The new england journal of medicine d r u g t h e r a p y Therapeutic Strategies for Rheumatoid Arthritisheumatoid arthritis, a chronic, systemic, inflammatoryFrom the Department of Internal Medicine,University of Nebraska Medical Center;autoimmune disease, has as its primary target the synovial tissues. When thedisease is unchecked, it leads to substan
Lbalberti.itVICTORIAN BRITAIN When we describe Great Britain in the Victorian period, words like stability,progress, prosperity, reform, and Imperialism come to mind. The British had grounds forsome satisfaction because evidence of great economic growth and technical progressseemed to abound. Despite the continued existence of widespread poverty, teeming,miserable slums and poor working conditions in many industries, the British could takesome real pride in the obvious fact that the vast majority of British subjects were betterfed, better housed, and enjoyed more of life's amenities than ever before. Political y,Great Britain enjoyed remarkable stability. From the moment of her accession, QueenVictoria (r. 18371901) showed the qualities that were to remain with her throughout her reign: a strong sense of duty, a conviction of moral righteousness, and a deep feeling for her country, “since it has pleased Providence to place me in this station,” she wrote in her diary, “I shall do my utmost to fulfil my duty towards my country I and perhaps in many, though not in all things, inexperienced, but I am sure, that very few have more good wil and more real desire to do what is fit and right than I have.” QueenVictoria’s marriage to the earnest young German prince, Albert of Saxe Coburg Gotha,helped to establish the modern role of the British monarchy. Victoria and Albert modernized the monarchy. Albert had great influence over his wife, and thus forced her to take an interest in matters that had previously bored her, such as science and literature and even industrial progress.
The Crystal Palace: 1851In 1849, Albert hit upon the idea of the Great Exhibition, “to give us a true test and aliving picture of the point of development at which the whole of mankind has arrived in thisgreat task of applied science and a new starting point from which al nations, wil be able to direct their further exertions.”Progress seemed to be on the march. Prince Albert’s opening speech stressed the theme of human dominance over nature. The Great exhibition of 1851 was a hymn of praise for the Idea of progress. Prince Albert gave a speech at the opening ceremonies that attracted a great deal of attention and approval. He struck a note of optimism for the power of science — “Science discovers laws of power, motion and transformation; industry applies them to raw matter, which the earth yields in abundance, but which become valuable only by knowledge.” It was now possible to conquer nature by culture; that is, by the application of human knowledge and skill. The London exposition made a great impact on most observers around the world. Manypeople resented the British Empire, many European nations chose to reject the British political system as a model, but everyone envied and admired British wealth. The economic historian Paul Kennedy has calculated that “with 2 of the world's population., Great Britain controlled about 45 of the world's industrial capacity.” (Kennedy, p. 151) These figures indicate that Britain was by far the wealthiest society on earth. It was also the world's most dynamic society. The Victorians were the first people to experience vast social and technological transformations as a constant factor in their lives.
The British could certainty point out some stunning examples of economic and technicalprogress. The British justly boasted that their smal kingdom was the "Workshop of the World."By 1850 such boasting was simple fact. The world was flooded with cheap, British products ranging from Watt-Boulton steam engines to Manchester cotton shirts.
Prosperity and Political StabilityBy 1851 Great Britain was also the world's shipper, the centre of the world's insurance andbanking. It was also the source of much of the world's capital for investment. Most of therailways in the United States for example were built with British capital. More importantly,Britain's wealth was not limited to the upper classes alone. Beginning in the 1850s the industrial working class at last began to share in the general prosperity. The reason for this was largely the result of a great economic boom that that began about 1850 and lasted until the beginning of a worldwide economic constriction that began about 1873. The British working class made some real political progress as wel : labour unions werelegalized; the right to strike was gradual y recognized by al governments. One result, a very important result, was that Great Britain, alone of al European countries did not develop a powerful socialist movement. Great Britain alone of all European nations did not experience a major revolutionary upheaval during the 19th century. The prevailing mood, even in the British working class was confidence in the nation and its political institutions. In the revolutionary year 1848, when thrones toppled in France, Italy, and Germany, Britain remained an island of political stability.
