COVID-19, SARS and MERS: are they

closely related? Nicola Petrosillo

Visit to download the full and correct content document:
https://ebookmass.com/product/covid-19-sars-and-mers-are-they-closely-related-nicol
a-petrosillo/
More products digital (pdf, epub, mobi) instant
download maybe you interests ...

Pathogenic Coronaviruses of Humans and Animals: SARS,

MERS, COVID-19, and Animal Coronaviruses with Zoonotic
Potential Lisa A. Beltz

https://ebookmass.com/product/pathogenic-coronaviruses-of-humans-
and-animals-sars-mers-covid-19-and-animal-coronaviruses-with-
zoonotic-potential-lisa-a-beltz/

Recurrence of positive SARS-CoV-2 RNA in COVID-19: A

case report Dabiao Chen

https://ebookmass.com/product/recurrence-of-positive-sars-
cov-2-rna-in-covid-19-a-case-report-dabiao-chen/

From SARS to COVID-19_ A previously unknown SARS-

related coronavirus (SARS-CoV-2) of pandemic potential
infecting humans – Call for a One Health approach
Mohamed E. El Zowalaty
https://ebookmass.com/product/from-sars-to-covid-19_-a-
previously-unknown-sars-related-coronavirus-sars-cov-2-of-
pandemic-potential-infecting-humans-call-for-a-one-health-
approach-mohamed-e-el-zowalaty/

Recommendations on management of the SARS-CoV-2

coronavirus pandemic (Covid-19) in kidney transplant
patients Verónica López

https://ebookmass.com/product/recommendations-on-management-of-
the-sars-cov-2-coronavirus-pandemic-covid-19-in-kidney-
transplant-patients-veronica-lopez/
Severe Acute Respiratory Syndrome (SARS) and
Coronavirus disease-2019 (COVID-19): From Causes to
Preventions in Hong Kong Siukan Law

https://ebookmass.com/product/severe-acute-respiratory-syndrome-
sars-and-coronavirus-disease-2019-covid-19-from-causes-to-
preventions-in-hong-kong-siukan-law/

The Philosophy of Comics: What They Are, How They Work,

and Why They Matter Henry John Pratt

https://ebookmass.com/product/the-philosophy-of-comics-what-they-
are-how-they-work-and-why-they-matter-henry-john-pratt/

A therapeutic non-self-reactive SARS-CoV-2 antibody

protects from lung pathology in a COVID-19 hamster
model

https://ebookmass.com/product/a-therapeutic-non-self-reactive-
sars-cov-2-antibody-protects-from-lung-pathology-in-a-
covid-19-hamster-model/

Severe acute respiratory syndrome coronavirus 2 (SARS-

CoV-2) and coronavirus disease-2019 (COVID-19): The
epidemic and the challenges Chih-Cheng Lai

https://ebookmass.com/product/severe-acute-respiratory-syndrome-
coronavirus-2-sars-cov-2-and-coronavirus-
disease-2019-covid-19-the-epidemic-and-the-challenges-chih-cheng-
lai/

Recomendaciones en el manejo de la pandemia por

coronavirus SARS-CoV-2 (Covid-19) en pacientes con
trasplante rena Verónica López

https://ebookmass.com/product/recomendaciones-en-el-manejo-de-la-
pandemia-por-coronavirus-sars-cov-2-covid-19-en-pacientes-con-
trasplante-rena-veronica-lopez/
Journal Pre-proof

COVID-19, SARS and MERS: are they closely related?

Nicola Petrosillo, Giulio Viceconte, Onder Ergonul, Giuseppe Ippolito, Eskild Petersen

PII: S1198-743X(20)30171-3
DOI: https://doi.org/10.1016/j.cmi.2020.03.026
Reference: CMI 1988

To appear in: Clinical Microbiology and Infection

Received Date: 16 February 2020

Revised Date: 9 March 2020
Accepted Date: 21 March 2020

Please cite this article as: Petrosillo N, Viceconte G, Ergonul O, Ippolito G, Petersen E, COVID-19,
SARS and MERS: are they closely related?, Clinical Microbiology and Infection, https://doi.org/10.1016/
j.cmi.2020.03.026.

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition
of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of
record. This version will undergo additional copyediting, typesetting and review before it is published
in its final form, but we are providing this version to give early visibility of the article. Please note that,
during the production process, errors may be discovered which could affect the content, and all legal
disclaimers that apply to the journal pertain.

© 2020 Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious
Diseases.
 1 COVID-19, SARS and MERS: are they closely related?

2 Nicola Petrosillo1,Giulio Viceconte2, Onder Ergonul3,4, Giuseppe Ippolito1,

3 Eskild Petersen.5,6,7
1
4 National Institute for Infectious Diseases “L. Spallanzani”, IRCCS, Rome, Italy
2
5 University “Federico II”, Department of Clinical Medicine and Surgery, Naples, Italy
3
6 Koc University, School of Medicine, Istanbul, Turkey
4
7 ESCMID Executive Committee
5
8 Directorate General for Disease Surveillance and Control, Min of Health, Muscat, Oman
6
9 ESCMID Emerging Infections Task Force, ESCMID, Basel
7
10 Institute for Clinical Medicine, Faculty of Health Sciences, University of Aarhus, Denmark

11

1
12

13 ABSTRACT

14 Background: The 2019 novel coronavirus (SARS-CoV-2) is a new human coronavirus which is

15 spreading with epidemic features in China and other Asian countries with cases reported

16 worldwide. This novel Coronavirus Disease (COVID-19) is associated with a respiratory illness that

17 may cause severe pneumonia and acute respiratory distress syndrome (ARDS). Although related to

18 the Severe Acute Respiratory Syndrome (SARS) and the Middle East Respiratory Syndrome (MERS),

19 COVID-19 shows some peculiar pathogenetic, epidemiological and clinical features which have not

20 been completely understood to date.

21 Objectives: We provide a review of the differences in terms of pathogenesis, epidemiology and

22 clinical features between COVID-19, SARS and MERS.

23 Sources: The most recent literature in English language regarding COVID-19 has been reviewed

24 and extracted data have been compared with the current scientific evidence about SARS and

25 MERS epidemics.

26 Content: COVID-19 seems not to be very different from SARS regarding its clinical features.

27 However, it has a fatality rate of 2.3%, lower than SARS (9.5%) and much lower than MERS

28 (34.4%). It cannot be excluded that because of the COVID-19 less severe clinical picture it can

29 spread in the community more easily than MERS and SARS. The actual basic reproductive number

30 (R0) of COVID-19 (2-2.5) is still controversial. It is probably slightly higher than the R0 of SARS (1.7-

31 1.9) and higher than MERS (<1),. The gastrointestinal route of transmission of SARS-CoV-2, which

32 has been also assumed for SARS-CoV and MERS-CoV, cannot be ruled out and needs to be further

33 investigated.

2
34 Implications: There is still much more to know about COVID-19, especially as concerns mortality

35 and capacity of spreading on a pandemic level. Nonetheless, all of the lessons we learned in the

36 past from SARS and MERS epidemics are the best cultural weapons to face this new global threat.

