Plagues And Diseases In History Research Paper

These changes, quite frequently depend on the human being, on his or her customs, social groupings, or on settlements that lead him or her to avoid malaria by settling in mosquito free zones or to control smallpox by vaccination. On other occasions, such changes do not depend on the human being but arise in the environment or within the diseases themselves that may appear or disappear of their own accord, as was the case with the ‘English sweate.’ On yet other occasions, these changes are merely due to cultural appreciations, such as is the case where certain sexual practices such as masturbation or homosexuality are stigmatized as diseases. On the other hand, disease is not always considered harmful: thus it may be considered a distinction of the gods, as was the case of epilepsy in the time of the classic authors. This same disease was associated with the devil by the Christians, and historically, it had always been a marked distinction of great personages from Caesar to Napoleon. Disease can also be considered a way towards perfection or transformation, leading to the creation of art or the salvation of the soul. It may also have political repercussions: it is claimed that George III’s madness gave rise to problems for the British crown while Roosevelt’s fragile health was considered to have placed him in a weak position in the Yalta negotiations. Socially, disease has sometimes been considered the stigma of groups or races. Medicine and politics have endeavored to preempt social changes by means of engenics which began with recommendations or orders to avoid marriages entailing risks (real or imaginary) and went on to such processes as sterilization and abortion. Hereditary problems are thus intertwined with cultural, social, religious, and moral ones. In contrast with the stark determination of former times, there is today an attempt to draw new optimism from the possibilities of genetic modification. Although, in this latter respect, there is fear of a future where such a formidable force could rest in the hands of the rich and powerful. Thus, individual disease or illness is rooted in society, being tied up with the history of great endemics and epidemics.

1. Plagues And Diseases in Ancient And Middle Times

Paleopathology enables us to discover the high incidence of diseases in the early inhabitants of the Earth, especially in the cases where such diseases left their mark on the bone. It is thus possible to detect remnants of tumors, infections, and osteoporosis as also traumatisms, dental alterations, rheumatism, and osteopathy. From the first settlements in the Fertile Crescent, changes have taken place in the relationship of man and animals with their environment and it is possible to establish an extensive catalogue of diseases which largely subsist down to this very day. Particularly significant are the forms of settlement, the crops, and the contact of man with cattle, pets, and parasites. Thus in the fourth and third centuries BC, malaria had already set in the early civilizations in marshy areas where the water and the crops provided the conditions for the mosquito to infect man. Evidence for the existence of seasonal and intermittent fevers is already to be found in Chinese, Indian, Sumerian, Assyrian, Babylonian, and Egyptian cultures. The link between splenomegaly and fever is mentioned in the Papyrus of Ebers, dating from 1570 BC. The connection between fever and marshy areas appears in the Hippocratic text On Airs, Waters and Places. Deforestation, agriculture, temperature, and a greater population density, as well as military and commercial movements favor the spread of the disease. In the third century BC in Italy, the disease becomes acute and in the first century BC Varron coincides with Lucretius in pointing to small animals as the cause of the disease and recommended that these be either abandoned or sold and that people should dwell on high ground, this latter being traditional advice and here also defense reasons counted. The spread of malaria got worse in Rome owing to negligence and flooding and it reached its zenith at the time of the fall of the empire, a cataclysm to which it may have contributed.

The bubonic plague was endemic in the Near East in pre-Classic times, the buboes being described by Hippocrates. In 430 BC, Thucydides describes the plague of Athens in the war against Sparta, but it is doubtful that this case refers to the bubonic plague. The first reliable description of this disease is that given by Rufus of Ephesus in the first to the second century AD, in the epoch of Trajanus; and in the sixth century, the plague of Justinianus initiates the descriptions of the first great epidemic cycles. Up until the Christian era, there is equilibrium between human beings, cities, and parasites but this equilibrium breaks down with the advent of the convoys that bring the two healthiest extremes into contact, namely, China and Rome. India and the Middle East continue to be dangerous and the situation at the extremes further deteriorates. Soldiers and merchants, animals and merchandise, slaves and prisoners all contribute to linking up the extremes of the known world. A consequence of this contact was the Antonine Plague in the second century. This plague was attributed to smallpox, something that had already existed as far back as the year 3000 BC, as certain mummies show.

