HIST 123 Quiz 2 (modes of healing - yellow fever)

Question 1

500 CE to c. 1600 CE What were the new and old diseases?

Answer 1

• Syphillis and typhus (linked to warfare)
• Malaria (environment change)
  
  • peak in about 1200
• Leprosy in decline,

Question 2

What was the Pain, Injuries and Ailments 500 CE to c. 1600

Answer 2

• Nutritional deficiencies
• Respiratory and gastrointestinal sickness
• Cancerous tumours, psychiatric illness, arthritis and rheumatism (which would have caused pain)
  -> would not describe it as we do today -> ppl would say they are “suffering” or “in pain”
• Childbirth

Question 3

How did they commonly treat pain from 500 CE to c. 1600 CE?

Answer 3

Through alcohol. -> one of the first and longest standing defences against pain.
- was included in doctor and medicine kits.

Question 4

What were the modes of healing in late medieval Europe?

Answer 4

Religion
- Saints and their relics
-> cults of saints important in medieval Christianity -> saints thought to interfere between humans and God to help out on behalf of people.
-> saints and relics had healing properties in medieval Christianity -> similar to worship of Asclepius
-> relics -> pilgrims would travel to the shrines to pray and get as close to the relic as possible.
- Confessions seen as having therapeutic value in Medieval world
Magic
- Alchemy and astrology
Empirical Healing
-> Folk medicine
-> Herbal remedies
Physicians and Surgeons

Question 5

What were “Birthing Girdles”

Answer 5

medieval Christian talismanic item that included names of saints and apostles and assures of safe delivery.
- were loaned by monasteries to parishioners for use during childbirth
- Infused with a sense of magic but within the Christian condition
-> Hierarchy in Church opposed to superstition but local priests would bless crops for harvests and bless women for delivering babies

Question 6

Magic and Neo-Platonic Beliefs in terms of Modes of Healing (17th c.)

Answer 6

• Growing interest in the hidden powers of nature
  
  • That there was power in the natural world that was a source of ill health or healing
• Macrocosm → universe
• thought that things in the universe could have an impact on the human body
• eg. if Saturn and Jupiter are in the wrong place, this can have an effect on the human body.
• Microcosm → human body
  
  • these two were seen to be related

Question 7

What was Empirical Healing like (500 Ce to 1300 CE) ?

Answer 7

• Daily practice
• Folk medicine: mixture of religion, magic, philosophy, and tradition
• Might include bleed and purging in line with Galenic theory
• Attention to diet and herbal traditions
  
  • Birthing girdle → found biological materials: honey, milk, broadbeans → thought to be good for childbirth → advised to follow a certain diet
• Practices of surgery and midwifery
• Reflected the local environment → plants and herbs rooted in those local places
• Plants with healing properties that were widely available → eg. marigold → used to make tinctures and ointments and washes to treat burns, bruises and cuts, as well as the minor infections the ycause.
  
  • has been shown to help prevent dermatitis or skin inflammation
  • learned these things through trial and error → if they showed good results they would use it again.
• Healing powers of folk medicine were seen as being passed down
• Women were seen as healers and an important part of modes of healing (folk medicine)

Question 8

When did Formal Medicine appear?

Answer 8

• By late 13th c —> professionalization of medicine
• People who had qualifications from a university → could confer professional expertise

Question 9

What constituted medical training in 13th c?

Answer 9

• Physicians could have privileges from public authority
  
  • Eg. Town physician, royal physician
  • usually also educated in uni
• Membership in a guild or college
• Education dominated by classical texts:
  
  • Galen, Hippocrates, and Medieval Arabic texts by Ibn Sina (Avicenna) and Ibn Sarabiyum (Serapion the Elder) → esteemed physician
• being a physician usually depended on your demand as a healer

Question 10

What did Canterbury Tales - Geoffrey Chaucer refer to?

Answer 10

referred to great medical physicians

Question 11

What was the Practice of Medicine like in 13th c? (500 Ce to c 1300 CE)

Answer 11

• Emphasis on humours as causing sickness
• Return to balance by bleeding, purging, diet and medication
• Otherwise, physicians offered remedies that often did not differ much from folk healers
  
  • gentler than physicians → physicians likely to use bleeding, scarification and surgery as treatments
• Physicians uncommon in villages, mostly in cities.

Question 12

When did the study of anatomy appear?

Answer 12

• From 13th century on → the study of anatomy
• Example of continuity and change
• Not really focused on hygienic practices
• But still did surgery which required expertise in anatomy
• Galen’s works were rich in terms of their anatomical detail.

Question 13

What was Mondino de Luzzi’s (1270-1326) significance on anatomy?

Answer 13

• Followed Galen’s authority
  
  • used to compose his texts: if Galen said the liver consisted of 5 lobes, so did Mondino de Luzzi
  • obedience to authority even if it was wrong
  • constraints to dissection → Physician/teacher sat in a chair and read from a book to guide the dissection and someone else (the student) performed the dissection → Luzzi could not notice discrepancies from this.
• Dissection resumed (wasn’t really done until now), but faced practical constraints
  
  • body didn’t last long
  • hasty dissection of corpses
• Also: no agreed-upon terminology
• No accurate reproductions of illustrations

Question 14

What was Islamic Medicine and Anatomy like in 13th c?

Answer 14

• Some references to dissection although practice no more common than in Europe.
• Abd al-Latif al-Baghdadi’s (d. 1231 CE) description of bones in the lower jaw and sacrum
  
  • Used skeletons of ppl who died of famine in Egypt for his study

Question 15

Why did there need to be changes in Anatomic knowledge (in 13th c) and what were the changes?

Answer 15

• Major barriers:
  
  1. Lack of agreed-upon terminology
     
     • different professors would have different names for the smaller organs
     • return to classical texts led to more agreed-upon terminology
  2. Lack of accurate reproductions of illustrations
     - emphasis that what you’re drawing is actually what you are saying
     - woodcuts, engravings and etching

Question 16

Who was Andreas Vesalius (1514-1564)?

Answer 16

• Realized the potential woodcuts had for anatomical representation
• Published De humani corporis fabrica [On the fabrin of the human body]
• Become essential to the fabric of realistic human anatomical representations
  
  • But also had Galenic povs

Question 17

What was the Galenic tradition of medicine?

Answer 17

• Three interconnected systems in the body
  
  • The brain and nerves
  • The heart and arteries
  • The liver and veins

Question 18

What was Vesalius’ Contributions to the Galenic tradition of medicine?

Answer 18

• Still firmly in Galenic tradition
• But willing to find Galen’s mistakes
• Innovation: thoroughness, accuracy, precise, anatomical illustrations
• Vivisection - dissecting live animal bodies
  
  • Practice revived in 16th c.
• Had many followers who continued to find and point out Galen’s errors
  
  • Became key to revolution of human body and its understanding

Question 19

What is Charles’ Rosenberg and Janet Golden’s views on disease (from a historian pov)?

Answer 19

• In some ways, disease does not exist until we agree that it does, by perceiving, naming and responding to it. - Charles Rosenberg and Janet Golden (historians of medicine)
  
  • cultural part of the disease is really what makes it
  • being able to identify a causative agent is only one part of the disease
  • new disease have significant but not apocolpytic impacts (as opposed to the first and second plague pandemic)

Question 20

When and how did Syphilis appear?