This brings up an interesting historical problem. How did the British manage to deal with an industrial revolution that literal y changed everything without seeing a great political upheaval occur at the same time? The British would have responded that the British political system provided a means for gradual reform. A number of reform bil s (1832 and 1867) extended the vote to people in the lower middle class and working classes; in principle at least, it was possible for the British to address social problems through a peaceful process of reform within Parliament without reverting to violence. On the other hand, politics is only part of the story. VICTORIANISMIn the mid 19th century of Western Europe and the United States, the response to socialchange was a middle class set of values and attitudes that we cal Victorianism. One of the most distinctive aspects of Victorianism was the process by which other social classes came to accept the classic middle class virtues of self-improvement, temperance, thrift, duty and character. In other words, it was the Middle Class (NOT THE ARISTOCRACY) who would set the tone for al of society in the mid-nineteenth century. The spread of Victorian morality ended the age of the aristocratic rake. Above al , Queen Victoria was the great symbol of this change. Queen Victoria replaced Wil iam IV, a royal rogue of the highest order, in 1837 and she set the behaviour of the Royal family squarely on the side of propriety.
For example, when it became known Lord Palmerston, head of the Liberal Party during the1850s, had seven children out of wedlock, Queen Victoria maintained an icy relationship with him. When her sensibilities were offended, the Queen often would respond with a chil y, “We are not amused.” And that was that! VICTORIAN MORALITY: SEXUAL PRUDERYIn many ways, the control of nature lay at the heart of Victorian ideology: we can control nature by spanning continents with railways. However, are we equal y able to control theimpulses of our own natures? Can we control our own impulses towards sexual license orintemperance in the use of alcohol? It is more difficult to understand Victorian morality than to ridicule it. Why did the Victorians feel so uncomfortable about human sexuality? A lady or gentlemanof the 19th century simply could not discuss the topic in polite company. Victorian prudery led to such absurdities as the separation of the works of female and male authors on library shelves and the use of euphemisms for every reference to the body.
Victorianism was an international phenomenon, not merely a British one and it was in the United States that a British visitor noticed that the “limbs” of a grand piano in a girl's school were decently covered by little knit trousers lest they lead adolescent minds down the path towards impure thoughts. It was the Victorians who gave the word “immorality” its present connotation of defying sexual convention rather than tel ing lies or fraud.
Why al this prudery? One part of the answer is that it reflects a profound sense of anxietyassociated with developments in the world of science. Charles Darwin published his Origin of Species in 1859 and the book caused a sensation. We often discuss the argument between scientists and the organized churches over the theory of evolution. But Darwin's book did something else: it suggested that humanity was part of the natural world. If we are descended from lower animals what part of that animal nature remained? Alfred Lord Tennyson wrote: Can it be that ManWho trusted God was love indeed,And love creation's final law —Tho' Nature, red in tooth and clawWith ravine, shrieked against his creed —Simply dies the death of all animals?0 life as futile, then, as frail. . .
What hope of answer, or redress?Behind the veil, behind the veil. Darwin's idea of nature was very different from that of Isaac Newton and the other thinkersof the 18th century Enlightenment. It was not the orderly work of the Creator. It was also not the heroic, authentic Nature that the romantics admired. Instead, it was an eternal struggle for survival, "Red in tooth and claw." What Karl Marx and the Social Darwinists admired in Darwin, respectable Victorians abhorred. When social Darwinists spoke about the “survival of the fit est,” many Victorians were appal ed that human success should be judged by the same standards as that of animals.
If human nature is the way that Darwin portrayed it, human nature needs to be restrained,disciplined, and curbed. For many people in the Victorian period, sex represented everything that was base and irrational in human nature. There were those Victorians like Dr. Bowdler, a wel -to-do physician and part time social reformer who added a new verb to the English language, “Bowdlerize” by editing a family edition of Shakespeare, “in which nothing is added to the original text ;but those words and expres ions are omit ed which cannot with propriety be read aloud in a family.” Dr. Bowdler also provided a guide to the Bible indicating passages that should be read once (Song of Solomon etc.) and then ignored.
Purity was the standard for the lady and restraint became at least the professed ideal for the gentleman. Thomas Huxley, Darwin's defender was also a good Victorian and his anatomical charts were published without genitals. For members of “polite society” good breeding meant that people should remain ignorant about the facts of life. Children came via the Stork. Museum curators added strategic fig leaves to classical statues.