37

38

39

3
40 INTRODUCTION

41 The 2019 novel coronavirus (SARS-CoV-2) is a new human coronavirus which emerged at the end

42 of December 2019 in Wuhan, China. It is currently spreading with epidemic features in China and

43 other Asian countries, with cases reported in Europe, Australia and North America. Currently, at

44 the date of 8th of March 2020, 105 586 confirmed cases have been reported in 101 countries with

45 a total number of 3584 deaths.1

46 COVID-19 (Coronavirus Disease) is the clinical syndrome associated with SARS-CoV-2 infection,

47 which is characterized by a respiratory syndrome with a variable degree of severity, ranging from a

48 mild upper respiratory illness to severe interstitial pneumonia and acute respiratory distress

49 syndrome (ARDS).2–4

50 Although SARS-CoV-2 belongs to the same betacoronavirus genus of the coronaviruses responsible

51 for the severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS)

52 (i.e SARS-CoV and MERS-CoV, respectively), this novel virus seems to be related to milder

53 infections. Moreover, SARS and MERS were mainly associated with nosocomial spread, whereas

54 SARS-CoV-2 is much widely transmitted in the community.5

55 In this review we aim to analyze the differences in terms of pathogenesis, epidemiology and

56 clinical features between COVID-19, SARS and MERS.

57 PHYLOGENY

58 Genome sequence analysis has shown that SARS-CoV-2 belongs to betacoronavirus genus, that

59 includes Bat SARS-like coronavirus, SARS-CoV, and MERS-CoV.6

60 SARS-CoV-2 possesses a genomic structure which is typical of other betacoronaviruses. Similarly to

61 other coronaviruses, its genome contains 14 open reading frames (ORFs), encoding for 27

62 proteins: the ORF1 and ORF2 at the 5’-terminal region of the genome encode for 15 non-structural

63 proteins important for virus replication. 7,8 The 3’-terminal region of the genome encodes for

4
64 structural proteins, namely spike (S), envelope protein (E), membrane protein (M) and

65 nucleocapsid (N), plus 8 accessory proteins.7,8

66 Phylogenetic tree analysis of the novel coronavirus showed that SARS-CoV-2 belongs, together

67 with SARS-CoV and Bat SARS-like coronavirus, to a different clade from MERS-CoV and it is more

68 phylogenetically related to Bat SARS-like coronaviruses isolated in China from horseshoe bats

69 between 2015 and 2018 than to the SARS-CoV (Table 1). This suggests a different viral evolution

70 from SARS and MERS, involving bats as wild reservoir. 9–14 Genomic comparison between SARS and

71 SARS-CoV2 has shown that there are only 380 amino acid substitutions between SARS-CoV-2 and

72 SARS-like coronaviruses, mostly concentrated in the nonstructural protein genes, while 27

73 mutations have been found on genes encoding for viral spike protein S responsible of receptor

74 binding and cell entry.8 This mutations might explain the apparent lower pathogenicity of SARS-

75 CoV-2 than SARS-CoV, but further studies are required. 9

76 PATHOGENICITY

77 Accumulating evidence based on genomic analysis suggest that SARS-CoV-2 shares the same

78 human cell receptor with SARS-CoV, the angiotensin-converting enzyme 2 (ACE2), while MERS-CoV

79 uses dipeptidyl peptidase 4 (DPP4) to enter in host’s cells (Table 1).15 It is well established that

80 SARS-CoV emerged as human pathogen thanks to favorable mutations on the receptor binding

81 domain (RBD) of the S protein, that increased its pathogenicity by strengthening its affinity to the

82 receptor; it is therefore assumed that SARS-CoV-2 has behaved in a similar way.15 However, in

83 SARS-CoV-2 no amino acid substitutions were present in the RBD that directly interact with human

84 receptor ACE2 compared with SARS-CoV, but six mutations occurred in the other regions of the

85 RBD.8 The role of such substitutions on the pathogenicity of SARS-CoV-2 must be further

86 investigated. Analysis of receptor affinity shows that SARS-CoV-2 binds ACE2 more efficiently than

87 the 2003 strain of SARS-CoV, although less efficiently than the 2002 strain. 15 Moreover, it has

5
 88 been predicted that a single nucleotide mutation on RBD of SARS-CoV-2, if occurs, could further

89 increase its pathogenicity.15

90 ACE2 is an ectoenzyme anchored to the plasma membrane of the cells of several tissues,

91 especially lower respiratory tract, heart, kidney and gastrointestinal tract.16 Inoculation of the

92 2019-nCoV onto surface layers of human airway epithelial cells in vitro causes cytopathic effects

93 and cessation of the cilia movements.17 SARS-CoV highly replicates in the type I and II

94 pneumocytes and in enterocytes, and the SARS-induced down-regulation of ACE2 receptors in

95 lung epithelium contributes to the pathogenesis of acute lung injury and subsequent ARDS.16,18 It

96 must be further investigated if the higher receptor affinity of SARS-CoV-2 than SARS-CoV for ACE2

97 could lead to a more severe lung involvement in COVID-19 than in SARS.

98 TRANSMISSIBILITY

99 The reproductive number (R0) of the novel infection is estimated by World Health Organization

100 (WHO) to range between 2 and 2.5, which is higher than SARS (1.7-1.9) and MERS (<1), suggesting

101 that SARS-CoV-2 has a higher pandemic potential.19–23 However, it must be noted that some

102 published studies have estimated a R0 for SARS reaching the value of 4.24 Interestingly, a recent

103 review by Liu and colleagues has shown that the average reproductive number of SARS-CoV-2 is

104 estimated to be 3.28, with a median value of 2.79, thus exceeding the WHO estimates.25

105 Nonetheless, in Table 1 we only report the WHO data, since the estimation of R0 depends on the

106 estimation method used and the current estimate can be biased by insufficient data and short

107 onset time of the diseases, as Liu and colleagues also state.

108 According to a recent large descriptive study carried out by the Chinese Center for Disease Control

109 and Prevention (CCDC) on 44 672 individuals diagnosed with COVID-19 in China, the fatality rate of

110 novel coronavirus infection is estimated to be 2.326, lower than SARS (9.5%) and much lower than

111 MERS (34.4%).5,27 Interestingly, according to CCDC, the case fatality rate in the Hubei province,

6
112 where the epidemic has started, is 7-fold higher than other provinces.26 This could be related to

113 the fact that, among the 44 672 cases reported by CCDC, 10 567 (14.6%) cases were diagnosed

114 only clinically and exclusively in the Hubei province. Therefore, it cannot be excluded that clinically

115 diagnosed cased presented with a more severe clinical picture, thus increasing the case fatality

116 rate.26 After the change of case definition, the number of cases increased due to the inclusion of

117 cases cumulated over the past weeks. The question is: were mild cases registered at all? It is not a

118 minor matter, because including mild cases will reduce the mortality rate. Indeed, the number of

119 infected outside of China is currently 24 727 with 484 fatal outcomes, and a mortality rate of

120 1.9%1. Of interest, the fatality rate of the novel coronavirus infection increases to an estimated

121 14% when considering only the hospitalized cases, reaching the overall SARS case-fatality rate that

122 was estimated to be around 15%.28,29

123 CLINICAL FEATURES

124 Up to date, complete clinical data concerning COVID-19 have been reported for 458 cases in the

125 English-language literature, of which 415 from Hubei province in China2–4,30, 17 in other Chinese

126 provinces31,32, 25 in Korea33,34 and 1 in USA35. In Table 2 the main clinical characteristics from the

127 three most significant case series of COVID-19 cases are listed and compared with the most

128 recently available data about SARS and MERS. The median age of the COVID-19 cases ranges from

129 49 to 57 years, similar to SARS and MERS, higher in those admitted to ICU; up to 50% of patients

130 reported a chronic comorbid illness in a slightly lower percentage compared to patients diagnosed

131 with MERS. The most common presenting symptoms is fever, followed by cough, sore throat and