Answer 20

• Beginning of 1490s a new disease arose in Italy from war
  
  • Armies big part of spread of disease → not disciplined, ill-practiced in hygiene, from all parts of the country, dirty → after war they were scattered back to where they came from
  • siege with tropps from Germany, Italy, Spain, and France → many fell sick → when they returned home, they dispersed it into their countries
  • Within 5 years of arriving in Europe, the disease was epidemic
  • Portugeuse carried it on ships to India in 1498, then China
  • European settlers carried POTs everywhere except Africa

Question 21

What was Jospeh Grunback (1473-1532)’s account of syphilis?

Answer 21

• “Horrible sickness”
• “from the western shores of Gaul” from France
• “a disease which is so cruel, so distressing, so appalling that until now nothing so horrifying, nothing more terrible or disgusting, has ever been known on this earth.”

Question 22

Where did Syphilis come from?

Answer 22

Columbian

vs.

Multi-regional

Columbian Origin
- Christopher Columbus reach Bahamas, Cuba, Hispaniols in October-December 1492, returned to Spain in March 1493.
- Crew of 44 men, as well as Indigenous people brough from the Americas

Question 23

What were the characteristics of 16th century Syphilis?

Answer 23

• Initially an acute disease
  
  • Genital ulcers, rash
  • Destroyed organs in the mouth, pain in muscles and death
  • Bone inflammation and hard pustules
• By mid-16th c. symptoms moderated and lethality (likelihood of imminent death) declined
  
  • Due to pathogen involved changing and becoming less virulent
  • and/or people gaining some immunity

Question 24

What are the characteristics of present-day syphilis?

Answer 24

• Sexually transmitted infection
• Primarily spread through sexual contact
• Can be spread through non-sexual means (contact with blood)
• Or transmitted to infants during pregnancy and childbirth
  
  • Congenital syphilis: miscarriage, stillbirth, severe anemia, blondness, enlarged liver or spleen

Question 25

What steps are in the progression of modern syphilis?

Answer 25

• Primary: infectious, sores on site where syphilis entered body
• Secondary: highly infectious, lesions, rash (’Great Pretender’)
  
  • rash is problem bc it can mask some other skin disease or other disease like measles or smallpox
  • most likely to transmit it during this time
• Latent: (hidden stage) can last for many years
  
  • no signs or symptoms
• Tertiary: non-infectious, can affect multiple organ systems
  
  • Especially brain, eyes: blindness, paralysis, dementia, and eventually causing death
  • bone deformities (bridge of nose collapses)
  • can be years later
  • usually die within 5 years of showing signs of this stage

Question 26

What was 19th century syphilis like?

Answer 26

• By 19th c. syphilus was far less acute but very widespread
  
  • Estimate 10% of European population infected
  • including well-known figures such as artist Henri de Toulouse-Lautrec

Question 27

What was the Columbian interpretation of Syphilis?

Answer 27

• Syphilis → new disease introduced to an immunologically naive population that then evolved rapidly
• Unlikely that Columbus’ crew imported venereal syphilis, more likely brought back a related pathogen (non-venereal version that evolved rapidly into syphilis)
• Initial infection from direct contact
  → was a regular practice in 14th c to kiss someone when you met them on the mouth → so if they had a coldsore → easy to transmit

Question 28

What was the Multi-Regional Theory?

Answer 28

• Columbus’ crew reported as all healthy
• Not all 16th c. observers were convinced that the disease was new
• Syphilis as the great imitator = misdiagnoses
  
  • eg. it has rash, pustules, fever, pain → very common symptoms of other disease
• Evidence of related bacteria found in European/Asian/African population

Question 29

What was/is the cause of Syphilis?

Answer 29

• Pathogen Treponema pallisdum → the bacterium that causes syphilis.
• Other species of Trepenema are responsible for other disease: yaws, pinta, and bejel (or ‘endemic’/non-veneral syphilis)
• Lots of evidence of terponemal disease in Americas before 1492 and were widespread
• Some evidence from Europe and Asia before 1492 (and Africa)
• but we also lack textual evidence, but are cases of skeletons found that show traces of these diseases.

Question 30

What were the Responses to the “Great Pox” (Syphilis)

Answer 30

• Eg. see Victims with syphilis appealing to the Virgin Mary (1496)
• Clearly widespread
• Bc there were often genital sores with it → led ppl to associate it with sex
• Venereal sores led to associated with sex, prostitution, and morality.
• Significant 19th c. public health interventions
  
  • and state interventions of morality too
• • The ways in which public health becomes linked to questions of morality

Question 31

Could Great Pox have arisen because of evolution of the disease in Europe alone?

Answer 31

• Yes, it is possible.
• Could have been a treponemal disease circulating in Europe that mutated
• Treponemal disease → could have come in from the Americas or been multi-regional, either way tho the European militia provided solid ground for the disease to spread

Question 32

What were the 16th c. approaches to Syphilis?

Answer 32

• How humoural theory shaped medical responses
• Galenic theory → pox related to humoural imbalances
  
  • Most settled on imbalance of the phlegm that was causing syphilius
  • Therefore treatment involved the expulsion of phlegm through sweating and spitting (from ppls bodies)

Question 33

Who were the main medical authorities of syphilis?

Answer 33

• Girolamo Fracastoro (1478-1553)
  
  • Origin of the name syphilis (not widely used until 18th c.)
  • Encouraged treatment with guaiacum and mercury
  • linked syphilis to immorality
• Philipus Aureolus Theophrastus Bombastus von Hohenheim aka Paracelsus (1493-1581)
  
  • German-Swiss physician and alchemist
  • Most effective treatment of disease through use of inorganic substances found in nature (mercury, sulphur and salt)
  • Published a clinical description of the pox in 1530.
  • Promoted mercury treatments for many diseases.
• Used mercury as salve applied directly to the legions or make it into a drink that ppl would drink
  
  • When you drinnk merucy (mercury poisoning) you start to produce copius amounts of saliva → which was great if you followed humoural theory and wanted to get it out of the body
  • Where their salivating heavily ppl thought it was working

Question 34

Who was Philipus Aureolus Theophrastus Bombastus von Hohenheim aka PARACELSUS (1493-1581)?

Answer 34

• German-Swiss physician and alchemist
• Most effective treatment of disease through use of inorganic substances founf in natrue (mercury, sulphur and salt)
• Published a clinical description of the pox in 1530.
• Promoted mercury treatments for many diseases.
• Used mercury as salve applied directly to the legions or make it into a drink that ppl would drink
  
  • When you drinnk merucy (mercury poisoning) you start to produce copius amounts of saliva → which was great if you followed humoural theory and wanted to get it out of the body
  • Where their salivating heavily ppl thought it was working

Question 35

What was Guaicim’s role in treating syphilis?

Answer 35

• Hard wood
• found in West Indies, Central and South America
• Ulrich von Hutten (he himself had syohilis)
• Made extract out of it and had people drink it
  
  • when administerd physican would confine the patient to a heated closed room and they would start sweating heavily → due to guaicum and hot room
• Belief in efficacy of guaicum was bc the wood came from America and the disease was thought to come from America

Question 36

What was The Pox: Syphilis?

