Infectious Diseases in the Ancient & Medieval World
Basic Concepts Infectious diseases are a major cause of human mortality Up until late 19 th 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 6 th century, but not before
Leper was social & religious outcast Associated with lust and sexual misconduct Leviticus 13: 1-8 –“unclean, unclean” Segregation from mainstream society
Rise of lazarettos by 7 th century Height of incidence in 14 th 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
Three forms 1. Bubonic % fatality rate 2. Septicemic 1.100% fatality rate 3. Pnemonic 1.100% fatality rate
Plague of Justinian 1 st known outbreak in Europe Centred around Constantinople 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 6 th – 8 th 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 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 of public health measures –Quarantine –Regulations –Bills of Mortality
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?