132 dyspnea; all of the infected patients had at least one symptom. However, according to the CCDC

133 report, 81% of the cases had mild symptoms and 1.2% were asymptomatic.26

134 Laboratory findings in patients diagnosed with COVID-19 are not remarkably different from those

135 diagnosed with the other coronavirus infections, with lymphopenia as the most common finding,

7
136 together with low platelet count, decreased albumin levels and increased aminotransferases,

137 lactic dehydrogenase, creatine kinase and C-reactive protein levels. No data are available on

138 lymphocyte subpopulations levels, but it can be interesting to know if the virus associated

139 lymphopenia affects in a different way CD4+ and CD8+ subpopulations, to predict the possible

140 development of superimposed bacterial or opportunistic infections, which have currently been

141 reported in a small amount of cases to date.2

142 Radiological presentation of COVID-19 is not much different from the other two coronavirus-

143 associated pneumonia, even though the proportion of cases with bilateral findings seems to be

144 higher in COVID-19 cases. The most common CT findings in COVID-19 is bilateral pulmonary

145 parenchymal ground-glass, consolidative or “crazy paving” pulmonary lesions, often with a

146 rounded shape and a peripheral distribution.36 Interestingly, in a recent study on 167 patients

147 from Hubei province with suspected COVID-19 who underwent chest CT scan and respiratory swab

148 for detection of SARS-CoV-2, five subject (3%) had a CT scan that was strongly suggestive of

149 COVID-19, but an initially negative real-time polymerase reaction (RT-PCR). These patients were

150 isolated for presumed COVID-19 pneumonia and the respiratory swab repeated between 2 and 8

151 days later turned positive.37

152 Patient diagnosed with COVID-19 may have an unfavorable clinical course with the onset of

153 dyspnea within 5 days, ARDS within 8 days in 30% of cases and need for invasive mechanical

154 ventilation and extracorporeal membrane oxygenation (ECMO) in 17% and 4% of cases,

155 respectively.3 These findings are in line with SARS percentages, while clinical course of MERS

156 seems to be characterized by a more frequent development of ARDS and needing of invasive life

157 support, especially in elderlies and smokers.38 In particular, acute kidney injury (AKI), which rarely

158 occurs in SARS and COVID-19, seems to be a peculiar complication of MERS. Although this could be

159 explained by a direct renal cytopathic effect induced by the virus, since DDP4 receptors are largely

8
160 represented in tubules and glomeruli, it seems more probable that the high percentage of AKI

161 reported is due to multi-organ failure, which occurs more frequently in MERS than in the other

162 coronavirus infections.39

163 CONCLUSIONS

164 COVID-19 seems no to be very different from SARS regarding the clinical features; it seems to be

165 less lethal than MERS, which is less related with the other two coronavirus both in terms of

166 phylogenetic and pathogenesis features.

167 COVID-19 generally has a less severe clinical pictures, and thus it can spread in the community

168 more easily than MERS and SARS, which have been frequently reported in the nosocomial setting.

169 The previous knowledge learned from SARS and MERS lessons might have contributed to the

170 institution of more efficient preventive measures in the healthcare settings.

171 Which are the causes of such different ability to spread among these three viruses? A first

172 hypothesis is a different viral tropism for the respiratory tract, resulting in a milder but highly

173 transmittable disease when the virus replicates in the upper respiratory tract and a severe

174 pneumonia with lower spreading potential when the viral tropism is higher for the lower

175 respiratory tract. This hypothesis derives from the example of the influenza viruses, namely

176 seasonal influenza viruses H1N1 and H3N2. They preferably bind alpha 2,6-linked sialic acid

177 receptors of the upper respiratory tract, usually causing a less severe but more transmissible

178 disease than avian influenza H5N1 or H7N9, which preferably bind alpha 2,3-linked sialic acid in

179 the lung alveoli, causing severe pneumonia.40 On the other hand, SARS-CoV-2, SARS-CoV and

180 MERS-CoV use receptors that have been found both in the upper and in the lower respiratory

181 tract. Moreover, other human coronaviruses, such as NL63-CoV, cause a mild illness even if they

182 bind to the same receptor of SARS-CoV-2 and SARS-CoV5. So, in our opinion, it is likely that the

183 different inoculum dose at the time of infection makes the difference in terms of severity of the

9
184 disease; heavy inoculum exposures seem to be linked to an higher penetration in the lower

185 respiratory tract, giving severe pneumonia, whereas lower inoculum exposures allow viruses to

186 only reach the upper airway, causing a milder infection.

187 Viral loads are higher at the time of symptoms onset and higher in nose than in throat

188 specimens.41,42 Furthermore, in patients affected by COVID-19, viral load progressively decreases

189 within days, following a different pattern than SARS, in which the highest shedding is recorded

190 after 10 days from the symptoms’ onset.41–43 These findings suggest that SARS-CoV-2 may spread

191 more easily in the community than SARS even when initial mild symptoms or no symptoms are

192 present.

193 The differences in the intrinsic virulence of the viruses themselves can explain the different

194 capacity of spreading. MERS-CoV has a higher mortality but a lower transmissibility probably

195 because it causes a more severe clinical picture than COVID-19 and SARS, requiring hospitalization

196 more frequently, thus reducing the community spreading of the infection and increasing the

197 nosocomial transmission.5,21 On the other hand, the higher mortality of MERS could be biased by

198 the fact that the largest data available on MERS were derived from hospitalized patients, thus

199 implicating a more severe clinical picture than community acquired cases.44 This hypothesis is

200 strengthened by the observation that, when the cohort of patients with MERS was derived from

201 the community and not from hospital outbreaks, the mortality rate decreased to 10%, as it has

202 been observed in a cohort study carried out in 2015 in Saudi Arabia.44

203 Interestingly, despite the high virological similarity between the SARS-CoV-2 and SARS-CoV,

204 gastrointestinal (GI) symptoms and diarrhea seem to be much more common in SARS, although

205 the proportion of SARS patients with GI symptoms varies among different studies, from 23% to

206 70% in the Toronto outbreak and in the Hong Kong community outbreak, respectively.43,45 Such

207 difference could be related to the fact that the Hong Kong outbreak seemed to originate from a

10
208 fecal contamination of a residence complex due to a faulty sewage system, while the Toronto

209 outbreak was mainly caused by nosocomial hospital droplet transmission.43,45 The GI route of

210 transmission has been also hypothesized for MERS-CoV, through the consumption of infected

211 camel milk; moreover, GI transmission has been demonstrated in the animal model through

212 intestinal DPP4 receptors.46 According to this findings, the reported detection of SARS-CoV-2 RNA

213 in the loose stools of the first US patient with COVID-19 is not surprising.35 SARS-CoV replicates in

214 the enteric epithelium by binding to the ACE2 receptor and it cannot be excluded that SARS-CoV-2

215 would behave in the same way.18 This may contribute to the hypothesis that SARS-CoV-2 could

216 also be transmitted via this route, together with the evidence that SARS-CoV and MERS-CoV

217 remain viable in environmental conditions that could facilitate faecal–oral transmission.47 In Table

218 3 we provide a synthesis of what is certain to date about COVID-19 and what needs to be further

219 addressed.

220 In conclusion, there is still much more to know about COVID-19, especially its epidemiological

221 features, such as mortality and capacity of spreading on a pandemic level. The lessons we have

222 learned in the past from the SARS and MERS epidemics are the best cultural weapons to face this

223 new global threat.