Answer 36

• New disease, yes, but new pathogen?
  
  • less clear
  • pathogen that evolved v rapidly
• Early modern experience of disease
• Columbian exchange
  
  • movement of people, plants and animals across the world
• Medicine and humoural theory
  
  • good example of how humoural theory shaped medical practices

Question 37

What were the English Sweats ?

Answer 37

• First appeared in 1485 in Southern England
• Outbreaks in 1507-8, 1517, 1528-30 and 1551
• Always appeared in summer
• 1528-29 only instance when reported outside England
  
  • Hamburg, Scandinavia, Low Countries
• People would fall ill, difficulty breathing, sweat profusely, within 224 hours ppl either got better or died
• Many did die
• After 1551 it never returned in recognizable form anywhere
• Was not typhus, plague, malaria or black plague
• Prominent bc it killed upperclass men in particular

Question 38

What was the hypothesized cause of the sweating sickness?

Answer 38

• Hypothesized it was an arbovirus (enzootic among small mammals, eg. mice) carried to people by insects
• New virus attacked ppl most likely to be out in the fields → young active males → who were also immunologically naive
• Disappeared after 1551 → disease that failed to parasitize humans

Question 39

Both malaria and typhus are significant in the way they what?

Answer 39

Involve vectors

Question 40

What is ecology?

Answer 40

looks at relationships between organisms, other organisms, and their environments.
- Eg. a disease can be from human relations between other organisms and their environments or vice versa.

Question 41

What is anthroponoses?

Answer 41

• Source is infectious human
• measles, influenza, poliomyelitis (was always a human disease, did not come from animals), smallpox

Question 42

What is Zoonoses?

Answer 42

• Source is infectious animal
• Ebola, rabies, monkeypox, avian flu, Lyme disease

Question 43

What is Sapronoses?

Answer 43

• Source is non-living environment (soil, water, decaying matter)
• Anthrax, botulism, Legionnaires’ disease, gangrene

Question 44

What are example of direct and indirect transmission in anthroponeses?

Answer 44

• Direct: smallpox, polio
  
  • from human to human
  • human to human relationship is least impacted by environmental change
• Indirect: most forms of malaria
  
  • vector is mosquitos

Question 45

What are examples of direct and indirect transmission in zoonoses?

Answer 45

• Zoonoses
  
  • Direct: Avian flu, rabies
    
    • eg. bitten by rabid dog or bat with rabies
  • Indirect: Bubonic plague, Lyme disease
    
    • vector → animal → vector → animal → human
    • most sentitive to environmental change bc the vector can be affected by it, the animal can be affected by it, and the humans can be affected by it.

Question 46

What are vectors?

Answer 46

• Vectors are small organisms that carry serious disease
• Common Vectors
  
  • Mosquitos: carry malaria parasites
  • Sandflies: carry Leishmania parasites
  • Ticks: can carry a range of bacteria, viruses, and parasites including the bacteria that cause Lyme disease.

Question 47

Ancient Malaria as Connected to Place

Answer 47

• Hippocrates (c. 460-370 BCE) described the recurring fevers and thought that they arose from drinking stagnant marsh waters (which led to an imbalance of humours)
• Hippocrates: At the harvest time, when Sirius (the dog star) was dominant in the night sky, fever and misery would soon follow → seasonality
• Empedocles (c. 494-434 BCE) is said to ahve delivered the town of Selinus from fever by draining a river marsh
• Columella (4-c 70CE) says that marshland “breed insects armed with annoying stings, which attack us in dense swarms” and other things, “from which are often contracted mysterious disease.”

Question 48

Malaria: Old Disease in New Places

Answer 48

• From late antiquity Mediterranean Europe had Plasmodium vivax and occasional outbreaks of malaria caused by Plasmodium falciparum
  
  • Recap: P. falciparum causes severe disease; P. vivax not as lethal
• During the Roman Empire, malaria (P. vivax) spread to lands around the North Sea.

Question 49

What was Anopheles atroparvus and what was its connection to Malaria?

Answer 49

• indigenous mosquito to northern Europe
• Malaria parasite was able to thrive even in colder environments
• Parasite also adapted to anopheles atroparvus
  
  • Once it adapted to this mosquito, it could go where they mosquito did.
  • Plasmodium vivax adapted to atroparvus, a mosquito which favours brackish water (salty freshwater) and does not travel far.
• Appearance of malaria was highly seasonal: wet months provided habitat for mosquitos
• From 9th c get Anglo-Saxon texts with references to ague.
• Vivax spread with drainage of wetlands for agriculture
  
  • Changed environment is set for humans and vivax disease to thrive and spread
• Highly localized
• English proverb: Marsh dweller who married a woman from the hills would bury her within 3 years.
  
  • someone who didn’t live in a marshy area would have not been exposed to malaria as a a child so if they moved into a marshy area, they were more likely to get serious illness and die.

Question 50

What did images of dragons in 15th c Europe signify?

Answer 50

• Image of dragons as epidemics.
  
  • Dragons became one way ppl thought about disease.
  • Dragons were thought to block access to pure water
  • Dragons were thought to bring illness and hardship to the people.
• Their slaying led to the restoration of health.
  
  • Dragon slayers made these places safe, and got rid of environmental hazards
  • One of these slayers was Saint Marcel, Bishop of Paris who lived in a marshy area

→ created representations of hazard and ill health through stories about things like dragons?

• only understood dragons as a hazard to health, not as causes of malaria.

Question 51

What was Typhus?

Answer 51

• Caused by Rickettsia organisms
  
  • Not to be confused with typhoid (Salmonella typhi)
• “War Fever” (”Jail Fever”, “Ships Fever”)
• Name from Hippocrates
  
  • Typhos = hazy and smoky
  • is epidemic typhus that we don’t have until the 18th c.
  • Described confused state, delirium → that would seen among typhus sufferers close to death.

Question 52

What was Typhus caused by?

Answer 52

Caused by Rickettsia organisms

Question 53

When was there a serious typhus epidemic?

Answer 53

1489-90.
- Spanish at war with Moors over Granada (southern Spain)
- Disease killed 17,000 of 25,000 soldiers (3,000 died in combat)
- More ppl died of disease in wars than the conflict itself.

Question 54

What were the symptoms of typhus?

Answer 54

• Headaches, chills, high fever
• Blotchy rash (5-6 days after infection)
  
  • appear on upper trunk then lower body (except on the face, palms of hands and soles of feet)
• Delirium, confusion, death
  
  • cells that lined the blood vessel were rupturing ,causing blood clots and hemorraging
• 30-70% mortality when epidemics
  
  • not as lethal as the Black Death
  • those who recover from Typhus are typically immune
• People thought it had come from Spanish armies from the Eastern terrian (but this is a common disease narrative)

Question 55

What does typhus come from?

Answer 55

• Rickettsia
• Rickettsia organisms that live in…
  
  • Fleas
  • Chigger Mites
  • Ticks
    
    • rickettsia that caused rocky mountain spotted fever
  • Lice

Question 56

What is Murine Typhus?

Answer 56

• Flea-brone typhus
• Caused by Rickettsia typhi
• (Rickettsia are very small species of bacteria)
• Spread through contact with infected fleas, specifically through fleas, specifically through flea feces
• Fleas defecate (flea dirt) when they feed and feces can be rubbed into wound, eyes, or inhaled.
• Not spread from person to person

Question 57

What is Epidemic Typhus?