In the Middle Ages, leprosy spread greatly. This biblical and present-day disease is accompanied by malignant connotations since dirtiness and overcrowding provided the conditions for the spread of the otherwise not extremely contagious Mycobacterium leprae. In this respect, the Route to Santiago de Compostella where pilgrims slept in groups and under conditions that left a lot to be desired provided a fertile ground for this disease. Another markedly religious character for the spread of the disease is to be found in the ‘Sacred Fire,’ ‘St Anthony’s Fire,’ or ergotism, during which rye ergot was eaten. These diseases are linked to many others that owed their spread to squalor and poverty, for example, scabies and lice, consumption and fevers, anthrax and ophthalmia. In the Mediterranean bowl, malaria continued to be endemic with the population tending to resort to residing on the hills and mountains, far from marshy lands. The plague set in the incipient cities with the effects of rats and lice, making this disease an explicative example par excellence of epidemic history; see in this respect, Zinsser (1934). A second epidemic cycle commences with the Black Death in 1348. At this time, Venice establishes control over persons and ships. Commerce and the cities collapse and thus the hegemony of Castille over Aragon takes place, giving rise to the origin of the modern European Kingdoms and empires.

2. Plagues And Diseases in Modern Times

European expansion meant a sudden traffic of parasites towards the new worlds. The discovery of America, with its scattered population devoted to agriculture, where there were no dirty cities and where the inhabitants were devoid of immunity to the diseases of old Europe, produced an enormous demographic crisis. Certain diseases, such as smallpox ravaged the indigenous population, first in South and later in North America. Syphilis has supposedly come from America, brought back by the Spaniards and it caused havoc in Renaissance Europe. Sea voyages led to the development of scurvy, due to the lack of fresh foods. Other diseases also came from overseas, such as yellow fever, although it originated from Africa and later from the tropics, due to the commerce of slaves and merchandise. In the seventeenth century, it took root in Brazil and is still present today in the Amazon. Soon this disease spread to the Caribbean and throughout America, reaching New York and Boston and likewise Colombia, Ecuador, and Peru. It affected warm America and Europe, especially the Iberian Peninsula. Immunity and cut offs in commerce stalled the disease and today it remains endemic in tropical areas of America and Africa.

The plague arrested demographic growth in Europe since the enimity between states and trade impeded protection against the disease. The last plague of Marseille in 1720 and the relative peace of the eighteenth century allowed all European nations to set up sea and land defenses with Austria becoming a solid bulwark in the face of the Ottoman Empire, thus sealing off all possible spread of the plague. Towards the middle of the eighteenth century, the third wave of the disease broke out and with the exception of Europe, it spread to all countries including Asia, Africa, and paradises like America and Australia, leaving remnants in those places. The eradication of the plague in Europe was a result of the advent of public hygiene, immunity to the disease, and the disappearance of rats and the old and dirty wooden buildings. The fire of London ‘purified’ the city, since the rebuilding was carried out in stone, eliminating animals and dirt.

The disappearance in Europe of the plague was followed by the appearance of cholera that had been endemic in India for 2000 years. This disease was described by Western travelers in the sixteenth century and its spread to Europe and America was a consequence of pilgrimages, trade, and a lack of cleanliness in water. A great pandemic broke out in 1817 and spread through Eastern Africa and Southern Asia and in a second wave it spread through Kabul and Persia reaching Russia and Poland in 1830. It then swept across Europe and had reached America by 1832. Over two centuries, terrible waves spread from the East and as late as the 1970s, the seventh outbreak of pandemic reached Europe. However, the timely and necessary cleansing of urban water supplies helped to stall its advance progressively. Nevertheless, as late as 1892, the free Hanseatic city of Hamburg suffered an outbreak of cholera epidemic while the neighboring Altona, governed by the new Prussian Reich, was able to avoid the disease, thanks to the successful filtering of its water. Cities and governments advanced in hygiene and they attempted to bring about healthier cities by means of appropriate public health measures.

Together with the major epidemics, death was continuously caused by two groups of endemic diseases. Two seasonal cycles of disease remained rooted into modern times: one in summer affecting children and due to enterocolitis, lactation problems, dysentery, and typhus, and another in winter affecting the old and due to typhus and pneumonia. The nineteenth century sees the beginning of the demographic revolution in Europe with a sharp decline in mortality, especially maternal and infant mortality. Diseases like diphtheria, chicken pox, scarlet fever, measles, and smallpox are combated with serum and later on with vaccination. Mother care also advanced both throughout pregnancy as also at childbirth and during lactation. Tertian fevers continue to be active and are combated in the Mediterranean area by clearing up the marshy areas, avoiding the mosquito by mechanical means, or by the use of cinchona bark (Peruvian bark), and later on of quinine.