11
224

225
Phylogenetic Animal Intermediate Receptor Case R0
origin reservoir host fatality
rate
SARS-CoV-2 Clade I,
SARS-CoV- Bats Unknown angiotensin- 2.3%26 2-2.519
cluster IIa converting
enzyme 2
(ACE2)
SARS-CoV Clade I,
SARS- Bats Palm civets angiotensin- 9.5% 1.7-1.9
cluster IIb converting
enzyme 2
(ACE2)
MERS-CoV Clade II
MERS- Bats Camels dipeptidyl 34.4% 0.7
peptidase 4
(DPP4)
226 Table 1 - Phylogenetic, pathogenetic and epidemiologic characteristics
227
228

12
229

230
COVID-191–3
COVID SARS45,48–50 MERS38,51,52
Date of emergence in human population
2019 2002 2012
Absolute number of cases
80 239 8096 2,260
Demographic and general characteristics,
characteristics, % of cases
Male 40-60 38-42 59.5-64
Female 40-55 64-68 35-40
Cardiovascular diseases 10-46 8 9.1
Chronic lung disease 1-2 1-2 10.2
Diabetes 10 16 18.8
Malignancy 2-4 6 15.5
Signs and symptoms
symptoms,
mptoms, % of cases
Fever 81-91 99-100 81.7-98
Cough 48-68 57-75 56.9-83
Dyspnea 19-31 40-42 22-72
Sore throat 29 13-25 9.1-14
Dizziness and confusion 22 4-43 5.4
Diarrhea 16 23-70 19.4-26
Nausea and vomiting 6 20-35 14-21
Laboratory findings on admission,
admission, % of cases
Leukopenia 35 33.9 14
Lymphopenia 35-72 54-70 32
Thrombocytopenia 12 44.8 36
Elevated 28-35 23 11-40
aminotransferases
Radiological chest findings on admission,
admission, % of cases
Unilateral infiltrate 10 46-54 14.3-62.6
Bilateral infiltrate 84-90 29-45 37.4-75
No findings 14 13-25 4.3-30
Complications,
Complications, % of cases
Intensive Care Unit 24 23-34 53-89
admission
Acute Respiratory Distress 18-30 20 20-30
Syndrome
Acute Kidney Injury 3 6.7 41-50
Deaths in hospitalized 10-11 3.6-15.7 30-40
231 Table 2 - Clinical characteristics
232
233

13
234
Facts about COVID-19
• SARS-CoV-2 is more phylogenetically related
to SARS-CoV than to MERS-CoV.
• Only minor differences have been found in
the genome sequences of SARS-CoV-2
comparing with SARS-CoV.
• SARS-CoV-2 affinity for angiotensin-
converting enzyme 2 (ACE2) receptor is
higher than in SARS-CoV.
• COVID-19 fatality rate is lower than that
found in SARS and MERS.
• SARS-CoV-2 RNA has been detected in the
stools of infected patients, similarly to SARS-
CoV and MERS-CoV.
• 1.2% of COVID-19 cases are asymptomatic.
• COVID-19 is not very different from SARS and
MERS regarding demographic characteristics,
laboratory and radiological findings.
• Clinical complications in COVID-19 are as
frequent as in SARS, but less frequent than in
MERS.
• Viral loads in COVID-19 patients are higher at
the time of symptoms onset and
progressively decrease during the clinical
course of the disease.
235 Table 3 - Facts and open issues about COVID-19
236
Questions needing to be further assessed
• Which is the role of aminoacid substitutions
on the SARS-CoV-2 receptor binding domain
in terms of pathogenesis?
• Does the higher affinity of SARS-CoV-2 than
SARS-CoV for angiotensin-converting
enzyme 2 (ACE2) receptor have an
implication in respiratory complications?
• Is the fecal-oral route of transmission
possible for COVID-19?
• Which is the role of asymptomatic COVID-
19 cases in the epidemiology of the
disease?
• Which is the actual COVID-19 basic
reproductive number (R0)?
• Are differences in viral kinetics in
respiratory tract responsible of the
different spreading potential of COVID-19,
SARS and MERS?
14
237

238

239 TRANSPARENCY DECLARATION

240 • Conflict of interest disclosure: authors have no conflict of interest to disclose.

241

242 • Funding: no external funding was received.

243

244 • Acknowledgments: work supported by Ricerca Corrente, IRCCS.

245

246 • Contribution: NP and GV contributed to literature search and writing the paper. EP, OE and GI

247 revised the manuscript and gave their final opinion for its intellectual content.

248

249

250

15
251

252

253

254 REFERENCES

255

256 1. World Health Organization. Coronavirus Disease 2019 (COVID-19) Situation Report-48, 08th

257 March 2020. Availabe from: https://www.who.int/docs/default-

258 source/coronaviruse/situation-reports/20200308-sitrep-48-covid-19.pdf?sfvrsn=16f7ccef_4

259 2. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of

260 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet (London,

261 England). 2020;0(0). doi:10.1016/S0140-6736(20)30211-7

262 3. Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019

263 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. February 2020.

264 doi:10.1001/jama.2020.1585

265 4. Liu K, Fang Y-Y, Deng Y et al. Clinical characteristics of novel coronavirus cases in tertiary

266 hospitals in Hubei Province. Chin Med J (Engl). 2020. doi:10.1097/CM9.0000000000000744

267 5. Munster VJ, Koopmans M, van Doremalen N, van Riel D, de Wit E. A Novel Coronavirus

268 Emerging in China — Key Questions for Impact Assessment. N Engl J Med. January

269 2020:NEJMp2000929. doi:10.1056/NEJMp2000929

270 6. Chen Y, Liu Q, Guo D. Emerging coronaviruses: Genome structure, replication, and

271 pathogenesis. J Med Virol. February 2020:jmv.25681. doi:10.1002/jmv.25681

272 7. Malik YS, Sircar S, Bhat S, et al. Emerging novel Coronavirus (2019-nCoV) - Current scenario,

273 evolutionary perspective based on genome analysis and recent developments. Vet Q.

274 February 2020:1-12. doi:10.1080/01652176.2020.1727993

16
275 8. Wu A, Peng Y, Huang B, et al. Commentary Genome Composition and Divergence of the

276 Novel Coronavirus ( 2019-nCoV ) Originating in China. Cell Host Microbe. February 2020:1-4.

277 doi:10.1016/j.chom.2020.02.001

278 9. Benvenuto D, Giovanetti M, Ciccozzi A, Spoto S, Angeletti S, Ciccozzi M. The 2019-new

279 coronavirus epidemic: Evidence for virus evolution. J Med Virol. February 2020:jmv.25688.

280 doi:10.1002/jmv.25688

281 10. Fuk-Woo Chan J, Yuan S, Kok K-H, et al. A familial cluster of pneumonia associated with the

282 2019 novel coronavirus indicating person-to-person transmission: a study of a family

283 cluster. Lancet. 2020;0(0). doi:10.1016/S0140-6736(20)30154-9

284 11. Chan JF-W, Kok K-H, Zhu Z, et al. Genomic characterization of the 2019 novel human-

285 pathogenic coronavirus isolated from a patient with atypical pneumonia after visiting

286 Wuhan. Emerg Microbes Infect. 2020;9(1):221-236. doi:10.1080/22221751.2020.1719902

287 12. Wu A, Peng Y, Huang B, et al. Genome Composition and Divergence of the Novel

288 Coronavirus (2019-nCoV) Originating in China. Cell Host Microbe. February 2020.

289 doi:10.1016/j.chom.2020.02.001

290 13. Lu R, Zhao X, Li J, et al. Genomic characterisation and epidemiology of 2019 novel

291 coronavirus: implications for virus origins and receptor binding. Lancet (London, England).