Answer 57

• Louse-borne typhus (lice)
• Caused by Rickettsia prowazeki
• Epidemic typhus was spread to people through contact with infected body lice
• Responsible for millions of deaths in history but in the present is considered a rare disease.

Question 58

What are lice and how do they spread typhus?

Answer 58

• Different species of lice, all of which can be vectors for the spread of epidemic typhus.
  
  • People can have several hundred on their body at a given time
  • Don’t need a lot to have typhus
• Body louse: Pediculus humanus corporis
  
  • lay egg on inside of clothes, if you don’t wash the clothes it will hatch in 7-9 days
• Crab/public louse: Phthirus pubis
• Head louse: Pediculus humanus capitis
  → as louse feet on humans they take in rickettsias from the infected human → louse poops on person and feeds on them → itchy → people scratch it into the skin.
• Speaks to the importance of sanitation and hygiene in terms of body level and public health level

Question 59

What is the connection between armies and typhus?

Answer 59

• A military processing of mercenary soldiers, followed by a winged figure of Death on horseback who is accompanied by two skeletal accomplices
• Armies → poor hygiene and washing clothes limited → breeding ground for lice
• people in the armies travel → spread far
• environment where you have ppl in super close conditions → fleas and lice can easily jump from person to person
• and not super well-nourished
• large masses of unwashed ppl living in close situations and washed clothes less frequently
  
  • mercenary armies → paid to fight, don’t really listen to the people who are paying them
• Spread typhus to the place where they fought and when they came back home
• 3o Years Wars significant time of Typhus spread

Question 60

Rats, Lice and History (book)

Answer 60

• Thirty Years War (1618-1648) estimated that disease (including plague, typhus, and dysentery) killed 10 million soldiers compared to 350,000 men who died in combat.
• Typhus was most significant from 1618-1630
• Also destroyed farms and fields leading to significant civilian deaths (estimates that 12% of civilian deaths were from starvation)
• And drove people from rural to urban areas

Question 61

What was the connection between Typhus and War?

Answer 61

• 16th and 17th c European armies - >made up of mercenaries, hired and somewhat controlled by governments
• Violent
• “Unwashed, itinerant, and promiscuous”
• Typhus epidemics followed in the wake of armies
• Rickettsia population seeded across Europe
• Decisive role in Napoleon Bonaparte’s failed campaign against Russia in 1812.
• Also significant killer in second world war in armies and concentration camps.

Question 62

What was the “Contact Era?”

Answer 62

• Period beginning in 1492 (Columbia voyages)
• But extended over centuries as colonizers arrived on, laid claim to, and ultimately sought to exploit Indigenous lands.
• A process in which disease played a significant role.
• What do you know of the role of disease as part of history of European colonization of the Americas?
• Town of Flushing Netherlands, 1593
• Urban environments important to spread of disease bc ppl are packed closely together
  
  • Places where you have dense urban populations → allow directly transmitted human diseases to spread

Question 63

What are Directly Transmitted Human Reservoir Diseases?

Answer 63

• Diseases that go between humans
  
  • and do not involve vectors
    EG:
    Disease
• Varicella (chickenpox)
  
  • Agent: Varicella-zoster
• Influenza
  
  • Agent: Influenza virus
• Rubeola (measles)
  
  • Agent: Measles virus
• Mumps
  -> Agent: Mumps virus
• Rubella (German measles)
  -> Agent: Rubella virus
• Variola (Small pox)
  -> Variola virus
• Scarlet Fever
  -> Groups A streptococci
• Perussis (Whooping Cough)
  -> Agent: Pertussis bacillus

Question 64

What were the animal origins of certain diseases?

Answer 64

• Rhinovirus → horse
• Smallpox → cattle or monkeys
• Measles → cattle (some sort of rhinderpest)
• Influenza → swine and poultry

Question 65

What was part 1 of contact era?

Answer 65

• Animal domestication
• Have pathogens that become adapted to humans
• Animals disease (zoonoses) transferred to human populations
  
  • No longer zoonotic, but change in the pathogen to make it human disease
• Small population: 50 people
  
  • 25 die / 25 immune
• Pathogen disappears when pool of susceptibles is exhausted
  
  • so diseases may appear and disappear
  • But this changes when you have crowded and large human populations

Question 66

What was part 2 of contact era?

Answer 66

• Large, crowded human population
• A city of 50,000 people
• You will start to have people who are neither dead nor immune (children):
• To maintain disease in human populations needed a reservoir
• Children serve as reservoir
  
  • Also “childhood” disease
  • Vaccination changes these dynamics
• Crowd diseases
  
  • diseases that thrive because of dense human populations

Question 67

What was argued in Plagues and Peoples, William H. McNeill?

Answer 67

• First published in 1976
• Argued that Europe, Asia, and Middle East had separate and epidemiologically distinct urban disease pools from 5000 BCE.
  
  • In places where there are different practices of animal husbandry, different animals that ppl interact with, there will be different diseases.
• After 500 BCE pools began to exchange disease in a process of disease homogenization.
  
  • Via trade and military networks
  • Starts between Europe and Asia and Middle East
  • Become more similar through trade and military relationship

Question 68

What is Critical Community Size?

Answer 68

• How many ppl you need for a disease to be continually present
  
  • need a reservoir where the disease is surviving
• Critical community size needed:
• In an isolated population
• Measles: 250,000
• Scarlet Fever: 48,000
• Whooping cough: 106,000
• Rubella: 151,000
• Influenza: several millions

→ but you never have a perfectly isolated population

→ how closely the interactions/ frequent they needed to be to keep that disease going.

→ if you had dense populations that were smaller than these populations alone and they interacted with each other regularly enough → keep it going.

Question 69

What were the disease ecologies in the Americas, before 1492?

Answer 69

• Large urban concentrations, but outside of urban centres, not nearly as dense as in Europe.
• Different relationships with domesticated animals
  
  • Eg. dogs
  • But not oxen, chickens and swine in same way that you see in Europe
• Trade and warfare had brought disease to and from Asia, Africa and Europe over several centuries already but had not yet crossed the ocean.

Question 70

What were the Pathogens and Disease in the Americas before 1492?

Answer 70

• Treponemal diseases
• Staphylococcus aureus
• Amoebic dysentery
• Hemorrhagic fevers
• Rabies
• Hepatitis
• Herpes
• Pertussis (whooping cough)
• Tuberculosis

Question 71

What were the pathogens and disease in the Americas after 1492?

Answer 71

• Measles
• Smallpox
• Mumps
• Chickenpox
• Influenza
• Bubonic plague
• Cholera
• Diphtheria
• Typhus
• Malaria
• Leprosy
• Yellow fever

Question 72

What were the oral histories of disease before 1492?

Answer 72

• Tell stories about disease from ancient times
• Stories from throughout the colonial period about colonialism and disease
• Eg. 1928 flu epidemic → still told among northern communities
• People’s life experiences that had been shared since the 19th c that we can use to understand what happened when new diseases appeared.

Question 73

What were the Acute Crowd Infections in the Americas after 1492?

