Disease Flashcards
What are the four historiographical approaches to disease
1) Epidemics- plague and pox
2) mortality vs. morbidity
3) Disease entities- history and biology
4) constructivist/relativist histories of health and healing
Define morbidity
the condition of being disease; rate of incidence
3 x explanations for the plague
1) Divine (wrath of god)
2) Celestial (malign plants)
3) Terrestrial (foul air)
5 individual responses to the plague
1) pray
2) healthy regime
3) restorative/preventative remedies
4) avoid foul air
5) flee the city
3 civic responses to the plague
1) monitor populations
2) improve sanitation
3) isolate affected
What are the three Galenic divisions of the causes of disease
1) imbalance of humours
2) malfunction of organs
3) trauma caused by external agent
What are the Avicenna’s three divisions of the causes of disease
1) internal
2) external
3) combination
How does Weisser argue EM patients viewed disease?
as continually shifting clusters of symptoms, rather than as discrete entities that operated the same in all bodies.
How many people in medieval Europe were killed by the Black Death
1.5 million
How did plague spread from Crimea?
Bodies of dead plagued soldiers catapulted over the walls to infect the inhabitants; fleeting traders took the plague to Sicily.
What modern event refuelled interest in scholarship around the spread of the Black Death?
Rise of the HIV/AIDs epidemic.
What does Samuel Cohn argue about the relationship between the Black Death and the later Bubonic Plague?
[The Black Death: End of a Paradigm]
Not the same pathogen- two diseases had different signs, symptoms and epidemiologies.
Humans have no natural immunity to plague, whereas populations adapted rapidly to black death pathogen
What five factors about the Black Death allow Cohn to argue it is different to later plague?
1) speed
2) mode of transmission
3) seasonality
4) cycles of recurrence
5) swiftness of adaptation
What did German physician Villiani identify during the German Plague 1357-58?
struck most vigorously in areas not infected by the first plague: doctors could react culturally, adapting new techniques.
Why does Siena argue we shouldn’t use the term ‘syphilis’?
It’s anachronistic: EM term ‘venereal disease’ was a single disease concept that subsumed many conditions now regarded as separate: not just syphillis, but also gonorrhea, chancre, and other urethral/genital issues’
Don’t read ‘modern bacteriological conception backwards’.
How did the 1348 University of Paris treatise explain the plague?
1) planetary constellations: conjunction of Saturn, Jupiter and Mars- Jupiter as a hot and moist planet, leading to putrefaction, leading to plague
2) terrestrial: bad air released after an earthquake.
3) Combination: bad planets causes thunder, rain and wind, which dispersed the poisoned air, and went to the heart.
How did the 1348 Paris treatise explain why certain individuals were unaffected
Only certain bodily constitutions were pre-disposed to suffer; those ‘hot and wet’ , where decay was more likely.
Who did Fay Getz identify was the intellectual influence for the 1348 University of Paris Treatise?
Hippocratic text ‘Epidemics’ - stressed the importance of astrology to medical practice
Aristotelian text ‘Meteorology’ - concerned atmospheric phenomena and putrefaction.
Method of attempt to rationally understand the causes of plague: a natural event, and by implication, part of God’s plan.
What did German physician Henry Lamme say in 1411 about the recurrence of plague?
‘It is better to say that the epidemic comes from God than to repeat all the opinions one hears.
Who did Henry Knighton blame for the plague?
‘hordes of prideful women’, who caused social excess as the wickedness of humanity manifested itself on earth. [Fay Getz]
Asides from plague, what else was caused by the ‘fatal alignment of Saturn, Jupiter and Mars’?
Produced poisonous vapours which caused the pox
When did astrological and providential theories decline?
Late 15th century- increasingly the cause of disease was more closely linked to the body.
How did a 1648 English Treatise explain the origins of the French Box
Venereal disease arises spontaneously in the wombs of women who had sex with numerous different men
‘The mixture of so many Seeds does occasion such a Corruption of the Passage of the Matrix that it degenerates into a proper virulent Ferment.
What did Venitians believe about witchcraft and disease?
[Laura McGough ‘Demons, Nature or God 2006]
Possible that which could cause disease, even disease linked to natural phenomena such as sexual intercourse. Witchcraft helped provide an explanation for incurable illnesses and account for death.
Two arguments made by Cohn in ‘The Black Death: End of a Paradigm”
1) Black death was not the same disease as the bubonic plague - two disease were radically different in their signs, symptoms and epidemiologies
2) Humans have no natural immunity to the modern bubonic plague, whereas Western European populations adapted rapidly to the Black death pathogen - this immunity conditioned a cultural response.
How did society get less violent in response to plague?
- Growth of centralized authority in Florence, decline in factional strife
- Growth of diplomacy and balance of power between city states in northern/central Italy 15thc.
- Conclusion of 100 yr War France mid 15thc.
Two responses to ‘plague guilt’ in Europe 1348-1350
- movements of flagellants
- burning of Jews
What is the romantic/gothic interpretation of the black death
as ‘giving birth’ to the Renaissance- evidence of men’s progression toward a new age.
