker).  Pox may in some cases have been an alternative spelling of these but is documented as a nickname for a “short man”, from the Low German Pōk (young child; Dwarf).  In some regions it may have been a Germanized form of both the Hungarian Pók and the Slovenian & Croatian Pok common in the Balkans.  In the US, Pox appears to have been an Americanized version of Pocks, most prevalent in the north-eastern states during the nineteenth century.

Coincidently, the Proto-Turkic bok means “dirt, dung” and was cognate with the Turkish bok & Chuvash пӑх (păh); in vulgar slang used predictably in the same sense as “shit” (solid excretory product evacuated from the bowel); the word persists in modern Azerbaijani.  The now idiomatic deprecatory adjective poxy entered English in the late nineteenth century as terms of distaste and disapprobation, having been in the medical literature sin 1853 in the sense of “infected with pox; pocked-marked”.

The noun pock-mark (pockmark later prevailed) dates from the 1670s and was used to describe “the scar or pit left by a pustule" after an infection, particularly after smallpox where the effects were most severe and it was noted as a verb & adjective after 1756.  The earlier word in this sense was the mid-fifteenth century pokbrokyn.  Pock-marked was used by astronomers to refer to the craters visible on the surface of the moon.

Cow-pox (also cowpox), was a disease of cattle, noted from the 1780s and the fluid of the vesicles made it transmissible to humans.  It played an important role in the history of inoculation because it was noted milkmaids (with much exposure to cowpox) enjoyed an almost complete immunity to smallpox.  Chicken-pox was first described circa 1730 and the name is thought either an allusion to the mildness of the condition (compared to syphilis (the pox) or smallpox) or it being most associated with children, or the resemblance of the lumps on the skin to chick-peas.  In medical Latin, the circa 1765 varicella (chicken-pox) was an irregular diminutive of variola, the adjectival form varicellous.  Smallpox, the acute, highly contagious disease and frequently (fatal in a quarter to a third of unvaccinated cases) deadly disease was first so named in the 1510s, as small pokkes, which distinguished the symptoms from the great pox (syphilis).

The famous exchange…

“You sir shall die either on the gallows or of the pox (ie from a STD)”.

“That sir, will depend on whether I embrace your principles or your mistress”.

.. has been attributed to many over the last two centuries odd so the ultimate source is uncertain but the first known record of what may anyway have been an apocryphal exchange appears to have been published in 1784 the London periodical The European Magazine.  Supposedly, protagonist and antagonist were the fourth Earl of Sandwich (1718-1792) and Samuel Foote (1720-1777) who met at a dinner held in his house by Sir Francis Blake Delaval. (1727–1771).

In the decades which followed, frequently the tale was re-told, sometimes with different participants (although Lord Sandwich was often named) and although occasionally embellished, what’s more interesting is that euphemisms and niceties were sometimes adopted; “the halter” replacing references to nooses and gallows and “p-x and “certain disease” substituting for pox.  Whether the changes reflected editorial taste or changes in what readers thought acceptable in print isn’t clear but by the early nineteenth century the anecdote was published with the punch-line but not the setup sentence.  That may however have been because, being well-known, by then a mere allusion was probably more funny still, a technique used to effect in the House of Commons as recently as 1968.  Whether or not the exchange ever happened or between who will never be known with certainty but the rejoinder is of such voltairesque quality it’s been attributed to more than half-a-dozen political notables.

Monkeypox

Little political energy could be summoned in the West to deal with climate change while it appeared to afflict only Africans, Arabs, Asians and animals (those inhabiting the places Mr Trump would have called “shithole countries”).  It took Europe & North America roasting, flooding and burning to focus minds.  Similarly, monkeypox (a zoonotic virus in the genus Orthopoxvirus) although for decades endemic in parts of Africa, attracted little interest in the West until outbreaks in 2022 and most people had probably never heard of it until a rapid spread of cases began to be reported in the UK, Europe and the US.  On 23 July 2022, the World Health Organization (WHO) declared the outbreak a Public Health Emergency of International Concern (PHEIC) with cases reported in 77 countries and territories, similar declaration in the past issued for Swine flu, polio, Ebola, Zika and Covid-19.