292 2020;0(0). doi:10.1016/S0140-6736(20)30251-8

293 14. Paraskevis D, Kostaki EG, Magiorkinis G, Panayiotakopoulos G, Sourvinos G, Tsiodras S. Full-

294 genome evolutionary analysis of the novel corona virus (2019-nCoV) rejects the hypothesis

295 of emergence as a result of a recent recombination event. Infect Genet Evol.

296 2020;79:104212. doi:10.1016/j.meegid.2020.104212

297 15. Wan Y, Shang J, Graham R, Baric RS, Li F. Receptor recognition by novel coronavirus from

298 Wuhan: An analysis based on decade-long structural studies of SARS. J Virol. January 2020.

17
299 doi:10.1128/JVI.00127-20

300 16. Imai Y, Kuba K, Ohto-Nakanishi T, Penninger JM. Angiotensin-Converting Enzyme 2 (ACE2) in

301 Disease Pathogenesis. Circ J. 2010;74(3):405-410. doi:10.1253/circj.CJ-10-0045

302 17. Zhu N, Zhang D, Wang W, et al. A Novel Coronavirus from Patients with Pneumonia in

303 China, 2019. N Engl J Med. January 2020. doi:10.1056/nejmoa2001017

304 18. Hamming I, Timens W, Bulthuis MLC, Lely AT, Navis GJ, van Goor H. Tissue distribution of

305 ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding

306 SARS pathogenesis. J Pathol. 2004;203(2):631-637. doi:10.1002/path.1570

307 19. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19), 16-24

308 February 2020. Available from: https://www.who.int/docs/default-

309 source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf. Accessed March

310 09, 2020.

311 20. Li Q, Guan X, Wu P, et al. Early Transmission Dynamics in Wuhan, China, of Novel

312 Coronavirus–Infected Pneumonia. N Engl J Med. January 2020:NEJMoa2001316.

313 doi:10.1056/NEJMoa2001316

314 21. Chen J. Pathogenicity and Transmissibility of 2019-nCoV-A Quick Overview and Comparison

315 with Other Emerging Viruses. Microbes Infect. February 2020.

316 doi:10.1016/j.micinf.2020.01.004

317 22. Wu JT, Leung K, Leung GM. Nowcasting and forecasting the potential domestic and

318 international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling

319 study. Lancet (London, England). January 2020. doi:10.1016/S0140-6736(20)30260-9

320 23. Liu T, Hu J, Kang M, et al. Transmission dynamics of 2019 novel coronavirus (2019-nCoV).

321 bioRxiv. January 2020:2020.01.25.919787. doi:10.1101/2020.01.25.919787

322 24. Bauch CT, Lloyd-Smith JO, Coffee MP, Galvani AP. Dynamically Modeling SARS and Other

18
323 Newly Emerging Respiratory Illnesses. Epidemiology. 2005;16(6):791-801.

324 doi:10.1097/01.ede.0000181633.80269.4c

325 25. Liu Y, Gayle AA, Wilder-Smith A, Rocklöv J. The reproductive number of COVID-19 is higher

326 compared to SARS coronavirus. J Travel Med. February 2020. doi:10.1093/jtm/taaa021

327 26. The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases

328 (COVID-19) — China, 2020. China CDC Wkly. 2020;8(2):113-122.

329 http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51. Accessed

330 February 20, 2020.

331 27. Chen J. Pathogenicity and Transmissibility of 2019-nCoV-A Quick Overview and Comparison

332 with Other Emerging Viruses. Microbes Infect. February 2020.

333 doi:10.1016/j.micinf.2020.01.004

334 28. Wu P, Hao X, Lau EHY, et al. Real-time tentative assessment of the epidemiological

335 characteristics of novel coronavirus infections in Wuhan, China, as at 22 January 2020.

336 Eurosurveillance. 2020;25(3):2000044. doi:10.2807/1560-7917.ES.2020.25.3.2000044

337 29. World Health Organization, Department of Communicable Disease Surveillance and

338 Response. Consensus Document on the Epidemiology of Severe Acute Respiratory

339 Syndrome (SARS), 16-17th May 2003.

340 30. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel

341 coronavirus in Wuhan , China. Lancet. 2020;6736(20):1-10. doi:10.1016/S0140-

342 6736(20)30183-5

343 31. Wang Z, Chen X, Lu Y, Chen F, Zhang W. Clinical characteristics and therapeutic procedure

344 for four cases with 2019 novel coronavirus pneumonia receiving combined Chinese and

345 Western medicine treatment. doi:10.5582/bst.2020.01030

346 32. Chang D, Lin M, Wei L, et al. Epidemiologic and Clinical Characteristics of Novel Coronavirus

19
347 Infections Involving 13 Patients Outside Wuhan, China. JAMA. February 2020.

348 doi:10.1001/jama.2020.1623

349 33. Kim JY, Choe PG, Oh Y, et al. The First Case of 2019 Novel Coronavirus Pneumonia Imported

350 into Korea from Wuhan, China: Implication for Infection Prevention and Control Measures. J

351 Korean Med Sci. 2020;35(5):e61. doi:10.3346/jkms.2020.35.e61

352 34. Ki M, -nCoV TFF. Epidemiologic characteristics of early cases with 2019 novel coronavirus

353 (2019-nCoV) disease in Republic of Korea. Epidemiol Health. 2020:e2020007.

354 doi:10.4178/epih.e2020007

355 35. Holshue ML, DeBolt C, Lindquist S, et al. First Case of 2019 Novel Coronavirus in the United

356 States. N Engl J Med. January 2020:NEJMoa2001191. doi:10.1056/NEJMoa2001191

357 36. Chung M, Bernheim A, Mei X, et al. CT Imaging Features of 2019 Novel Coronavirus (2019-

358 nCoV). Radiology. February 2020:200230. doi:10.1148/radiol.2020200230

359 37. Xie X, Zhong Z, Zhao W, Zheng C, Wang F, Liu J. Chest CT for Typical 2019-nCoV Pneumonia:

360 Relationship to Negative RT-PCR Testing. Radiology. February 2020:200343.

361 doi:10.1148/radiol.2020200343

362 38. Azhar EI, Hui DSC, Memish ZA, Drosten C, Zumla A. The Middle East Respiratory Syndrome

363 (MERS). Infect Dis Clin North Am. 2019;33(4):891-905. doi:10.1016/j.idc.2019.08.001

364 39. Cha RH, Joh JS, Jeong I, et al. Renal Complications and Their Prognosis in Korean Patients

365 with Middle East Respiratory Syndrome-Coronavirus from the Central MERS-CoV

366 Designated Hospital. J Korean Med Sci. 2015;30(12):1807-1814.

367 doi:10.3346/jkms.2015.30.12.1807

368 40. Yang W, Punyadarsaniya D, Lambertz RLO, et al. Mutations during the Adaptation of H9N2

369 Avian Influenza Virus to the Respiratory Epithelium of Pigs Enhance Sialic Acid Binding

370 Activity and Virulence in Mice. J Virol. 2017;91(8). doi:10.1128/jvi.02125-16

20
371 41. Kim JY, Ko J-H, Kim Y, et al. Viral Load Kinetics of SARS-CoV-2 Infection in First Two Patients

372 in Korea. J Korean Med Sci. 2020;35(7). doi:10.3346/jkms.2020.35.e86

373 42. Zou L, Ruan F, Huang M, et al. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of

374 Infected Patients. N Engl J Med. February 2020:NEJMc2001737.

375 doi:10.1056/NEJMc2001737

376 43. Peiris JSM, Chu CM, Cheng VCC, et al. Clinical progression and viral load in a community

377 outbreak of coronavirus-associated SARS pneumonia: A prospective study. Lancet.