Answer 73

• Appear after 1942
  
  • Measles
  • Smallpox
  • Mumps
  • Chickenpox
  • Influenza
  → Directly infectious→ passing from human to human→ acute in that it passes or victim dies within days or weeks

Question 74

Characteristics of Acute Crowd Infections?

Answer 74

• Infectious / communicable - involve specific agent or organism that is passed from one host to another
• Directly transmitted - no intermediate host or reservoir (yellow fever, malaria, bubonic plague all involve vectors)
• Acute - brief duration (days or weeks) after which victim either recovers or dies.

Question 75

What are “The Seams of Pangaea?”

Answer 75

• an argument from geography
• main person who advanced the idea of “Virgin Soil Epidemics”
• “Virgin Soil Epidemics” - a model of disease spread and demographic impact
• Biology vs. Culture
  
  • A lot of. the older ways in which historians and Europeans in particular told these stories as Indigenous inferiority to European technology and knowledge → that’s why Indigenous people got sick and died from diseases

Question 76

What is meant by “Virgin Soil Epidemics”?

Answer 76

• What happened when acute crowd infections introduced to Indigenous populations in the Americas who had not previously encountered these diseases
• Immunologically naive
• Novel pathogens→ Super fast transmission→ Infection much more severe→ See adults also passing away
  IMPACTS
  - Killed adults
  - Cascading social, economic and demographic impacts
  - reproduction disrupted → pregnant women more vulnerable to infection → them dying
  - Adults typically the ones who provide food, nursing care, political roles
• Disrupt food production, normal economic life
• Disrupt political leadership
• Loss of caregivers

Question 77

“Virgin soil epidemics” led to what?

Answer 77

DEMOGRAPHIC COLLAPSE
- Population in the Americas (estimated):
- In 1500 between 50-100 million
- By 1650 between 5-10 million
-> Uneven effects but in some communities 90% or more of people died

Question 78

What is ecological imperialism?

Answer 78

• Pathogens as part of a larger process of conquest and colonization
• Other biological dimensions: Portmanteau biota

Question 79

What was Portmanteau Biota?

Answer 79

• Domesticated pigs introduced
• Colonizers did not have the means to keep them fenced in → went wild
  
  • Free pigs and other livestock → part of ecological imperialism that created new niches → more similar to Europe

Question 80

What are the strengths of looking at Ecological Imperialism?

Answer 80

• Strengths
  
  • Helps us to recognize how other-than-human nature (pathogens, plants, and animals) can act independently in history
  • Offers mechanisms to help explain disproportionate Indigenous mortality (compared to mortality among European colonizers)
    
    • Did not have immunity to the disease Europeans carried with them
    • Not just one novel pathogen → encountering multiple novel pathogens

Question 81

What is the weakness of looking at Ecological Imperialism?

Answer 81

• Overstates the significance biology compared to the role of warfare, violence, seizure of land, failures of care
  
  • Ppl not only fighting disease but also fighting against occupation
• Language of “virgin soils” illuminates some key cultural biases at work
  
  • Equates Indigenous ppl to the soil → as opposed to understanding Indigenous communities as historically complex
  • part of a long history of colonial narratives
• Part of long history of colonial narratives about disease that displaced responsibility from colonizers and onto Indigenous populations
  
  • root cause is seen as Indigenous ppl
  • but colonialism is the key factor that drew these diseases

Question 82

Failures of Care and Moral Communities: Papal Bull, Inter Caetera

Answer 82

SEE SLIDES
- Granted land to Portugal
- Spoke to how the Catholic Churhc understood what was happening
- “…therein dwell very many peoples living in peace, and, as reported, going unclothed, and not eating flesh.”
- described them as an unsophisticated peoples
- “In the isalnds and countries already discoverd

→ about coming in peace, taking control of the land, and describing/seeing the people already there as inferior. → disregard for the health and wellbeing of Indigenous people.

Question 83

What was smallpox?

Answer 83

• Acute infection
  
  • after 10 days you have either perished from it or have survived
• Exposure confers a high degree of immunity
• Human-to-human (direct transmission) usually via respiratory system
  
  • anthropormorphus
• Once established among a population, becomes a disease of childhood
• Telltale scarring: pockmarks (pox from the Anglo-Saxon word pocca meaning ‘Pocket or ‘pocket’)
  
  • scars on face and hands from the pox
  • means at some point in those ppl’s lives smallpox had been present

Question 84

How did Smallpox travel across the Atlantic?

Answer 84

• Voyages were longer than a month → so it was unlikely that a person would get it and bring it to
• So would have to spread around the ship to keep it active for when they got there
• Could be from goods → but does not lead to a lot of cases
• typical thought: you would need more than 1 person on board who had not been previously exposed to the disease and someone who had it → it would also help if the voyage was shorter than average

Question 85

What are the main variants of smallpox and the virulence of smallpox?

Answer 85

• Two main variants that produce similar lesions but greatly different mortality
  
  • Variola major mortality of 25-30%
  • Variola minor mortality of 1% or less
• Declining virulence in Europe up to 16th century.
• By beginning of 17th century had become a more serious disease in Europe as well.

Question 86

When did Smallpox happen/arrive in the Americas? And what were its effects?

Answer 86

• Arrived very soon after Europeans landed in the Americas
• By 1519 had killed 30-50% of population of islands of Hispaniola and Puerto Rico
• Critical role in siege of Tenochtitlan (1519-21)
  
  • 1519-1520 → 5 to 8 million people died in Mexico
  • Smallpox arrived in October 1520 and lasted 2 months
• By 1524 smallpox had spread from Mexico south to the Peruvian Incan civilizations
  
  • Preceded Spanish in 1532 (Francisco Pizzaro)
• Reached Brazil in 1562 from Portugal
  
  • Further epidemics fuelled by trans-Atlantic slave trade → regular movement of ppls and slave ppls further spread disease → contributing to the mortality we see in these epidemics
  • Smallpox and measles moved together

Question 87

How fast and far did smallpox travel?

Answer 87

• Incubation period is 10-14 days (from infection to appearance of first symptoms)
• Long enough for an infected person to travel long distances by foot, canoe, or horseback.
  
  • They saw it in their village → left, not realizing they were sick
• In early 16th century, Calusa people on the Florida coast travelled by canoe back and forth to Cuba.

Question 88

When was the first smallpox epidemic on the Eastern Seaboard?

Answer 88

• 1617-19
• Most likely from English or Dutch fishing boats
• killed up to 2000 people, including Indigenous peoples living on the lands where English Puritan settlers would land in November 1620.
• Within 2 decades there was another major smallpox epidemic in 1634

Question 89

Smallpox, 1634

Answer 89

• Arrived in British North America and New France by ships from France
• Also epidemics in New England at the same time

Question 90

Who were the Heron Peoples?

Answer 90

• Practiced agriculture
• A lot died from smallpox in 1634
• Since agriculture was disrupted, the fields were ruined/destroyed → led to local subsitence crisis → no one heathy enough to do agriculture, hunt or gather → famine → increase susceptibility to disease and mortality.

Question 91

What were the cumulative effects of Smallpox?

Answer 91

• Not just one plague but successive outbreaks of new infections
• Disrupted harvests and seasonal provisioning leading to hunger or famines
• Some may only have weakened (eg. Influenza) but then mad epeople more vulnerable to next infection
• In tropical, coastal areas malaria would also have been a new disease.
  