Monkeypox movement out of Africa 2022 tracked by the US Center for Disease Control (CDC).

Monkeypox gained its name in 1958 when scientists in Denmark isolated the virus in laboratory monkeys in 1958, when two outbreaks of the disease occurred in monkey colonies.  It’s since become clear that a number of rodents are much more efficient vectors of transmission and the virus is neither exclusive too nor most prevalent in monkey populations but, in the way of these things, the name stuck.  This is not a new phenomenon; the famous Spanish flu linked to the pandemic of 1918-1920 picked up the name only because cases there were reported in the press in 1918 whereas news of those already detected in the US, Europe and the UK were suppressed by wartime censorship which wasn’t applied in neutral Spain.  Another case is Rubella which came to be known as “German” measles, simply because it was scientists in that country which identified and first describe the cause and there are many more, most associated with countries not the source of the disease which bears the name.  It’s not known where and where a person first was infected but a human case of monkeypox was first documented in 1970 in the Democratic Republic of Congo (DRC) in 1970.  Since then, the DRC has always recorded the majority of infections although between then and 2022, it had spread to a number of African countries, cases beyond the continent rare until 2022.

Example of regional variations in reported transmission: Nigeria 2017-2022.

Other associations linked to the name monkeypox have also become controversial and the WHO announced it is to receive a new name, noting comments from scientists and public health officials that the current name is "discriminatory and stigmatizing" and it’s also inaccurate to name versions of the virus after parts of Africa.  Accordingly, the WHO has already renamed two clades (from the Ancient Greek κλάδος (kládos) (shoot, branch, family) of the virus to avoid the stigma associated with geographical names: The variant formerly known as “Congo Basin'' will now be referred to as “Clade I” and the “West Africa” variant will be known as “Clade II”.  The first suggestion of a new name is hMPXV, to denote the human version of the monkeypox virus and rather than anything geographic locations, letters and numbers should be used, based on order of discovery. In that system, the lineage behind the current international outbreak would be dubbed hMPXV-B1.  Some local authorities have acted preemptively, Chicago public health authorities for example using the bland “MPV”.  Whatever it ends up being called however, in the West, like COVID-19, monkeypox may be here to stay.

Take-off point of 2022 spread charted by the Lancet.

One aspect of the epidemiology of monkeypox in the West is that some 95% of those diagnosed are gay or bi-sexual men (“men who have sex with men” now the preferred and most accurate terminology).  Activists from the relative LGBTQQIAAOP faction are among those advocating a change of name although this is unlikely to remove the stigmatization based on the rate of transmission among men who have sex with men; presumably a stigmatization associated with hMPXV-B1 (or whatever) must be thought less offensive than one linked with monkeypox, probably because  an alpha-numeric string is a step removed from any link with animals and thus the slur of bestiality.  In the 1980s, that was one of the complaints once it was revealed HIV/AIDS was probably a mutated monkey virus from Africa and, even in the pre-internet era, unsubstantiated theories soon circulated that the entry of the virus into the human system was linked to men having sex with monkeys, a slur on both African men and the gay community who at the point constituted the bulk of infections, almost all as a result of sexual contact.  The consensus now is that HIV/AIDS entered human circulation (perhaps even as long ago as the nineteenth century) because of blood-blood mixing while monkeys were being butchered as part of the bush-meat trade.  The monkeypox vector may have been the same.

Naming virus species is the responsibility of the International Committee on the Taxonomy of Viruses (ICTV) (the expert group which brought us COVID-19) but the WHO has decided to ask for the public’s help, announcing an “…open consultation for a new disease name for monkeypox.  Anyone wishing to propose new names can do so”.  A portal will soon be provided.