Transcript Infectious Diseases in the Ancient & Medieval World

Infectious Diseases in
the Ancient & Medieval
World
Basic Concepts
 Infectious
diseases are a major
cause of human mortality
 Up until late 19th century, infections
kills the majority of people
 In developed countries today, 4% of
mortality attributed to infections
– Not including STIs and AIDS
 Defined
as a disease that can be
passed from one person to another
 Basic
modes of transmission
– Direct contact
– Indirect contact
 Incidence
– Endemic
– Epidemic
– Pandemic
Limits to our Current Knowledge
 Do
not know exactly what diseases
were experienced
– No dedicated data gathering strategies
– Confusing descriptions
 Evident
they understood epidemics &
non-epidemics
 Typical explanations:
– Gods
– Demons
– Corruption of the air
– Imbalance of individual constitutions
 Hippocratic
emphasis on individual
predisposition created a particular
perspective
 Galen silent on contagion
 Religious
beliefs created other
perspective
– Job & divine punishment
Leprosy
 Primary
exemplar of divine
punishment
 Disease resembling leprosy
mentioned in old & new testaments
 Caused
by Mycobacterium Leprae
 Causes considerable disfigurement of
facial features & skeleton


Uncertain if biblical
accounts believed
to be about leprosy
were in fact that
disease
Skeletal evidence
for presence in
Europe by 6th
century, but not
before
 Leper
was social & religious outcast
 Associated with lust and sexual
misconduct
 Leviticus 13: 1-8
– “unclean, unclean”
 Segregation
society
from mainstream
 Rise
of lazarettos by 7th century
 Height
of incidence in 14th century
Smallpox
 Viral
infection caused by variola
major
 Case fatality rate 20-40% if
untreated
 Spread by
– Direct contact
– Indirect contact
 Antonine
plague (Rome) believed to
be smallpox
 Imported
by troops returning from
Mesopotamia
¼
to 1/3 of population died
 Consequences
– Civil disorder
– Population decline
– Decreased tax revenues
– Military unrest
Plague
 Caused
by Yersinia pestus
 Zoonosis
 Transmitted by bite of flea which
lives on rats
 Originated in Himalayan border
between India & China

1.
Three forms
Bubonic
1. 50-60% fatality rate
2.
Septicemic
1. 100% fatality rate
3.
Pnemonic
1. 100% fatality rate
Plague of Justinian
1st known outbreak
in Europe
 Centred around
Constantinople
 542-543 CE
 Believed to be
imported from
Egypt on trade
ships

Social Impact
 Estimated
10,000 people/day died
 Killed 40% of population of city
 Estimated 100 million people died in
empire
 Overwhelmed capacity to deal with
bodies
 Beginning of Dark Ages
 Political
Impact
– Ended Justinian’s efforts to reunite
Rome & Constantinople
– Rise of the Islamic Empire
– Decline of Mediterranean as centre of
Western civilization
 Medical
Impact
– Physicians had little to offer
The Black Death
 After
6th – 8th century, plague
disappeared in Europe for about 700
years
 Re-appeared in 1347
 Probably originated in China
 Moved to Central Asia
 Broke out in Crimea amongst Tartar
troops fighting the Italians
 Taken to Mediterranean
 From
there, spread to rest of Europe
 Within 2 years, killed 25-30% of
population of Europe
 Plague
re-appeared regularly for
next 4 centuries
 Great Plague of London (1665)
 After this plague disappeared from
N. Europe
 Marseilles 1720-21 last major
outbreak in Europe
Social Impact
 Flight
 Violence
 Scapegoating
 Decline
in authority of Church
 Changes in personal practices
 “A more troubled age”
Medical Responses
 Still
had little to offer
 Individual focus
 Typical therapies
– Diet
– Herbs
– Fumigation
 Still
focussed on miasma, corruption
of air
 Astronomy
 No power to enact public health
reglations
Political Responses
 Institutionalization
measures
– Quarantine
– Regulations
– Bills of Mortality
of public health
 Population
Decline
– Recovery of population took over a
century
– Laws re: agricultural workers
– Threats to food security
– Higher wages
– Possibly de-stabilized feudalism
 Decline
in Spain’s Imperial power
 So
. . . What in general can we say
about the impact of infectious
diseases on Europe?