378 2003;361(9371):1767-1772. doi:10.1016/S0140-6736(03)13412-5

379 44. Bleibtreu A, Bertine M, Bertin C, Houhou-Fidouh N, Visseaux B. Focus on Middle East

380 respiratory syndrome coronavirus (MERS-CoV). Médecine Mal Infect. November 2019.

381 doi:10.1016/j.medmal.2019.10.004

382 45. Booth CM. Clinical Features and Short-term Outcomes of 144 Patients With SARS in the

383 Greater Toronto Area. JAMA. 2003;289(21):2801. doi:10.1001/jama.289.21.JOC30885

384 46. Zhou J, Li C, Zhao G, et al. Human intestinal tract serves as an alternative infection route for

385 Middle East respiratory syndrome coronavirus. Sci Adv. 2017;3(11):eaao4966.

386 doi:10.1126/sciadv.aao4966

387 47. Yeo C, Kaushal S, Yeo D. Enteric involvement of coronaviruses: is faecal–oral transmission of

388 SARS-CoV-2 possible? Lancet Gastroenterol Hepatol. 2020;0(0). doi:10.1016/S2468-

389 1253(20)30048-0

390 48. Hui DSC, Zumla A. Severe Acute Respiratory Syndrome. Infect Dis Clin North Am.

391 2019;33(4):869-889. doi:10.1016/j.idc.2019.07.001

392 49. Lee N, Hui D, Wu A, et al. A Major Outbreak of Severe Acute Respiratory Syndrome in Hong

393 Kong. N Engl J Med. 2003;348(20):1986-1994. doi:10.1056/NEJMoa030685

394 50. Chu KH, Tsang WK, Tang CS, et al. Acute renal impairment in coronavirus-associated severe

21
395 acute respiratory syndrome. Kidney Int. 2005;67(2):698-705. doi:10.1111/j.1523-

396 1755.2005.67130.x

397 51. Choi WS, Kang C-I, Kim Y, et al. Clinical Presentation and Outcomes of Middle East

398 Respiratory Syndrome in the Republic of Korea. Infect Chemother. 2016;48(2):118.

399 doi:10.3947/ic.2016.48.2.118

400 52. Saad M, Omrani AS, Baig K, et al. Clinical aspects and outcomes of 70 patients with Middle

401 East respiratory syndrome coronavirus infection: A single-center experience in Saudi Arabia.

402 Int J Infect Dis. 2014;29:301-306. doi:10.1016/j.ijid.2014.09.003

403

404

405

22
Another random document with
no related content on Scribd:
The Project Gutenberg eBook of Female affection
 This ebook is for the use of anyone anywhere in the United
States and most other parts of the world at no cost and with
almost no restrictions whatsoever. You may copy it, give it away
or re-use it under the terms of the Project Gutenberg License
included with this ebook or online at www.gutenberg.org. If you
are not located in the United States, you will have to check the
laws of the country where you are located before using this
eBook.

Title: Female affection

Author: Basil Montagu

Release date: May 13, 2022 [eBook #68068]

Language: English

Original publication: United Kingdom: J. Bohn, 1815

Credits: Turgut Dincer and the Online Distributed Proofreading

Team at https://www.pgdp.net (This file was produced
from images generously made available by The
Internet Archive)

*** START OF THE PROJECT GUTENBERG EBOOK FEMALE

AFFECTION ***
FEMALE AFFECTION.
BY
BASIL MONTAGU.

LONDON:
J. BOHN, KING WILLIAM STREET, STRAND.
MDCCCXLV.
 LONDON:
WILLIAM STEVENS, PRINTER, BELL YARD,
TEMPLE BAR.
 TO HIS DEAR EDITH, FROM HER
AFFECTIONATE GRANDFATHER.—B. M.
 PREFACE.

There are certain properties of the female mind upon which doubt
has existed, and may, possibly, long exist.
1. Women are said to be fond of ornament—an evil against which
they were thus warned by St. Paul—“I will that women adorn
themselves in modest apparel, with shamefacedness and sobriety,
not with embroidered hair, or gold, or pearls, or costly array, but
which becometh women professing godliness, with good works.”
2. Women are said to be fond of gaiety:
“Some men to business, some to pleasure take,”—
but the ruling passion of woman is not the love of business.
3. It is said that women act more from impulse than from foresight:
“Men have many faults, women have only two,—”
of which the want of foresight is one.
4. Women, it is said, are variable:
——“Varium et mutabile semper
Fœmina.”
Women are fond of intellect, of courage, of virtue; and are capable of
the most heroic acts.
Such are properties of the female mind, upon which doubt may be
entertained; but there is one property upon which doubt cannot exist
—it is the nature of woman to be affectionate.
B. M.
 FEMALE AFFECTION.

THE PLEASURES OF AFFECTION.

The pleasures of the affections are Love, Friendship, Gratitude, and
general Benevolence.
“For the pleasures of the affections,” says Lord Bacon, “we must
resort to the poets, for there affection is on her throne, there we may
find her painted forth to the life.”
Instead of referring us to the poets, he might, according to his own
admonitions, have referred us to the certain mode of discovering
truth, by observing facts around us, and particularly by observing the
nature sought, where it is most conspicuous.
In searching, for any nature, observe it, he says, where it is most
conspicuous; as, in inquiring into the nature of flame, observe the
sudden ignition and expansion of gas—these are what he calls
“glaring instances.”
The glaring instance of affection is Female Affection; there indeed
she is on her throne, there we may find her painted forth to the life. It
is the nature of woman to be affectionate.
 § I.
FEMALE AFFECTION IN GENERAL.
MUNGO PARK.
When stating the miseries to which he was exposed in Africa,
Mungo Park says, “I never, when in distress and misery, applied for
relief to a female, without finding pity,—and if she had the power,
assistance.” And he thus mentions one instance,—“I waited,” he
says, “more than two hours for an opportunity to cross that river, but
one of the chief men informed me that I must not presume to cross
without the King’s permission; he therefore advised me to lodge at a
distant village, to which he pointed, for the night. I found to my great
mortification that no person would admit me into his house;—I was
regarded with astonishment and fear, and was obliged to sit all day
without victuals in the shade of a tree; and the night threatened to be
very uncomfortable, for the wind rose, and there was great
appearance of a heavy rain; and the wild beasts are so very
numerous that I should have been under the necessity of climbing up
the tree and resting among the branches. About sunset as I was
preparing to pass the night in this manner, and had turned my horse
loose that he might graze at liberty, a woman, returning from the
labours of the field, stopped to observe me, and perceiving that I was
weary and dejected, inquired into my situation, which I briefly
explained to her; whereupon, with looks of great compassion, she
took up my saddle and bridle, and told me to follow her. Having
conducted me into her hut, she lighted a lamp, spread a mat on the
floor, and told me I might remain there for the night. Finding that I
was hungry, she gave me a very fine fish for my supper; and pointing
to the mat, and telling me I might sleep there without apprehension,
she called to the female part of her family, who had stood gazing on
me all the while in fixed astonishment, to resume their task of
spinning cotton, in which they continued to employ themselves great
part of the night. They lightened their labour by songs; one of which
was composed ex-tempore—for I was, myself, the subject of it: it
was sung by one of the young women, the rest joining in a sort of
chorus. The air was sweet and plaintive; and the words, literally
translated, were these:—
“The winds roared, and the rains fell,—the poor white man, faint and
weary, came and sat under our tree,—he has no mother to bring him
milk,—no wife to grind his corn.—Chorus—Let us pity the white man,
—no mother has he!” &c.