Good Victorians believed that if we hide al expressions of sexuality, we can eliminate thetroubling thoughts they might engender. Decent people did not read French literature. That good Victorian Sigmund Freud forbade his sister to read Gustave Flaubert's great novel of feminine liberation, Madame Bovary because decent people simply did not read French literature.
Is it even necessary to point out that al this public posturing certainly did not mean that theVictorians were avoiding sexual activity? Victorians were people like us, who try but often fail to live up to our standards. Pornography flourished, and prostitution was widespread. One London street was so famous for its streetwalkers that it was described as the "Western equivalent of an Eastern slave market." The London police kept records of 70,000 registered prostitutes. It was obvious that someone was keeping them employed. Part of the explanation lies in the medical realities of the nineteenth century. In an age before antibiotics, venereal diseases could wel lead to long il ness and death.
More than a few famous figures died of Syphilis: the philosopher Friedrich Nietzsche and Al Capone, for example. Incurable until the discovery of penicil in, Syphilis was the equivalent of AIDS today.
The Bourgeois FamilyNo age ever praised the virtues of family life more thoroughly than our Victorianancestors. The Victorian family was patriarchal, bound by unspoken rules and the wife was seen as the domestic angel who provided a safe haven for her husband and a strong, moral example for the children. Although the middle class wife was in no way the equal of her husband in the sense that she shared access to education or political and civil rights, she did exert power over other people. The Victorian wife was the household manager, responsible for the moral instruction of the servants as wel as the children. Families were large, and the average wife spent “about 15 years in a state of pregnancy and nursing children in the first year of life.” After infancy, children were expected to be seen but not heard. The alternative would have been bedlam (=chaos). The Queen herself set an example: Victoria and Albert's marriage was a true love-match.
Victoria gave birth three times in the first three years of marriage, six times in her first eight years of marriage. In al , the Royal couple had nine children. Although al of her children lived to adulthood, she did not enjoy childbearing: “What you say of the pride of giving life to a soul is very fine my dear,” she wrote to her oldest daughter, "but I think much more of our being like a cow or a dog at such moments when our poor nature becomes so very animal and unecstatic.”Many middle class wives were caught in a no-win situation. For the sake of her husband's career, she was expected to maintain her public image as the idle wife, freed from demeaning physical labour and able to pass her time in ornamental pursuits. In manyways, the great symbol of al this was Queen Victoria herself.
Young women were taught to aspire to ideal of femininity popularized by writers like the poet Alfred Lord Tennyson:Man for the field and woman for the hearth:Man for the sword and for the needle she:Man with the head and woman with the heart:Man to command and woman to obey;All else confusion. Victorian psychology taught that men were more animalistic than women, more tied to theirprimitive natures. Perhaps the most Victorian of al novels might be Robert Louis Stevenson's classic Dr. Jekyll and Mr. Hyde: the novel of a man who gives in to the beast within us al .
Victorians like Dr. Thomas Bowdler believed that it was impossible to overstate the importance of morality; indeed good behaviour and good morality was the only defence available to society in a time of economic and political upheaval. One must be ever vigilant lest the beast within burst the bonds of law and custom. Edmund Burke expressed the idea wel : “Manners are of more importance than law. The law touches us but here and there and now and then. Manners are what vex or soothe, corrupt or purify, exalt or debase, barbarize or refine us, by a constant, steady, uniform, and insensible operation, like that of the air we breathe in.” Because of this, men's sexual escapades were tolerated as inevitable; those of women were never tolerated. All of this amounted to a double standard. Women were expected to live a life of utter purity, yet young ladies at finishing school were taught to flirt andmanipulate the men in their lives.
YELLOW PAGES SA SENIOR CHAMPS at COETZENBURG, STELLENBOSCH on 2009/03/13 ===============FINALS============= Final Women 100m (-0.7) 1.TSHOLOFELO,THIPE(11.36) ; 2.NOMBULELO,MKENKU(11.45) ; 3.THANDIWE,VILAKAZI(11.71) ; 4.CINDY,STEWART(11.74) ; 5.CARINA,HORN(11.81) ; 6.CHRISTINE,RAS(11.99) ; 7.CHERESE,JONES(12.04) ; 8.MELISSA,HEWITT(12.22) ; Final Women 200m (-0.4) 1.ISABEL,LE ROUX(23.43) ; 2.NOMBULE