What is the Annales school interpretation of the black death
used municipal records to see Black Death as evidence for the enduring nature of medieval social and intellectual institutions.
What was the regimen of James of Agramont 1348
Causes of the plague by examining how they were cured
-> emphasis on the importance of pure air in the prevention of disease. Plague killed both master and servant;: distinguished it
Nietzchien idea that illness was vital for culture to develop
The black death was the ‘crisis of the European soul’ and 1348 the ‘year in which the modern man was conceived.
Socio-economic revisionism
attack the notion that plague = drop in population = crop failure = labour shortages =end of feudalism = growth of mercantile culture: plague returned time and time again, population already falling,
What were the London Bills of Mortality
Kept in London from 1529 plague, started in order to inform the royal court when plague had reach a state that meant flight from town was necessary, printed every Thursday- recorded births and deaths of members of CoE, their predominant symptom, and what the doctor diagnosed them.
17th century diseases with no modern equivalent
Ague
Bloody flux
consumption
Quinsy
How many people in London 1632 died of diseases no longer recognised today
3783, according to the Bills of Mortality
What were the effects of the Plague in Rennes [France] 1605
Bad.
- 20% affected died within 24 hours
- 80% within 5 days
What was the lethality rate of the plague 1500-1770 in France
60-80%
How many years were plague free in France 1500-1770
[Jones ‘Plague and its metaphors]
None.
What was the population lose due to plague in Angers in the late 1580s?
between 25-33%
What was the population lose due to plague in Lyons 1628-30
50% - 70,000 to 35,0000
When was the last major Western European outbreak of plague?
1630s.
How many texts related to plague were written in France 1500-1700
264, written in French or Latin, all mention God/disease as divine punishment.
What do government records of Venice 1541 tell about the causes of fever affecting Padua?
Stagnant pools and slow streams left by heavy rain changed environment surrounding the city and thus caused disese.
What did Claudia Stein’s Augsburg Pox hospital study show?
Common belief that pox was linked to particular temperaments and complexions, which made a person with certain mental and physical characteristics susceptible to disease
What was the aim of the tract of William Clowes
linked contagion and disease in order to justify the demonisation of alehouse: one could be ‘unknowingly infected by poxed rogues’
How does Andrew Wear describe the role of food and drink in disease?
Perceived to be the cause: poor digestion produced by too much food, or food unsuitable for an individual’s constitution could cause the corruption of digestion.
What is the dual role of religion?
1) explaining why disease occurred
2) offering healing through prayer and repentance.
What is the ‘forgotten fear of excrement’
EM preoccupation with obstruction and flow: blockages could be a cause of certain illness -> treatments such as bleeding or urging ensured ‘continuous output of waste’
What does Mary Dobson’s study of South East England show?
Less healthy areas tended to be low lying, marshy areas: contemporaries blamed high mortality rates on bad air
Possible malaria- similar symptoms, mosquitoes prevalent, disease treated with Peruvian bark
Providential explanations of disease
1) God’s remedy for numerous accounts of sinful behaviour
2) Plague as caused by the wickedness of humanity which manifested itself on earth
3) Plague as a cure for social fragmentation and sin
4) conviction that God sent ill health to convey a message
Constructivist approach to disease
- Makes disease into a cultural phenomenon
- Allows for complex causal explanations
- Asks the question ‘what did early modern sufferers believe caused disease rather than applying modern historical concepts to the past
What three factors did Alice Thornton believes caused her illness on her wedding day?
1) anxiety surrounding marriage (emotional)
2) washing her feet with cold water (physical)
3) punishment from God for being un-keen about prospect of marriage (spiritual)
a demonstration of how patients drew on co-existing humoral, emotional and religious explanations of illness: a ‘nexus of concerns’
Role of religion in explaining the body
Shared repertoire for making sense of suffering.
What is Protestant providential theory?
God sent ill health - a framework for making sense of the natural body.
What does Olivia Weisser argue about piety?
Spiritual practices were integral to responses as well as explanations for ill health
What did surgeon Peter Lowe (1596) argue caused the Pox?
‘filthy lusts of men and women’, punished by God.
What did Albrecht Drürer pray for? (painter in the German Renaissance)
that he would be ‘saved’ from French disease, which ‘eats up many people so that they die’
-Fear of the pox and its cultural response
When did ‘French Disease’ begin to spread through Europe?
1490s
What were the symptoms of French Disease?
aches and sores that eventually covered the whole body.
What did Vivian Nutton argue about contagion?
The notion of contagion was not foreign either to Galen, or to Renaissance university medicine.
Physicians such as Girolamo Fracastoro were able successful when in their ability to systematise the idea of contagion within the framework of sixteenth-century Galenism.
What were healing contracts?
Most common in Italy: practitioner promised to cure the sufferer, while the sufferer promised to pay the practitioner an agreed some.
Identified
- the nature of the illness
- the duration of the treatment
- the cost of the medicines.
