What is Bitcoin?

Definition of "Money"

Brief Chronology of Money

• She goes to the Amherst motel behind Domino's & meets up with BF.
• The Saturn is towed from or picked up at Zbylut Motorworks garage (aka Autozone) (open since 2003.) This is one example but there seems to have been other auto-repair shops nearby.

• Maura goes to ATM & receipt is printed around 3:15 PM.
• She gets the insurance forms from AAA located between liquors 44 & the bottle return place.
• She or her BF returns the cans & either both or one or the other buys the alcohol & cigarettes at the liquor store & pays at 3:43 PM.

• What is Rheumatoid arthritis?
• Best shoes for Rheumatoid arthritis
• Rheumatoid arthritis and exercises
• Additional foot care practices for RA

What is Rheumatoid Arthritis?

Best Shoes for Rheumatoid Arthritis

• Rocker bottoms: Also called rocker soles, this shoe feature can reduce pain and help with mobility and activity limitation in RA patients. They are designed to reduce pressure under the ball of the foot and excessive toe motion.
• Wide toe box: Rheumatoid arthritis can lead to foot deformities in the form of severe bunions, claw toes and hammertoes. It can also cause severely flat feet, and a widened forefoot, sometimes called splay foot. Rheumatoid nodules (firm bumps of tissue) can also pop up anywhere along the affected area. Wearing shoes with a wide toe box is imperative for maintaining a certain comfort level and accommodating these deformities.
• Adjustable straps: When you have Rheumatoid arthritis, having more room in the entire shoe to accommodate stiff joints and deformities can be a major plus.
• Breathable materials: A 2019 study highlighting important features of retail shoes for women with RA found that breathable materials (such as soft mesh uppers) were crucial for most patients.

Rheumatoid Arthritis and Exercise

Here are some multi-purposeful exercises that can also help with RA:

Be sure to also check out our two-part series on the best exercises for arthritis!

• Part 1
• Part 2

Additional Foot Care Practices for RA

• The RICE Method: Sometimes, your pain may flare up to the point where all you can do is be patient and wait until it passes. Luckily the magical combination of rest, ice (or heat), compression, and elevation can help you accommodate severe pain and swelling.
• Summer footwear: During the warm months, wear sandals with open toes.
• Warmth: Keep your feet as warm as possible, as cold air can worsen joint pain. A heating pad can also be very helpful for loosening stiff muscles.
• Foot baths: The warm water in foot baths can loosen up stiff joints. Try adding Gehwol foot bath products for added comfort!
• Meditation: Stress can often trigger RA flare-ups, so reducing anxiety via healthy, quiet rumination can be a wonderful preventative measure. Other stress-reducing lifestyle habits include taking walks (when physically able) and listening to soothing music.

Don't Forget to Visit Feet First Clinic!

Exit, Pursued by a Bear

• We call this temporal shortening of distance Globalization and the end of the 19th century represented the first hard step in that effort. Looking at the graph we can see that over the 60 years that rail development took off, rail development was the driving force behind Globalization. A quick look at the rail maps of the German Empire in 1840 vs 1880 shows that having a rail line close to your city or port was crucial for the economic (and defense) of the country. Russia…is a different story or rather an even bigger story. Much bigger.