  • Malaria infection also undermines immune system → causes anemia → ppl more vulnerable when smallpox arrived → this is what we mean by synergistic effects
• Synergistic effects.
  
  • famine and multiple pathogens make it more difficult to fight and avoid disease
  • Measles bad disease when it comes to synergistic effect → it basically wipes out your immune system → virus destroys existing immunity to other disease
    
    • If there are dogs present, then sometimes the dogs would end up consuming the bodies of those that perished from the epidemic (due to not burying them) → dog distemper

Question 92

What is Mobiliviruses and waht do they include?

Answer 92

• a family of disease
• Rinderpest (dated to c. 376 BCE) - Eurasia
• Measles (dated to c. 900 CE) - Eurasia
• Canine distemper (dated to 1735 CE) - South America
• No evidence of canine distemper in pre-Columbian dogs
• Hypothesis → canine distemper evolved from measles as a direct consequence of mass human measles mortality.

Question 93

What were the responses to smallpox epidemics?

Answer 93

• Persisted through 17th and 18th centuries.
  
  • so never endemic BUT ppl did start to recognize it.
• Indigenous communities responded
  
  • Effectively and ineffectively
  • Local experiences with place (avoid generalizations)
  • Own cosmologies
• Most Indigenous Responses Involved Empirical healing in general
  
  • Herbal, surgical, spiritual responses
  • Observable effects
    
    • used based on whether they were effective or not

Question 94

How did the Cherokee in the US respond to Smallpox epidemics?

Answer 94

• Saw health and wellbeing as a collective affair
• Emphasized good relations between nature and the cosmos to prevent chaos and harm

Cherokee Responses to Smallpox

• Sickness arising from failed relationships with the spirit world, especially thunders and winds
• Diseases like lighting
• About having failed to remain proper relationships
• Treatments included pouring cold water on those who were sick
• Sweat baths, followed by submerging in cold water
• Contempory European ppl criticized these treatments based on humoural theory → thought you needed to sweat → so the after sweat being conserved in cold water was seen as bad
• But head from fevers can causes brain damage leading to death so putting them in cold water could have saved lives
• Sick patients would have been sent out of the village and into the fields
  
  • Seclusion was understood to be necessary for those who had blood outside of their bodies 9bc it disrupted connection with the spiritual world)
  • so not understanding of contagion
  • communal disruption with nature

Question 95

What were Smallpox ceremonies?

Answer 95

• 7 days when village shut off
• Medicine: communally prepared and used wood from trees resistant to lightening (to make broth) → since lighting was seen to be part of transmitting the disease
• Could only move within village for food
• If had to leave village - at midnight and had to go through woods, not follow the main paths
• Other rituals, sacrifices, divination.
• Ceremony would end with sacrifice, divination and a meal → made sure ppl had food
• Also counselled their followers on places seen to be harbouring disease (usually places with large European settler population)

Question 96

What were effective responses to smallpox epidemics?

Answer 96

• Avoid communities where disease was known to circulate
• Offer nursing care to those who fell ill
• Control movement (eg. quarantines) to prevent the spread of contagion
• Promote calmness and solidarity so that community did not experience breakdown

Question 97

How did Europeans use smallpox in the Americas?

Answer 97

• took advantage of disease → took over places where many had died
• 1800s spread of smallpox as form of biological warfare
• 1763 → smallpox broke out at post - >when conference ended they gave the Indigenous people food AND some blankets from their smallpox hospital with the hopes that they would have the intended effect → killing them

Question 98

Who was Jeffery Amherst?

Answer 98

commanding general of British forces in North America during the Seven Years War
- he used smallpox to try and get rid of Indigenous people
- Distributing blankets to “innoculate the Indians” → to infect them and kill them → in the context of warfare, not in the context of trade.
- Amherst approved this plan and further suggestes “to try Every other method that can serve to Extirpate this Execrable Race.”

Question 99

When was Yellow Fever?

Answer 99

1640-1800

Question 100

Characteristics of Acute Crowd Infections?

Answer 100

• nfectious/communicable - involve specific agent or organism that is passed from one host to another.
• Directly transmitted - No intermediate host or reservoir (yellow fever, malaria, bubonic plague all involve vectors)
  
  • malaria had synergistic effects → cause anemia → made you more susceptible to disease
  • yellow fever in part transmitted well as part of environmental change →
• Acute - brief duration (days or weeks) after which victim either recovers or dies.

Question 101

What was the Geopolitical Conflict in the Americas and Caribbean

Answer 101

• “Great Powers” (Spain, France, the Netherlands, Britain) struggled among themselves for control over territories, respources and people
  
  • Eg. Seven Years War (1756-63)
  • From late 18th c. on, some of the people of the Americas sought independence through revolutions
    
    • Included enslaved people, Indigenous peoples, and colonial settlers
    • Eg. American and Haitian revolutions

Question 102

What is the Yellow Fever Virus?

Answer 102

• Acute viral hemorrhagic disease
• Flavivirus (genus includes West Nile virus among others)
• 3,000 years old but stable for at least past 500 years
• Native to Africa (East of Central)
• Shows considerable genetic variety in Africa
• In Americas only one version, very similar to West African variety (dated to 1537)

Question 103

What were the symptoms of Yellow Fever?

Answer 103

• called so bc jaundice is one of its symptoms
• Symptoms: high fever, muscle pains, headache, nausea and dizziness
• Lasted 3-4 days, then disappear
• if they recurred, followed by jaundice (”yellow fever” → indicative of liver breakdown) and internal hemorrhage
• Victims ooze blood though nose and ears, suffer delirium, and vomit up partly coagulated blood (”black vomit”)
• Onset of symptoms to death ~2 weeks

Question 104

Who were most at risk for Yellow Fever?

Answer 104

• Young healthy adults at prime risk because of immune reaction.
  
  • bc part of what would lead the second stage to occur was a strong immune reaction to the virus → as opposed to children who had weaker immune responses.
• Could have mortality about 80% in an immunologically naive population.
• In order for yellow fever to develop you would need the vector (host) to survive → Aedes Aegypti → African origins mosquito
  
  • Need not only the virus to cross the Atlantic, but also need the mosquitos to cross the Atlantic and establish a population somewhere.
  • Female mosquitos bite humans to get blood to make eggs

Question 105

When did Yellow Fever begin/begin spreading?

Answer 105

• General epidemic 1647-52 began on Barbados (killed 6,000 or about 1 in 7 people on Island)
  
  • needed an established population of mosquitos
• Went to Cuba, Yucatan, Florida, coastal ports in Central America
• 20-50% mortality
• Reappeared in 1690s

Question 106

What were the Environmental Conditions that Enabled the Appearance of Yellow Fever Epidemics?

Answer 106

• Aedes aegypti preferred to live/breed in water vessels
• Especially clay water vessels like flower pots → lay them on the dry clay, then the water would fill the thing and cause the eggs to develop
• Unlike other mosquitos, they like clean, unpolluted water
• Progression to adults is slower by colder temps and is sped up by hotter temps

Question 107

What is the 21st century disctribution of Aedes aegypti?

