Epidemic Disease and Medicine

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Epidemic Disease and Medicine

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Syphilis. Approximately two years after Columbus reached the New World, an unknown disease appeared among the ranks of a French army that was laying siege to the southern Italian city of Naples. Characterized by terrible pain, swelling, and open sores on the penis and scrotum, the disease was recognized by the surgeons and physicians who treated it as a new kind of venereal disease. Unlike gonorrhea, this new disease led to secondary skin lesions on almost any part of the body, along with skeletal pains that made sleep difficult. The French army blamed it on the locals, calling it the Neapolitan Disease. Much of the rest of Europe associated it with the invading French, whose army disbanded in 1495, further spreading it, and called it the French Disease, or simply the pox. It became known as syphilis, a name first used by the Italian poet, physician, and natural philosopher Girolamo Fracastoro, who described the travails of a shepherd boy he called “Syphilis” in a poem describing the new disease.

Mercury Cure. Historians continue to debate whether syphilis was brought to Europe from the West Indies with returning Spanish ships or if it was caused by a sudden mutation of a milder, nonvenereal form of treponemosis that was already present in Europe and Africa. Whatever its origin, European observers, many of them victims, reacted to the disease as if it were new to the Continent and quickly associated it with prostitution and the loose morality of the Renaissance. Associated with adultery, it was foisted on unsuspecting spouses and transmitted congenitally to innocent children. Owing to the open sores and skin lesions, physicians and surgeons treated syphilis as a disease of the blood that provoked rashes and sores as a result of the body’s effort to expel corrupted matter. Skin diseases were sometimes treated with salves containing mercury and other toxic metals, and mercurial salves soon became the standard treatment for syphilis, because in large doses, mercury provoked both sweating and salivating, another means of ridding the body of “morbific” (disease-causing) matter. Physicians who believed that chemically prepared metallic drugs were useful as orally administered medicines against the pox and other diseases distilled various mercury salts to dose patients. The apparent success of these “chemical physicians,” as they were called, upset the established medical profession and led to vigorous debate that shook the foundations of medical theory and education. Patients treated with mercury achieved some degree of cure, although if treatments were not long enough or not repeated, the disease sometimes went into dormancy only to reemerge years later as tertiary syphilis. This disease, which is characterized by lesions of the cranium, nasal bones, shin bones, and occasionally other parts of the skeleton, resulted in horrible disfigurement and death.

English Sweat and Typhus. Syphilis was not the only new disease in the late fifteenth and sixteenth centuries, merely the most physically and morally horrifying. A more mysterious disease struck England in 1485, first appearing among mercenary troops. Called simply the English Sweat, it reoccurred four more times, the last in 1551, and often killed within hours of the appearance of symptoms. Even in a society faced with the constant presence of fatal disease, such a sudden death was astonishing. Typhus was another apparent newcomer, appearing among Spanish troops who were attempting to expel the Muslim Moors from the city of Granada in southern Spain in 1489-1490. Characterized by high fever, rash, headache, delirium, and high fatality, typhus became a constant companion of European armies into the twentieth century, often accounting for more casualties than did armed conflict.

Smallpox. Another major illness that erupted in the sixteenth century was smallpox. Possibly long extant in Europe in a mild form and not distinguished from other “fevers,” smallpox became a major killer when introduced to natives of the Western Hemisphere. Never exposed to this disease, nor typhus, measles, and influenza, Native Americans had no immunities or experience to help them respond to epidemics. Both factors enabled diseases to spread rapidly, wiping out large populations and discouraging survivors from resisting the Europeans. Under these circumstances, smallpox apparently mutated into a more virulent form and became a serious, disfiguring disease when it was reintroduced to Europe in the seventeenth century.

Guaiacum Wood. The appearance of new diseases stimulated the medical community to find new treatments and new theories to account for disease. For a time, guaiacum wood was imported from South America and powdered for use as an infusion against syphilis, partly on the reasoning that divine providence would have placed a cure near the source of the disease, which was widely regarded as the New World. Moreover, guaiacum also provoked sweating, which medical theory at the time regarded as curative.

Contagion Theory. In the sixteenth century, syphilis began to be viewed as being spread by contagion, or contact, rather than arising as an imbalance in the body’s basic fluids (known as humors). This latter theory had dominated medicine since the time of Hippocrates, and even plague was thought to arise possibly from a miasma in the air that people inhaled, causing an imbalance in their blood. During the course of the 1500s, however, medical theorists began to give new attention to an ancient contagion theory that was described by the Roman poet Lucretius in the first century B.C.E. Fracastoro’s study of syphilis, which he published in 1530, had suggested that the disease was caused by invisible but material “seeds”—a term Lucretius had used to describe atoms—that were physically transmitted from one person to another. This idea appealed to physicians and public health authorities, who thought plague was spread by impurities in hair and woolen goods as well as by maismas in the air. The seed theory also implied that some diseases had a specific material origin, which challenged the traditional conception of disease as a physiological condition.

Organic Pathology. Roughly contemporary with Fracastoro, a Swiss-German physician named Paracelsus came to a similar conclusion that diseases were caused by specific entities, but he regarded them as infective spirits rather than material seeds and thought that they could be countered with spiritually active chemical drugs. This spiritual-seed theory was further developed by one of Paracelsus’s followers, Petrus Severinus, into a general theory of organic pathology that influenced seventeenth-century ideas about the specificity of diseases. The idea that disease was a specific entity, regardless of whom it affected, rather than an imbalance or physiological malfunction that was unique to each victim, revolutionized the medical marketplace. Once diseases were identified as particular entities, or types, specific drugs could be prescribed against them or bought without the need for expensive medical consultation. (Why pay the doctor, when one can get the cure from the druggist?) The seed theories of Fracastoro and Severinus also provided justification for the practices of quarantine, isolation, and the destruction of infected clothing and furs, as

well as cats and dogs, which public health authorities had already recommended during times of plague. Enforcement of such measures became stricter and more universal in the seventeenth century and may have contributed to the disappearance of bubonic plague from Europe. In any case, the amount of money spent on control of epidemic plague and the economic losses that were suffered because of quarantine are witnesses to contemporaries’ belief that such measures were warranted.

Sources

Robert S. Gottfried, The Black Death: Natural and Human Disaster in Medieval Europe (New York: Free Press, 1893; London: Collier Macmillan, 1983).

Vivian Nutton, “The Seeds of Disease: An Explanation of Contagion and Infection from the Greeks to the Renaissance,” Medical History, 27 (1983): 1-34.

Claude Quetel, History of Syphilis, translated by Judith Braddock and Brian Pike (Baltimore: Johns Hopkins University Press, 1990).