• If you are unaware the Russian Empire was HUGE; at its peak it covered 22.8 MILLION square miles and is the third largest empire in history (after the British Empire and the Mongol Empire). For much of its history, upwards of 80% of the population of Russia lived west of the Ural Mountains in what is called European Russia. But with that area of Russia being occupied densely for thousands of years, most of the natural resources were extracted from Siberia while farming was extracted from the Chernozem region (modern day Ukraine and Kazakhstan). So in order for food or raw materials to be shipped from the outer edges of the empire into the heartland, it would have to cover upwards of one thousand kilometers. Before rail, this was a 2 week journey and all the while you are racing against the clock so the food doesn’t spoil before it gets to the markets in the middle of St. Petersburg.
  • Up until the creation of the railroad, like most civilizations, trade was done via rivers and luckily the Volga River runs north-south straight through the middle of European Russia. Despite this centrally located river traversing the upper portions of the river were frozen for 6-7 months per year making it basically useless for transferring cargo. Peter the Great built the Vyshnii Volochek System, an extensive canal system, that linked the newly created St. Petersburg with the old capital of Moscow in 1709. Although the canals improved travel it still took 3 months to travel from Moscow and St. Petersburg. To go from Astrakhan on the Black Sea up to St. Petersburg (traversing the entire length of European Russia) was a notable 2 year trip. One way.
  • Well why not roads? Well Russia at the time was known for very wet soils that made roads extremely muddy and dangerous. In fact, the best time to traverse by road was during the winter when the mud was frozen but this added the danger of trying to transport people and animals in the sub-zero temperatures. Alexander I laid the first real roads in 1817 between Moscow and St. Petersburg which was finished in 1834. If weather held, a small cart could make the trip between the two cities in 10 days but the road was small and could only really allow for small non bulky goods to be moved. The true time was closer to 70 days. In response to this Nicholas I founded a committee to study plans for road development in 1833 that would be studied and funded by central, provincial, and local authorities so all roads in Russia were improved slowly but surely. Despite the good intention, the plan failed due to a lack of funds, engineers, and labor.
• Despite the problems with river and road transport, Russian leaders were hesitant to embrace the railroad. Minister of Finance Count Kankrin and Minister of Ways and Communication Count K F Toll believed that money should be spent improving the agricultural sector rather than building these large and expensive machines and rail systems (completely looking over the fact that there was plenty of food it just couldn’t be transported quick enough). The first railroad would then be privately sponsored for mining and would instantly prove their usefulness over horse and cart. In just 15 years the cost of the railroad would be paid for. In response to this the Russian Government believed that private industry should take the financial risk rather than embracing the technology.
• On January 6, 1835 Austrian engineer Franz Anton von Gerstner sent a letter to Nicholas I and proposed an extensive Russian railway system. Von Gerstner was probably the most qualified person in Europe due to being the first person to build a railway on continental Europe (Danube-Moldavia line) and he provided statistics about the usefulness of rail. Probably the most important of which was the English’s ability to suppress Irish disorder quickly with easy troop movements. The first line to be completed was between Moscow and Tsarskoe Selo in 1836, with a new St. Petersburg-Moscow line in 1851. With great attribution to the Crimean War (1853-1856), the total amount of rail would increase from 5000km in 1860 to over 53,200km in 1899.

• Probably most important among these railways was the Trans-Siberian Railway started by Tsar Nicholas II in 1891. Starting in Moscow in the West, this railroad would stretch 9,289km (5,772mi) to its terminus at Vladivostok in the East. To put this in perspective,if you were standing in San Francisco and boarded a train, the final destination would be Spain, yeah you’d go over the Atlantic Ocean. That’s how long this thing is! Despite being the largest province in the country, Siberia represented the least developed part of the country mostly due to its vastness and inability to traverse laterally. Several rivers flow through the region but are untraversable except for 5 months of the year due to freezing over. Walking the distance could take upwards of a year but once the railway was completed it took a mere 7 days. That’s nuts!

Wow you really love trains don't you?

• Little did Heyfelder know but he had just encountered one of the first people to be infected in the 1889 pandemic and the disease would spread quickly via—you guessed it—railroad. See back in 1879 a new Trans-Caspian Railway was built along an old Silk Road corridor which would have bypassed Bukhara entirely. That is if it wasn’t for the last Emir of Bukhara Muhammad Alim Khan (1880-1944) who was unhappy with the nearest station being dozens of miles away in Kagan so he built a private spur to Bukhara itself. With the rail connection established the disease spread quickly up the railway into Russia and then exported to the rest of the world over weeks. I found a great map from a 1892 book published on the Russian Flu that shows the spread of disease by coloring the map. [In case it's hard to read, go to the link and then page 218 of the pdf].

• From the first cases reported in Bukhara, Russian Flu would travel up to Tomks in Western Siberia, Ufa (100 km east of Moscow), Kazan (700 km east of Moscow), Ukraine, and Novgorod (near St. Petersburg) by October of 1889. By November Moscow was hit with 20,000 cases alone which crippled the growing worker’s population and grinded production to a halt. Somewhere between 25-50% of soldiers and students were taken ill which added an extra burden on families. Mid-November saw 180,000 of the one million citizens of St. Petersburg infected. The bread-basket of the Russian Empire was struck next when Kiev and the rest of Ukraine fell to the disease although luckily it hit after the Autumn harvest had already come in.
• Once established in Russian the disease was able to spread out of the motherland to other regions. Via St. Petersburg the infection hopped aboard Baltic ships and was exported to Finland, Sweden, Germany, and Denmark. In Sweden up to 60% of the population would be infected within 2 months of the Flu landing. As a major trading hub, Posen had an extensive rail network that allowed for the Flu to move throughout Germany infecting half of the 1.5 million residents of Berlin. Vienna and Rome got it by early December; Paris by Christmas; Spain in January where up to 300 people died a day in Madrid alone. London, Birmingham, Glasgow, and Dublin took a punch by Christmas as well.