Answer 107

• Hotter places, more aedes aegypti
• Cases of these mosquitos in Quebec City and Ireland were due to a hot spell
• Exist year-round in Caribbean, espeically along coasts.
• Silent, don’t buzz, females bite the ankles.
• More active in hotter weather
• Like humans more than other animals: more likely to go from human to human
• Bc they like water casts, they were good stowaways on ships
• On board ships Aedes aegypti could stowaway on water casks.
  
  • 4 people per square meter, chained in pairs
  • 2 month journey → needed a lot of fresh water to ensure survival of crew and captives
  • 335 barrels of water on board for cooking, drinking, and washing
  • → Slave ships very effective means for transporting aedes aegypti to the americas from Africa

Question 108

What were the necessary conditions for Yellow Fever Epidemics?

Answer 108

• Necessary conditions:
  
  • Population densities of non-immune people
  • and population densities of Aedes aegypti
    
    • population only transmits by mosquito, not from person to person directly
• Virus cannot be transmitted person-to-person
• Critical community. size does not apply to Yellow Fever bc we have mosquito populations as well

Question 109

What was the connection to Herd Immunity and Yellow Fever?

Answer 109

• 60% of population is immune can still host a yellow fever epidemic
• 80% of population is immune then infected mosquitos die before biting a susceptible person.
• High proportion of immunes can shield susceptible people
  
  • Logic behind present-day vaccination programs
  • why anti-vax sentiment is such a big problem for everyone

Question 110

What is the result of Countries that are in the Yellow Fever Belt?

Answer 110

• Eg. Argentina, Brazil, Cameroon, Central African Republic
  People who grew up in the Yellow Fever zone in tropical areas were more likely to be immune to Yellow Fever
• More likely to have encountered it when they were young (endemic population) → survived and became immune
  
  • Meant that if they encountered it as an adult, they wouldn’t develop the disease → they would be fine.
• So sentiment still remains: need enough mosquitos and enough susceptibles to create an epidemic
• Sugar plantations key to rise of Yellow Fever cases
  
  • Enslaved people → indentured them originally and they would work for 7 years until they paid off their enslavement → free
  • Sugarcane fluorished in tropical soil → merchantible commodities → scarce in Europe and worth a lot but flurosihed in other place
  • Wealthy landowners bought more plots of land across caribbean → established plantations → worked by people who are enslaved → ecological changes: land is cleared, deforestation → decline in bird populations that are eating mosquitos
  • Sugar plantations are also like cities: human communities that store lots of water → breeding ground for mosquitos
• Suagr moulds → sugar put in top of the pot, molasses would drain into the pot, mollases pour out → sugar would be the food, clay pot was the home/breeding ground for mosquitos
• Sugar meant population growth → more food for mosquitos
• Trade from west africa and enslavement from Africa → more mosquitos
• Havana → largest city from the West Indies
• Every port and ship was a source of fresh water → nesting ground for mosquitos

Question 111

What was the key to the rise of Yellow Fever cases?

Answer 111

• Sugar plantations key to rise of Yellow Fever cases
  
  • Enslaved people → indentured them originally and they would work for 7 years until they paid off their enslavement → free
  • Sugarcane flourished in tropical soil → merchantible commodities → scarce in Europe and worth a lot but flourished in other places
  • Wealthy landowners bought more plots of land across caribbean → established plantations → worked by people who are enslaved → ecological changes: land is cleared, deforestation → decline in bird populations that are eating mosquitos
  • Sugar plantations are also like cities: human communities that store lots of water → breeding ground for mosquitos
• Sugar moulds → sugar put in top of the pot, molasses would drain into the pot, molasses pour out → sugar would be the food, clay pot was the home/breeding ground for mosquitos
• Sugar meant population growth → more food for mosquitos
• Trade from west africa and enslavement from Africa → more mosquitos
• Havana → largest city from the West Indies
• Every port and ship was a source of fresh water → nesting ground for mosquitos

Question 112

What was the connection between Yellow Fever and Newcomers?

Answer 112

• Disease of newcomers from cool climates
  
  • Recognized in early 18th c.
  • Military personnel mutinied, officers refused posts, chose lashes instead
  • Yellow fever conferred immunity
    
    • “Seasoning” → ppl who were in the tropics for a while would become “seasoned” or acclimatized to Yellow Fever
    • Also why white ppl were more susceptible
• Some inherited immunity (but unrelated to “race”)
  
  • construction of race that supported the slave trade
  • 18th c. race as a biological phenomenon

Question 113

What was the belief of Yellow Fever and “race”?

Answer 113

• Constructed racialized immunities
• Used to justify social and economic subordination
• Lines artificially drawn by humans for political projects → where are you located in respect to the system?
• Those lines that are artificially drawn are drawn around African and Black populations → they’re immunity to Yellow Fever is used to justify their enslavement → bc they can “work” without being sick. → rooted in the fact that they were born and raised in a place where they were exposed to yellow fever

Question 114

What are Differential Immunities?

Answer 114

• Yellow fever and malaria
• Exposure in childhood when effects were mild, protected against more lethal encounter later in life.
• Similar to crow disease, but product less of population densite than of interrelationships between people, vectors (mosquitos), and pathogens
• Created hazardous conditions for outsiders with naive immune systems.
• Caused the collapse and failed establishment of colonies/outsider establishments
• Expedition for Germany ? → out of 2500 settlements, majority perished.
• In French colony at Kourou → 6000 ppl died within a year.
• Spanish - >reacted on locally appointed men → expected malaria to do its work for them: as long as the French and British recruited ppl for their armies that were not from the Yellow Fever Zone

Question 115

What is the historical significance of Differential Immunities?

Answer 115

• Race became linked to immunity/vulnerability to yellow fever and malaria
  
  • These links, as part of the construction of race, were used to justify slavery and the economic and social subordination of Black people in the Americas
• Led to failed settlement schemes
  
  • Dairen (by Scotland) 1690s
  • Kourou (bu France) 1763
• Impacts on military expeditions
• Spanish as favoured target after 1580.
  -> But Spanish recruited locals and used heavy fortifications.

Question 116

What medicine was used to treat Yellow Fever in the 17th to 19th c?

Answer 116

• Bloodletting: 10-15% of blood
  
  • not effective medical treatment
  • rooted in humoural theory
• Cinhona bark and Mercury
  
  • Chinona bark relieved malaria sysmtoms but did nothing for yellow fever
• Preventative Measures
  
  • high zone or low zone
• Afro-Caribbean medicine and nursing care
  
  • Most effective for wounds, sores and macroparasites but not for yellow fever.
  • Slaves of African descent were not permitted to practice medical treatmens
• After 1770s geopolitics shift → more important is revolutionary sentiment than imperialism

Question 117

What was the Haitian Revolution 1791-1804?

Answer 117

• Slaves made up more than 90% of St. Domingue’s population in 1780s
• French and British expeditionary forces sent to suppress revolution
• Of 60-65,000 French sent to fight, 35-45,000 died of Yellow Fever
• Successful revolution: colony achieved independence, free from slavery.
  
  • aimed to keep the British and French confined to plains, lowlands where they faced more vulnerability to yellow fever → hgih mosquito population.

Question 118

When was the Haitian Revolution?

Answer 118

1791-1804.

Question 119

What was Smallpox in the 18th c. like?