No treatment was due if the patient did not get better, and it was up to the patient to determine this.
What does Gentilcore suggest was different about Italian responses to Pox compared to English?
Little evidence of Italian healers promoting patient confidentiality and privacy as a way of drumming up business.
‘within a few years of its initial outbreak, venereal disease had passed from being a serious and even embarrassing private affair and become just another public calamity’.
Why was York protected from plague 1631?
President Wentworth isolated the city and removed shantytown suburbs outside the city walls- administrative measures at containment and sanitation.
Galenic Body
- Humours- fluids that influenced bodily health [blood/phlegm/black bile/yellow bile]
- Each individual had a characteristic temperament determined by the balance of the humours
- Organs channels for the humours- blood carried them through the body
- Illness = imbalance
Melancholy
Caused by too much black bill- humours could make one ‘unbalanced’ mentally
What could blood turn into
Lactating women- breastmilk
Intercourse- semen
Robert Burton’s argument in the Anatomy of Melancholy
Emotions and mental states as liked to imbalances in the four bodily humors:
- too much blood - bold, courageous,
- too much phlegm - sluggish, apathetic
- yellow bile- angry, irritated
- black bile- sad, depressed, melancholy.
See medicine as connected to
broader intellecual, social and cultural developments.
Socio-cultural factors shaped…
…the way symptoms were interpreted - same symptoms had different meannings and came to represent different illnesses
‘green sickness’
[diseases having different cultural meanings]
EMP-turned skin pale green- young, unmarried women were seen as particularly likely to suffer, sometimes called the virgin’s disease. Treatment: warming the body so blood would flow [best method sexual intercourse.
19thc - chlorosis- iron deficiency anaemia - could be measured
What was a civic outcome of the 14th-century plague outbreaks?
Towns and cities, first in northern Italy, appointed official city physicians or boards of medical commissioners - charged with developing and enforcing measures that would limit the spread of disease.
Hospitals pre 1450
Primarily charitable institutions whose main function was caring for the spiritual and physical needs of the ill, infirm, mentally ill or elderly poor
Pox Houses
Set up in the advent of syphilis 1490s in German and Italian cities.
Impact of public health measures
limited- still plague outbreaks and diseases in seventeenth and eighteenth century Europe [ie. cholera].
Cookbooks, herbals, household guides
contained huge numbers of recipes for treatments- home remedies the msot common way of handling illness
Nutton, Seeds of Disease
Galen had indeed written of the possibility of seeds of disease, a view which suggested a belief in the contagious nature of some diseases, in such tracts as On initial causes, On the different types of fever, and in his commentary on the first book of the Epidemics.
Galen’s ‘seeds’ were intended to explain why some people contracted a particular disease while others escaped and he located them within the body
Overshadowed by humoral theory
Changes in theories of the pox
16thc: providential and astrological theories
17thc: angled towards the body: ‘spontaneous mixture’, contagion, fermentation, putrefaction
Prostitutes and pox
Represented the most visible, identifiable group of sexually active women upon whom to pin the new disease. - but not the only group blamed
Venereal disease demonized
perceived threats to the social order: anti-popery and alehouses
Venereological care
One of the most lucrative practices for early modern city doctors- all groups competed to a) theorise and b) treat
Adoption of iatrochemistry
Served practical economic purposes
Theodore Brown study of London College of Physicians
College responded to the intensely competitive London scene by adopting new science to solidify its own position- iatrochemistry suited ‘forward-looking orientation.
Social disorder pox was used to control
- closing alehouses
- riding country of catholics
- end practice of wet nursing
- controlling female sexuality
- demonize interracial sex
Poz a useful image to ‘buttress moral stance’.
Dual role of religion
1) explaining why disease occurred
2) offering healing through prayer and repentence
What did Christ do as a sign of his divinity?
healed the sick.
How did Weisser use ego literature?
to reconstruct how EM patients depicted their own disease: coexisting humoral, emotional and religions explanations- a nexus of concerns that we should use to interpret disease.
Why is discovering the biological cause of sickness less important?
idea of the maintenance of a balanced, flowing bodily composition: the search for historical pathogens as a cause of disease negates how EM sufferers actually viewed their own bodies.
Expulsion as
absolutely necessary for the preservation of health
What did treatments such as bleeding, expulsion and purging ensure?
considerable continuous output of waste particle.
Bad Air South East England [Mary Dobson
some areas far healthier than others - low lying, marshy regions highest disease rates- contemporaries aware of this- priests sought permission to live on higher ground.
What was a more worrisome sin than syphillis?
Sodomy- syphillis a way of policing it.
What did Gentilcore challenge about pox treatment?
the belief that respectable medical practitioners avoided treating the pox, and charlatans became the resort of necessity for its sufferers: demonstrated that the poxed consulted ‘whomever they pleased’
Sienna- London pox hospitals
Did not welcome pox, but did not exclude sufferers
‘triangulated conflict between indignation, a drive for Christian mercy, and a civic obligation to address a public health crisis.