• Remember that this is the age of small Earth where globalization has made a trip across the Atlantic as short as 7 days. Russian Flu entered Boston and New York City on December 18th, 1889 before being sent West towards Chicago and San Francisco (who would particularly be hit bad). Once in the United States it would spread north to Montreal and south to Mexico and the rest of South America. By February the disease reached East via the Dutch trading companies and spread liberally among the South East Asian population. Japan, Australia, and New Zealand all caught it in April; China in May.

The Deadly Disease Wasn’t That Deadly

• So what even happened then? It would start with typical cold symptoms: sweating, fever and chills, sneezing, watery eyes, and dry cough. But contemporary doctors did identify 4 distinct clinical forms of Russian Flu: a simple fever that would increase over 48 hours and then subside within 3 or 4 days; a gastrointestinal form in which people had severe diarrhea, fevers, and stomach aches (which honestly could have been a co-infection with the raging Cholera epidemic at the time); a rarer catarrhal form (profuse mucus production that would fill the sinuses and lungs and progress to pneumonia); and finally the worst one, a “nervous” form that caused intense nerve pain in the hands and feet driving people mad. Regardless of which form someone got the worst symptom, and the most common reason why someone would die outside of catching pneumonia (fluid in the lungs) is developing skin lesions. These bullae (large blisters filled with white fluid) were painful, itchy, and formed in the creases of the feet, hands, and extremities which were prone to popping—once popped they were open sores ripe for infection. If you didn’t manage to die from the skin lesions then kidney failure, digestive inability, or spinal nerve damage that would drive people towards suicide was another common way to die.
  • Here’s the problem with Russian Flu…it doesn’t appear to be a Flu. Nowadays we attribute the word Flu to the Influenza Virus, a small RNA virus from the family Orthomyxoviridae but back in previous centuries the word Influenza meant any disease that affected humans. The word is derived from the Latin influentia meaning “to flow into” and it was believed that the stars gave off an intangible fluid that flowed into humans and caused sickness. Eventually this idea would morph into the Humoral Theory of Disease in which there are 4 fluids in the body that need to be balanced else they cause disease. There are 4 types of Influeza Virus: A and C which infect a variety of different animals (human, pig, bird, horse, bat), B which exclusively infects humans (although seals have been seen with Influenza B), and D which exclusively infects pigs and cows. If you’re older than 10 years old, you’ve almost certainly been infected with Flu at some point—already the 2022-2023 Flu season has 26 million infections in just the US alone.

• Real quick I want to talk about the names of Influenza Viruses. The Influenza Virus is a sphere shaped particle that has primarily two proteins on its surface: Hemagglutinin (HA or H) and Neuraminidase (NA or N). These proteins are incredibly important for the virulence of the pathogen—the Hemagglutinin helps the virus bind to the target cell and infect its viral genome into the cell while the Neuraminidase helps burst the cell when the baby viruses are ready to be released. So far 18 HA subtypes (called serotypes) and 11 NA serotypes have been isolated in nature allowing for considerable genetic variation. Thus we classify Influenza A viruses based on what version of the H and N proteins they have: H1N1 caused the Spanish Flu of 1918 (killing 20-100 million people) and the Swine Flu of 2009 (killing about 400,000 people); or H3N2 caused Hong Kong Flu in 1968-9 (1 million dead). Even still there are several combinations that only infect animals, such as H5N1 is Avian Flu and is tracked by many governments to prevent a possible transmission from bird to humans. All Flu A viruses are also classified by a standard nomenclature based on where and when they were first discovered. For example, Swine Flu was referred to as A/Brisbane/59/2007 since it was first discovered in Brisbane in 2007.