GRIFFITH.
“On the northern side of the plain we had just entered, was a large
encampment of these people. Being in absolute want of milk, I
determined to solicit the assistance of these Turcomans.
Approaching their tents, with gradual step, and apparent
indifference, I passed several, without observing any probability of
succeeding: children, only, were to be seen near the spot where I
was, and men with their flocks, at a certain distance; advancing still
farther, I saw a woman, at the entrance of a small tent, occupied in
domestic employment. Convinced that an appeal to the feelings of
the female sex, offered with decency, by a man distressed with
hunger, would not be rejected, I held out my wooden bowl, and
reversing it, made a salutation according to the forms of the country.
The kind Turcomannee covered her face precipitately, and retired
within the tent. I did not advance a step; she saw me unassuming,—
my inverted bowl still explained my wants. The timidity of her sex,
the usages of her country, and, even the fear of danger, gave way to
the benevolence of her heart: she went to the tent again; returned
speedily with a bowl of milk, and, advancing towards me with a
glance more than half averted, filled my bowl to the brim, and
vanished.”

LEDYARD.
“I never addressed myself in the language of decency and
friendship to a woman, whether civilized or savage, without receiving
a decent and friendly answer. With man it has often been otherwise,
—in wandering over the barren plains of inhospitable Denmark,
through honest Sweden, frozen Lapland, rude and churlish Finland,
unprincipled Russia, and the wide-spread regions of the wandering
Tartar, if hungry, dry, cold, wet, or sick, woman has ever been friendly
to me,—and uniformly so; and to add to this virtue, so worthy the
appellation of benevolence, these actions have been performed in so
kind a manner, that if I was dry, I drank the sweet draught,—and if
hungry, ate the coarse morsel with a double relish.”

PHARAOH’S DAUGHTER.
“And there went a man of the house of Levi, and took to wife a
daughter of Levi. And the woman conceived, and bare a son: and
when she saw him that he was a goodly child, she hid him three
months. And when she could not longer hide him, she took for him
an ark of bulrushes, and daubed it with slime and with pitch, and put
the child therein; and she laid it in the flags by the river’s brink. And
his sister stood afar off, to wit what would be done to him. And the
daughter of Pharaoh came down to the river; and her maidens
walked along by the river’s side; and when she saw the ark among
the flags, she sent her maid to fetch it. And when she had opened it,
she saw the child: and, behold, the babe wept. And she had
compassion on him, and said,—This is one of the Hebrews’ children.
Then said his sister to Pharaoh’s daughter, ‘Shall I go and call to
thee a nurse of the Hebrew women, that she may nurse the child for
thee?’ And Pharaoh’s daughter said to her, ‘Go.’ And the maid went
and called the child’s mother. And Pharaoh’s daughter said unto her,
‘Take this child away, and nurse it for me, and I will give thee thy
wages.’ And the woman took the child, and nursed it.”
 § II.
DIFFERENT FORMS OF FEMALE
AFFECTION.
The nature of female affection may be seen in a variety of forms,—in
Infancy, in the sweet love of Youth, of a Wife, of a Mother, of a
Daughter, of a Widow.

INFANCY.
The following is an account which I somewhere read of Nell Gwynn,
when a child:—“My first love, you must know, was a link-boy,”—“A
what?”—“’Tis true,” said she, “for all the frightfulness of your what!—
and a very good soul he was, too, poor Dick! and had the heart of a
gentleman; God knows what has become of him, but when I last saw
him he said he would humbly love me to his dying day. He used to
say that I must have been a lord’s daughter for my beauty, and that I
ought to ride in my coach; and he behaved to me as if I did. He, poor
boy, would light me and my mother home, when we had sold our
oranges, to our lodgings in Lewknor’s Lane, as if we had been ladies
of the land. He said he never felt easy for the evening ’till he had
asked me how I did, then he went gaily about his work; and if he saw
us housed at night, he slept like a prince. I shall never forget when
he came flushing and stammering, and drew out of his pocket a pair
of worsted stockings, which he brought for my naked feet. It was
bitter cold weather; and I had chilblains, which made me hobble
about ’till I cried,—and what does poor Richard do but work hard like
a horse, and buy me these worsted stockings? My mother bade him
put them on; and so he did, and his warm tears fell on my chilblains,
and he said he should be the happiest lad on earth if the stockings
did me any good.”
When the Commissioners visited the Penitentiary at Lambeth, where
the prisoners are punished by solitary confinement, they found in
one cell a little girl, between eleven and twelve years of age. This
child must have spent many hours every day in the dark; was poorly
clad, and scantily fed, and her young limbs were deprived of all the
joyous modes of playful exercise, so necessary and so pleasant to
that age: she asked neither for food, nor clothes, nor light, nor liberty,
—all she wished for was “a little doll, that she might dress and nurse
it.” Her innocent and child-like request put an end to this cruel
punishment for children.
“I yesterday took my dear grand-daughter to see Westminster Abbey.
She is between seven and eight years of age, and is one of the
sweetest angels that ever existed on earth. It was a bitter cold
morning: on the tomb of Mrs. Warren, who was a mother to poor
children, there is a beautiful statue of a poor half-clothed Irish girl,
with her little naked baby in her arms;—my dear little child looked up
at me, and, through her tears, earnestly said, ‘How I should like to
nurse that little baby!’”