The rise of great and industrial cities with low-grade outskirts and the emigration of peasants to the city favored the spread of maladies associated with poverty, squalor, lack of appropriate food, and exposure of people devoid of defenses. Some of the diseases are strictly occupational which is the case of miners and textile workers who were exposed to injury and to the industrial poisons that affected the proletariat. Other diseases are closely related to the harsh conditions of life with the spread of typhus and pulmonary diseases, especially tuberculosis, being due to this factor. Tuberculosis spread over the turn between the eighteenth and nineteenth centuries and while it was known as the disease in fashion, affecting notable and distinguished people, it struck the proletariat much more severely. Today, tuberculosis is again a serious threat. The same can be claimed regarding the enormous spread of syphilis as also with respect to drug abuse, beginning with alcohol and continuing with marihuana, cocaine, and morphine. At the middle of nineteenth century the opium trade was legalized in China, after the victory of the British army.

3. Plagues And Diseases in Contemporary Times

This last century marked the descent of the high mortality rates in countries that reached high standards of sanitary development, that is countries that invested in public health care, such as Britain or the USSR. Such advances have been due to public health services, hospitals, antibiotics, surgery, and vaccination and they have been reinforced by the developments in immunology, pharmacology, and biotechnology and with the promising future of improved genetic material. Smallpox is the first disease to be considered totally eradicated with only some samples of the virus being kept at a few laboratories for study purposes. But other viruses have taken its place. Thus the old influenza caused three heavy outbreaks of pandemic in 1918–9, 1957–8, and 1968: these were known respectively as the ‘Spanish ’flu,’ which originated in the USA, the ‘Asian ’flu,’ and the ‘Hong Kong ’flu.’ Poliomyelitis originated in the USA, affecting non-immune children and this disease has only been controlled in developed countries by means of vaccination. AIDS has meant a development in virus pathology and this disease has associations with the exploitation of poor countries, drug trading, and also an elite sector that has sprung rapid research in the field. The world commotion surrounding this disease has served both to reveal human altruism on the one hand, but, on the other, contempt towards those infected by the disease, since AIDS is becoming more and more the lot of the poor, such as large areas of Africa or southern Asia and of downcast or marginal groups such as the chronically ill, drug addicts, prostitutes, and homosexuals. Nevertheless, heterosexual transmission is advancing and is placing the future of all Africa in danger.

Forms of illness are changing. Development has managed to stamp out old forms of infectious morbidity. On the other hand, the increase in life expectation favors the development of Alzheimer and cancer. Cardiovascular accidents and traumatism, traffic and sports, factories and radiation are something that the twenty-first century will inherit. Ghettos and unemployment, and some of the old drugs such as heroin and tobacco or new synthetic ones are causing havoc even to the rich world. But in underdeveloped countries, the old morbidity continues to exist, giving rise to very low life expectation. Death is most rampant amid the least protected, especially women, children and the elderly, with the wars causing high death rates amongst men. Under such circumstances, diseases caused by deprivation and infection continue to be the most rampant.

Malaria has been eradicated from Europe thanks to drainage, improvements in crop cultivation, mechanical means, quinine, and insecticides. Today, faith is also placed on vaccination and the genetic modification of the mosquito. Yet malaria continues to be endemic in warm zones of America, Asia, and Africa. In the interwar years, the Rockefeller Foundation sponsored a campaign against the disease. In 1955, the World Health Assembly, meeting in Mexico, warned against the resistance of the mosquitoes to insecticides. Together with the WHO and the UNICEF, the US government was financing the eradication program of the Pan-American Health Organization. Today, an effort is being made to interest governments in this disease, a disease that represents a danger to 40 percent of the population. In Africa the situation is very serious due to the increase in agriculture and irrigation as well as emigration, the political and economic problems and the bad sanitary conditions following in the wake of housing expansion and deforestation. The WHO, through the 51st World Health Assembly of 1998, set up the program ‘Roll Back Malaria’ and, with aid from UNICEF and the World Bank, is endeavoring to bring about economic and sanitary improvements in developing countries.

Cholera continues to be endemic in Asia, between India and the Far East, and also in warm zones in America and Africa. Yersinia (or Pasteurella) pestis, discovered by Yersin and Kitasato, is still to be found throughout the world, except in Western Europe, carried by rodents, rabbits, and related species. Bacteria are carried by black and brown house rats, Rattus rattus: rat fleas are the arthropod vectors transmitting ‘epizootic’ plague to humans from rodent hosts, but transmission among humans is also possible. Shortterm human immunity requires frequent vaccination. Almost forgotten in the civilized world, there is nevertheless always the possibility that the devil may once more send his rats to the old, rich cities.

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