• The thing is, Russian Flu may not be an Influenza like we first thought. Traditionally it is believed that the Russian Flu was caused by H3N8 (which primarily infects horses) or H2N2 (which caused the Asian Flu of 157-8). The problem with this is that Russian Flu does not share many of the common Flu symptoms we have seen in other outbreaks—Flu follows a pretty consistent 2-8 day pattern focusing mostly in the lungs. Severe complications of Flu can lead to more severe respiratory distress, meningitis, or encephalitis but other organ involvement is pretty limited. Russian Flu almost always involved other organs. This idea isn’t a contemporary one either, people had suspicions on just what Russian Flu really was.
  • Following the discoveries of Louis Pasteur and Robert Koch in the field of microbiology, the race of finding the causative agents for common diseases was on. In 1891, German Richard Pfeiffer isolated an unknown bacteria from the nose swabs of patients infected with Influenza. On January 4th, 1892 he announced he had found it, the cause of Influenza: Haemophilus influenzae. There was a momentous uproar in the scientific community because if we know what causes a disease it indicates that we can treat the disease. The problem is that Pfeiffer could not replicate the infection of H. influenzae showing definitively that it caused Flu. But as more and more people kept finding H. influenzae in patients affected with Flu, the observations were corroborated and later was accepted as fact—by 1900 it was believed that the cause of Flu (any lung infection) was due to this bacteria. This fact was firmly cemented in the medical psyche as H. influenzae was found over and over again in Flu victims during the Spanish Flu epidemic of 1918.

• But there was some skeptics—one of the big reasons to doubt was that antibiotics at the time did not touch Flu. Now this was before Penicillin but drugs like Salvarsan were the goto agent to kill a multitude of bacteria (you can read more about this arsenic containing ‘medicine’ in my post here!) but it couldn’t touch the Flu. It wouldn’t be until 1931 that the disease Influenza was discovered to be from a virus not a bacteria like once thought. When the development of genome sequencing came about, we were able to sequence Spanish Flu (1918) as H1N1, the same one that caused the Asian Influenza epidemic in 1957 and later Swine Flu in 2009. In 2005 we used samples from graves to ‘revive’ the 1918 virus and found that it was incredibly infectious in primates. When Flu was discovered in 1933, scientists back-dated all epidemics that were called Influenza and claimed it was caused by H1N1. There is additional evidence to support this claim though that Flu may have caused Russian Flu. By looking at serotypes in corpses of adults born between 1863 and 1886, they discovered higher antibodies for the H2 subtype. But when they analyzed samples from corpses from 1910, they had the same levels.

The Hunt for Red Corona

• Following the COVID-19 pandemic, researchers started to take another look at the Russian Flu and see if it was infact Flu. COVID-19 does resemble Influenza epidemics due to its similar respiratory symptoms but with other organ involvement, a Coronavirus was implicated more than a Influenza one. There are 7 Coronaviruses that are infectious to humans—3 caused deadly epidemics SARS-CoV-1 (9% mortality) usually referred to the SARS outbreak in 2002-2004, MERS-CoV (30% mortality) which popped up in 2012, and SAR-CoV-2 (0.6-2%) which we are in right now. The other 4 Coronaviruses are implicated in 15-30% of common colds and have been in the population for decades (probably centuries), HCoV-229E, HCoV-NL63, HCoV-OC43, and HCoV-HKU1. The milder viruses are seasonal and show up every 3-4 years during the normal Flu season of autumn to early spring.In 2005 Belgian researchers found that HCoV-OC43’s genome was very similar to another coronavirus found in cow, BCoV. The DNA sequence of OC43 was almost identical to that of BCoV isolated from corpses from 1890. Does this mean that a coronavirus was the cause of Russian Flu? Well let’s look at the evidence:
  • Firstly, we know viruses can jump between species, especially when there is big populations of that species in prolonged contact with the second—this is why giant pig or bird farms can be hotbeds for viral transmission. With the development of railways in Russia in the second half of the 19th century, cows started to be transported in mass quantities along the railway. This meant that thousands of cattle were packed into tiny poorly ventilated compartments allowing for easy transmission of disease. From 1870 to 1890, the bacteria Mycoplasma mycoides completely crushed cattle populations due to them being packed in close quarters and herds had to be slaughtered quickly to prevent the spread from going worldwide. What would those workers have been exposed to as they started to slaughter more and more animals? Diseases, specifically cow diseases that could have made the jump. This isn’t as far-fetched as it seems—the 2002 SARS epidemic became much worse following the slaughter of thousands of civets for human consumption. Likewise it was noted in 1889 that the cows showed the same symptoms as humans. So it's possible that HCoV-OC43 is the virus that mutated from cows into humans. So between the similarity in symptoms between COVID-19 and Russian Flu, the industrialization of the railways allowing for viruses to mutate and then for people to spread it quickly and globally, and the use of genomic science, we now believe that Russian Flu was really Russian COVID. Let’s just be glad that HCoV-OC43 is now a mild cold and doesn’t cause painful blisters and horrible nerve pain. Cheers!