Answer 119

Smallpox in the 18th Century

• 1/3 of all childhood deaths in 17th and 18th c. Europe from smallpox
  
  • Feared also because of scarring it produced
• Example: Chester, England — 1774
  
  • 1200 cases out of a population of 14,700
  • 202 deaths
• Affected people of all ranks:
  
  • eg. King William III of England lost his father, mother, and wife all to smallpox in the later 17th century; Emperor Highashiyama of Japan died 1710, aged 34.
• Smallpox went from milder to more virulent in medieval England → increased in severity in 17th and 18th centuries.
• Fear of smallpox laid in potential of mortality and scarring
  
  • when you got the disease you would get the pustules on face and hands and elsewhere and it would leave severe scars

Question 120

What was the connection between smallpox and cowpox?

Answer 120

• Smallpox - orthopox virus (genus)
  
  • first disease for which a vaccine was developed.
• Cowpox, monkeypox separate species
• But overlapping immunities

Question 121

What were some of the first variolation references?

Answer 121

some of first refrences to this from China 16th century texts

Question 122

What was variolation?

Answer 122

• Would take matter out of smallpox legions (the pus) and then take it and place it in the nostrils or the skin of the person they were trying to variolate.
  
  • Goal was to provoke a mild attack of the disease so that the person gets sick, recovers and has immunity to it going forward
  • and/or would have a much milder cases if they got it later on
• People would also intentionally expose their children to ppl who had smallpox in hopes that they would have a mild case and going forward be immune
• In Europe it was largely a folk practice -> this changed in 18th c. because the disease became more serious.

Question 123

Who were Hans Sloan (1660-1753) and Charles Maitland (1668-1748)?

Answer 123

• Physicians who advocated for and practiced smallpox variolation.
• Caroline, Princess of Wales (1683-1737), asked for experiments on variolation, after which she chose variolation for her own children.
  
  • Tested variolation on 6 prisoners → got sick and recovered and 6th showed no symptoms (probably lied and had it when he was younger) → either way showed variolation was a success
  • Also tested on orphans

Question 124

Who were usually pro-variolation?

Answer 124

• Cotton Mather (well-known minister: learned of the practice from Onesimus an enslaved black man) and Onesimus
  
  • Cotton Mather (in Boston) was a religious leader and surprisingly supported variolation
• In Europe and the colonies

Question 125

Who were usually Anti-variolation?

Answer 125

• Physicians, community leaders
• Because some people would get smallpox and die from it.
• Benjamin Franklin originally opposed variolation until his son got it and died → then became pro variolation (bc he thought he should have tried and done sth more to proect his son)
• Part of it was that they thought it was Gods will whether you got smallpox and died of it → thought clergymen were being hypocritical

Question 126

What was Benjamin Franklin’s (1706-90) relation to smallpox?

Answer 126

• Initially opposed to variolation
• Argued that it was hypocritical for clergy to promote variolation (went against God’s Providence/Will)
• Then changed his mind after the loss of a son in 1736 to smallpox.

Question 127

More on Variolation (and James Kirkpatrick)

Answer 127

• James Kirkpatrick practiced variolation in the 1740s.
• Claimed he had a safer method.
• Physicians, surgeons, apothecaries detailed that variolation should be preceded by bleeding, purging, and proper diet to bring the body’s humours into balance.
• In some respects variolation wasn’t like 20th c vaccination campaigns that actually had significant effects on mortality

Question 128

Smallpox c. 1775-82.

Answer 128

• “Pox Americana”
• Mexico City to Portage La Loche (today: Canada)
  
  • killed a lot of ppl in what is now Manitoba and Saskatchewan
• Continental pandemic
• Coincided with American Revolution (1775-82)

Question 129

In the Americas, who was most vulnerable to smallpox in the 1750s and 1760s?

Answer 129

• People fighting for the revolution → poor hygiene, wounded, malnourished (weak immune systems), close quarters
• The British hired German soldiers who were coming from Europe → much more likely to be exposed to smallpox as children
  
  • Those born and raised in the Americas → many children of colonists were more vulnerable to smallpox than the Europeans they were fighting against
• Meant that George Washington’s soldiers were more vulnerable to smallpox than the British
  -> Politics to differential immunity

Question 130

What were the Politics of Differential Immunity?

Answer 130

• American Revolution (1775-1783)
• Washington required his troops to be variolated.
• SEE IMAGE
• During the American Revolution, George Washington also imposed a “vaccination mandate”
• Said there was more to fear from smallpox than the enemy army
• In general, the variolation served to protect the Americans

Question 131

Who was Edward Jenner (1749-1832)

Answer 131

• 1749-1832
• practicing physician
• was also an amateur scientist
• approached natural knowledge in a general way
• realized those who got cowpox did not usually contract smallpox
• Disease went from the cows to the dairymaids → those who milked the cows saw inflamed spots appear on different part of the hands and on the wrists
• Cowpox made person kind of sick and had bumps on wrist, but not sick like with smallpox.
• Published his studies
• Began to practice experiments:
  
  • with ppl who are marginal
  • orphan → gave him cowpox and then tried to variolate him with smallpox → when the boy didn’t get any sickness with smallpox after being sick with cowpox, this confirmed his hypothesis.
  • At the time this was perceived as potentially benefiting those children
  • Did these experiments on his own children as well bc he had successful attempts
• Vacca - latin for Cow
• Could take mild, non-scarring disease (cowpox) and it would give you immunity to smallpox
• Vaccine was lymph material from those already infected with cowpox → inject it into the skin
• Not universally well-received by everyone at the time
• Faced opposition from ppl who didn’t like variolation in the first place; opposition also from variolators (stealing their business with the vaccination)

Question 132

What was the Hudson’s Bay Vaccination Program?

Answer 132

1838-39
- Vaccination and variolation
- Jenner said vaccination would confer lifelong immunity
- By 1809 it was recognized that you would need to get multiple vaccinations and that it would not have lifelong immunity
- Every time smallpox broke out, they would try to encourage ppl to get vaccinated
- Widespread dissemination of vaccine
- Via Hudson’s Bay company to Canada
- Outside of military conflict, it was in the HBC’s best interest to not have smallpox spread → in the self interest of trade with the Hudson’s Bay Company they did try to provide indigenous ppl with some sort of healthcare, including providing vaccination.
- Encouraged isolation to avoid spread
- Lymph could be preserved by drying and the ivory points used as needles were easy to transport
- could vaccinate one person and use that person to vaccinate others
- some success in 1830s, but lymph was not always working by the time it crossed the Atlantic/made its way there
- other challenges: opposition and support; sometimes indigenous ppl and their families would hear about vaccinations and come into the trade posts to seek them out; in other stories mercenaries would have to chase them down to vaccinate them

Question 133

What was the Medicine Chest Clause, Treaty 6?

Answer 133

“That a medicine chest shall be kept at the house of each Indian Agent for the use and benefit of the Indians at the direction of such agent.”
- Vaccination program/healthcare for Indigenous ppl from the HBC

Question 134

Vaccination and its discontents

Answer 134

• Eventually lead to eradication of smallpox in 20th c.
• Smallpox vaccination campaigns, vaccination mandates, and anti-vaccination sentiment
• Long-standing, historical, shared themes.