YOUTH.
Of the influence of love upon youth and inexperience, it can scarcely
be necessary to adduce any instances. I must, however, mention
one fact which occurred during the rebellion in ’45.
“When I was a young boy, I had delicate health, and was somewhat
of a pensive and contemplative turn of mind: it was my delight in the
long summer evenings, to slip away from my companions, that I
might walk in the shade of a venerable wood, my favourite haunt,
and listen to the cawing of the old rooks, who seemed as fond of this
retreat as I was.
“One evening I sat later than usual, though the distant sound of the
cathedral clock had more than once warned me to my home. There
was a stillness in all nature that I was unwilling to disturb by the least
motion. From this reverie I was suddenly startled by the sight of a tall
slender female who was standing by me, looking sorrowfully and
steadily in my face. She was dressed in white, from head to foot, in a
fashion I had never seen before; her garments were unusually long
and flowing, and rustled as she glided through the low shrubs near
me as if they were made of the richest silk. My heart beat as if I was
dying, and I knew not that I could have stirred from the spot; but she
seemed so very mild and beautiful, I did not attempt it. Her pale
brown hair was braided round her head, but there were some locks
that strayed upon her neck; altogether she looked like a lovely
picture, but not like a living woman. I closed my eyes forcibly with my
hands, and when I looked again she had vanished.
“I cannot exactly say why I did not on my return speak of this
beautiful appearance, nor why, with a strange mixture of hope and
fear, I went again and again to the same spot that I might see her.
She always came, and often in the storm and plashing rain, that
never seemed to touch or to annoy her, looked sweetly at me, and
silently passed on; and though she was so near to me, that once the
wind lifted those light straying locks, and I felt them against my
cheek, yet I never could move or speak to her. I fell ill; and when I
recovered, my mother closely questioned me of the tall lady, of
whom, in the height of my fever, I had so often spoken.
“I cannot tell you what a weight was taken off my spirits when I learnt
that this was no apparition, but a most lovely woman; not young,
though she had kept her young looks,—for the grief which had
broken her heart seemed to have spared her beauty.
“When the rebel troops were retreating after their total defeat, a
young officer, in that very wood I was so fond of, unable any longer
to endure the anguish of his wounds, sunk from his horse, and laid
himself down to die. He was found there by the daughter of Sir
Henry Robinson, and conveyed by a trusty domestic to her father’s
mansion. Sir Henry was a loyalist; but the officer’s desperate
condition excited his compassion, and his many wounds spoke a
language a brave man could not misunderstand. Sir Henry’s
daughter with many tears pleaded for him, and promised that he
should be carefully and secretly attended. And well she kept that
promise,—for she waited upon him (her mother being long dead) for
many weeks, and anxiously watched for the first opening of eyes,
that, languid as he was, looked brightly and gratefully upon his
young nurse. You may fancy, better than I can tell you, as he slowly
recovered, all the moments that were spent in reading, and low-
voiced singing, and gentle playing on the lute; and how many fresh
flowers were brought to one whose wounded limbs would not bear
him to gather them for himself; and how calmly the days glided on in
the blessedness of returning health, and in that sweet silence so
carefully enjoined him. I will pass by this, to speak of one day, which,
brighter and pleasanter than others, did not seem more bright or
more lovely than the looks of the young maiden, as she gaily spoke
of ‘a little festival, which (though it must bear an unworthier name)
she meant really to give, in honour of her guest’s recovery;’—‘and it
is time, lady,’ said he, ‘for that guest, so tended and so honoured, to
tell you his whole story, and speak to you of one who will help him to
thank you—may I ask you, fair lady, to write a little note for me,
which, even in these times of danger I may find some means to
forward?’ To his mother, no doubt, she thought, as with light steps
and a lighter heart she seated herself by his couch, and smilingly
bade him dictate: but, when he said ‘My Dear Wife,’ and lifted up his
eyes to be asked for more, he saw before him a pale statue, that
gave him one look of utter despair, and fell (for he had no power to
help her) heavily at his feet. Those eyes never truly reflected the
pure soul again, or answered by answering looks the fond inquiries
of her poor old father. She lived to be as I saw her,—sweet, and
gentle, and delicate always, but reason returned no more. She
visited, ’till the day of her death, the spot where she first saw that
young soldier, and dressed herself in the very clothes he said so well
became her.”

THE WOMAN IN WHITE.

“In walking through a street in London, I saw a crowd of men women
and children hooting and laughing at a woman, who, looking neither
to the right-hand nor to the left, passed through the midst of them in
perfect silence; upon approaching her, I saw that all this derision was
caused by her dress, which, equally unsuited to the weather and her
apparent rank in life, was from head to foot entirely white,—her
bonnet, her shawl, her very shoes were white; and though all that
she wore seemed of the coarsest materials, her dress was perfectly
clean. As I walked past her, I looked stedfastly in her face. She was
thin and pale, of a pleasing countenance, and totally unmoved by the
clamour around her. I have since learnt her story:—The young man
to whom she was betrothed died on the bridal-day, when she and
her companions were dressed to go to church: she lost her senses,
—and has ever since, to use her own words, been ‘expecting her
bridegroom.’ Neither insult or privation of any kind can induce her to
change the colour of her dress; she is alike insensible of her
bereavement by death, or of the lapse of time,—‘she is dressed for
the bridal, and the bridegroom is at hand.’”
Such is the nature of Woman’s Love—continuing in imagination,
when reality is no more:
“As once I knew a crazy Moorish maid,
Who dressed her in her buried lover’s clothes,
And o’er the smooth spring in the mountain’s cleft
Hung with her lute, and played the selfsame tune
He used to play, and listened to the shadow
Herself had made.”—Coleridge.
Such is the tenderness, such the intensity of the love of innocence. It
has for ever existed, and will for ever exist,—from Eve, on the first
day of her creation, to the many whose hearts at this moment beat
with affection and love:
“All thoughts, all passions, all desires,
Whatever stirs this mortal frame,
All are but ministers of Love,
And feed his sacred flame.”

WIFE.
Let us now consider affection where it appears in one of its sweetest
forms,—in the love of a wife,—love, in the strength of which, hoping
all things, she does not hesitate to quit her father and her mother
and all dear to her to share the joys and sorrows of her husband. In
prosperity she delights in his happiness, in sickness she watches
over him, feeling more grief than she shows.
A young soldier, thus speaks of the affection of his wife:—
“For five campaigns
Did my sweet Lucy know
Each hardship and each toil
We soldiers undergo.
Nor ever did she murmur,
Or at her fate repine,
She thought not of her sorrow,
But how to lessen mine:
In hunger, or hard marching,
Whate’er the ill might be,
In her I found a friend,
Who ne’er deserted me:
And in my tent when wounded,
And when I sickening lay,
Oft from my brow with trembling hand,
She wiped the damps away.
And when this heart, my Lucy,
Shall cease to beat for thee,
Oh! cold, clay cold,
Full sure this heart must be.”

THE ROBBER.
“A friend of mine who had long struggled with a dangerous fever,
approached that crisis on which his life depended, when sleep,
uninterrupted sleep might ensure his recovery;—his wife, scarcely
daring to breathe, sat by him; her servants, worn out by watching,
had all left her; it was past midnight,—the room door was open for
air; she heard in the silence of the night a window thrown open
below stairs, and soon after footsteps approaching; in a short time, a
man came into the room—his face was covered with a black crape:
she instantly saw her husband’s danger; she pointed to him, and,
pressing her finger upon her lip to implore silence, held out to the
robber her purse and her keys: to her great surprise he took neither;
he drew back, and left the room,—whether he was alarmed, or
struck by this courage of affection cannot now be known; but, without
robbing a house sanctified by such strength of love—he departed.”

SENECA.
How well did the artist to whom we are indebted for the celebrated
picture of the Death of Seneca, understand this deep feeling of
female affection! It may be said of Seneca, as he said of a friend, “I
have applied myself to liberal studies, though both the poverty of my
condition, and my own reason might rather have put me upon the
making of my fortune. I have given proof, that all minds are capable
of goodness; and I have illustrated the obscurity of my family by the
eminency of my virtue. I have preserved my faith in all extremities,
and I have ventured my life for it. I have never spoken one word
contrary to my conscience, and I have been more solicitous for my
friend, than for myself. I never made any base submissions to any
man; and I have never done any thing unworthy of a resolute, and of
an honest man. My mind is raised so much above all dangers, that I
have mastered all hazards; and I bless myself in the providence
which gave me that experiment of my virtue: for it was not fit,
methought, that so great a glory should come cheap. Nay, I did not
so much as deliberate, whether good faith should suffer for me, or I
for it. I stood my ground, without laying violent hands upon myself, to
escape the rage of the powerful; though under Caligula I saw
cruelties, to such a degree, that to be killed outright was accounted a
mercy, and yet I persisted in my honesty, to show, that I was ready to
do more than die for it. My mind was never corrupted with gifts; and
when the humour of avarice was at the height, I never laid my hand
upon any unlawful gain. I have been temperate in my diet; modest in
my discourse; courteous and affable to my inferiors; and have ever
paid a respect and reverence to my betters.”
Such was the man whom the tyrant murdered. He is represented by
the artist, bleeding to death, the punishment to which he was